Table: enrolled_medi_cal_fee_for_service_ffs_providers , legal_name like T*

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
1	Fee-for-Service	1023026143	1023026143	1	1	THEODORE S FEIT MD INC	9/24/2012	261QR0200X	NA	Mammography/MRI Provider	026	PHYSICIANS	32804	None	None	0	In state provider	None	10918 RIVERSIDE DR	SUITE A	NORTH HOLLYWOOD	CA	91601	2210	19	06037	34.15223653	-118.3687155	Los Angeles County
5	Fee-for-Service	1043054950	1043054950	1	1	TOSIC, GENESIS CCC-SLP	4/14/2025	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	599 S BARRANCA AVE	STE 555	COVINA	CA	91723	2791	19	06037	34.079373	-117.881338	Los Angeles County
6	Fee-for-Service	1326110651	1326110651	1	1	TRAN, KHAI A MD	1/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133219	30	Radiology	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
38	Fee-for-Service	1891948766	1891948766	1	1	TORRES, BERNABELA V	11/20/2008	163WM0102X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	15392 CITATION AVE	None	FONTANA	CA	92336	4108	36	06071	34.1354613	-117.4689733	San Bernardino County
57	Fee-for-Service	1083926406	1083926406	1	1	THIEL, LISA M LCSW	6/29/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	71000	-	NOT APPLICABLE	0	In state provider	None	10201 MISSION GORGE RD	STE O	SANTEE	CA	92071	3027	37	06073	32.83844552	-116.9759925	San Diego County
66	Fee-for-Service	1003850215	1003850215	1	1	TOKHNER, VADIM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55652	05	Anesthesiology	0	In state provider	None	333 N PRAIRIE AVE	None	INGLEWOOD	CA	90301	4501	19	06037	33.9670722	-118.3439911	Los Angeles County
108	Fee-for-Service	1104900711	1104900711	1	1	TRISTANT, STEVE PAUL DPM	11/30/1990	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	7622 AUBURN BLVD	None	CITRUS HEIGHTS	CA	95610	2215	34	06067	38.704455	-121.289958	Sacramento County
114	Fee-for-Service	1194781161	1194781161	1	1	THOMAS WALSH MD	12/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 BURDICK EXPY W	None	MINOT	ND	58701	4406	00	None	48.2325845	-101.2938165	Ward County
116	Fee-for-Service	1629137328	1629137328	1	1	TAFRESHI, FARIBA NP	10/18/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
121	Fee-for-Service	1063919090	1063919090	1	1	TAN, MICHAEL H MD	10/11/2022	207L00000X	NA	Other	026	PHYSICIANS	166163	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
133	Fee-for-Service	1134650435	1134650435	1	1	TIRATURYAN, TIGRAN MD	9/1/2020	207R00000X	NA	Other	026	PHYSICIANS	166051	41	Internal Medicine	0	In state provider	None	1509 WILSON TER	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
174	Fee-for-Service	1558466979	1558466979	1	1	TSENG, THERESA MD	5/3/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38398	41	Internal Medicine	0	In state provider	None	1153 S GARFIELD AVE	None	ALHAMBRA	CA	91801	4714	19	06037	34.08087826	-118.1230792	Los Angeles County
178	Fee-for-Service	1902977986	1902977986	1	1	TELLER, THOMAS MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34256	41	Internal Medicine	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
215	Fee-for-Service	1679501100	1679501100	1	1	TON, ANTHONY T MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90934	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
246	Fee-for-Service	1376652800	1376652800	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05882	1301 MUNRAS AVE	None	MONTEREY	CA	93940	6103	27	06053	36.58603605	-121.9000363	Monterey County
313	Fee-for-Service	1619338712	1619338712	1	1	TRENTACOSTA, ROBERT DO	8/30/2024	207R00000X	NA	Other	026	PHYSICIANS	20912	41	Internal Medicine	0	In state provider	None	9888 GENESEE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
336	Fee-for-Service	1073676243	1073676243	1	2	TIBURCIO VASQUEZ HEALTH	10/26/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	22331 MISSION BLVD	None	HAYWARD	CA	94541	3911	01	06001	37.67442187	-122.0867356	Alameda County
463	Fee-for-Service	1609034222	1609034222	1	1	TUPPER, LAURIE A NP	10/24/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
496	Fee-for-Service	1912343948	1912343948	1	1	TRUONG, JOTIKA H LAC	8/24/2022	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
534	Fee-for-Service	1689695090	1689695090	1	1	TRAN, PHUONG A MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74949	41	Internal Medicine	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
539	Fee-for-Service	1609887231	1609887231	3	1	TRHC OPCO, INC.	1/1/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 S CANAL ST	None	SOUTH SAN FRANCIS	CA	94080	4606	41	06081	37.65063463	-122.4149935	San Mateo County
575	Fee-for-Service	1750343851	1750343851	1	1	TREYNOR, ELIZABETH C MD	10/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65307	22	Pathology (M.D. only)	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
580	Fee-for-Service	1194922625	1194922625	1	1	TREGER, RICHARD M MD	9/15/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	83636	45	Nephrology (Renal-Kidney)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
587	Fee-for-Service	1073803631	1073803631	1	1	TREIMAN, MICHAEL A MD	6/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	5330 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
615	Fee-for-Service	1821169715	1821169715	1	1	TILLER, GEORGE E MD	11/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63286	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
684	Fee-for-Service	1629515705	1629515705	1	2	TWO CHAIRS BEHAVIORAL HEALTH	12/20/2021	101Y00000X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
718	Fee-for-Service	1629515705	1629515705	1	7	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	GROUP, A PSYCHOLOGY COR	409 13TH	STE 1900	OAKLAND	CA	94612	2605	01	06001	37.80326679	-122.2707988	Alameda County
799	Fee-for-Service	1790928075	1790928075	1	1	TRIEU, CHRISTINE T MD	9/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114154	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
857	Fee-for-Service	1871815829	1871815829	1	1	THOMPSON, ALLISON L PHD	4/1/2010	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
859	Fee-for-Service	1780346072	1780346072	1	1	TRAVIS, LIISA M NP	11/17/2022	363L00000X	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
861	Fee-for-Service	1669105417	1669105417	1	1	TRUST THE ABILITY FAMILY COU	9/23/2023	193200000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NSELING, A PROFESSIONA	222 W 6TH ST	STE 400	SAN PEDRO	CA	90731	3345	19	06037	33.73876969	-118.2824628	Los Angeles County
894	Fee-for-Service	1447369897	1447369897	1	1	THRIFTY PAYLESS INC	3/28/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6327	4710 COMMONS WAY	None	CALABASAS	CA	91302	3364	19	06037	34.15376786	-118.6445698	Los Angeles County
941	Fee-for-Service	1912191164	1912191164	1	1	TAO, BONITA G MD	12/27/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	96323	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
973	Fee-for-Service	1811915333	1811915333	1	1	TRINH, NINA X MD	3/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	64931	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
979	Fee-for-Service	1629515705	1629515705	1	2	TWO CHAIRS BEHAVIORAL HEALTH	7/10/2020	101Y00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
982	Fee-for-Service	1144614983	1144614983	1	1	TORRES, HEATHER LCSW	10/2/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16250 VENTURA BLVD	SUITE 465	ENCINO	CA	91436	4620	19	06037	34.15682212	-118.4871886	Los Angeles County
1002	Fee-for-Service	1629515705	1629515705	1	7	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	409 13TH	STE 1900	OAKLAND	CA	94612	2605	01	06001	37.80326679	-122.2707988	Alameda County
1020	Fee-for-Service	1518412709	1518412709	1	1	THANOO, NIVAAS MD	3/18/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
1036	Fee-for-Service	1205056033	1205056033	1	1	TERESA MEDICAL CENTER	4/16/2003	207VG0400X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	INC	326 N VERMONT AVE	None	LOS ANGELES	CA	90004	3511	19	06037	34.077159	-118.2916705	Los Angeles County
1104	Fee-for-Service	1598866642	1598866642	1	1	TARNAY, MICHAEL, MD	11/1/1998	207P00000X	NA	Other	026	PHYSICIANS	61548	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16237 VENTURA BLVD	None	ENCINO	CA	91436	2201	19	06037	34.15686987	-118.4871369	Los Angeles County
1146	Fee-for-Service	1407812142	1407812142	1	1	TAYLOR, JO MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	53791	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7601 HOSPITAL DR	STE 220	SACRAMENTO	CA	95823	5408	34	06067	38.464794	-121.415571	Sacramento County
1155	Fee-for-Service	1659983682	1659983682	1	1	THEISEN, ELOISE G CNP	5/11/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
1197	Fee-for-Service	1396194486	1396194486	1	1	TOMPANE, TREVOR MD	12/21/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	150553	None	None	0	In state provider	None	1600 WEST AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
1198	Fee-for-Service	1235549148	1235549148	1	1	TAPARRA, KIANE K M	2/19/2015	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
1219	Fee-for-Service	1699881540	1699881540	1	1	TOLUMNE ME-WUK INDIAN	8/18/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER INC	18880 CHERRY VALLEY BLVD	None	TUOLUMNE	CA	95379	9506	55	06109	37.96511668	-120.2399015	Tuolumne County
1233	Fee-for-Service	1821027525	1821027525	1	1	TILARO, FRANK E. MD	3/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4401 HARRISON BLVD	None	OGDEN	UT	84403	3195	00	None	41.18328	-111.9536955	Weber County
1258	Fee-for-Service	1811915333	1811915333	1	1	TRINH, NINA X MD	3/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	64931	83	Rheumatology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
1260	Fee-for-Service	1629515705	1629515705	1	2	TWO CHAIRS BEHAVIORAL HEALTH	7/10/2020	101Y00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	GROUP, A PSYCHOLOGY COR	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
1290	Fee-for-Service	1629515705	1629515705	1	7	TWO CHAIRS BEHAVIORAL HEALTH	12/20/2021	101YP2500X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	409 13TH	STE 1900	OAKLAND	CA	94612	2605	01	06001	37.80326679	-122.2707988	Alameda County
1319	Fee-for-Service	1992774699	1992774699	1	1	TRANG, KRISTIE M OD INC	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9260 SIERRA COLLEGE BLVD	STE 500	ROSEVILLE	CA	95661	5932	31	06061	38.73045217	-121.2261495	Placer County
1324	Fee-for-Service	1205056033	1205056033	1	1	TERESA MEDICAL CENTER	4/16/2003	207VG0400X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	INC	326 N VERMONT AVE	None	LOS ANGELES	CA	90004	3511	19	06037	34.077159	-118.2916705	Los Angeles County
1330	Fee-for-Service	1184773459	1184773459	1	1	THARPE, BETTY LMFT	7/26/2023	174400000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2612 ALCATRAZ AVE	SUITE 5	BERKELEY	CA	94705	2723	01	06001	37.85120744	-122.2527431	Alameda County
1355	Fee-for-Service	1568879005	1568879005	1	1	TURNER, BLAIR M NP	11/1/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95071427	-	NOT APPLICABLE	0	In state provider	None	726 POLK STREET	4TH FLOOR	SAN FRANCISCO	CA	94109	7813	38	06075	37.78379532	-122.4192766	San Francisco County
1372	Fee-for-Service	1013218387	1013218387	1	1	TRUONG, LINDA T DO	3/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11470	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
1380	Fee-for-Service	1689607053	1689607053	1	1	TELGT MCKINNEY, YVONNE R MD	11/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	87666	01	General Practice	0	In state provider	None	16519 VICTOR ST	STE 307	VICTORVILLE	CA	92395	3922	36	06071	34.5212432	-117.3044617	San Bernardino County
1432	Fee-for-Service	1609198779	1609198779	1	1	TIWARI, AMBOOJ MD	2/22/2024	2084V0102X	NA	Neurology	026	PHYSICIANS	156282	None	None	0	In state provider	None	225 N JACKSON AVENUE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
1483	Fee-for-Service	1245228519	1245228519	1	1	TOVAR, ALEXANDER S MD	10/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	57558	None	None	0	In state provider	ALEXANDER S TOVAR MD INC	2701 W ALAMEDA AVE	STE 300	BURBANK	CA	91505	4408	19	06037	34.15751343	-118.3303715	Los Angeles County
1490	Fee-for-Service	1902131287	1902131287	1	1	TAHOE ORTHOPEDICS & SPORTS	6/28/2010	207X00000X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICINE INC	1139 THIRD STREET	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
1548	Fee-for-Service	1629515705	1629515705	1	2	TWO CHAIRS BEHAVIORAL HEALTH	7/10/2020	101Y00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
1578	Fee-for-Service	1629515705	1629515705	1	7	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	409 13TH	STE 1900	OAKLAND	CA	94612	2605	01	06001	37.80326679	-122.2707988	Alameda County
1581	Fee-for-Service	1346602844	1346602844	1	1	TISDALE, REBECCA L MD	6/7/2019	207R00000X	NA	Other	026	PHYSICIANS	151974	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
1598	Fee-for-Service	1518015833	1518015833	1	1	TRILLANES, CAESAR MD	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	38383	30	Radiology	0	In state provider	None	1745 S IMPERIAL AVE	RM 1	EL CENTRO	CA	92243	4243	13	06025	32.77792365	-115.569499	Imperial County
1612	Fee-for-Service	1205056033	1205056033	1	1	TERESA MEDICAL CENTER	4/16/2003	207VG0400X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	326 N VERMONT AVE	None	LOS ANGELES	CA	90004	3511	19	06037	34.077159	-118.2916705	Los Angeles County
1628	Fee-for-Service	1720356793	1720356793	1	1	TAWFIK-SEXTON, DAHLIA MD	4/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146283	02	General Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
1629	Fee-for-Service	1093151268	1093151268	1	1	TANG, LONI R MD	8/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143177	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
1637	Fee-for-Service	1154728285	1154728285	1	1	THV ENTERPRISES	7/18/2019	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	3025 FAIRFAX ROAD	None	BAKERSFIELD	CA	93306	4621	15	06029	35.38554618	-118.9298174	Kern County
1699	Fee-for-Service	1609915057	1609915057	1	1	TRIVEDI, NEIL N MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81631	41	Internal Medicine	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
1705	Fee-for-Service	1407117161	1407117161	1	1	THIRUVADI, GITANJALI RAMAN	6/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
1708	Fee-for-Service	1942904263	1942904263	1	1	TOP CARE TRANSPORTATION INC	6/20/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2064 WALSH AVE	STE C1	SANTA CLARA	CA	95050	2526	43	06085	37.36947634	-121.9610029	Santa Clara County
1749	Fee-for-Service	1962028241	1962028241	1	1	TUMINARO, SAMANTHA	9/4/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
1810	Fee-for-Service	1053945253	1053945253	1	1	TIPPETTS, JOSEPH PA-C	8/15/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1129, 1133, 1135, 1141,	SUITE D & E	REDDING	CA	96002	2139	45	06089	0	0	None
1833	Fee-for-Service	1285882506	1285882506	1	1	TAWFIQUE, ARAZ MD	11/10/2022	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	109527	-	NOT APPLICABLE	0	In state provider	None	31642 S COAST HWY	STE 102	LAGUNA BEACH	CA	92651	7017	30	06059	33.50297967	-117.7446885	Orange County
1912	Fee-for-Service	1063695195	1063695195	1	1	THRIFTY PAYLESS INC	2/11/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6489	8008 PANAMA BLVD	None	LAMONT	CA	93241	1322	15	06029	35.26701152	-118.9152045	Kern County
1916	Fee-for-Service	1982798948	1982798948	1	1	TIRUVILUAMALA, PARVATHI MD	5/23/2006	174400000X	NA	Other	026	PHYSICIANS	79302	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
1917	Fee-for-Service	1205329125	1205329125	1	1	TAYLOR, SHIRLEY R PT	2/19/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
1925	Fee-for-Service	1235744210	1235744210	1	1	TS COMPASSION HOSPICE &	3/4/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	14545 FRIAR ST	STE 233	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
2039	Fee-for-Service	1528324381	1528324381	1	1	TOBEY, DAVID DO	8/15/2019	2086S0129X	NA	General Surgery	026	PHYSICIANS	15014	None	None	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
2061	Fee-for-Service	1578594289	1578594289	2	1	TAYLOR, CHARLES L MD	1/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	38699	30	Radiology	0	In state provider	None	11411 BROOKSHIRE AVE	STE 100	DOWNEY	CA	90241	5026	19	06037	33.93667091	-118.1309273	Los Angeles County
2085	Fee-for-Service	1396076147	1396076147	1	1	TARZANA TREATMENT CENTERS, I	11/3/2016	283Q00000X	NA	Hospitals	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	NC.	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
2091	Fee-for-Service	1700267721	1700267721	1	1	THAO, JAI	8/23/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4700 ENTERPRISE WAY	None	MODESTO	CA	95356	0000	50	06099	37.705761	-121.072012	Stanislaus County
2095	Fee-for-Service	1093799306	1093799306	1	1	TEKLE, ELSA A MD	9/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	78066	None	None	0	In state provider	None	17100 EUCLID STREET	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
2112	Fee-for-Service	1891089587	1891089587	1	1	TRAN, PHU N MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129084	41	Internal Medicine	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
2119	Fee-for-Service	1962703702	1962703702	1	1	TABERNA, MARK LMFT	8/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
2123	Fee-for-Service	1992262646	1992262646	1	1	TELEHEALTHDOCS MEDICAL CORPO	2/3/2021	171W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1017 ELLINGTON	None	DELANO	CA	93215	2621	15	06029	35.76891908	-119.2515219	Kern County
2132	Fee-for-Service	1679131833	1679131833	1	1	TRUST MEDICAL CORPORATION	7/18/2022	347C00000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	449 W DOUGLAS AVE	None	EL CAJON	CA	92020	7607	37	06073	32.79384925	-116.9672404	San Diego County
2156	Fee-for-Service	1528080694	1528080694	1	1	TANNENBAUM,DANA P MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67997	18	Ophthalmology	0	In state provider	None	4418 VINELAND AVE	STE 106	NORTH HOLLYWOOD	CA	91602	2159	19	06037	34.15107052	-118.3702155	Los Angeles County
2183	Fee-for-Service	1609928787	1609928787	1	1	TRAN, FRANK H MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	53470	05	Anesthesiology	0	In state provider	None	500 S MAIN ST	STE 1210	ORANGE	CA	92868	4556	30	06059	33.77991974	-117.8674745	Orange County
2203	Fee-for-Service	1982798948	1982798948	1	1	TIRUVILUAMALA, PARVATHI MD	5/23/2006	174400000X	NA	Other	026	PHYSICIANS	79302	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
2208	Fee-for-Service	1235744210	1235744210	1	1	TS COMPASSION HOSPICE &	3/4/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	14545 FRIAR ST	STE 233	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
2226	Fee-for-Service	1396896478	1396896478	1	1	TRUDE, KEVIN MD	3/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52518	40	Pediatrics	0	In state provider	None	3100 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	3866	31	06061	38.74399612	-121.2349547	Placer County
2250	Fee-for-Service	1457989030	1457989030	1	1	TRAN, TAM M DO	12/4/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21392	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
2275	Fee-for-Service	1609188796	1609188796	1	1	THE HEART MEDICAL GROUP	12/24/2012	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	16320 ROSCOE BLVD	SUITE 100	VAN NUYS	CA	94106	4822	19	06037	34.22128033	-118.4884471	Los Angeles County
2325	Fee-for-Service	1841206133	1841206133	1	1	THRIFTY DRUG STORE 5482	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	1720 AVIATION BLVD	None	REDONDO BEACH	CA	90278	2810	19	06037	33.87151915	-118.3821725	Los Angeles County
2348	Fee-for-Service	1528429453	1528429453	1	1	TAYLOR, ANNE C MD	12/27/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	153011	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
2364	Fee-for-Service	1750841870	1750841870	1	1	TRAN, TAM MD	12/17/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	184216	None	None	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
2373	Fee-for-Service	1396076147	1396076147	1	1	TARZANA TREATMENT CENTERS, I	7/26/2011	No Taxonomy Provided	NA	None	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	NC.	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
2383	Fee-for-Service	1912332107	1912332107	1	1	TULLY, LAURA M PHD	9/5/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
2387	Fee-for-Service	1669007977	1669007977	1	1	TULE RIVER INDIAN HEALTH CEN	10/7/2020	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TER INC	380 N RESERVATION RD	None	PORTERVILLE	CA	93257	9673	54	06107	36.02996779	-118.7882551	Tulare County
2407	Fee-for-Service	1962566950	1962566950	1	1	TSAI, MING F MD	11/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	38579	41	Internal Medicine	0	In state provider	None	18350 ROSCOE BLVD	SUITE 210	NORTHRIDGE	CA	91325	4151	19	06037	34.22071855	-118.5341175	Los Angeles County
2411	Fee-for-Service	1992262646	1992262646	1	1	TELEHEALTHDOCS MEDICAL CORPO	2/3/2021	171W00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1017 ELLINGTON	None	DELANO	CA	93215	2621	15	06029	35.76891908	-119.2515219	Kern County
2478	Fee-for-Service	1932276854	1932276854	1	1	THIIM, CHRISTIAN DO	2/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9109	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
2491	Fee-for-Service	1982798948	1982798948	1	1	TIRUVILUAMALA, PARVATHI MD	5/23/2006	174400000X	NA	Other	026	PHYSICIANS	79302	41	Internal Medicine	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
2501	Fee-for-Service	1629859244	1629859244	1	1	TUTSON, RYKELL NICKEYA	11/8/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	25792 IRIS AVENUE	UNIT B	MORENO VALLEY	CA	92551	2970	33	06065	33.88967888	-117.2116555	Riverside County
2504	Fee-for-Service	1518313600	1518313600	1	2	THRIFTY PAYLESS INC	8/12/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	431 34TH STREET	None	BAKERSFIELD	CA	93301	2236	15	06029	35.39046047	-119.0067165	Kern County
2517	Fee-for-Service	1235284381	1235284381	1	1	TRESENRITER, WESLEY M PT	12/21/2017	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITE 370	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
2532	Fee-for-Service	1700822079	1700822079	1	1	THURSTON, JAMES D MD	12/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	58139	01	General Practice	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
2554	Fee-for-Service	1174014658	1174014658	1	1	TAO, YUAN OT	3/3/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2005 DE LA CRUZ BLVD	STE #165	SANTA CLARA	CA	95050	3030	43	06085	37.36107355	-121.941418	Santa Clara County
2620	Fee-for-Service	1346564606	1346564606	1	1	TURNING POINT OF CENTRAL	12/16/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA INC	711 NORTH COURT STREET	None	VISALIA	CA	93291	3638	54	06107	36.336384	-119.292543	Tulare County
2629	Fee-for-Service	1033418801	1033418801	1	1	TOOHEY, SHANNON L MD	10/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125633	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
2641	Fee-for-Service	1245417021	1245417021	1	1	TAYLOR, ROBERT R H	3/16/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1285 SOUTH MAIN STREET	None	LAKEPORT	CA	95453	5518	17	06033	39.03322541	-122.9159073	Lake County
2643	Fee-for-Service	1801975941	1801975941	1	1	THEIN, JOCELYN C MD	6/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	88036	07	Dermatology	0	In state provider	None	801 TRAEGER AVE	STE 310	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
2661	Fee-for-Service	1396076147	1396076147	1	1	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	NC.	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
2688	Fee-for-Service	1669891370	1669891370	1	1	TISOVIC, KELLY L MD	7/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155170	13	Neurology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06269295	-118.2030006	Los Angeles County
2690	Fee-for-Service	1770999450	1770999450	1	1	TRAN, STEPHANIE A MD	10/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139644	08	Family Practice	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
2695	Fee-for-Service	1962566950	1962566950	1	1	TSAI, MING F MD	11/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	38579	10	Gastroenterology (M.D. only)	0	In state provider	None	18350 ROSCOE BLVD	SUITE 210	NORTHRIDGE	CA	91325	4151	19	06037	34.22071855	-118.5341175	Los Angeles County
2699	Fee-for-Service	1992262646	1992262646	1	1	TELEHEALTHDOCS MEDICAL CORPO	1/18/2023	171W00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1017 ELLINGTON	None	DELANO	CA	93215	2621	15	06029	35.76891908	-119.2515219	Kern County
2734	Fee-for-Service	1629489919	1629489919	1	1	TRUONG, JIMMY MD	9/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133338	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
2789	Fee-for-Service	1437593720	1437593720	1	1	THOMAS, TANYA M MD	7/7/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	136434	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
2790	Fee-for-Service	1629859244	1629859244	1	1	TUTSON, RYKELL NICKEYA	11/8/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	25792 IRIS AVENUE	UNIT B	MORENO VALLEY	CA	92551	2970	33	06065	33.88967888	-117.2116555	Riverside County
2856	Fee-for-Service	1588688972	1588688972	1	1	TENG, PETER I MD	8/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84598	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
2859	Fee-for-Service	1508203720	1508203720	1	1	THOMAS, TIMMY C MD	2/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139900	01	General Practice	0	In state provider	None	2016 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
2943	Fee-for-Service	1609805134	1609805134	1	1	TSAI, PATRICIA S MD INC	7/7/2011	193400000X	NA	Other	026	PHYSICIANS	64184	10	Gastroenterology (M.D. only)	0	In state provider	None	ONE HOAG DR	None	NEWPORT BEACH	CA	92658	4162	30	06059	33.62421676	-117.9309656	Orange County
2949	Fee-for-Service	1396076147	1396076147	1	1	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	NC.	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
2978	Fee-for-Service	1477764736	1477764736	1	1	TURTURRO, KIMBERLY A PT	8/12/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	24671 MONROE AVE	#101C	MURRIETA	CA	92562	2527	33	06065	33.56694181	-117.2021151	Riverside County
2988	Fee-for-Service	1992262646	1992262646	1	1	TELEHEALTHDOCS MEDICAL CORPO	3/23/2023	171W00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1017 ELLINGTON	None	DELANO	CA	93215	2621	15	06029	35.76891908	-119.2515219	Kern County
3010	Fee-for-Service	1003128711	1003128711	1	1	THOMPSON, ANNE SP	10/19/2010	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7098	34	06067	38.56554	-121.4664615	Sacramento County
3030	Fee-for-Service	1831247659	1831247659	1	1	TRAN, TRAM A DO	8/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8263	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
3052	Fee-for-Service	1174771331	1174771331	1	1	TAFRESHIAN, SEPIDEH MD	12/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104881	08	Family Practice	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9989	39	06077	37.88652418	-121.2820956	San Joaquin County
3055	Fee-for-Service	1578591426	1578591426	1	1	TOLLY, KRISTY L MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67500	40	Pediatrics	0	In state provider	None	17822 BEACH BLVD	STE 278	HUNTINGTON BEACH	CA	92647	7180	30	06059	33.70331388	-117.9890471	Orange County
3101	Fee-for-Service	1699038950	1699038950	1	1	TAYLOR, LAURA B MD	1/27/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165933	08	Family Practice	0	In state provider	None	1520 SAN PABLO ST	STE 1300	LOS ANGELES	CA	90033	5312	19	06037	34.06269295	-118.2030006	Los Angeles County
3175	Fee-for-Service	1689781924	1689781924	1	1	TRIVEDI, MONA MD	3/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84030	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
3206	Fee-for-Service	1063564805	1063564805	1	1	TOY, ANTHONY C OD	8/31/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNOIN CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
3217	Fee-for-Service	1356570022	1356570022	1	1	THONAR, BENJAMIN E J MD	9/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114192	41	Internal Medicine	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
3237	Fee-for-Service	1396076147	1396076147	1	1	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	NC.	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
3286	Fee-for-Service	1861653255	1861653255	1	1	TALLEY, JOHN R MD	10/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110607	24	Plastic 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
3309	Fee-for-Service	1306955752	1306955752	1	1	THIRIFTY PAYLESS INC	6/26/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6074	5610 STOCKTON BLVD	None	SACRAMENTO	CA	95824	1612	34	06067	38.524401	-121.442868	Sacramento County
3312	Fee-for-Service	1932256427	1932256427	1	1	TORRES, KIMBERLY A LMFT	1/18/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2505 VALHALLA PLACE	110	CHICO	CA	95973	8276	04	06007	39.761604	-121.8180955	Butte County
3322	Fee-for-Service	1194389346	1194389346	1	1	THE HOME HEALTH AGENCY, INC.	3/18/2024	251E00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	4730 WOODMAN AVE	STE 303	SHERMAN OAKS	CA	91423	2442	19	06037	34.156701	-118.4312045	Los Angeles County
3327	Fee-for-Service	1982261178	1982261178	1	1	TANG, GEORGE H MD	10/23/2023	207R00000X	NA	Other	026	PHYSICIANS	182535	None	None	0	In state provider	None	18035 BROOKHURST ST	SUITE 1300	FOUNTAIN VALLEY	CA	92708	6738	30	06059	33.701184	-117.9544385	Orange County
3365	Fee-for-Service	1376753517	1376753517	1	1	TOGNETTI, JUDITH LAC	12/29/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
3482	Fee-for-Service	1942087861	1942087861	1	1	TANNER, ALEXANDRA PHD	2/21/2025	103TC0700X	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
3495	Fee-for-Service	1295834695	1295834695	1	1	TANGCHITNOB, DUMRONG MD INC	5/31/1989	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	42027	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1135 S SUNSET AVE	STE 401	WEST COVINA	CA	91790	3921	19	06037	34.06215064	-117.9453997	Los Angeles County
3525	Fee-for-Service	1396076147	1396076147	1	1	TARZANA TREATMENT CENTERS, I	8/30/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC.	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
3531	Fee-for-Service	1184633430	1184633430	1	1	THAI, NICOLE HONG PHUONG T	12/26/1989	193400000X	NA	Other	026	PHYSICIANS	47898	None	None	0	In state provider	MD INC	200 JOSE FIGUERES AVE	STE 355	SAN JOSE	CA	95116	1593	43	06085	37.36122014	-121.8505998	Santa Clara County
3540	Fee-for-Service	1609330547	1609330547	1	1	TUSTIN HILLS HEALTHCARE, INC	5/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1800 OLD TUSTIN AVE	None	SANTA ANA	CA	92705	7810	30	06059	33.7613722	-117.8358137	Orange County
3578	Fee-for-Service	1942750971	1942750971	1	1	TAVILL, TESS E	7/2/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
3616	Fee-for-Service	1437152857	1437152857	2	1	TSAI, JAMES Y MD	4/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	70963	41	Internal Medicine	0	In state provider	None	201 LAURSEN ST	None	HEMET	CA	92543	4417	33	06065	33.749676	-116.960847	Riverside County
3650	Fee-for-Service	1760159123	1760159123	1	1	TEJEDA, ANA M AU	10/19/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
3662	Fee-for-Service	1346884921	1346884921	1	1	TUOYO, ELIZABETH	4/1/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
3675	Fee-for-Service	1215564927	1215564927	1	1	TAN, JOY	9/13/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
3696	Fee-for-Service	1265551808	1265551808	1	1	TOWER, SARAH J LCSW	8/27/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
3710	Fee-for-Service	1003994823	1003994823	1	1	TSANG, LI M MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68508	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
3718	Fee-for-Service	1275864217	1275864217	1	1	THORNE, SUSAN A MD	9/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123891	08	Family Practice	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
3730	Fee-for-Service	1528444684	1528444684	1	1	TU, THOMAS N T LCSW	11/28/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
3738	Fee-for-Service	1861787665	1861787665	1	1	TABARES, ADRIAN MD	8/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122451	01	General Practice	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
3802	Fee-for-Service	1821176629	1821176629	1	1	TABIBIAN, LEILA MD	11/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70921	34	Urology and Urological Surgery	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
3851	Fee-for-Service	1609898279	1609898279	2	1	THRIFTY PAYLESS INC	2/25/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2640 FLORAL AVE	None	SELMA	CA	93662	3602	10	06019	36.57631483	-119.6241043	Fresno County
3861	Fee-for-Service	1326364373	1326364373	1	1	TOOMARI, NOJAN DO	5/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11162	02	General Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
3906	Fee-for-Service	1437152857	1437152857	2	1	TSAI, JAMES Y MD	4/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	70963	68	Hematology	0	In state provider	None	201 LAURSEN ST	None	HEMET	CA	92543	4417	33	06065	33.749676	-116.960847	Riverside County
3994	Fee-for-Service	1467428870	1467428870	1	1	TITUS, ROBIN L MD	12/26/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	3919 CARTER DRIVE	None	WELLINGTON	NV	89444	9995	00	None	38.73144685	-119.5064055	Douglas County
4032	Fee-for-Service	1154438968	1154438968	1	1	TANNER, JESSICA B. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3600 E HARRY ST	None	WICHITA	KS	67218	3713	00	None	37.66460552	-97.2931275	Sedgwick County
4064	Fee-for-Service	1265491732	1265491732	1	1	THORSON, PHATARAPORN K MD	6/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	82041	22	Pathology (M.D. only)	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
4072	Fee-for-Service	1669727665	1669727665	1	1	TRAVIS A. NEWBY	10/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 KOOTENAI HEALTH WAY	None	COEUR D ALENE	ID	83814	6051	00	None	47.695635	-116.792906	Kootenai County
4083	Fee-for-Service	1356403182	1356403182	1	1	TSENG, SUSAN S MD	7/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89237	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
4112	Fee-for-Service	1124060306	1124060306	1	1	TRAINER, AUDREY T. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	665 WINTER ST SE	None	SALEM	OR	97301	3919	00	None	44.933211	-123.0355125	Marion County
4193	Fee-for-Service	1437152857	1437152857	2	1	TSAI, JAMES Y MD	4/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	70963	78	Neoplastic Diseases/Oncology	0	In state provider	None	201 LAURSEN ST	None	HEMET	CA	92543	4417	33	06065	33.749676	-116.960847	Riverside County
4214	Fee-for-Service	1013056258	1013056258	1	1	TEXIDOR, TANIA I	10/3/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
4222	Fee-for-Service	1093803819	1093803819	1	1	TANJOCO, MOLLIE E	1/30/2013	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
4236	Fee-for-Service	1013973783	1013973783	1	1	TUNG, JAGDEEP S MD	1/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92233	41	Internal Medicine	0	In state provider	None	9041 MAGNOLIA AVE	STE 107	RIVERSIDE	CA	92503	3942	33	06065	33.92541585	-117.4378266	Riverside County
4300	Fee-for-Service	1528399482	1528399482	1	1	THERAPEUTIC LIVING CENTERS	9/21/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR THE BLIND INC	7355 SHOUP AVENUE	None	WEST HILLS	CA	91307	1737	19	06037	34.204311	-118.6147095	Los Angeles County
4351	Fee-for-Service	1811160377	1811160377	1	1	TSO, JOHN W L MD	2/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	103220	01	General Practice	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
4476	Fee-for-Service	1619935251	1619935251	1	3	THE REGENTS OF THE UNIVERSIT	3/23/2020	208600000X	NA	General Surgery	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
4486	Fee-for-Service	1881013399	1881013399	1	1	TRUONG, BAO D MD	1/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146176	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
4490	Fee-for-Service	1225341670	1225341670	1	1	TYSON, KATELIN E LMFT	12/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
4537	Fee-for-Service	1346403912	1346403912	1	1	TIBBLE, COURTNEY J A MD	12/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103174	41	Internal Medicine	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
4644	Fee-for-Service	1174204291	1174204291	1	1	TARRANT, CHRISTOPHER G CRNA	12/7/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
4649	Fee-for-Service	1942264072	1942264072	1	1	TERRAZAS, ENRIQUE MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80790	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	# 300	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
4676	Fee-for-Service	1811307440	1811307440	1	1	TERMEZY, TARA OT	2/8/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
4677	Fee-for-Service	1821254616	1821254616	1	1	TRAN, CHINH N MD	8/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110547	05	Anesthesiology	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
4703	Fee-for-Service	1225192453	1225192453	1	1	TANNER, TODD M PT	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
4741	Fee-for-Service	1891793089	1891793089	1	1	TER-BAGDASARIAN, LEVON A	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1041 W BADILLO ST	STE 103	COVINA	CA	91722	4194	19	06037	34.08651527	-117.910828	Los Angeles County
4765	Fee-for-Service	1619935251	1619935251	1	3	THE REGENTS OF THE UNIVERSIT	6/28/2019	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	84	Surgery-Head and Neck	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
4796	Fee-for-Service	1982998217	1982998217	1	1	TRAVIS, JOSHUA A DO	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13449	41	Internal Medicine	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
4817	Fee-for-Service	1295878254	1295878254	1	1	TSOI, EDMUND K M MD	9/30/1986	208600000X	NA	General Surgery	026	PHYSICIANS	55099	02	General Surgery	0	In state provider	None	950 STOCKTON ST	STE 388	SAN FRANCISCO	CA	94108	1618	38	06075	37.79469747	-122.4079497	San Francisco County
4824	Fee-for-Service	1063686624	1063686624	1	1	THEODOROU, WILLIAM W MD	6/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126060	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
4890	Fee-for-Service	1306391875	1306391875	1	1	TSOY, ELENA PHD	10/8/2024	103T00000X	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
4905	Fee-for-Service	1932134822	1932134822	1	1	TOMPKINS, RICHARD B MD	10/20/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76216	41	Internal Medicine	0	In state provider	None	1100 BUTTE STREET	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
4937	Fee-for-Service	1942264072	1942264072	1	1	TERRAZAS, ENRIQUE MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80790	90	Pathology-Forensic	0	In state provider	None	400 PARNASSUS AVE	# 300	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
4943	Fee-for-Service	1053967612	1053967612	1	1	TUSTIN URGENT CARE, APC	2/4/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	12860 BEACH BLVD	SUITE E	STANTON	CA	90680	4084	30	06059	33.7749891	-117.9926221	Orange County
5068	Fee-for-Service	1447651278	1447651278	1	1	TELLO, JENNIFER LCSW	6/15/2022	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
5075	Fee-for-Service	1548634520	1548634520	1	1	TRAN, JENNIFER CNP	3/21/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4950 BARRANCA PARKWAY	SUITE 104	IRVINE	CA	92604	4630	30	06059	33.67620851	-117.7948348	Orange County
5120	Fee-for-Service	1225590979	1225590979	1	1	THAM YONG REN, TRISTAN M MD	5/11/2024	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	None	04	Otology, Laryngology, Rhinology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
5194	Fee-for-Service	1891037347	1891037347	1	1	TRENTINI, JOHN F III MD	12/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2306	00	None	36.132948	-115.136874	Clark County
5245	Fee-for-Service	1952133167	1952133167	1	1	TULARE COUNTY DOULA LLC	9/3/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	54	06107	0	0	None
5322	Fee-for-Service	1821247297	1821247297	1	1	TABADDOR, KHOSROW MD	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	40537	20	Orthopedic Surgery	0	In state provider	None	3392 MOTOR AVE	None	LOS ANGELES	CA	90034	3712	19	06037	34.02780514	-118.4095758	Los Angeles County
5386	Fee-for-Service	1649389644	1649389644	1	1	TAYEK. JOHN MD	2/28/1989	207RE0101X	NA	Endocrinology	026	PHYSICIANS	45140	41	Internal Medicine	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
5408	Fee-for-Service	1215096938	1215096938	1	1	THOMAS, ELIZABETH D NP	11/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
5461	Fee-for-Service	1033989603	1033989603	1	1	TCHA, VALERIE NP	1/16/2025	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3656 W SHAW AVE	None	FRESNO	CA	93711	3231	10	06019	36.80840238	-119.8594473	Fresno County
5483	Fee-for-Service	1467213611	1467213611	1	1	TAYLOR, FAITH LPCC	12/26/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1300 E SHAW AVE	SUITE 109	FRESNO	CA	93710	7903	10	06019	36.80872147	-119.765979	Fresno County
5499	Fee-for-Service	1811031461	1811031461	1	1	TAHOE FOREST WOMEN'S CTR	6/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10175 LEVONE AVE	None	TRUCKEE	CA	96161	4821	29	06057	39.32413811	-120.2000473	Nevada County
5504	Fee-for-Service	1104343128	1104343128	1	1	TOGUAL, VERONICA LCSW	8/27/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
5507	Fee-for-Service	1639257470	1639257470	1	1	TANG, HAI-TAO MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79127	08	Family Practice	0	In state provider	None	3700 VACA VALLEY PKWY	None	VACAVILLE	CA	95688	9430	48	06095	38.39008977	-121.9378499	Solano County
5565	Fee-for-Service	1194081950	1194081950	1	1	TRAN, THANH C MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129083	41	Internal Medicine	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
5610	Fee-for-Service	1922117381	1922117381	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05464	11096 JEFFERSON BLVD	None	CULVER CITY	CA	90230	5520	19	06037	33.9966	-118.395332	Los Angeles County
5658	Fee-for-Service	1902299100	1902299100	1	1	TAM, AMANDA Y NP	10/26/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
5696	Fee-for-Service	1033703038	1033703038	1	1	THORNTON, RACHEL NP	6/7/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
5709	Fee-for-Service	1407485550	1407485550	1	1	THAKER, KUNAL DO	10/18/2023	207R00000X	NA	Other	026	PHYSICIANS	21117	None	None	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
5733	Fee-for-Service	1720172083	1720172083	1	1	TRAN, LETHUY T MD	12/1/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	61005	08	Family Practice	0	In state provider	None	1505 WILSON TER	STE 150	GLENDALE	CA	91206	4076	19	06037	34.14960934	-118.2313491	Los Angeles County
5734	Fee-for-Service	1194934760	1194934760	1	1	TIOLECO-CHENG, MELANIE	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	90752	40	Pediatrics	0	In state provider	G MD	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
5766	Fee-for-Service	1245230069	1245230069	1	1	THAO, CHA C DO	2/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	6749	08	Family Practice	0	In state provider	HILLSIDE FAMILY PRACT	4703 ENGLE RD	STE 2	CARMICHAEL	CA	95608	2223	34	06067	38.6320173	-121.3550894	Sacramento County
5771	Fee-for-Service	1477915320	1477915320	1	1	THOMPSON, JUANITA M LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
5853	Fee-for-Service	1174590723	1174590723	1	1	TONG LI MD	3/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 W CLARENDON AVE	STE 142	PHOENIX	AZ	85013	3449	00	None	33.49179	-112.07844	Maricopa County
5878	Fee-for-Service	1164695037	1164695037	1	1	TADLAOUI, KARIM MD	3/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109771	None	None	0	In state provider	None	15615 POMERADO RD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
5885	Fee-for-Service	1396863270	1396863270	1	1	TREVOLEDES, PATRICE A MFT	1/13/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	405 CHINN ST	STE 101	SANTA ROSA	CA	95404	4309	49	06097	38.44485	-122.7075075	Sonoma County
5920	Fee-for-Service	1457079030	1457079030	1	1	TAKRONI, RADWAN I MD	9/21/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	181161	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
6012	Fee-for-Service	1467883983	1467883983	1	1	TO, JONATHAN V	9/22/2015	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
6018	Fee-for-Service	1407145469	1407145469	1	1	TANDON, SURUCHI MD	2/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126059	41	Internal Medicine	0	In state provider	None	3801 HOWE STREET	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
6031	Fee-for-Service	1336547686	1336547686	1	1	TRAN, AMY N M	4/10/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
6035	Fee-for-Service	1265898076	1265898076	1	1	THE AMAAD INSTITUTE	12/13/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	10221 S. COMPTON AVE,	SUITE 105 & 103	LOS ANGELES	CA	90002	2802	19	06037	33.943518	-118.246236	Los Angeles County
6054	Fee-for-Service	1376801332	1376801332	1	1	TOENSING, CHRISTOPHER C MD	8/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	127662	30	Radiology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
6062	Fee-for-Service	1770508848	1770508848	1	1	THOMAS, JOSEPH N MD	12/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75200	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5900 W OLYMPIC BLVD	None	LOS ANGELES	CA	90036	4671	19	06037	34.05760692	-118.3604361	Los Angeles County
6066	Fee-for-Service	1780724955	1780724955	1	1	TOWN & COUNTRY DIAGS INC	10/6/2009	No Taxonomy Provided	NA	None	028	PORTABLE X-RAY	-	-	NOT APPLICABLE	0	In state provider	None	6125 W LAURA AVEUE	None	VISALIA	CA	93277	5558	54	06107	36.311004	-119.359368	Tulare County
6096	Fee-for-Service	1992868897	1992868897	1	1	TSUR, SHAI LMFT	2/20/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
6130	Fee-for-Service	1336190826	1336190826	1	1	THORNE, ROGER P MD	1/1/1982	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	37446	20	Orthopedic Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
6201	Fee-for-Service	1134660491	1134660491	1	1	TESFAYE, HEYWAN M MD	4/21/2020	207R00000X	NA	Other	026	PHYSICIANS	157357	41	Internal Medicine	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
6218	Fee-for-Service	1841367786	1841367786	1	1	TONG, JIANG MD	7/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78539	13	Neurology (M.D. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
6219	Fee-for-Service	1447308515	1447308515	1	1	TESLA MEDICAL CORPORATION	6/9/2004	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	72150	30	Radiology	0	In state provider	TESLA MEDICAL GROUP	171 MANSIONETTE DR	None	HANFORD	CA	93230	7410	16	06031	36.3660925	-119.6471758	Kings County
6260	Fee-for-Service	1023088598	1023088598	1	1	TAY, JONATHAN S MD	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	77 PRINGLE WAY	None	RENO	NV	89502	1474	00	None	39.52484706	-119.7951825	Washoe County
6340	Fee-for-Service	1780986919	1780986919	1	1	TAN, CYNTHIA K K Z MD	9/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140221	02	General Surgery	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
6357	Fee-for-Service	1982836854	1982836854	1	1	THOMAS, JINA NP	10/20/2012	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
6378	Fee-for-Service	1275700239	1275700239	2	1	TERRA BELLA COMMUNITIES	10/10/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1119 AYER DRIVE	None	GILROY	CA	95020	5423	43	06085	37.00487087	-121.5902346	Santa Clara County
6391	Fee-for-Service	1427117035	1427117035	1	1	TA, QUOC B MD	10/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80607	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
6398	Fee-for-Service	1750429643	1750429643	1	1	TOLBERT, GLENNA P MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70820	01	General Practice	0	In state provider	None	16550 VENTURA BLVD	None	ENCINO	CA	91436	2004	19	06037	34.15778374	-118.4942662	Los Angeles County
6417	Fee-for-Service	1285845719	1285845719	1	1	THERAPEUTIC LIVING CENTERS	2/22/1999	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR THE BLIND	7927B LINDLEY AVE	None	RESEDA	CA	91335	2122	19	06037	34.21434393	-118.527408	Los Angeles County
6447	Fee-for-Service	1841984614	1841984614	1	1	TRAN, CHI M AU	10/13/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
6472	Fee-for-Service	1922212042	1922212042	1	1	TANG, HUA MD	9/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124811	46	Hand Surgery	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
6506	Fee-for-Service	1689212524	1689212524	1	1	TANOUE, MATTHEW PT	5/7/2020	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
6529	Fee-for-Service	1962747097	1962747097	1	1	THARA, SAEEDA MD	12/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	49845	40	Pediatrics	0	In state provider	None	12371 IMPERIAL HIGHWAY	None	NORWALK	CA	90650	3129	19	06037	33.9172593	-118.0692375	Los Angeles County
6634	Fee-for-Service	1629313374	1629313374	1	1	TAYLOR-HUI, ELIZABETH A MD	1/14/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	144518	08	Family Practice	0	In state provider	None	1755 COURT STREET	None	REDDING	CA	96001	1721	45	06089	40.58041248	-122.3945221	Shasta County
6636	Fee-for-Service	1285712935	1285712935	1	1	TRIVEDI, RAJENDRAKUMA	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	44666	03	Allergy	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
6682	Fee-for-Service	1164958658	1164958658	1	2	TCY PHARMACY INC	3/21/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1120 E 8TH ST	None	NATIONAL CITY	CA	91950	2546	37	06073	32.67900136	-117.0953858	San Diego County
6686	Fee-for-Service	1750429643	1750429643	1	1	TOLBERT, GLENNA P MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70820	25	Physical Medicine and Rehabilitation	0	In state provider	None	16550 VENTURA BLVD	None	ENCINO	CA	91436	2004	19	06037	34.15778374	-118.4942662	Los Angeles County
6707	Fee-for-Service	1699896357	1699896357	1	1	TAN, RAYMOND C MD APC	2/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	73252	78	Neoplastic Diseases/Oncology	0	In state provider	None	3850 G STREET	None	MERCED	CA	95340	8787	24	06047	37.33931727	-120.4689461	Merced County
6772	Fee-for-Service	1407834146	1407834146	1	1	THOMAS, GREGORY S MD	9/30/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	49797	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	27800 MEDICAL CENTER RD	STE 126	SAN JUAN CAPISTRA	CA	92691	6407	30	06059	33.55952733	-117.6645199	Orange County
6800	Fee-for-Service	1285322701	1285322701	1	1	THE AMELIA ANN ADAMS WHOLE L	9/17/2024	171M00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	IFE CENTER	6702 INGLEWOOD AVE	K	STOCKTON	CA	95207	2767	39	06077	38.01266214	-121.3174259	San Joaquin County
6803	Fee-for-Service	1750023164	1750023164	1	1	TACKETT, AMBER NP	4/17/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
6836	Fee-for-Service	1164463907	1164463907	1	1	TAKAHASHI, BRUCE DO	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
6852	Fee-for-Service	1992265623	1992265623	1	1	TRAN, KEVIN MD	2/3/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	181861	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
6868	Fee-for-Service	1710797311	1710797311	1	1	THOMPSON, JUNE PT	3/13/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
6870	Fee-for-Service	1003129388	1003129388	1	1	THOMAS, ISAC C MD	12/21/2017	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	130326	06	Cardiovascular Disease (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
6887	Fee-for-Service	1033228408	1033228408	1	1	THRIFTY PAYLESS INC	9/6/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5783	221 E HARVARD BLVD	None	SANTA PAULA	CA	93060	3315	56	06111	34.34718725	-119.0692569	Ventura County
6897	Fee-for-Service	1861689705	1861689705	1	1	TROUNG, MAI THY T MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88089	84	Surgery-Head and Neck	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
6911	Fee-for-Service	1346347291	1346347291	1	1	TANGAAN, ALLAN B	11/29/2005	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3087	31	06061	38.76566391	-121.2457432	Placer County
6969	Fee-for-Service	1396932398	1396932398	1	1	TRAN, VAN K MD	8/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92415	05	Anesthesiology	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
6995	Fee-for-Service	1699896357	1699896357	1	1	TAN, RAYMOND C MD APC	2/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	73252	30	Radiology	0	In state provider	None	3850 G STREET	None	MERCED	CA	95340	8787	24	06047	37.33931727	-120.4689461	Merced County
7016	Fee-for-Service	1396050746	1396050746	1	1	THEPYASUWAN, NATTAPAUN N DO	10/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11922	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
7058	Fee-for-Service	1255353629	1255353629	1	1	TAN, RICARDO A MD	9/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	52236	03	Allergy	0	In state provider	None	44726 CERISA ST	None	LANCASTER	CA	93535	1705	19	06037	34.696017	-118.0842535	Los Angeles County
7135	Fee-for-Service	1013198696	1013198696	1	1	TOLIA, VAISHAL M MD	9/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109481	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
7185	Fee-for-Service	1861689705	1861689705	1	1	TROUNG, MAI THY T MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88089	04	Otology, Laryngology, Rhinology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
7198	Fee-for-Service	1366484412	1366484412	1	1	THOMPSON, SUSAN E	7/24/2017	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1775 THOMPSON ROAD	None	COOS BAY	OR	97420	2125	00	None	43.383456	-124.2330435	Coos County
7215	Fee-for-Service	1003116674	1003116674	1	1	TAYLOR, TIFFNEY S DO	12/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11540	41	Internal Medicine	0	In state provider	None	1220 LAS TABLAS RD	SUITE 1418	TEMPLETON	CA	93465	9736	40	06079	35.55442452	-120.7211175	San Luis Obispo County
7234	Fee-for-Service	1508181348	1508181348	1	1	TANG, CINDY S MD	10/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128227	01	General Practice	0	In state provider	None	1000 FRANKLIN PKWY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
7235	Fee-for-Service	1770070906	1770070906	1	1	TYE, ERIK Y MD	10/31/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	163603	20	Orthopedic Surgery	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
7306	Fee-for-Service	1821506478	1821506478	1	2	THOMAS, ALYSHA D LMFT	3/1/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
7309	Fee-for-Service	1497136527	1497136527	1	1	TANIELIAN, ALINE Z PSYD	6/29/2015	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
7323	Fee-for-Service	1013918283	1013918283	1	1	TAN, KENNETH K MD	2/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	44401	08	Family Practice	0	In state provider	None	4900 PROSPECT AVE	None	YORBA LINDA	CA	92886	2128	30	06059	33.88961003	-117.8379389	Orange County
7340	Fee-for-Service	1104966126	1104966126	1	2	TURAKHIA, ATUR MD	4/4/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	100063	-	NOT APPLICABLE	0	In state provider	None	1200 NORTH MAIN ST	STE 100B, 301, 500	SANTA ANA	CA	92701	3640	30	06059	33.755175	-117.8676195	Orange County
7346	Fee-for-Service	1255353629	1255353629	1	1	TAN, RICARDO A MD	9/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	52236	41	Internal Medicine	0	In state provider	None	44726 CERISA ST	None	LANCASTER	CA	93535	1705	19	06037	34.696017	-118.0842535	Los Angeles County
7419	Fee-for-Service	1215129044	1215129044	1	1	TO, THOMAS-DUYTHUC N MD	1/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107659	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
7449	Fee-for-Service	1699888156	1699888156	1	1	TWERSKY, JOY M MD	4/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89925	07	Dermatology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
7538	Fee-for-Service	1083725386	1083725386	1	1	TERRY L ROUNSBORG MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	555 S 70TH STREET	None	LINCOLN	NE	68510	0000	00	None	40.808151	-96.62516802	Lancaster County
7574	Fee-for-Service	1811100548	1811100548	1	1	TOURIEL, ALBERT T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	23176	34	Urology and Urological Surgery	0	In state provider	None	105 S ROWAN AVE	None	LOS ANGELES	CA	90063	2400	19	06037	34.03579844	-118.1870323	Los Angeles County
7617	Fee-for-Service	1508932393	1508932393	1	1	TRUONG, QUYNH HOA T OD A	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PENINSULA OPTOMETRY	19051 GOLDENWEST ST	STE 102	HUNTINGTON BEACH	CA	92648	2156	30	06059	33.68533427	-118.0062792	Orange County
7645	Fee-for-Service	1033191069	1033191069	1	1	TA, VU D MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71030	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
7666	Fee-for-Service	1992334957	1992334957	1	1	TRAN, NICHOLAS MD	8/3/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	186178	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
7670	Fee-for-Service	1750745774	1750745774	1	1	TAGLIAFERRO, THEA MD	7/14/2021	390200000X	NA	Other	026	PHYSICIANS	156939	None	None	0	In state provider	None	300 HILLMONT AVENUE	None	VENTURA	CA	93003	1651	56	06111	34.27771547	-119.2540344	Ventura County
7717	Fee-for-Service	1508348533	1508348533	1	1	TU, DOUGLAS LCSW	8/22/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
7748	Fee-for-Service	1811465768	1811465768	1	1	TAKAOKA-MARTINEAU, KIMBERLY	1/10/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	D	2335 VISTA WAY	None	OCEANSIDE	CA	92054	5663	37	06073	33.18316476	-117.3365251	San Diego County
7753	Fee-for-Service	1023123023	1023123023	1	1	TIONG-KEAT YEOH, 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	500 17TH AVE	None	SEATTLE	WA	98122	5711	00	None	47.60689769	-122.3102467	King County
7771	Fee-for-Service	1093107740	1093107740	1	1	THOMAS, MICHAEL A MD	4/8/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
7787	Fee-for-Service	1972254332	1972254332	1	1	TRIPLEAIM HEALTHCARE	9/8/2022	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
7806	Fee-for-Service	1104572007	1104572007	1	1	TOLMIE, SIMONE E CNM	8/24/2022	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	583 SUMMERFIELD RD	None	SANTA ROSA	CA	95405	5239	49	06097	38.45268	-122.672088	Sonoma County
7817	Fee-for-Service	1588058184	1588058184	1	1	TIEN, VIVIAN MD	9/11/2020	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	145002	77	Infectious Disease	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
7828	Fee-for-Service	1851851117	1851851117	1	1	TOTAL RENAL CARE INC	1/8/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1503 E MAIN ST	None	SANTA MARIA	CA	93458	4803	42	06083	34.95289773	-120.4110133	Santa Barbara County
7832	Fee-for-Service	1720019995	1720019995	1	1	TENET HEALTHSYSTEM	12/24/2005	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	NORTHSHORE INC	1100 NW 95TH ST	None	MIAMI	FL	33150	2038	00	None	25.859304	-80.214633	Miami-Dade County
7862	Fee-for-Service	1750365771	1750365771	1	1	TSUEI, FRANK M DC INC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	ADVANCED CHIROMED FAMILY	19119 COLIMA RD	STE 107	ROWLAND HEIGHTS	CA	91748	3055	19	06037	33.98733841	-117.8859459	Los Angeles County
7923	Fee-for-Service	1508887720	1508887720	1	1	TARAKCHYAN, VARTAN MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	73766	05	Anesthesiology	0	In state provider	None	2701 W ALAMEDA AVE	STE 203	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
7941	Fee-for-Service	1265643969	1265643969	1	1	THOMAS, SETH C MD	7/13/2009	207P00000X	NA	Other	026	PHYSICIANS	10072	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
7983	Fee-for-Service	1013118454	1013118454	1	1	TARAMAN, SHARIEF K MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116566	79	Neurology-Child	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
8045	Fee-for-Service	1972996601	1972996601	1	1	THATCH, ALLISON	3/7/2015	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2941 N DANTE AVE	None	FRESNO	CA	93722	0407	10	06019	36.77809044	-119.8843573	Fresno County
8048	Fee-for-Service	1770589517	1770589517	1	1	TEDFORD, PATRICK MD INC	1/31/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	24629	40	Pediatrics	0	In state provider	None	643 W EAST AVE	None	CHICO	CA	95926	7201	04	06007	39.75013896	-121.8723855	Butte County
8073	Fee-for-Service	1144262452	1144262452	1	1	TU, MARK K MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60238	None	None	0	In state provider	None	1001 POTRERO AVE	# 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
8077	Fee-for-Service	1932598737	1932598737	1	1	TRINH, BRIAN MD	7/6/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	152888	None	None	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
8081	Fee-for-Service	1841784675	1841784675	1	1	TARANTINO, RACHEL L LCSW	2/28/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11230 SORRENTO VALLEY RD	STE 220	SAN DIEGO	CA	92121	1300	37	06073	32.90734306	-117.2281918	San Diego County
8106	Fee-for-Service	1588058184	1588058184	1	1	TIEN, VIVIAN MD	9/11/2020	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	145002	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
8109	Fee-for-Service	1528060100	1528060100	1	1	TREMOULET, PAUL-THOMAS	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76789	66	Emergency Medicine (Urgent Care)	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
8120	Fee-for-Service	1720019995	1720019995	1	1	TENET HEALTHSYSTEM	12/24/2005	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	NORTHSHORE INC	1100 NW 95TH ST	None	MIAMI	FL	33150	2038	00	None	25.859304	-80.214633	Miami-Dade County
8127	Fee-for-Service	1073582888	1073582888	1	1	THE REGENTS OF THE UNIVERSIT	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	200 MED PLAZA STE 430	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
8132	Fee-for-Service	1710349402	1710349402	1	1	TANNER, COLBY MD	2/25/2020	207L00000X	NA	Other	026	PHYSICIANS	153377	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
8167	Fee-for-Service	1467915959	1467915959	1	1	TALMADGE, ROJEAN L LMFT	2/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1881 COMMERCENTER DRIVE	SUITE 232	SAN BERNARDINO	CA	92408	3479	36	06071	34.06789529	-117.2822533	San Bernardino County
8172	Fee-for-Service	1063654978	1063654978	1	1	TAN, KEVIN S MD	8/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114778	18	Ophthalmology	0	In state provider	None	3939 THIRD AVENUE	None	SAN DIEGO	CA	92103	3002	37	06073	32.74905668	-117.16268	San Diego County
8226	Fee-for-Service	1801930201	1801930201	1	1	THIEN NGUYEN	3/4/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1035 116TH AVE NE	None	BELLEVUE	WA	98004	4604	00	None	47.620296	-122.1856955	King County
8247	Fee-for-Service	1942344791	1942344791	1	1	TORREY PINES ORTHOPAEDIC	6/26/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	MEDICAL GROUP INC	9850 GENESEE AVE	STE 210	LA JOLLA	CA	92037	1206	37	06073	32.882913	-117.226341	San Diego County
8263	Fee-for-Service	1629385927	1629385927	1	1	TAN, JUSTIN H J MD	10/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113634	30	Radiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
8292	Fee-for-Service	1689859662	1689859662	1	1	TAYLOR, AISHA R MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102253	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8120 TIMBERLAKE WAY	None	SACRAMENTO	CA	95823	5413	34	06067	38.461023	-121.41414	Sacramento County
8336	Fee-for-Service	1972996601	1972996601	1	1	THATCH, ALLISON	3/7/2015	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2941 N DANTE AVE	None	FRESNO	CA	93722	0407	10	06019	36.77809044	-119.8843573	Fresno County
8353	Fee-for-Service	1619070273	1619070273	1	1	TAKAO, LLOYD H MD	12/29/2010	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	29936	40	Pediatrics	0	In state provider	None	1332 PARK ST	STE 200	ALAMEDA	CA	94501	4417	01	06001	37.76330843	-122.2435444	Alameda County
8401	Fee-for-Service	1568538502	1568538502	1	1	TOMINA, SOFIA G LCSW	7/11/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
8405	Fee-for-Service	1144652496	1144652496	1	1	TSE, JAMES DO	1/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13626	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
8418	Fee-for-Service	1376637249	1376637249	1	1	THOMPSON, ANGELA M CRNA	6/14/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
8427	Fee-for-Service	1871666735	1871666735	1	1	TIWARI, PIYUSH MD	9/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142011	10	Gastroenterology (M.D. only)	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
8485	Fee-for-Service	1982690954	1982690954	1	1	TRAN, HAI T DPM	10/27/2011	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	6244 EL CAJON BLVD	STE 29	SAN DIEGO	CA	92115	3918	37	06073	32.76342577	-117.0636924	San Diego County
8486	Fee-for-Service	1326212994	1326212994	1	1	TSINBERG, MICHAEL MD	11/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117189	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
8498	Fee-for-Service	1063068930	1063068930	1	3	TAHOE FOREST HOSPITAL DISTRI	2/28/2020	207Q00000X	NA	Adult Primary Care	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CLINICS PRIMARY CARE	925 NORTH LAKE BLVD	102B	TAHOE CITY	CA	96145	0000	31	06061	39.17441644	-120.1374812	Placer County
8509	Fee-for-Service	1184609836	1184609836	1	1	THOM, WAYNE S MD	8/28/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	33247	08	Family Practice	0	In state provider	None	4241 FLORIN RD STE 40	STE 40	SACRAMENTO	CA	95823	2535	34	06067	38.496816	-121.4582625	Sacramento County
8516	Fee-for-Service	1710111653	1710111653	1	1	TAYLOR, JARED R DO	7/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12129	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
8530	Fee-for-Service	1750931036	1750931036	1	1	TADEMARU, STEPHANIE H AU	4/30/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	175 N JACKSON AVE	STE 204	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
8555	Fee-for-Service	1497173579	1497173579	1	1	TENG, ALEXANDRA E MD	9/23/2021	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	141282	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
8578	Fee-for-Service	1922416338	1922416338	1	1	TITTLE, ANNE W	8/24/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	403 W ADAMS BLVD	4TH FLOOR	LOS ANGELES	CA	90007	2664	19	06037	34.02741539	-118.2743622	Los Angeles County
8616	Fee-for-Service	1174567051	1174567051	1	1	TABAS, JEFFREY A MD	12/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	76933	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
8634	Fee-for-Service	1164502035	1164502035	1	1	TKACH, LAWRENCE V MD	1/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	46691	20	Orthopedic Surgery	0	In state provider	None	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
8679	Fee-for-Service	1538579370	1538579370	1	1	THINDA, NITIN MD	12/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147972	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LN	STE 280	FRESNO	CA	93721	2211	10	06019	36.74333844	-119.7831874	Fresno County
8722	Fee-for-Service	1962909929	1962909929	1	1	TRAN, ANDREW M MD	4/22/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	187164	77	Infectious Disease	0	In state provider	None	400 PEPPER	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
8729	Fee-for-Service	1700946977	1700946977	1	1	TRAN, THIEN T CRNA	11/9/2010	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
8730	Fee-for-Service	1639128556	1639128556	1	1	TANIOS, MAGED A MD	5/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74946	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3605 LONG BEACH BLVD	STE 405	LONG BEACH	CA	90807	4026	19	06037	33.822693	-118.1893765	Los Angeles County
8752	Fee-for-Service	1619952397	1619952397	1	2	TUOLUMNE MEWUK INDIAN HEALTH	5/17/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	18451 CARTER STREET	None	TUOLUMNE	CA	95379	9715	55	06109	37.95717262	-120.2362329	Tuolumne County
8766	Fee-for-Service	1568968402	1568968402	1	1	TETTEH, GILBERT MD	9/2/2022	207P00000X	NA	Other	026	PHYSICIANS	176288	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
8790	Fee-for-Service	1609325430	1609325430	1	1	TOM, CASSANDRA CNP	3/10/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4950 BARRANCA PARKWAY	SUITE 104	IRVINE	CA	92604	4630	30	06059	33.67620851	-117.7948348	Orange County
8801	Fee-for-Service	1972798098	1972798098	1	1	TRUONG, DONNA PSYD	5/8/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2373 COLORADO BOULEVARD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
8817	Fee-for-Service	1245734151	1245734151	1	1	TRAN, ANNIE T MD	10/28/2022	207L00000X	NA	Other	026	PHYSICIANS	166201	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
8840	Fee-for-Service	1104100221	1104100221	1	1	THORNG, SEIHA DPM	6/5/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2545 W HAMMER LN	None	STOCKTON	CA	95209	2839	39	06077	38.0214303	-121.3461515	San Joaquin County
8855	Fee-for-Service	1457578866	1457578866	1	1	THOGARUCHEETI, ANIL B MD	10/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144772	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
8861	Fee-for-Service	1942393384	1942393384	3	1	TOWERS PHARMACY INC	5/3/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5451 LA PALMA AVE	STE 17	LA PALMA	CA	90623	1729	30	06059	33.84643146	-118.038843	Orange County
8907	Fee-for-Service	1174567051	1174567051	1	1	TABAS, JEFFREY A MD	12/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	76933	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
8975	Fee-for-Service	1669751095	1669751095	1	1	TRAN, THAI OD	10/22/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1500 ADAMS AVE	SUITE 102	COSTA MESA	CA	92626	3864	30	06059	33.67333707	-117.9208053	Orange County
8976	Fee-for-Service	1679116586	1679116586	1	1	THOMAS, KANDACE OT	4/4/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
8992	Fee-for-Service	1336489657	1336489657	1	1	TYSON, HEATHER L	10/21/2013	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
8996	Fee-for-Service	1760801476	1760801476	1	1	TAWFIK, REEM MD	4/13/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	170137	None	None	0	In state provider	None	1850 W. FLORIDA AVE.	None	HEMET	CA	92545	6738	33	06065	33.74751552	-116.991432	Riverside County
9012	Fee-for-Service	1962909929	1962909929	1	1	TRAN, ANDREW M MD	4/22/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	187164	41	Internal Medicine	0	In state provider	None	400 PEPPER	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
9017	Fee-for-Service	1639128556	1639128556	1	1	TANIOS, MAGED A MD	5/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74946	41	Internal Medicine	0	In state provider	None	3605 LONG BEACH BLVD	STE 405	LONG BEACH	CA	90807	4026	19	06037	33.822693	-118.1893765	Los Angeles County
9023	Fee-for-Service	1528177060	1528177060	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05880	540 CANAL ST	None	KING CITY	CA	93930	3446	27	06053	36.20464214	-121.1304059	Monterey County
9037	Fee-for-Service	1891098505	1891098505	1	1	THOMPSON, DAVID C MD	5/3/2019	208600000X	NA	General Surgery	026	PHYSICIANS	28583	02	General Surgery	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
9041	Fee-for-Service	1619952397	1619952397	1	2	TUOLUMNE MEWUK INDIAN HEALTH	10/30/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	18451 CARTER STREET	None	TUOLUMNE	CA	95379	9715	55	06109	37.95717262	-120.2362329	Tuolumne County
9051	Fee-for-Service	1114998515	1114998515	1	1	TINDALL, RICHARD S MD	2/8/2015	2084N0400X	NA	Neurology	026	PHYSICIANS	21619	13	Neurology (M.D. only)	0	In state provider	None	399 E HIGHLAND AVE	STE 511	SAN BERNARDINO	CA	92404	3825	36	06071	34.1358627	-117.2757898	San Bernardino County
9060	Fee-for-Service	1497434260	1497434260	1	1	TUAZON, AMANDA NP	4/17/2025	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
9154	Fee-for-Service	1558600593	1558600593	2	1	TPCRX INC	6/8/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1513 S GRAND AVE	STE 100	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
9165	Fee-for-Service	1033352984	1033352984	1	1	TEACHER, ERIC T MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113183	None	None	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
9188	Fee-for-Service	1760412845	1760412845	1	1	TAKHER, SUKHDDEP S OD	4/1/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1145 COLUSA AVE	STE C	YUBA CITY	CA	95993	5259	51	06101	39.14185356	-121.6322619	Sutter County
9227	Fee-for-Service	1982790325	1982790325	1	1	THOMPSON M WILLIAMS MD	2/7/2010	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
9323	Fee-for-Service	1619952397	1619952397	1	1	TUOLUMNE MEWUK INDIAN HEALTH	12/21/2005	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER, INC	18880 CHERRY VALLEY BLVD	None	TUOLUMNE	CA	95379	9506	55	06109	37.96511668	-120.2399015	Tuolumne County
9338	Fee-for-Service	1043512130	1043512130	1	1	TUCKER, TAMARA LCSW	4/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	70634	-	NOT APPLICABLE	0	In state provider	None	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	19	06037	34.007238	-118.2653065	Los Angeles County
9347	Fee-for-Service	1730143454	1730143454	1	1	THE REGENTS OF THE UNIVERSIT	1/1/1994	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	UNIVERSITY OF CALIFORNIA	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
9362	Fee-for-Service	1346355401	1346355401	1	1	TRAN, KATHY OD	9/21/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
9380	Fee-for-Service	1518194836	1518194836	1	1	TRAN, LINH L MD	8/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	116719	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DR	MC:5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
9402	Fee-for-Service	1225055742	1225055742	1	1	TRAN, KHANH P MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62648	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1111 W LA PALMA AVE	None	ANAHEIM	CA	92801	2804	30	06059	33.84718298	-117.933758	Orange County
9440	Fee-for-Service	1962689406	1962689406	1	1	TAVENER, MICHELLE D NP	9/29/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	670 SIERRA ROSE DR	None	RENO	NV	89511	2072	00	None	39.4735137	-119.7995156	Washoe County
9458	Fee-for-Service	1417387234	1417387234	1	1	TSAI, CONNIE OD	10/15/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15333 CULVER DR	SUITE 690	IRVINE	CA	92604	7143	30	06059	33.69534179	-117.7972555	Orange County
9469	Fee-for-Service	1720361116	1720361116	1	1	TAYLOR, TABITHA S LMFT	8/17/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1611 PACIFIC COAST HWY	None	REDONDO BEACH	CA	90277	5606	19	06037	33.81973754	-118.3853919	Los Angeles County
9528	Fee-for-Service	1396789426	1396789426	1	1	TURETSKY, DAVID L OD	9/20/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	377 E CHAPMAN AVE	STE 240	PLACENTIA	CA	92870	5091	30	06059	33.87122847	-117.8635161	Orange County
9569	Fee-for-Service	1467738963	1467738963	1	1	TAKANG, ERNEST NP	3/17/2021	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	5493 STONEVIEW RD	None	RANCHO CUCAMONGA	CA	91739	8933	36	06071	34.15424712	-117.5318491	San Bernardino County
9575	Fee-for-Service	1275516288	1275516288	1	1	TAFLER, ALAN	6/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 OCEAN PARKWAY	None	BROOKLYN	NY	11235	7745	00	None	40.586031	-73.9657305	Kings County
9612	Fee-for-Service	1619952397	1619952397	1	1	TUOLUMNE MEWUK INDIAN HEALTH	5/17/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER, INC	18880 CHERRY VALLEY BLVD	None	TUOLUMNE	CA	95379	9506	55	06109	37.96511668	-120.2399015	Tuolumne County
9614	Fee-for-Service	1376595975	1376595975	1	1	TRUONG, ANH T OD	2/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	EYE ZONE OPTOMETRY	3871 PACIFIC COAST HWY	None	TORRANCE	CA	90505	5915	19	06037	33.80610618	-118.3536072	Los Angeles County
9616	Fee-for-Service	1356511729	1356511729	1	1	TINCOPA, MONICA A MD	10/12/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	173083	None	None	0	In state provider	None	15503 VENTURA BLVD	240, 340, 350	ENCINO	CA	91436	3115	19	06037	34.15483303	-118.4722163	Los Angeles County
9638	Fee-for-Service	1730143454	1730143454	1	1	THE REGENTS OF THE UNIVERSIT	1/1/1994	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	UNIVERSITY OF CALIFORNIA	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
9641	Fee-for-Service	1558523670	1558523670	1	1	TSENG, TONY K MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130532	41	Internal Medicine	0	In state provider	None	11525 BROOKSHIRE AVE	STE 400	DOWNEY	CA	90241	4982	19	06037	33.93544635	-118.1318321	Los Angeles County
9651	Fee-for-Service	1952798670	1952798670	1	1	TJHO, STEPHANIE MD	5/3/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	146339	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
9676	Fee-for-Service	1134285331	1134285331	1	1	TZVIELI, ORI MD	1/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76711	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
9684	Fee-for-Service	1871317271	1871317271	1	1	TAFOLLA, CELESTE PT	12/16/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1700 KEYSTONE PACIFIC PK	STE C2	PATTERSON	CA	95363	8874	50	06099	37.47600952	-121.160718	Stanislaus County
9694	Fee-for-Service	1598799751	1598799751	1	2	TALK TO ME TECHNOLOGIES LLC	6/30/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1100 TECHNOLOGY PARKWAY	None	CEDAR FALLS	IA	50613	6955	00	None	42.47325031	-92.4580809	Black Hawk County
9698	Fee-for-Service	1194250431	1194250431	1	1	TRINH, SHAUNA	11/5/2024	2086S0129X	NA	General Surgery	026	PHYSICIANS	158517	02	General Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
9703	Fee-for-Service	1992402416	1992402416	1	1	THE EMMADA INSTITUTE OF BEHA	12/9/2024	103T00000X	NA	Mental Health Outpatient Services	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	VIORAL HEALTH AND WELL	8939 S SEPULVEDA BLVD	200	LOS ANGELES	CA	90045	3667	19	06037	33.95485856	-118.3962461	Los Angeles County
9707	Fee-for-Service	1396240289	1396240289	1	1	TAI, HAITONG MD	9/7/2021	207R00000X	NA	Other	026	PHYSICIANS	165310	None	None	0	In state provider	None	1221 E SPRUCE AVE	None	FRESNO	CA	93720	3374	10	06019	36.84197867	-119.761714	Fresno County
9721	Fee-for-Service	1215366851	1215366851	1	1	THOMAS, NYSSA C NP	6/15/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
9727	Fee-for-Service	1578657292	1578657292	1	1	TAM, SIU MING MD	1/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	76271	30	Radiology	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
9740	Fee-for-Service	1528027349	1528027349	1	1	TOTAL RENAL CARE, INC	12/1/1998	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1610 W KETTLEMAN LANE	STE D	LODI	CA	95242	4210	39	06077	38.11535057	-121.2928749	San Joaquin County
9767	Fee-for-Service	1417101908	1417101908	1	3	TOM YANG, M.D., INC.	5/8/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	None	45	Nephrology (Renal-Kidney)	0	In state provider	None	255 W HERNDON AVE	103	CLOVIS	CA	93612	0318	10	06019	36.83766353	-119.7141345	Fresno County
9769	Fee-for-Service	1174972517	1174972517	1	1	TOBIAS, CLAIRE J MD	9/10/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168476	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
9807	Fee-for-Service	1629492897	1629492897	1	1	TOLENTINO, MARIA L NP	7/7/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
9839	Fee-for-Service	1356313167	1356313167	1	1	THOMPSON, MICHAEL A MD	6/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88489	46	Hand Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
9847	Fee-for-Service	1467738963	1467738963	1	1	TAKANG, ERNEST NP	3/17/2021	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	5493 STONEVIEW RD	None	RANCHO CUCAMONGA	CA	91739	8933	36	06071	34.15424712	-117.5318491	San Bernardino County
9879	Fee-for-Service	1629825468	1629825468	1	1	TAYLOR, TY-JUANA LCSW	10/24/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1307 6TH ST	108	CORONA	CA	92882	3294	33	06065	33.87790309	-117.589666	Riverside County
9885	Fee-for-Service	1063582872	1063582872	1	1	THRIFTY PAYLESS INC	2/2/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6482	15331 BASELINE AVE	None	FONTANA	CA	92336	5773	36	06071	34.12131154	-117.4699395	San Bernardino County
9908	Fee-for-Service	1750335824	1750335824	1	1	TENDER LOVING CARE HEALTH	2/14/2005	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE SERVICES WESTERN	1350 BAYSHORE HWY	SUITE 777	BURLINGAME	CA	94010	1816	41	06081	37.59463917	-122.3645784	San Mateo County
9921	Fee-for-Service	1831544196	1831544196	3	1	TJONG, WILLY W MD	7/6/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	173468	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
9928	Fee-for-Service	1487606711	1487606711	1	1	TRAN, HOANG N MD	5/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80012	20	Orthopedic Surgery	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
9960	Fee-for-Service	1568407310	1568407310	1	1	THE HEALTH AND HOSPITAL CORP	1/9/2014	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORP OF MARION COUNTY	720 ESKENAZI AVE	None	INDIANAPOLIS	IN	46202	5166	00	None	39.77775316	-86.18286549	Marion County
9991	Fee-for-Service	1265647556	1265647556	1	1	THRIFTY PAYLESS INC	7/9/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	900 SUNRISE AVE	None	ROSEVILLE	CA	95661	4507	31	06061	38.73137607	-121.2720884	Placer County
10005	Fee-for-Service	1750677886	1750677886	1	1	TERESA LYNN MOORE	1/27/2011	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	730 BREEZE HILL RD	#284	VISTA	CA	92081	4317	37	06073	33.1876653	-117.2562975	San Diego County
10009	Fee-for-Service	1346683489	1346683489	1	1	TAN, CRYSTAL E MD	8/26/2019	207L00000X	NA	Other	026	PHYSICIANS	161886	05	Anesthesiology	0	In state provider	None	CLAY AND BUCHANNAN ST	None	SAN FRANCISCO	CA	94115	0000	38	06075	37.791126	-122.4309105	San Francisco County
10019	Fee-for-Service	1215460647	1215460647	1	1	TRAN, NGOC-ANH T MD	2/4/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175702	None	None	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
10096	Fee-for-Service	1215695531	1215695531	1	1	THORNHILL, ANGELA	10/23/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
10122	Fee-for-Service	1467561993	1467561993	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05865	2011 W SHAW AVE	None	FRESNO	CA	93711	3404	10	06019	36.80815353	-119.8270395	Fresno County
10125	Fee-for-Service	1275581001	1275581001	1	1	TSANG, LINDA E MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61696	None	None	0	In state provider	None	412 W CARROLL AVE	STE 204	GLENDORA	CA	91741	4711	19	06037	34.13415622	-117.8702547	Los Angeles County
10132	Fee-for-Service	1356313167	1356313167	1	1	THOMPSON, MICHAEL A MD	6/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88489	20	Orthopedic Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
10154	Fee-for-Service	1316400542	1316400542	1	1	TERBIO, PAULINE EMMANUELLE Y	7/21/2022	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	DO	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
10159	Fee-for-Service	1033248885	1033248885	1	1	TAETZSCH, WILLIAM J PHD	4/7/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	188 COHASSET LN	None	CHICO	CA	95926	2206	04	06007	39.75016217	-121.8525872	Butte County
10176	Fee-for-Service	1538696778	1538696778	1	1	TRAN, DERRICK MD	5/15/2024	2085R0204X	NA	Other	026	PHYSICIANS	190232	30	Radiology	0	In state provider	None	4501 BIRCH STREET	None	NEWPORT BEACH	CA	92660	1990	30	06059	33.66902484	-117.8655315	Orange County
10193	Fee-for-Service	1760877922	1760877922	1	1	TIMBANG, MARY ROZ MD	8/16/2022	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	144389	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
10201	Fee-for-Service	1669975462	1669975462	1	1	TAN, WAYLEE MD	10/11/2021	207R00000X	NA	Other	026	PHYSICIANS	166239	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
10204	Fee-for-Service	1649295734	1649295734	1	1	TASK SUPPLY CORP	1/27/2022	332BX2000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1333 FLATBUSH AVE	None	BROOKLYN	NY	11226	7680	00	None	40.638717	-73.9536705	Kings County
10245	Fee-for-Service	1578967717	1578967717	1	2	TARIQ JAVED, MD INC.	1/27/2015	207RN0300X	NA	Nephrology	026	PHYSICIANS	102388	None	None	0	In state provider	None	390 PEARSON DR	None	PORTERVILLE	CA	93257	3368	54	06107	36.07297342	-119.0275758	Tulare County
10248	Fee-for-Service	1568407310	1568407310	1	1	THE HEALTH AND HOSPITAL CORP	9/30/2007	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORP OF MARION COUNTY	720 ESKENAZI AVE	None	INDIANAPOLIS	IN	46202	5166	00	None	39.77775316	-86.18286549	Marion County
10261	Fee-for-Service	1821107343	1821107343	1	2	THRIFTY PAYLESS INC	11/7/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4525 E PACIFIC COAST HWY	None	LONG BEACH	CA	90804	3228	19	06037	33.78807533	-118.1398784	Los Angeles County
10283	Fee-for-Service	1578554986	1578554986	1	1	TEJAVANIJA, PHET-YOON MD	8/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89277	08	Family Practice	0	In state provider	None	24355 LYONS AVE	STE 210	SANTA CLARITA	CA	91321	2381	19	06037	34.37868281	-118.5605291	Los Angeles County
10325	Fee-for-Service	1033529912	1033529912	1	1	TURKMANI-BAZZI, SOPHIA MD	6/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137680	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
10351	Fee-for-Service	1790955300	1790955300	1	1	TA, WILLIAM C MD	8/11/2020	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	118947	08	Family Practice	0	In state provider	None	515 MICHIGAN BLVD	None	WEST SACRAMENTO	CA	95691	2705	57	06113	38.58298316	-121.5265736	Yolo County
10354	Fee-for-Service	1114108800	1114108800	1	1	THOMPSON, KADEE E MD	7/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115983	34	Urology and Urological Surgery	0	In state provider	None	2702 LOW CT	None	FAIRFIELD	CA	94534	9771	48	06095	38.23678474	-122.0847463	Solano County
10369	Fee-for-Service	1891764536	1891764536	1	1	THRUN, CAROL J	1/1/1979	207R00000X	NA	Other	026	PHYSICIANS	28687	None	None	0	In state provider	None	10 CONGRESS ST	STE 203	PASADENA	CA	91105	3023	19	06037	34.13396893	-118.1528162	Los Angeles County
10440	Fee-for-Service	1174545206	1174545206	1	1	THRIFTY DRUG STORE 6095	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6424 WESTSIDE RD	None	REDDING	CA	96001	4833	45	06089	40.52111546	-122.3824845	Shasta County
10473	Fee-for-Service	1487851408	1487851408	1	1	TRAN, HIEN T MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104847	07	Dermatology	0	In state provider	None	200 W ARBOR	None	SAN DIEGO	CA	92120	3900	37	06073	32.7537975	-117.1658298	San Diego County
10488	Fee-for-Service	1902425861	1902425861	1	1	TANG, JESSICA MD	10/30/2023	207R00000X	NA	Other	026	PHYSICIANS	183651	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
10496	Fee-for-Service	1194784785	1194784785	1	1	TETEF, MERRY L	10/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	64196	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
10506	Fee-for-Service	1164809539	1164809539	1	1	TAYLOR, JASMINE E	2/11/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4131 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3101	38	06075	37.78096053	-122.4637512	San Francisco County
10537	Fee-for-Service	1174544571	1174544571	1	1	TOBIAS, JUSTIN S MD	5/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82042	05	Anesthesiology	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
10548	Fee-for-Service	1457363798	1457363798	1	1	THORDARSON, DAVID B MD	8/31/1987	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	56184	20	Orthopedic Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
10557	Fee-for-Service	1992963961	1992963961	1	1	TARASOFF, GREGORY J MD	4/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	60464	36	Psychiatry	0	In state provider	None	2001 JUNIPERO SERRA BLVD	SUITE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
10558	Fee-for-Service	1962511311	1962511311	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05568	17266 SATICOY ST	None	VAN NUYS	CA	91406	2103	19	06037	34.20838952	-118.509489	Los Angeles County
10583	Fee-for-Service	1598843377	1598843377	1	1	TANOUYE, CHERYL A MD	2/28/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	53087	01	General Practice	0	In state provider	None	1999 MOWRY AVE	None	FREMONT	CA	94538	1738	01	06001	37.55783419	-121.9808484	Alameda County
10620	Fee-for-Service	1841484391	1841484391	1	2	TRI MINH NGUYEN MD INC	12/13/2022	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	11100 WARNER AVE	104	FOUNTAIN VALLEY	CA	92708	7506	30	06059	33.716291	-117.9355051	Orange County
10630	Fee-for-Service	1417432840	1417432840	1	1	THE CHARLOTTE-MECKLENBURG HO	2/16/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	10628 PARK RD	None	CHARLOTTE	NC	28210	8407	00	None	35.091657	-80.8716195	Mecklenburg County
10656	Fee-for-Service	1346473006	1346473006	1	1	TIRIC, DZENANA LMFT	5/23/2022	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
10658	Fee-for-Service	1982764361	1982764361	1	1	TAN, CHEE-KEN MD	6/14/2005	207L00000X	NA	Other	026	PHYSICIANS	31938	05	Anesthesiology	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
10692	Fee-for-Service	1447308390	1447308390	1	1	TABAK, MICHAEL A MD	5/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	46953	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
10701	Fee-for-Service	1366904997	1366904997	1	1	TSOU, PETER MD	10/4/2022	207P00000X	NA	Other	026	PHYSICIANS	179400	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
10729	Fee-for-Service	1023127305	1023127305	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5505	12319 NORWALK BLVD	None	NORWALK	CA	90650	2039	19	06037	33.919101	-118.072699	Los Angeles County
10770	Fee-for-Service	1851400204	1851400204	1	1	THRIFTY PAYLESS INC	12/29/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5759	111 N MAIN ST	None	SANTA ANA	CA	92701	5210	30	06059	33.745986	-117.8676115	Orange County
10818	Fee-for-Service	1831206812	1831206812	1	1	THOMPSON, GEORGE R III MD	10/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109280	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
10827	Fee-for-Service	1689791741	1689791741	1	1	TEWARI, ARPANA G MD	12/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
10870	Fee-for-Service	1023033792	1023033792	1	1	TENET HEALTH SYSTEM	11/20/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HAHNEMANN, LLC	BROAD & VINE	None	PHILADELPHIA	PA	19102	0000	00	None	39.957714	-75.1624515	Philadelphia County
10910	Fee-for-Service	1508127879	1508127879	1	1	TALAVERA, YESENIA MFT	7/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	STE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
10919	Fee-for-Service	1417432840	1417432840	1	1	THE CHARLOTTE-MECKLENBURG HO	2/16/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	10628 PARK RD	None	CHARLOTTE	NC	28210	8407	00	None	35.091657	-80.8716195	Mecklenburg County
10925	Fee-for-Service	1265477731	1265477731	1	1	TORCHIA, JULIE A	11/21/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
10934	Fee-for-Service	1760770366	1760770366	1	1	TEHRANI, NILOUFAR MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122194	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
10937	Fee-for-Service	1043220502	1043220502	1	1	THISTLE, RICHARD E MD	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	41839	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
10954	Fee-for-Service	1295938553	1295938553	1	1	TITUS, GREGORY P MD	6/20/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
11048	Fee-for-Service	1740274018	1740274018	1	1	TIEN, HUEY YUAN MD	9/27/2022	2086S0105X	NA	General Surgery	026	PHYSICIANS	181073	None	None	0	In state provider	None	2300 W SUNNYSIDE AVE	None	VISALIA	CA	93277	7287	54	06107	36.303597	-119.316294	Tulare County
11070	Fee-for-Service	1063497212	1063497212	1	1	TALLAKSON, WILLIAM A MD	1/31/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84686	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
11092	Fee-for-Service	1700085586	1700085586	1	1	TUOT, DELPHINE S MD	4/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99413	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
11101	Fee-for-Service	1386751188	1386751188	1	1	TALWAR, INDU MD	4/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	56156	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
11159	Fee-for-Service	1023033792	1023033792	1	1	TENET HEALTH SYSTEM	11/20/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HAHNEMANN, LLC	BROAD & VINE	None	PHILADELPHIA	PA	19102	0000	00	None	39.957714	-75.1624515	Philadelphia County
11165	Fee-for-Service	1407845969	1407845969	2	1	TRAM PHAM PHARMD, INC	6/3/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15735 HAWTHORNE	110	LAWNDALE	CA	90260	2664	19	06037	33.887664	-118.3527595	Los Angeles County
11190	Fee-for-Service	1548459282	1548459282	1	1	TEISMANN, NATHAN A MD	2/25/2008	207P00000X	NA	Other	026	PHYSICIANS	95888	66	Emergency Medicine (Urgent Care)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94511	5642	01	06001	37.8242017	-122.2578306	Alameda County
11198	Fee-for-Service	1962663138	1962663138	1	1	TULARE DISTRICT	7/31/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	869 N CHERRY ST	None	TULARE	CA	93274	2207	54	06107	36.220932	-119.337698	Tulare County
11237	Fee-for-Service	1528146198	1528146198	1	1	THOMAS, CHERYL L CNM	9/15/2023	363LX0001X	NA	Nurse Practitioner	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
11296	Fee-for-Service	1689783045	1689783045	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11340 CRENSHAW BLVD	None	INGLEWOOD	CA	90303	2807	19	06037	33.9315435	-118.3263509	Los Angeles County
11307	Fee-for-Service	1144400656	1144400656	1	1	THORNE, OLGA P MD	6/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106908	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 S WELLS RD	STE 100	VENTURA	CA	93004	1302	56	06111	34.29321532	-119.1597424	Ventura County
11316	Fee-for-Service	1053854612	1053854612	1	1	TILLAY, SARAH E 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
11336	Fee-for-Service	1508204652	1508204652	1	1	THOMPSON, SHARON K PHD	12/1/2014	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6540 LUSK BLVD	STE C277	SAN DIEGO	CA	92121	2783	37	06073	32.90160951	-117.2021882	San Diego County
11382	Fee-for-Service	1700085586	1700085586	1	1	TUOT, DELPHINE S MD	4/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99413	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
11384	Fee-for-Service	1376724005	1376724005	1	1	TIAN, WENQIANG MD	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	105362	13	Neurology (M.D. only)	0	In state provider	None	23430 HAWTHORNE BLVD	SUITE 105, BLDG 3	TORRANCE	CA	90505	4777	19	06037	33.81316465	-118.3510077	Los Angeles County
11387	Fee-for-Service	1194408468	1194408468	1	1	TERBIO, IMMANUEL Y PT	8/17/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7525 METROPOLITAN DR	STE 306	SAN DIEGO	CA	92108	4404	37	06073	32.77677653	-117.1592911	San Diego County
11398	Fee-for-Service	1245531607	1245531607	1	2	THARAYIL, MITHU M MD	11/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	121045	01	General Practice	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
11447	Fee-for-Service	1871689372	1871689372	1	1	TRAN, HUNG D MD	4/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	81260	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
11461	Fee-for-Service	1215103304	1215103304	1	2	TORRES, REBECCA MD AMC	11/14/2014	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	31946 MISSION TRAIL	STE A	LAKE ELSINORE	CA	92530	4539	33	06065	33.65640803	-117.2979656	Riverside County
11472	Fee-for-Service	1427390186	1427390186	1	1	TIAN, DAVID C MD	10/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134437	41	Internal Medicine	0	In state provider	None	1411 EAST 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
11556	Fee-for-Service	1376106336	1376106336	1	1	TANGONAN, KATHLEDA MD	9/26/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181986	None	None	0	In state provider	None	251 TURNPIKE	None	FOLSOM	CA	95630	0000	34	06067	38.654946	-121.170537	Sacramento County
11613	Fee-for-Service	1316031438	1316031438	1	1	TORRANCE PATHOLOGY ASSC	1/1/1985	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
11632	Fee-for-Service	1538233572	1538233572	1	1	TERUYA, THEODORE MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71912	None	None	0	In state provider	None	11370 ANDERSON ST	# 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
11694	Fee-for-Service	1538253869	1538253869	1	1	THOMAS ROBINSON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13199 E MONTVIEW BLVD	PO BOX 111719	AURORA	CO	80042	1719	00	None	39.748041	-104.834673	Adams County
11751	Fee-for-Service	1386910636	1386910636	1	1	TAN, TERESA P	8/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142220	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
11807	Fee-for-Service	1275888026	1275888026	1	1	TODD M. SCHOENBERGER	9/11/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 W 8TH AVE	None	SPOKANE	WA	99204	2307	00	None	47.647989	-117.4112415	Spokane County
11850	Fee-for-Service	1295944023	1295944023	1	1	THERAPEUTIC LIVING CENTERS	11/27/2006	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR TNE BLIND	8808 WOODLEY AVE	None	NORTH HILLS	CA	91343	4732	19	06037	34.2304681	-118.4850879	Los Angeles County
11856	Fee-for-Service	1598911695	1598911695	1	1	TAKEHANA, CHRISTOPHER S MD	2/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108849	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
11933	Fee-for-Service	1801831227	1801831227	1	1	TULARE COUNTY HLTH SVS	6/18/1998	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	FARMERSVILLE HLTH CARE	660 E VISALIA RD	None	FARMERSVILLE	CA	93223	1641	54	06107	36.29776153	-119.2011415	Tulare County
11936	Fee-for-Service	1053595280	1053595280	2	1	TELLES, CONNOR MD	10/8/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	115099	20	Orthopedic Surgery	0	In state provider	None	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	2073	26	06051	37.64575895	-118.9638914	Mono County
11972	Fee-for-Service	1801813597	1801813597	1	1	TEICHMAN, SIEGMUND MD	1/1/1982	207RN0300X	NA	Nephrology	026	PHYSICIANS	17772	45	Nephrology (Renal-Kidney)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
11981	Fee-for-Service	1467414417	1467414417	1	1	TACVORIA, ELIZABETH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	19300 SW 65TH	None	TUALATIN	OR	97062	7706	00	None	45.378774	-122.740551	Clackamas County
12007	Fee-for-Service	1396761003	1396761003	1	1	TANK, HIMAT G MD	8/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	35478	40	Pediatrics	0	In state provider	None	1414 S MILLER ST	STE 10	SANTA MARIA	CA	93454	6916	42	06083	34.937433	-120.431561	Santa Barbara County
12010	Fee-for-Service	1699446096	1699446096	1	1	THERAPY CENTER FOR FAMILY CO	3/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NSCIOUSNESS INC.	615 HARRIS ST	None	EUREKA	CA	95503	4447	12	06023	40.78044158	-124.1622821	Humboldt County
12065	Fee-for-Service	1053683334	1053683334	1	1	TSAI, DAVID Y MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120477	41	Internal Medicine	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
12099	Fee-for-Service	1225539422	1225539422	1	1	TANJI, JOHNNA A AU	4/26/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
12117	Fee-for-Service	1932496379	1932496379	2	1	TRAN, TRUNG V OD	12/16/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3824 LA SIERRA AVE	None	RIVERSIDE	CA	92505	3528	33	06065	33.90447335	-117.4771776	Riverside County
12118	Fee-for-Service	1629542378	1629542378	1	1	THRALL, PEGGY L RCP	9/20/2020	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
12222	Fee-for-Service	1801831227	1801831227	1	1	TULARE COUNTY HLTH SVS	6/18/1998	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	FARMERSVILLE HLTH CARE	660 E VISALIA RD	None	FARMERSVILLE	CA	93223	1641	54	06107	36.29776153	-119.2011415	Tulare County
12224	Fee-for-Service	1396029724	1396029724	1	1	THE HEALTHCARE CENTER OF	10/1/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	DOWNEY LLC	12023 LAKEWOOD BLVD	None	DOWNEY	CA	90242	2635	19	06037	33.92612783	-118.1311336	Los Angeles County
12257	Fee-for-Service	1821107350	1821107350	1	1	THRIFTY PAYLESS INC	3/17/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06091	2700 ORO DAM BLVD E	None	OROVILLE	CA	95966	5117	04	06007	39.50721791	-121.5452948	Butte County
12263	Fee-for-Service	1801813597	1801813597	1	1	TEICHMAN, SIEGMUND MD	1/1/1982	207RN0300X	NA	Nephrology	026	PHYSICIANS	17772	41	Internal Medicine	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
12302	Fee-for-Service	1407465008	1407465008	1	1	TANG, BRIAN M CRNA	3/9/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
12319	Fee-for-Service	1487234860	1487234860	1	1	TUNG, SPENCER DO	12/20/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	1000 FRANKLIN PARKWAY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
12321	Fee-for-Service	1033296272	1033296272	1	1	TRI-CITY HEALTH CENTER	5/1/1995	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2299 MOWRY AVE	STE 3B	FREMONT	CA	94538	1621	01	06001	37.55671415	-121.9817758	Alameda County
12330	Fee-for-Service	1639317340	1639317340	1	1	TATISHCHEV, SERGEI MD	6/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111978	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	STE B186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
12331	Fee-for-Service	1558924209	1558924209	1	1	TOMA, NAYER MD	8/5/2024	207L00000X	NA	Other	026	PHYSICIANS	178861	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
12363	Fee-for-Service	1720279060	1720279060	1	1	TURSHANI, YOUSEF Y MD	11/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105486	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90051	0717	19	06037	34.07671715	-118.3799413	Los Angeles County
12392	Fee-for-Service	1730186610	1730186610	1	1	TIMOTHY KELLY COLGAN, 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	755 N 11TH ST	STE P2200	BEAUMONT	TX	77702	0000	00	None	30.08812663	-94.12992647	Jefferson County
12397	Fee-for-Service	1336194760	1336194760	1	1	TSITSIS,TIANNA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1415 E KINCAID ST	None	MOUNT VERNON	WA	98274	0000	00	None	48.41748257	-122.3241732	Skagit County
12426	Fee-for-Service	1376610279	1376610279	1	1	TOURAN, TOURAJ MD	6/30/1988	2086S0105X	NA	General Surgery	026	PHYSICIANS	59114	01	General Practice	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
12443	Fee-for-Service	1093393498	1093393498	1	1	TREMBLEY, JEROME R DO	7/22/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	22725	40	Pediatrics	0	In state provider	None	3700 MALL VIEW RD	None	BAKERSFIELD	CA	93306	3050	15	06029	35.39462173	-118.9518506	Kern County
12462	Fee-for-Service	1649284555	1649284555	1	1	TUNG, KINGMAN MD	2/16/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	08	Family Practice	0	In state provider	FREEPORT MEDICAL CENTER	1620 35TH AVE	STE A	SACRAMENTO	CA	95822	3425	34	06067	38.520315	-121.499604	Sacramento County
12502	Fee-for-Service	1326584186	1326584186	1	1	TARRANT, LAUREN A CCC-SP	9/14/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 ROWLAND WAY	220	NOVATO	CA	94945	5008	21	06041	38.09755172	-122.5591766	Marin County
12512	Fee-for-Service	1801831227	1801831227	1	1	TULARE COUNTY HLTH SVS	6/18/1998	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	FARMERSVILLE HLTH CARE	660 E VISALIA RD	None	FARMERSVILLE	CA	93223	1641	54	06107	36.29776153	-119.2011415	Tulare County
12533	Fee-for-Service	1013246719	1013246719	1	1	TOTAL RENAL CARE INC	4/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2438 N PONDEROSA DRIVE	STE C-101	CAMARILLO	CA	93010	2369	56	06111	34.24219545	-119.0227012	Ventura County
12545	Fee-for-Service	1992264881	1992264881	1	1	TONG, WENTING MD	7/21/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	182169	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
12585	Fee-for-Service	1043742729	1043742729	1	1	TSUTSUMI, YURI PSYD	12/7/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
12599	Fee-for-Service	1902024623	1902024623	1	1	TANGELLA, VIJAYA K MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	45065	01	General Practice	0	In state provider	None	750 W OLIVE AVE	STE 101	MERCED	CA	95348	2436	24	06047	37.31917248	-120.480657	Merced County
12607	Fee-for-Service	1033296272	1033296272	1	1	TRI-CITY HEALTH CENTER	5/1/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2299 MOWRY AVE	STE 3B	FREMONT	CA	94538	1621	01	06001	37.55671415	-121.9817758	Alameda County
12614	Fee-for-Service	1467843961	1467843961	1	1	TRINH, HOI MEDICAL	2/19/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	51429	41	Internal Medicine	0	In state provider	CORPORATION INC	6590 STOCKTON BOULEVARD	SUITE 100	SACRAMENTO	CA	95823	1612	34	06067	38.506617	-121.4347095	Sacramento County
12616	Fee-for-Service	1760138796	1760138796	1	1	TOYOTA, BRIAN D MD	3/17/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	176615	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
12638	Fee-for-Service	1992233803	1992233803	1	1	THOMAS, ROBYNN E LCSW	6/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
12670	Fee-for-Service	1417057118	1417057118	1	1	TAYLOR, CLIVE R MD	10/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	31898	22	Pathology (M.D. only)	0	In state provider	None	2011 ZONAL AVE	None	LOS ANGELES	CA	90033	1054	19	06037	34.05979479	-118.2053794	Los Angeles County
12687	Fee-for-Service	1265588842	1265588842	1	1	TSAI, JEFFREY J MD	4/4/2008	2084N0400X	NA	Neurology	026	PHYSICIANS	99733	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
12699	Fee-for-Service	1467093849	1467093849	1	1	TONY TRAN, D.O., INC.	4/27/2022	2084P0800X	NA	Psychiatry	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	13075 BLACKBIRD ST	None	GARDEN GROVE	CA	92843	2902	30	06059	33.77353611	-117.9130729	Orange County
12706	Fee-for-Service	1770747701	1770747701	1	1	TALAGA, KEVIN C OD	12/3/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	94816	7058	34	06067	38.564991	-121.4696565	Sacramento County
12708	Fee-for-Service	1427148295	1427148295	1	1	TSE, DOMINIC H W MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	32234	20	Orthopedic Surgery	0	In state provider	None	728 PACIFIC AVE	STE 505	SAN FRANCISCO	CA	94133	4449	38	06075	37.79687859	-122.4074282	San Francisco County
12714	Fee-for-Service	1376610279	1376610279	1	1	TOURAN, TOURAJ MD	6/30/1988	2086S0105X	NA	General Surgery	026	PHYSICIANS	59114	24	Plastic Surgery	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
12754	Fee-for-Service	1396188660	1396188660	1	1	TARRO, THOMAS M MD	8/10/2020	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	150101	77	Infectious Disease	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
12801	Fee-for-Service	1801831227	1801831227	1	1	TULARE COUNTY HLTH SVS	6/18/1998	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	FARMERSVILLE HLTH CARE	660 E VISALIA RD	None	FARMERSVILLE	CA	93223	1641	54	06107	36.29776153	-119.2011415	Tulare County
12843	Fee-for-Service	1104937408	1104937408	1	2	TAHOE EMERG PHYSICIANS	4/1/2008	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL CORPORATION	1501 KIRKWOOD MEADOWS DR	None	KIRKWOOD	CA	95646	0001	09	06017	38.6848853	-120.066128	Alpine County
12860	Fee-for-Service	1902058928	1902058928	1	1	TANTOD, KULIN R MD	5/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109655	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
12862	Fee-for-Service	1730143454	1730143454	1	6	THE REGENTS OF THE UNIVERSIT	3/15/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
12886	Fee-for-Service	1902024623	1902024623	1	1	TANGELLA, VIJAYA K MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	45065	41	Internal Medicine	0	In state provider	None	750 W OLIVE AVE	STE 101	MERCED	CA	95348	2436	24	06047	37.31917248	-120.480657	Merced County
12901	Fee-for-Service	1467843961	1467843961	1	1	TRINH, HOI MEDICAL	2/19/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	51429	01	General Practice	0	In state provider	CORPORATION INC	6590 STOCKTON BOULEVARD	SUITE 100	SACRAMENTO	CA	95823	1612	34	06067	38.506617	-121.4347095	Sacramento County
12928	Fee-for-Service	1265803944	1265803944	1	1	TINKER, MONROE G NP	10/25/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
12939	Fee-for-Service	1689105777	1689105777	1	1	TAMADONFAR, EMILY T MD	7/3/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	171184	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
12988	Fee-for-Service	1467093849	1467093849	1	1	TONY TRAN, D.O., INC.	3/11/2021	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	13075 BLACKBIRD ST	None	GARDEN GROVE	CA	92843	2902	30	06059	33.77353611	-117.9130729	Orange County
13012	Fee-for-Service	1336437730	1336437730	1	1	TOHME, FADI MD	7/14/2021	207RN0300X	NA	Nephrology	026	PHYSICIANS	172910	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
13042	Fee-for-Service	1396188660	1396188660	1	1	TARRO, THOMAS M MD	8/10/2020	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	150101	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
13114	Fee-for-Service	1063842649	1063842649	1	1	TANGCHITNOB, EDWARD P MD INC	11/8/2013	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	110608	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1135 S SUNSET AVE	STE 102	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
13136	Fee-for-Service	1013092980	1013092980	1	1	THOMAS, JAY R MD	5/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	55197	41	Internal Medicine	0	In state provider	None	4311 3RD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
13150	Fee-for-Service	1730143454	1730143454	1	6	THE REGENTS OF THE UNIVERSIT	3/15/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
13220	Fee-for-Service	1225092877	1225092877	1	1	THOMAS, MOHSEN T MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48297	41	Internal Medicine	0	In state provider	None	128 N AKERS ST	STE A	VISALIA	CA	93291	5121	54	06107	36.330552	-119.3477265	Tulare County
13274	Fee-for-Service	1467093849	1467093849	1	1	TONY TRAN, D.O., INC.	3/11/2021	2084P0800X	NA	Psychiatry	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13075 BLACKBIRD ST	None	GARDEN GROVE	CA	92843	2902	30	06059	33.77353611	-117.9130729	Orange County
13296	Fee-for-Service	1780884361	1780884361	1	1	TOMA, LANDON S	10/19/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
13308	Fee-for-Service	1588090005	1588090005	1	1	TAGWERKER, KRISTINE S CRNA	9/17/2014	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
13314	Fee-for-Service	1558417204	1558417204	1	1	TEKLAY, DANIEL MD	9/13/2024	207P00000X	NA	Other	026	PHYSICIANS	70442	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
13315	Fee-for-Service	1497453609	1497453609	1	1	TACTAY, JAMIE F LMFT	5/30/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
13363	Fee-for-Service	1760425987	1760425987	1	1	TIAMSON-KASSAB, MARIA L A MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	49744	36	Psychiatry	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
13416	Fee-for-Service	1811007693	1811007693	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 6015	1449 E F ST	STE 102	OAKDALE	CA	95361	9266	50	06099	37.77196205	-120.8329225	Stanislaus County
13424	Fee-for-Service	1285723411	1285723411	1	1	TANAKA, GEORGE H MD	10/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	78526	18	Ophthalmology	0	In state provider	None	490 POST ST	STE 608	SAN FRANCISCO	CA	94102	1407	38	06075	37.78812774	-122.4096884	San Francisco County
13436	Fee-for-Service	1730143454	1730143454	1	6	THE REGENTS OF THE UNIVERSIT	3/15/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	32	Radiation Therapy (D.O. only)	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
13485	Fee-for-Service	1407306665	1407306665	1	1	TIMOTHY S. JOHNSTON, M.D. PC	5/22/2017	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	3349 G STREET	SUITE F	MERCED	CA	95340	0978	24	06047	37.32432497	-120.4693064	Merced County
13510	Fee-for-Service	1225092877	1225092877	1	1	THOMAS, MOHSEN T MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48297	45	Nephrology (Renal-Kidney)	0	In state provider	None	128 N AKERS ST	STE A	VISALIA	CA	93291	5121	54	06107	36.330552	-119.3477265	Tulare County
13532	Fee-for-Service	1912907726	1912907726	1	1	TAN, HAU H MD	3/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	63428	41	Internal Medicine	0	In state provider	None	4533 COLLEGE AVE	None	SAN DIEGO	CA	92115	4010	37	06073	32.759334	-117.066313	San Diego County
13542	Fee-for-Service	1407923212	1407923212	1	1	TAKASUGI, JAN K MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	52850	02	General Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
13543	Fee-for-Service	1326442336	1326442336	1	1	THE CHARLOTTE-MECKLENBURG HO	5/19/2021	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	201 E GROVER ST	None	SHELBY	NC	28150	3917	00	None	35.302698	-81.536283	Cleveland County
13564	Fee-for-Service	1467093849	1467093849	1	1	TONY TRAN, D.O., INC.	5/2/2022	2084P0800X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	13075 BLACKBIRD ST	None	GARDEN GROVE	CA	92843	2902	30	06059	33.77353611	-117.9130729	Orange County
13617	Fee-for-Service	1700097540	1700097540	1	4	THE NORTHEAST COMMUNITY CLNC	3/17/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1414 S GRAND AVE	SUITE 300	LOS ANGELES	CA	90015	3072	19	06037	34.03661142	-118.2657227	Los Angeles County
13631	Fee-for-Service	1710913249	1710913249	1	1	TULPULE, ANIL MD	3/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	45220	68	Hematology	0	In state provider	None	1441 EASTLAKE AVE	STE 162	LOS ANGELES	CA	90089	0178	19	06037	34.06169385	-118.2044698	Los Angeles County
13643	Fee-for-Service	1396849311	1396849311	1	2	THOMASSON, MELISSA J PHD	7/15/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	205 N H ST	SUITE 214	LOMPOC	CA	93436	6026	42	06083	34.64088471	-120.4579052	Santa Barbara County
13650	Fee-for-Service	1760425987	1760425987	1	1	TIAMSON-KASSAB, MARIA L A MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	49744	13	Neurology (M.D. only)	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
13675	Fee-for-Service	1225147671	1225147671	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5635	3813 PLAZA DR	None	OCEANSIDE	CA	92056	4624	37	06073	33.18214516	-117.2933721	San Diego County
13688	Fee-for-Service	1104345339	1104345339	1	1	TRAN, CHRISTINE H MD INC	6/20/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 204	GARDEN GROVE	CA	92843	1908	30	06059	33.77450141	-117.9123364	Orange County
13704	Fee-for-Service	1609085430	1609085430	1	1	THERAPEUTIC LIVING CNTRS	6/26/1995	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR THE BLIND	20619 DEVONSHIRE ST	None	CHATSWORTH	CA	91311	3212	19	06037	34.25726883	-118.5827823	Los Angeles County
13714	Fee-for-Service	1346560844	1346560844	1	1	TUN, KYAW N DO	8/17/2018	2085N0700X	NA	MRI Provider	026	PHYSICIANS	15177	30	Radiology	0	In state provider	None	2301 BAHAMAS DR	None	BAKERSFIELD	CA	93309	0663	15	06029	35.37447628	-119.0453594	Kern County
13726	Fee-for-Service	1275309205	1275309205	1	1	TARRANT, TIMOTHY PT	12/26/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	210 W PINE ST	None	LODI	CA	95240	2020	39	06077	38.13427214	-121.2755342	San Joaquin County
13735	Fee-for-Service	1831324656	1831324656	1	1	TALENTO, GRACE R MD	10/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119592	01	General Practice	0	In state provider	None	1220 ROSSMOOR PKWY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
13739	Fee-for-Service	1609370345	1609370345	1	1	TIEN, JUSTIN MD MPH	8/17/2021	207R00000X	NA	Other	026	PHYSICIANS	173600	None	None	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
13775	Fee-for-Service	1407306665	1407306665	1	1	TIMOTHY S. JOHNSTON, M.D. PC	5/22/2017	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3349 G STREET	SUITE F	MERCED	CA	95340	0978	24	06047	37.32432497	-120.4693064	Merced County
13784	Fee-for-Service	1972675627	1972675627	1	1	TORGERSEN, NAOMI MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	60534	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
13790	Fee-for-Service	1245349653	1245349653	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17055 VAN BUREN BLVD	None	RIVERSIDE	CA	92504	5923	33	06065	33.88228051	-117.364779	Riverside County
13793	Fee-for-Service	1346295474	1346295474	1	1	TORRES, ANNA M OD	10/1/2001	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1420 N CLAREMONT BLVD	STE 209B	CLAREMONT	CA	91711	3528	19	06037	34.10905443	-117.7028026	Los Angeles County
13800	Fee-for-Service	1467414581	1467414581	1	1	TAILLAC,PETER P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	50 N MEDICAL DRIVE	None	SALT LAKE CITY	UT	84132	0001	00	None	40.77197161	-111.8352608	Salt Lake County
13831	Fee-for-Service	1326442336	1326442336	1	1	THE CHARLOTTE-MECKLENBURG HO	5/19/2021	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	201 E GROVER ST	None	SHELBY	NC	28150	3917	00	None	35.302698	-81.536283	Cleveland County
13863	Fee-for-Service	1538384268	1538384268	1	1	TANNER, JOHN G DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	TANNER CHIROPRACTIC INC	3750 ARLINGTON AVE	None	RIVERSIDE	CA	92506	2607	33	06065	33.94621715	-117.399167	Riverside County
13879	Fee-for-Service	1093134850	1093134850	1	1	TEA, SAVONG	4/9/2013	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4311 E ANDREWS PLACE	None	FRESNO	CA	93726	7103	10	06019	36.78117848	-119.7532162	Fresno County
13889	Fee-for-Service	1043215502	1043215502	1	1	TIU, ALFREDO B DO	12/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7678	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
13905	Fee-for-Service	1700097540	1700097540	1	4	THE NORTHEAST COMMUNITY CLNC	3/17/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1414 S GRAND AVE	SUITE 300	LOS ANGELES	CA	90015	3072	19	06037	34.03661142	-118.2657227	Los Angeles County
13908	Fee-for-Service	1134790991	1134790991	1	1	THIRRUKOTLA, PAMELA R PT	8/11/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	350 JOHN MUIR PKWY	250	BRENTWOOD	CA	94513	5183	07	06013	37.91980577	-121.734715	Contra Costa County
13929	Fee-for-Service	1376288936	1376288936	1	1	TRAN, THANH D MD	6/10/2024	163WG0000X	NA	Other	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	19	06037	34.28200485	-118.4030797	Los Angeles County
13947	Fee-for-Service	1508065053	1508065053	1	1	THUO, JAMES CLEMENT	12/6/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	7271 BLUE CRAB CT	None	EASTVALE	CA	92880	3449	19	06037	33.95620749	-117.5646523	Riverside County
13960	Fee-for-Service	1427167816	1427167816	1	1	THRIFTY DRUG STORE 5694	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	1133 N MOUNT VERNON AVE	None	COLTON	CA	92324	2554	36	06071	34.0754531	-117.3138757	San Bernardino County
14004	Fee-for-Service	1235604646	1235604646	1	1	THREE ARCH LLC	8/31/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	20400 SARATOGA LOS GATOS	None	SARATOGA	CA	95070	5927	43	06085	37.25731584	-122.0302461	Santa Clara County
14009	Fee-for-Service	1740369891	1740369891	1	1	THEODOSSY, SULEIMAN J MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	80040	30	Radiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
14018	Fee-for-Service	1285141143	1285141143	1	1	TODA, ELENA NP	12/7/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
14023	Fee-for-Service	1831324656	1831324656	1	1	TALENTO, GRACE R MD	10/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119592	08	Family Practice	0	In state provider	None	1220 ROSSMOOR PKWY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
14028	Fee-for-Service	1780989301	1780989301	1	1	THE FAMILY GUIDANCE & THERAP	6/16/2020	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	Y CENTER OF SOUTHERN CAL	3555 KENYON ST	101/102	SAN DIEGO	CA	92110	5333	37	06073	32.75016963	-117.2160064	San Diego County
14060	Fee-for-Service	1407306665	1407306665	1	1	TIMOTHY S. JOHNSTON, M.D. PC	5/22/2017	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3349 G STREET	SUITE F	MERCED	CA	95340	0978	24	06047	37.32432497	-120.4693064	Merced County
14105	Fee-for-Service	1548312333	1548312333	1	1	TROBISCH, JAN H MD	5/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	83160	41	Internal Medicine	0	In state provider	None	1700 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
14115	Fee-for-Service	1477620557	1477620557	1	1	TANG, VANESSA R MD	1/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87200	05	Anesthesiology	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
14122	Fee-for-Service	1982832945	1982832945	1	1	TRIBUZIO, BIANCA A MD	1/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11675	25	Physical Medicine and Rehabilitation	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
14131	Fee-for-Service	1598721474	1598721474	1	1	TORABI, MAJID MD FACS	12/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	39000 BOB HOPE DR	PROBST 202	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
14144	Fee-for-Service	1720162704	1720162704	1	1	THOMASON, GAMIN MARY	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69086	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
14147	Fee-for-Service	1265581037	1265581037	1	1	TALARICO, ROSS H DPM	12/22/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
14158	Fee-for-Service	1205982543	1205982543	1	1	TED'S VILLAGE PHARM, INC	3/1/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	29 W 25TH AVE	None	SAN MATEO	CA	94403	2236	41	06081	37.54394043	-122.3065166	San Mateo County
14170	Fee-for-Service	1093134850	1093134850	1	1	TEA, SAVONG	4/9/2013	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4311 E ANDREWS PLACE	None	FRESNO	CA	93726	7103	10	06019	36.78117848	-119.7532162	Fresno County
14177	Fee-for-Service	1043215502	1043215502	1	1	TIU, ALFREDO B DO	12/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7678	45	Nephrology (Renal-Kidney)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
14184	Fee-for-Service	1487669933	1487669933	1	1	TAI, EDMUND W	12/31/1984	207ZP0102X	NA	Other	026	PHYSICIANS	50493	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
14192	Fee-for-Service	1700097540	1700097540	1	4	THE NORTHEAST COMMUNITY CLNC	4/19/2022	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1414 S GRAND AVE	SUITE 300	LOS ANGELES	CA	90015	3072	19	06037	34.03661142	-118.2657227	Los Angeles County
14231	Fee-for-Service	1356386403	1356386403	1	1	TALAG, EMELITA B MD	8/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92488	36	Psychiatry	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
14234	Fee-for-Service	1508065053	1508065053	1	1	THUO, JAMES CLEMENT	12/6/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	7271 BLUE CRAB CT	None	EASTVALE	CA	92880	3449	19	06037	33.95620749	-117.5646523	Riverside County
14254	Fee-for-Service	1194219345	1194219345	1	1	THOMAS, SELINA MD	9/19/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165044	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
14316	Fee-for-Service	1780989301	1780989301	1	1	THE FAMILY GUIDANCE & THERAP	3/28/2024	106H00000X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	Y CENTER OF SOUTHERN CAL	3555 KENYON ST	101/102	SAN DIEGO	CA	92110	5333	37	06073	32.75016963	-117.2160064	San Diego County
14333	Fee-for-Service	1225430655	1225430655	1	1	TYNER, ELIZABETH JULIA ANN	11/19/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1079 EUCALYPTUS	STE B	MANTECA	CA	95337	4317	39	06077	37.80126585	-121.2326114	San Joaquin County
14336	Fee-for-Service	1629415047	1629415047	1	1	TIONG, BENEDICT K MD	4/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131775	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
14337	Fee-for-Service	1386026128	1386026128	1	1	TIRRELL, TIMOTHY F MD	7/30/2024	2086S0120X	NA	General Surgery	026	PHYSICIANS	145045	85	Surgery-Pediatric	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
14405	Fee-for-Service	1417274523	1417274523	1	1	THOMAS, JESSICA S MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	118566	05	Anesthesiology	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
14427	Fee-for-Service	1710982632	1710982632	1	1	TARREL, RONALD M. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 E 28TH ST	None	MINNEAPOLIS	MN	55407	3723	00	None	44.95428	-93.2614155	Hennepin County
14469	Fee-for-Service	1043215502	1043215502	1	1	TIU, ALFREDO B DO	12/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7678	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
14516	Fee-for-Service	1528295680	1528295680	1	1	TED LE SCHWARM M.D.	1/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	407 S WHITE ST	None	MT PLEASANT	IA	52641	2263	00	None	40.96213584	-91.55820952	Henry County
14570	Fee-for-Service	1578821922	1578821922	1	1	TANNA, PRIYA MD	7/1/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	161376	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
14602	Fee-for-Service	1780989301	1780989301	1	1	THE FAMILY GUIDANCE & THERAP	6/16/2020	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	Y CENTER OF SOUTHERN CAL	3555 KENYON ST	101/102	SAN DIEGO	CA	92110	5333	37	06073	32.75016963	-117.2160064	San Diego County
14625	Fee-for-Service	1629415047	1629415047	1	1	TIONG, BENEDICT K MD	4/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131775	83	Rheumatology	0	In state provider	None	200 MEDICAL PLAZA	365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
14626	Fee-for-Service	1982710430	1982710430	1	1	TOPE-ANIFOWOSE, FUNMILOL	6/6/2007	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ANNIFF MEDICAL SUPPLY	10030 S WESTERN AVE	None	LOS ANGELES	CA	90047	4254	19	06037	33.944454	-118.3090015	Los Angeles County
14706	Fee-for-Service	1982629408	1982629408	1	1	TOMASZEWSKI, CHRISTIAN A	11/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88375	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
14723	Fee-for-Service	1922564624	1922564624	1	1	TOQUINTO, SIGNY M CNM	4/12/2019	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	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
14739	Fee-for-Service	1083784243	1083784243	1	1	TRUCKEE FIRE PROTECTION	7/1/1995	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10049 DONNER PASS RD	None	TRUCKEE	CA	96161	0317	29	06057	39.32806132	-120.1842646	Nevada County
14745	Fee-for-Service	1023894805	1023894805	1	1	THOMAS, DAPHNE	5/20/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
14761	Fee-for-Service	1336227099	1336227099	1	1	THACKER, GARY J MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	54762	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
14766	Fee-for-Service	1184809329	1184809329	1	1	TRAN, BAO C MD INC	6/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	175 W LA VERNE AVE	STE D	POMONA	CA	91767	2347	19	06037	34.08615354	-117.7522473	Los Angeles County
14771	Fee-for-Service	1356525141	1356525141	1	1	TANG, WEI S MD	4/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98672	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
14872	Fee-for-Service	1730746892	1730746892	1	1	TRUE CHOICE HOME HEALTH INC	5/21/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	221 E GLENOAKS BLVD	STE 225B	GLENDALE	CA	91207	2085	19	06037	34.15856042	-118.253151	Los Angeles County
14933	Fee-for-Service	1366496937	1366496937	1	1	TRIDENT MEDICAL CENTER LLC	10/4/2023	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	9330 MEDICAL PLAZA DR	None	CHARLESTON	SC	29406	9104	00	None	32.976	-80.072973	Charleston County
14936	Fee-for-Service	1073121018	1073121018	1	1	TRAN, KRISTINA NP	10/20/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
14950	Fee-for-Service	1801467543	1801467543	1	1	THOMAS, ANDREW G DPM	6/27/2024	390200000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	4343 MARKET ST	STE B	RIVERSIDE	CA	92501	3500	33	06065	33.97734857	-117.3791849	Riverside County
15050	Fee-for-Service	1720441785	1720441785	1	1	TERRERO-SALCEDO, MABEL P LCS	4/21/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
15084	Fee-for-Service	1316546856	1316546856	1	1	TEJADA, STEPHANIE CRNA	8/30/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
15091	Fee-for-Service	1851643068	1851643068	1	1	TREPPENDAHL, EMILY CRNA	3/6/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	75 NIELSON	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7937089	Santa Cruz County
15092	Fee-for-Service	1629388855	1629388855	1	1	TOTAL RENAL CARE INC	9/21/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1900 OUTLET CENTER DRIVE	None	OXNARD	CA	93036	0677	56	06111	34.22014556	-119.1484924	Ventura County
15120	Fee-for-Service	1174647077	1174647077	1	1	TANAKA, LINDA PHD	4/21/2006	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	HEARING AID PROFESSIONAL	933 S SUNSET AVE	STE 302	WEST COVINA	CA	91790	3410	19	06037	34.06428275	-117.9432037	Los Angeles County
15123	Fee-for-Service	1891161162	1891161162	1	1	TARAR, OMER H MD	11/29/2022	207RE0101X	NA	Endocrinology	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
15149	Fee-for-Service	1477828069	1477828069	1	2	TODD FARRER MD INC	4/13/2024	207QG0300X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FIELD	7702 MEANY AVE	SUITE 101	BAKERSFIELD	CA	93308	5199	15	06029	35.3942865	-119.087946	Kern County
15178	Fee-for-Service	1346388469	1346388469	1	1	TRUONG, CHRISTINE T CRNA	1/25/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
15192	Fee-for-Service	1679560627	1679560627	1	1	TUTTLE'S DOYLE PARK PHAR	3/30/1995	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1220 SONOMA AVE	None	SANTA ROSA	CA	95405	6621	49	06097	38.441385	-122.698422	Sonoma County
15219	Fee-for-Service	1467561555	1467561555	1	1	TUN, AUNG M MD	9/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	93421	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
15222	Fee-for-Service	1366496937	1366496937	1	1	TRIDENT MEDICAL CENTER LLC	10/4/2023	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	9330 MEDICAL PLAZA DR	None	CHARLESTON	SC	29406	9104	00	None	32.976	-80.072973	Charleston County
15237	Fee-for-Service	1710963608	1710963608	2	1	TURKIS, MARTIN E OD	9/14/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2773 HARRIS PLACE	STE H	EUREKA	CA	95503	4866	12	06023	40.78052829	-124.1363953	Humboldt County
15295	Fee-for-Service	1982649141	1982649141	1	1	TAKEUCHI, DARREN L MD	12/1/1994	207P00000X	NA	Other	026	PHYSICIANS	77351	None	None	0	In state provider	None	2632 E WASHINGTON BLVD	None	PASADENA	CA	91107	1411	19	06037	34.1691255	-118.096119	Los Angeles County
15324	Fee-for-Service	1659458743	1659458743	1	1	TENCATI, JOHN R MD	10/1/2000	207K00000X	NA	Other	026	PHYSICIANS	38287	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
15367	Fee-for-Service	1720348659	1720348659	1	1	TONE, MONICA J MD	1/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151148	36	Psychiatry	0	In state provider	None	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
15390	Fee-for-Service	1982081980	1982081980	1	1	TANG, MING-YUN MD	7/12/2019	207L00000X	NA	Other	026	PHYSICIANS	161117	05	Anesthesiology	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
15396	Fee-for-Service	1043512130	1043512130	1	2	TUCKER, TAMARA LCSW	2/19/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
15425	Fee-for-Service	1255407714	1255407714	1	1	TSOU, PAUL MD	5/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	22091	20	Orthopedic Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
15461	Fee-for-Service	1861658718	1861658718	1	1	TIEU, DAVID D MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120391	04	Otology, Laryngology, Rhinology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
15462	Fee-for-Service	1659441574	1659441574	1	1	TAYLOR,NORA,MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3300 GALLOWS RD	None	FALLS CHURCH	VA	22042	0000	00	None	38.858193	-77.226426	City of Fairfax
15476	Fee-for-Service	1871579656	1871579656	1	1	TIETS, GREGORY C DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EMERGENCY MEDICAL SPCLST	3033 S PARKER RD, #800	None	AURORA	CO	80014	0000	00	None	39.6612	-104.8603095	Arapahoe County
15515	Fee-for-Service	1174641526	1174641526	1	1	TWOY, RICHARD NP	9/10/2020	164W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
15551	Fee-for-Service	1659599983	1659599983	1	1	TRIANDAFYLLIS, KAREN NP	10/16/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	721519	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	WARD 93/95	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
15579	Fee-for-Service	1982666905	1982666905	1	1	TITOV, VLADIMIR A MD	7/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	56479	41	Internal Medicine	0	In state provider	None	13851 E 14TH STREET	SUITE 305	SAN LEANDRO	CA	94578	2630	01	06001	37.71458918	-122.1418781	Alameda County
15615	Fee-for-Service	1124043344	1124043344	1	1	TEIXEIRA, PAUL A	1/15/2012	174400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1306 JOHNSON AVENUE	None	SAN LUIS OBISPO	CA	93401	5804	40	06079	35.28217851	-120.6550815	San Luis Obispo County
15730	Fee-for-Service	1437538618	1437538618	1	1	TRAILSTONE DIALYSIS LLC	8/22/2017	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2403 S VINEYARD AVE	SUITE D	ONTARIO	CA	91761	6471	36	06071	34.02972	-117.608238	San Bernardino County
15757	Fee-for-Service	1093138661	1093138661	1	1	THE COLLABORATIVE VILLAGE OF	11/4/2022	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	4987 GOLDEN FOOTHILL PKW	100	EL DORADO HILLS	CA	95762	9364	09	06017	38.63795293	-121.0685958	El Dorado County
15779	Fee-for-Service	1669519500	1669519500	1	1	TUMMALA, PADMINI MD	7/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	61977	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
15826	Fee-for-Service	1215550058	1215550058	1	1	THE BFF CORPORATION	2/17/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	29255 RUUS RD	None	HAYWARD	CA	94544	6334	01	06001	37.62229107	-122.0645264	Alameda County
15864	Fee-for-Service	1134165012	1134165012	1	1	THOMAS W YOO MD INC , A MED	7/21/2004	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	73559	None	None	0	In state provider	ICAL CORPORATION	555 E HARDY ST	None	LOS ALAMITOS	CA	90720	0081	30	06059	0	0	None
15889	Fee-for-Service	1033414651	1033414651	1	1	THOMPSON, JEAN LCSW	12/27/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82355	-	NOT APPLICABLE	0	In state provider	None	2101 MAGNOLIA AVE	None	LONG BEACH	CA	90806	4521	19	06037	33.79557701	-118.1981495	Los Angeles County
15891	Fee-for-Service	1356372643	1356372643	1	1	TUCKER, KELLY J MD	10/31/1988	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	64833	01	General Practice	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
15900	Fee-for-Service	1649343500	1649343500	1	1	THEODOROU, ANDREAS A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
15919	Fee-for-Service	1215399407	1215399407	1	1	TOPPEN, WILLIAM MD	4/24/2019	207R00000X	NA	Other	026	PHYSICIANS	155816	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
15921	Fee-for-Service	1770790461	1770790461	1	1	TAKAHASHI, DONNA M MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	41048	40	Pediatrics	0	In state provider	None	1595 SOQUEL DR	STE 400	SANTA CRUZ	CA	95065	1724	44	06087	36.98879599	-121.9826354	Santa Cruz County
15935	Fee-for-Service	1154354660	1154354660	1	1	TRIMBERGER, DANIEL L. MD	8/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1615 DELAWARE ST	None	LONGVIEW	WA	98632	2367	00	None	46.1309207	-122.9408931	Cowlitz County
15950	Fee-for-Service	1043989551	1043989551	1	1	THE COTTAGES AT ARTESIA	12/2/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6041 KINGMAN AVE	None	BUENA PARK	CA	90621	0405	30	06059	33.87274778	-118.0012294	Orange County
15975	Fee-for-Service	1992819015	1992819015	1	1	TRANG, DENNIS N MD	1/1/1982	2085B0100X	NA	MRI Provider	026	PHYSICIANS	32414	30	Radiology	0	In state provider	None	443 S SOTO ST	None	LOS ANGELES	CA	90033	4315	19	06037	34.03962728	-118.2124322	Los Angeles County
16048	Fee-for-Service	1093138661	1093138661	1	1	THE COLLABORATIVE VILLAGE OF	11/4/2022	101YM0800X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4987 GOLDEN FOOTHILL PKW	100	EL DORADO HILLS	CA	95762	9364	09	06017	38.63795293	-121.0685958	El Dorado County
16049	Fee-for-Service	1669268611	1669268611	1	1	TRIANA MURILLO, LUZ	4/17/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
16136	Fee-for-Service	1194801589	1194801589	1	1	TOBIN, THOMAS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 W 5TH AVE	None	SPOKANE	WA	99204	2803	00	None	47.651778	-117.423477	Spokane County
16269	Fee-for-Service	1013405612	1013405612	1	1	THIND, RAVNEET K DO	8/23/2022	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	19412	None	None	0	In state provider	None	6121 N THESTA ST	STE 303	FRESNO	CA	93710	5294	10	06019	36.82493955	-119.783139	Fresno County
16295	Fee-for-Service	1366821498	1366821498	1	1	TORRES, ROSALICIA D MD	8/19/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	171749	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
16319	Fee-for-Service	1487944062	1487944062	1	1	TAYLOR, SHABNAM K MD	6/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124498	18	Ophthalmology	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
16332	Fee-for-Service	1720211519	1720211519	1	2	THAO, CHANG LCSW	10/4/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1130 CONROY LN	SUITE 150	ROSEVILLE	CA	95661	4154	31	06061	38.73792807	-121.2748427	Placer County
16356	Fee-for-Service	1124290960	1124290960	1	1	TEMPLETON, ERIK C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 7TH AVE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
16360	Fee-for-Service	1306994280	1306994280	1	1	TYRRELL, LAURIE J MD	9/27/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54846	22	Pathology (M.D. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
16367	Fee-for-Service	1619199312	1619199312	1	1	TCHERNIANTCHOUK, OXANA MD	7/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83340	22	Pathology (M.D. only)	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
16368	Fee-for-Service	1568660942	1568660942	1	1	TRAN, MICHAEL P	6/22/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4201 W CHAPMAN AVENUE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
16405	Fee-for-Service	1619241999	1619241999	1	1	TESFALUL, MARTHA A MD	6/11/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	142407	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
16419	Fee-for-Service	1922040849	1922040849	1	1	TILLIS, TOYA A MD	11/12/2010	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	75203	40	Pediatrics	0	In state provider	None	250 W BONITA AVE	STE 200	POMONA	CA	91767	1850	19	06037	34.09664881	-117.751261	Los Angeles County
16504	Fee-for-Service	1396849311	1396849311	1	1	THOMASSON, MELISSA J PHD	1/17/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	10218	-	NOT APPLICABLE	0	In state provider	None	303 SOUTH C ST	None	LOMPOC	CA	93436	7305	42	06083	34.63525845	-120.451628	Santa Barbara County
16518	Fee-for-Service	1407002397	1407002397	1	1	TOVAR, LIDIA LCSW	6/26/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
16529	Fee-for-Service	1619322831	1619322831	1	1	TATAPUDY, SONALI MD	10/18/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	170498	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
16537	Fee-for-Service	1437210978	1437210978	1	1	TOWN OF PAHRUMP / PVFRS	1/5/2010	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	400 N HIGHWAY 160	None	PAHRUMP	NV	89060	4013	00	None	36.22835225	-115.9972082	Nye County
16538	Fee-for-Service	1336233600	1336233600	1	1	TORABZADEH, SIMIN MD	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	51845	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
16605	Fee-for-Service	1629731047	1629731047	1	1	TRUTH HEALING AND EVOLUTION	2/6/2024	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	SELING MARRIAGE & FAMILY	1060 E FOOTHILL BLVD	204	UPLAND	CA	91786	4070	36	06071	34.1070235	-117.6371235	San Bernardino County
16607	Fee-for-Service	1891004198	1891004198	1	1	TANITA, DOUGLAS MD	7/18/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	116603	None	None	0	In state provider	None	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
16609	Fee-for-Service	1114224680	1114224680	1	1	TOWNS, MARK D PHD	2/8/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	15823 WESTERN AVE	None	GARDENA	CA	90247	3788	19	06037	33.886692	-118.3091895	Los Angeles County
16613	Fee-for-Service	1760420962	1760420962	1	1	TOPACIO, RUTH G MD	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44817	01	General Practice	0	In state provider	None	9604 ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	8043	19	06037	33.87472842	-118.1288599	Los Angeles County
16634	Fee-for-Service	1750591657	1750591657	2	1	TRUST HOME HEALTH CARE INC	3/17/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1017 N BRAND BLVD	SUITE A	GLENDALE	CA	91202	2906	19	06037	34.160895	-118.255108	Los Angeles County
16648	Fee-for-Service	1306994280	1306994280	1	1	TYRRELL, LAURIE J MD	9/27/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54846	40	Pediatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
16668	Fee-for-Service	1770655086	1770655086	2	1	TING, BELINDA D	9/4/2007	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
16721	Fee-for-Service	1366687998	1366687998	1	1	TOWNES MCMANN, KATIE L DO	9/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	2825 E BARNETT RD	None	MEDFORD	OR	97504	8332	00	None	42.31650147	-122.8306005	Jackson County
16727	Fee-for-Service	1114098019	1114098019	1	1	TING, PAUL P MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	62124	02	General Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
16767	Fee-for-Service	1427434968	1427434968	1	1	TU, ALBERT MD	8/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137483	14	Neurological Surgery	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
16827	Fee-for-Service	1548971542	1548971542	1	1	TOBIAS, FAITH PSYD	7/3/2023	103TC0700X	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
16849	Fee-for-Service	1184893133	1184893133	1	1	TRAN, TRACY T DO	11/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11361	41	Internal Medicine	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
16875	Fee-for-Service	1134284524	1134284524	1	1	THOMAS, THOMAS DO	7/25/2024	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
16897	Fee-for-Service	1972681591	1972681591	1	1	THOMSON, LORNA M, MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71823	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
16899	Fee-for-Service	1760420962	1760420962	1	1	TOPACIO, RUTH G MD	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44817	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	9604 ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	8043	19	06037	33.87472842	-118.1288599	Los Angeles County
16929	Fee-for-Service	1285875971	1285875971	1	1	TRINITY HEALTH AND WELLNESS	6/29/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	100360	08	Family Practice	0	In state provider	MEDICAL GROUP, INC	7231 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90046	6724	19	06037	34.09075945	-118.347435	Los Angeles County
16957	Fee-for-Service	1851736961	1851736961	1	1	TAKYAR, VARUN K MD	12/21/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	130685	None	None	0	In state provider	None	4053 LONE TREE WAY	201	ANTIOCH	CA	94531	6210	07	06013	37.97569499	-121.800733	Contra Costa County
16967	Fee-for-Service	1083802979	1083802979	1	1	TRADITIONS PSYCH GRP INC	11/1/2000	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	TRADITIONS BHVL HLTH	1580 1ST ST	None	NAPA	CA	94559	2841	28	06055	38.29720702	-122.2908931	Napa County
16973	Fee-for-Service	1013048123	1013048123	1	1	TREVINO, JUAN LCSW	5/7/2024	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
16997	Fee-for-Service	1447546833	1447546833	1	1	TELESZ, BRIAN J MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134921	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
17044	Fee-for-Service	1487763868	1487763868	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8447 ALONDRA BLVD	None	PARAMOUNT	CA	90723	4405	19	06037	33.88934226	-118.1520312	Los Angeles County
17047	Fee-for-Service	1831590884	1831590884	1	1	TURNER, LACIE LMFT	8/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5740 N PALM AVE STE 101	None	FRESNO	CA	93704	1800	10	06019	36.82151326	-119.8082243	Fresno County
17077	Fee-for-Service	1548524317	1548524317	1	1	THOMAS, KELLY D PSYD	5/5/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	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
17114	Fee-for-Service	1497947337	1497947337	1	1	TRUONG, THUY N LCSW	12/2/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	25088	-	NOT APPLICABLE	0	In state provider	None	1560 BERGER DRIVE	None	SAN JOSE	CA	95112	2703	43	06085	37.37266497	-121.8970417	Santa Clara County
17117	Fee-for-Service	1376755306	1376755306	1	1	TSENG, BI-HWA	10/24/2013	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
17121	Fee-for-Service	1386919108	1386919108	2	1	TRUE SOUND HEARING AID	10/3/2014	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	1539 SLOAT BLVD	None	SAN FRANCISCO	CA	94132	1222	38	06075	37.73396982	-122.4897505	San Francisco County
17125	Fee-for-Service	1356920383	1356920383	1	1	TATE, ALYSSA MD	4/2/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	182647	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
17135	Fee-for-Service	1134238553	1134238553	1	1	THRIFTY PAYLESS INC DBA	5/6/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2135 JACKSON AVE	None	ESCALON	CA	95320	2051	39	06077	37.79421051	-120.985929	San Joaquin County
17139	Fee-for-Service	1902839160	1902839160	1	1	TENG, CHIA Y MD	8/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	69120	41	Internal Medicine	0	In state provider	None	420 N GARFIELD AVE	STE 202	MONTEREY PARK	CA	91754	1206	19	06037	34.0670077	-118.1228585	Los Angeles County
17146	Fee-for-Service	1215287867	1215287867	1	2	THOMPSON, ERA M LCSW	5/2/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
17165	Fee-for-Service	1184897944	1184897944	1	1	TARUN PANDEY, 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	4301 W MARKHAM ST	None	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
17176	Fee-for-Service	1801861190	1801861190	1	2	TRI CITY HOSPITAL	12/30/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	WOUND CARE & HYPRBARIC	6260 EL CAMINO	SUITE 201	CARLSBAD	CA	92009	1609	37	06073	33.12215813	-117.266659	San Diego County
17184	Fee-for-Service	1457367179	1457367179	1	1	TAGLE, AMANDA G MD	11/26/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	60188	40	Pediatrics	0	In state provider	None	7215 55TH ST	None	SACRAMENTO	CA	95823	2601	34	06067	38.495196	-121.440681	Sacramento County
17188	Fee-for-Service	1760420962	1760420962	1	1	TOPACIO, RUTH G MD	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44817	41	Internal Medicine	0	In state provider	None	9604 ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	8043	19	06037	33.87472842	-118.1288599	Los Angeles County
17197	Fee-for-Service	1285028738	1285028738	1	1	TRUONG, KENT MD	6/30/2021	207ZP0102X	NA	Other	026	PHYSICIANS	149033	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
17222	Fee-for-Service	1710144829	1710144829	1	1	TOMASSI, MARCO J MD	3/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103631	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
17288	Fee-for-Service	1629066527	1629066527	1	1	TEMNYK, MICHAEL G MD	6/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	58232	20	Orthopedic Surgery	0	In state provider	None	981 E TUOLUMNE RD	None	TURLOCK	CA	95382	1544	50	06099	37.51464451	-120.8375145	Stanislaus County
17339	Fee-for-Service	1336175611	1336175611	1	1	THYMES, DEONZA N MD	8/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88766	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1025 S ANAHEIM BLVD	None	ANAHEIM	CA	92805	5806	30	06059	33.81994338	-117.9087416	Orange County
17345	Fee-for-Service	1477504553	1477504553	1	1	TUBBS, KEVIN D DO	8/1/1997	207P00000X	NA	Other	026	PHYSICIANS	6172	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18800 DELAWARE ST	None	HUNTINGTON BEACH	CA	92648	1959	30	06059	33.68911733	-117.9931535	Orange County
17348	Fee-for-Service	1437819968	1437819968	1	1	TIWANA, GURPREET K	4/16/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
17392	Fee-for-Service	1649223140	1649223140	1	1	TROUT, TERE E MD	5/31/1992	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	70276	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
17420	Fee-for-Service	1831150424	1831150424	1	1	TUMAS, VYDUNAS 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	933 NEWBURY ST	None	RIPON	WI	54971	1730	00	None	43.83465949	-88.83736461	Fond du Lac County
17445	Fee-for-Service	1043933393	1043933393	1	1	TRINH, LINDA PT	12/12/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
17449	Fee-for-Service	1013917939	1013917939	1	1	TRAUGOTT, CRAIG A MD	7/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	33987	40	Pediatrics	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	45	06089	40.57278686	-122.3958519	Shasta County
17510	Fee-for-Service	1598874968	1598874968	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1735 EUCLID AVE	None	SAN DIEGO	CA	92105	5414	37	06073	32.72325604	-117.0848986	San Diego County
17519	Fee-for-Service	1548753288	1548753288	1	1	TRUONG, JENNY LMFT	2/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41880 KALMIA STREET	SUITE 115	MURRIETA	CA	92562	8835	33	06065	33.55740114	-117.2157733	Riverside County
17543	Fee-for-Service	1306065388	1306065388	1	1	THOMAS, JUSTIN M MD	9/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125306	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
17566	Fee-for-Service	1982751756	1982751756	1	1	THANKACHEN, SANJAI M MD	10/30/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	103818	-	NOT APPLICABLE	0	In state provider	None	2272 PAMELA LANE	UNITS A, B, C	COSTA MESA	CA	92627	2903	30	06059	33.65705591	-117.9309485	Orange County
17572	Fee-for-Service	1265515753	1265515753	1	1	TRACEY ANN MCGUINN MD	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	345 SMITH AVE N	None	SAINT PAUL	MN	55102	2346	00	None	44.94251219	-93.1074995	Ramsey County
17582	Fee-for-Service	1922006378	1922006378	1	1	TSAI, EUGENE MD	8/17/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85849	20	Orthopedic Surgery	0	In state provider	None	911 S GARFIELD AVE	None	ALHAMBRA	CA	91801	4442	19	06037	34.08561	-118.1230895	Los Angeles County
17599	Fee-for-Service	1689348369	1689348369	1	1	TORRANCE PHARMACY LTC INC	5/11/2023	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	23600 TELO AVE	SUITE 160	TORRANCE	CA	90505	4035	19	06037	33.81215054	-118.3384029	Los Angeles County
17624	Fee-for-Service	1649565771	1649565771	1	1	THEOLOGIS, ALEXANDER A MD	7/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	124464	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
17674	Fee-for-Service	1215011879	1215011879	1	1	TU, STANLEY S MD	12/3/2007	207R00000X	NA	Other	026	PHYSICIANS	91082	41	Internal Medicine	0	In state provider	None	959 E WALNUT ST	STE 120	PASADENA	CA	91106	5364	19	06037	34.14962102	-118.1305187	Los Angeles County
17705	Fee-for-Service	1972919983	1972919983	1	1	TANJAVOUR, POOJA MD	2/12/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	158889	45	Nephrology (Renal-Kidney)	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5795	36	06071	34.47092468	-117.2977236	San Bernardino County
17734	Fee-for-Service	1396979688	1396979688	1	1	TRIFIRO, MICHAEL D MD	6/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115042	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
17763	Fee-for-Service	1144439944	1144439944	1	1	TRAN, VIVAN N MD	8/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121716	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
17765	Fee-for-Service	1801258264	1801258264	1	1	TZENG, ERIC MD	8/23/2021	207L00000X	NA	Other	026	PHYSICIANS	153819	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
17796	Fee-for-Service	1144296716	1144296716	1	1	TUBLIN,MITCHELL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3705 FIFTH AVE	None	PITTSBURGH	PA	15213	0000	00	None	40.44154544	-79.95885126	Allegheny County
17816	Fee-for-Service	1316056708	1316056708	1	1	THRIFTY PAYLESS INC	6/20/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	1300 W F ST	None	OAKDALE	CA	95361	3501	50	06099	37.76023251	-120.8622617	Stanislaus County
17832	Fee-for-Service	1306065388	1306065388	1	1	THOMAS, JUSTIN M MD	9/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125306	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
17881	Fee-for-Service	1053470708	1053470708	1	1	TSAI, PATRICIA S MD	9/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73191	18	Ophthalmology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
17946	Fee-for-Service	1013148246	1013148246	1	1	TEHRANY, GABRIELLA M MD	8/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112392	17	Ophthalmology, Otolaryngology, Rhinology (D.O.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
17982	Fee-for-Service	1508116377	1508116377	1	1	TOTAL RENAL CARE INC	12/1/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	5820 DOWNEY AVE	None	LONG BEACH	CA	90805	4517	19	06037	33.861168	-118.1511625	Los Angeles County
17994	Fee-for-Service	1902900350	1902900350	1	1	TAYMOR, MICHAEL J MD	6/29/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	60535	40	Pediatrics	0	In state provider	None	145 N CALIFORNIA AVE	None	PALO ALTO	CA	94301	3965	43	06085	37.43014536	-122.1416431	Santa Clara County
18001	Fee-for-Service	1770661670	1770661670	1	1	TAPIA, MARTHA F	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7804	None	None	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
18104	Fee-for-Service	1801883731	1801883731	1	1	TRI-VALLEY ORTHOPEDIC &	6/12/1986	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	SPORTS MEDICAL GROUP INC	5601 NORRIS CANYON RD	STE 130A	SAN RAMON	CA	94583	5407	07	06013	37.77772182	-121.9579459	Contra Costa County
18106	Fee-for-Service	1538302187	1538302187	1	1	TAN, JONATHAN M MD	9/9/2020	207LP3000X	NA	Other	026	PHYSICIANS	170009	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
18121	Fee-for-Service	1306065388	1306065388	1	1	THOMAS, JUSTIN M MD	9/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125306	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
18123	Fee-for-Service	1992763528	1992763528	1	1	TABATABAI, ZOHREH L MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74106	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
18134	Fee-for-Service	1669955043	1669955043	1	1	TALHADAS, RENATO LMFT	2/18/2025	1041C0700X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	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
18135	Fee-for-Service	1245720820	1245720820	1	1	TOTAL RENAL LABORATORIES INC	6/5/2019	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	3000 DAVITA WAY	None	DELAND	FL	32724	2005	00	None	29.07771764	-81.29415932	Volusia County
18259	Fee-for-Service	1679613863	1679613863	1	1	TOH, IRENE K MD	2/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	92955	41	Internal Medicine	0	In state provider	None	250 ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.06343546	-118.3835578	Los Angeles County
18274	Fee-for-Service	1194819565	1194819565	1	1	TOMLINSON, AMY L MD	1/17/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	144986	None	None	0	In state provider	None	2175 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	7024	09	06017	38.91234551	-119.9972565	El Dorado County
18313	Fee-for-Service	1225048713	1225048713	1	1	TERAN, KARI K MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61873	08	Family Practice	0	In state provider	None	1144 SONOMA AVE	STE 119	SANTA ROSA	CA	95405	4812	49	06097	38.441097	-122.6989755	Sonoma County
18323	Fee-for-Service	1073552295	1073552295	1	1	TRAN, MICHAEL T	10/29/2019	174400000X	NA	Other	026	PHYSICIANS	64366	67	Endocrinology	0	In state provider	None	1310 W STEWART DR	215	ORANGE	CA	92868	3837	30	06059	33.78236048	-117.8664975	Orange County
18356	Fee-for-Service	1639533862	1639533862	1	1	TURNING POINT OF CENTRAL	5/23/2017	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA, INC	1845 SOUTH COURT STREET	None	VISALIA	CA	93277	5423	54	06107	36.313893	-119.2924215	Tulare County
18379	Fee-for-Service	1053398552	1053398552	1	1	TOLIVER, ELMER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 W VOTAW ST	None	PORTLAND	IN	47371	1322	00	None	40.441311	-84.9849345	Jay County
18414	Fee-for-Service	1992763528	1992763528	1	1	TABATABAI, ZOHREH L MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74106	90	Pathology-Forensic	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
18417	Fee-for-Service	1992883565	1992883565	1	1	TRUONG, SARAH L MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93047	07	Dermatology	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
18426	Fee-for-Service	1639124217	1639124217	1	1	TORRES, JAMES C. MD	3/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 HOSPITAL DR	None	KETCHUM	ID	83340	0100	00	None	43.6482607	-114.3490716	Blaine County
18458	Fee-for-Service	1205835634	1205835634	1	1	TANDON,SMITA B MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	49104	None	None	0	In state provider	None	11100 WARNER AVE	STE 368	FOUNTAIN VALLEY	CA	92708	7514	30	06059	33.716291	-117.9355051	Orange County
18477	Fee-for-Service	1740413780	1740413780	1	1	TIWANA, HARMANDEEP S MD	4/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121271	41	Internal Medicine	0	In state provider	None	400 E OAK AVE	None	VISALIA	CA	93291	5034	54	06107	36.332253	-119.288691	Tulare County
18490	Fee-for-Service	1639715220	1639715220	1	1	TORRES, CHRISTIAN EUGENE PT	8/3/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	815 TUCKER RD	B	TEHACHAPI	CA	93561	2513	15	06029	35.123004	-118.4678255	Kern County
18502	Fee-for-Service	1760411045	1760411045	1	1	TULL, GERALD MD	10/31/1994	207L00000X	NA	Other	026	PHYSICIANS	60677	05	Anesthesiology	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
18512	Fee-for-Service	1033779947	1033779947	1	2	TOTAL INFUSION INC.	7/14/2021	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	6955 FOOTHILL BLVD	67A	OAKLAND	CA	94605	2455	01	06001	37.76924146	-122.1732586	Alameda County
18537	Fee-for-Service	1730258336	1730258336	1	1	TOMS, CARLA A MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	81444	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 204B	LOMA LINDA	CA	92354	3130	36	06071	34.04805253	-117.249534	San Bernardino County
18542	Fee-for-Service	1215666250	1215666250	1	1	TICE, MEGAN N AU	1/9/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W. PROVIDENCE	None	ORANGE	CA	92868	3808	30	06059	33.78142951	-117.866583	Orange County
18544	Fee-for-Service	1043478126	1043478126	1	1	TERRIO, TIMOTHY J PT	10/28/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11206 OLIVE DR	102	BAKERSFIELD	CA	93312	5846	15	06029	35.41981347	-119.1272175	Kern County
18563	Fee-for-Service	1275730699	1275730699	1	1	TURNER, TAMARA K LMFT	5/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
18579	Fee-for-Service	1144812314	1144812314	1	1	THOMAS, JEANETTA LCSW	3/24/2025	101YM0800X	NA	Other	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
18619	Fee-for-Service	1235248626	1235248626	1	1	THRIFTY PAYLESS, INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20 E 18TH ST	None	ANTIOCH	CA	94509	2400	07	06013	38.00492045	-121.804875	Contra Costa County
18656	Fee-for-Service	1619178498	1619178498	1	1	TOBIN, MICHELLE L LAC	2/21/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1730 MAIN ST	C	FORTUNA	CA	95540	2467	12	06023	40.59765205	-124.14804	Humboldt County
18666	Fee-for-Service	1144594318	1144594318	1	1	TUTTLE, STACEY M	3/19/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
18689	Fee-for-Service	1598260424	1598260424	1	1	TAYA, MICHIO D MD	6/14/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184498	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
18701	Fee-for-Service	1730331000	1730331000	1	1	TRIPLE R RESOURCES INC	8/28/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	537 E VINE AVE	STE A	WEST COVINA	CA	91790	5102	19	06037	34.05777437	-117.9351276	Los Angeles County
18755	Fee-for-Service	1356303168	1356303168	1	1	TLC PEDIATRIC MED GRP	10/8/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	30210 RANCHO VIEJO RD	STE A	SAN JUAN CAPISTRA	CA	92675	1574	30	06059	33.52396438	-117.6658881	Orange County
18763	Fee-for-Service	1437338696	1437338696	1	1	TIROL, FRANCISCO T MD IN	12/14/2007	208600000X	NA	General Surgery	026	PHYSICIANS	36171	02	General Surgery	0	In state provider	None	751 W LEGION RD	#205	BRAWLEY	CA	92227	7732	13	06025	32.95996012	-115.5538196	Imperial County
18777	Fee-for-Service	1487009460	1487009460	1	1	TEMPLE, WILLIAM C MD	6/27/2022	2080P0207X	NA	Hematology	026	PHYSICIANS	155787	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
18828	Fee-for-Service	1083817514	1083817514	1	1	TAN, MICHELLE H	5/7/2012	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	101 S FIRST STREET	STE 1800	BURBANK	CA	91502	1959	19	06037	34.17942444	-118.3096895	Los Angeles County
18928	Fee-for-Service	1154789360	1154789360	1	1	TIMMER, CAROLINE LCSW	7/2/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
19079	Fee-for-Service	1528421823	1528421823	1	1	THOMAS, ADRIAN MD	7/1/2020	207P00000X	NA	Other	026	PHYSICIANS	155177	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
19097	Fee-for-Service	1720544679	1720544679	1	1	TERAN DE RODRIGUEZ, FRANCELI	9/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	A LMFT	3585 MAPLE ST	246	VENTURA	CA	93003	3504	56	06111	34.26916737	-119.2456769	Ventura County
19107	Fee-for-Service	1891720116	1891720116	1	1	TALAN, STACI J DC	2/17/2021	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
19125	Fee-for-Service	1013334168	1013334168	1	1	TRUONG, BRIAN V A MD	1/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140896	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
19134	Fee-for-Service	1588797773	1588797773	1	1	TRINH, HAYLEY T LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
19142	Fee-for-Service	1407172935	1407172935	1	1	TAMM-DANIELS, INGE J MD	10/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136135	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
19144	Fee-for-Service	1336333954	1336333954	1	1	TWIN CITIES SURGICAL HOSP	6/16/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	455 PLUMAS BLVD	None	YUBA CITY	CA	95991	5074	51	06101	39.13180779	-121.6136017	Sutter County
19170	Fee-for-Service	1396781597	1396781597	1	1	TAO, YONG MD	12/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87920	22	Pathology (M.D. only)	0	In state provider	None	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
19191	Fee-for-Service	1184119505	1184119505	1	1	TAN, ANDREW P MD	7/20/2022	390200000X	NA	Other	026	PHYSICIANS	166162	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
19213	Fee-for-Service	1326331364	1326331364	1	1	TRAINOR MEDICAL TRANSPORT	7/6/2011	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	4326 HIGHLAND PLACE	None	RIVERSIDE	CA	92506	1105	33	06065	33.9716547	-117.3924692	Riverside County
19222	Fee-for-Service	1144753773	1144753773	1	1	TELLEZ, MARCUS DO	1/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18487	None	None	0	In state provider	None	150 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	2142	19	06037	34.06812722	-118.3837146	Los Angeles County
19237	Fee-for-Service	1063537512	1063537512	1	1	TACBAS, JEREMY L LMFT	7/2/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5727 DUNSMUIR AVE	None	DUNSMUIR	CA	96025	2008	47	06093	41.21155776	-122.2717303	Siskiyou County
19260	Fee-for-Service	1548291180	1548291180	1	1	TAW, LAWRENCE B MD	6/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84687	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
19336	Fee-for-Service	1932493053	1932493053	1	1	TOLPINRUD, WHITNEY L MD	7/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142515	07	Dermatology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
19341	Fee-for-Service	1801530878	1801530878	1	1	TRENT BROOKSHIER DPM PC	5/29/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3989 32ND ST	None	SAN DIEGO	CA	92104	2001	37	06073	32.75020917	-117.1251946	San Diego County
19361	Fee-for-Service	1124219316	1124219316	1	1	TIBUNI-SANDERS, SUSAN M MD	11/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123761	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
19365	Fee-for-Service	1548399207	1548399207	1	2	TSE-YEE, KAM-NIN J LCSW	2/2/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	11721 TELEGRAPH RD	None	SANTA FE SPRINGS	CA	90670	3674	19	06037	33.94629336	-118.0832752	Los Angeles County
19372	Fee-for-Service	1073647632	1073647632	1	1	TRIPP, SHERI L LMFT	9/18/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2600 MISSION STREET	SUITE 201	SAN MARINO	CA	91008	1676	19	06037	34.11610632	-118.1375175	Los Angeles County
19394	Fee-for-Service	1578967717	1578967717	1	1	TARIQ JAVED, MD INC.	12/1/2014	207RN0300X	NA	Nephrology	026	PHYSICIANS	102388	None	None	0	In state provider	None	515 S LOCUST ST	None	VISALIA	CA	93277	2616	54	06107	36.325647	-119.2936365	Tulare County
19431	Fee-for-Service	1336333954	1336333954	1	1	TWIN CITIES SURGICAL HOSP	6/16/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	455 PLUMAS BLVD	None	YUBA CITY	CA	95991	5074	51	06101	39.13180779	-121.6136017	Sutter County
19433	Fee-for-Service	1154430643	1154430643	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5706	13720 BEAR VALLEY RD	None	VICTORVILLE	CA	92392	8713	36	06071	34.47044148	-117.3637665	San Bernardino County
19441	Fee-for-Service	1184943250	1184943250	1	1	TUNG, JOY T DO	4/7/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	12251	08	Family Practice	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
19522	Fee-for-Service	1841533502	1841533502	1	1	TSAI, BENJAMIN T MD	8/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132840	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
19533	Fee-for-Service	1972033785	1972033785	1	1	TLIMAT, NOUR MD	9/3/2021	207R00000X	NA	Other	026	PHYSICIANS	170013	None	None	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
19536	Fee-for-Service	1508977158	1508977158	1	1	TRANG, NHAN V MD	10/31/1995	208M00000X	NA	Other	026	PHYSICIANS	60532	41	Internal Medicine	0	In state provider	None	488 E VALLEY PKWY	STE 314	ESCONDIDO	CA	92025	3376	37	06073	33.12523814	-117.0769715	San Diego County
19591	Fee-for-Service	1427167873	1427167873	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06008	1707 MCHENRY AVE	None	MODESTO	CA	95350	4306	50	06099	37.669248	-120.9940175	Stanislaus County
19617	Fee-for-Service	1972965630	1972965630	1	1	TEAL, ELIZABETH N MD MPH	6/15/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	153397	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
19640	Fee-for-Service	1073151213	1073151213	1	1	TERUKINA, CAITLIN PT	6/25/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	949 S STATE ST	None	HEMET	CA	92543	7182	33	06065	33.73230496	-116.9716029	Riverside County
19648	Fee-for-Service	1326046400	1326046400	1	1	TIMOTHY H TROEH	8/26/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	915 ANDERSON DR	None	ABERDEEN	WA	98520	1006	00	None	46.979334	-123.8464165	Grays Harbor County
19673	Fee-for-Service	1144370594	1144370594	1	1	THIRD STREET SURGERY	1/12/2005	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER LP	420 E 3RD ST	STE 110	LOS ANGELES	CA	90013	1645	19	06037	34.04702011	-118.241912	Los Angeles County
19719	Fee-for-Service	1164777975	1164777975	1	1	TU, JENNIFER M OD	10/11/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
19756	Fee-for-Service	1235982265	1235982265	1	1	TMC FREIGHT LLC	4/22/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	139 W 119TH ST	None	LOS ANGELES	CA	90061	1739	19	06037	33.92470147	-118.275399	Los Angeles County
19777	Fee-for-Service	1467459776	1467459776	1	1	TORRANCE MEMORIAL MED CT	5/10/1994	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90509	9977	19	06037	33.81253631	-118.3435557	Los Angeles County
19782	Fee-for-Service	1528177078	1528177078	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	JUNDTS PHARMACY #5529	647 FOOTHILL BLVD	None	LA CANADA	CA	91011	3403	19	06037	34.20325513	-118.1924747	Los Angeles County
19784	Fee-for-Service	1225320237	1225320237	1	1	THOMPSON, KIMBERLY A MD	2/5/2022	2086S0129X	NA	General Surgery	026	PHYSICIANS	122195	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
19818	Fee-for-Service	1063976769	1063976769	1	1	THORNE, CHANDRA	11/16/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	215 S GALE DR APT C	None	BEVERLY HILLS	CA	90211	3491	19	06037	34.06387061	-118.3741211	Los Angeles County
19859	Fee-for-Service	1164494514	1164494514	1	1	TOMAICH, JOHN A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	79814	02	General Surgery	0	In state provider	J ALEX TOMAICH, DDS INC	116 B ST	None	DAVIS	CA	95616	4610	57	06113	38.54182804	-121.7440864	Yolo County
19917	Fee-for-Service	1700097540	1700097540	1	2	THE NORTHEAST COMMUNITY CLNC	8/27/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5420 N FIGUEROA STREET	None	LOS ANGELES	CA	90042	4118	19	06037	34.10779213	-118.196385	Los Angeles County
19932	Fee-for-Service	1003152869	1003152869	1	1	THURMAN, DAVID M LMFT	1/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28481 RANCHO CALIFORNIA	205	TEMECULA	CA	92590	3610	33	06065	33.49799525	-117.1575116	Riverside County
19939	Fee-for-Service	1417482522	1417482522	1	1	THAKKAR, ADITI R MD	8/24/2022	207RE0101X	NA	Endocrinology	026	PHYSICIANS	170101	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
19949	Fee-for-Service	1851454128	1851454128	1	1	THEARD, NICOLETTE M PT	2/26/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
19968	Fee-for-Service	1073523007	1073523007	1	1	TURLOCK EYE PHYSICIANS	5/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	MEDICAL GROUP	880 DELBON AVE	None	TURLOCK	CA	95382	2005	50	06099	37.51046554	-120.8381799	Stanislaus County
19997	Fee-for-Service	1629502711	1629502711	1	1	TSAO, JESSICA MD	8/4/2022	207P00000X	NA	Other	026	PHYSICIANS	172542	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
20029	Fee-for-Service	1295933653	1295933653	1	1	TENNER, ANDREA G MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132134	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
20103	Fee-for-Service	1063976769	1063976769	1	1	THORNE, CHANDRA	11/16/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	215 S GALE DR APT C	None	BEVERLY HILLS	CA	90211	3491	19	06037	34.06387061	-118.3741211	Los Angeles County
20137	Fee-for-Service	1518490218	1518490218	1	1	THOMAS, SEAN V MD	4/25/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	171303	None	None	0	In state provider	None	1200 DISCOVERY DR	None	BAKERSFIELD	CA	93309	7032	15	06029	35.36397746	-119.0589062	Kern County
20162	Fee-for-Service	1699884015	1699884015	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	135 SUNSET AVE	None	SUISUN CITY	CA	94585	2062	48	06095	38.24443096	-122.018532	Solano County
20170	Fee-for-Service	1811023443	1811023443	1	1	TADIKONDA, MOHAN V MD	8/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85738	13	Neurology (M.D. only)	0	In state provider	PACIFIC NEUR CONSULTANTS	2880 ATLANTIC AVE	STE 280	LONG BEACH	CA	90806	1705	19	06037	33.809382	-118.185001	Los Angeles County
20173	Fee-for-Service	1679831630	1679831630	1	1	THERTUS, VALERIE MD	3/20/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	171256	36	Psychiatry	0	In state provider	None	415 KNOLLCREST DR	STE 101	REDDING	CA	96002	0181	45	06089	40.57267376	-122.3643496	Shasta County
20205	Fee-for-Service	1700097540	1700097540	1	2	THE NORTHEAST COMMUNITY CLNC	5/31/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5420 N FIGUEROA STREET	None	LOS ANGELES	CA	90042	4118	19	06037	34.10779213	-118.196385	Los Angeles County
20209	Fee-for-Service	1619041449	1619041449	1	1	TULARE COUNTY CCS	5/28/2004	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	PORTERVILLE MTU	1051 S PLANO ST	None	PORTERVILLE	CA	93257	6026	54	06107	36.0471881	-119.0084126	Tulare County
20250	Fee-for-Service	1962781260	1962781260	1	1	TOWNSEND, KEVIN C	1/24/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	11600 WILSHIRE BLVD	STE 114	LOS ANGELES	CA	90025	1733	19	06037	34.05055194	-118.4594619	Los Angeles County
20272	Fee-for-Service	1528014412	1528014412	1	1	THEOCHARIDES, THOMAS MD	7/22/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166702	None	None	0	In state provider	None	ONE HOAG DR	6100	NEWPORT BEACH	CA	92658	6100	30	06059	33.62421676	-117.9309656	Orange County
20294	Fee-for-Service	1336496587	1336496587	1	1	TERZIAN, MICHAEL V OD PC	10/22/2012	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11151 TAMPA AVE	None	NORTHRIDGE	CA	91326	2254	19	06037	34.27373836	-118.5564202	Los Angeles County
20317	Fee-for-Service	1528566429	1528566429	1	1	TIL SERVICES INC	9/1/2018	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	2215 E COLORADO BLVD	None	PASADENA	CA	91107	3642	19	06037	34.14609645	-118.104543	Los Angeles County
20363	Fee-for-Service	1851542633	1851542633	1	2	TADROS, SINDY K DO	2/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9767	None	None	0	In state provider	None	11411 BROOKSHIRE AVE	ST 304	DOWNEY	CA	90241	7010	19	06037	33.93667091	-118.1309273	Los Angeles County
20379	Fee-for-Service	1871998955	1871998955	1	1	TAFT, LISA M CRNA	5/25/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
20442	Fee-for-Service	1013788199	1013788199	1	1	TRAJANO, LAUREN NP	7/28/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
20493	Fee-for-Service	1700097540	1700097540	1	2	THE NORTHEAST COMMUNITY CLNC	9/3/2019	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5420 N FIGUEROA STREET	None	LOS ANGELES	CA	90042	4118	19	06037	34.10779213	-118.196385	Los Angeles County
20524	Fee-for-Service	1558411975	1558411975	1	1	TACTICAL MEDICAL GROUP INC	11/13/2015	207P00000X	NA	Other	026	PHYSICIANS	80484	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4398	13	06025	32.78144947	-115.568541	Imperial County
20529	Fee-for-Service	1578967717	1578967717	1	3	TARIQ JAVED, MD INC.	9/14/2023	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	855 GARNER AVE	None	HANFORD	CA	93230	4314	16	06031	36.32600845	-119.6573226	Kings County
20546	Fee-for-Service	1619073400	1619073400	1	1	TAYLOR, BRYAN S MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	89122	05	Anesthesiology	0	In state provider	None	14662 NEWPORT AVENUE	None	TUSTIN	CA	92780	6064	30	06059	33.73088521	-117.8293385	Orange County
20590	Fee-for-Service	1477631554	1477631554	1	1	TAN, KATHERINE MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	51983	40	Pediatrics	0	In state provider	None	5601 DEER VALLEY RD	None	ANTIOCH	CA	94531	8577	07	06013	37.9518204	-121.7780768	Contra Costa County
20700	Fee-for-Service	1376691303	1376691303	1	1	TALBOT, KAY S MD	4/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87229	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
20726	Fee-for-Service	1700895018	1700895018	1	1	TREANOR, SHANNA L MD	10/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70557	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
20771	Fee-for-Service	1962613422	1962613422	2	1	TUPAZ HOMES LLC	6/6/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3456 CALVIN AVENUE	None	SAN JOSE	CA	95124	2545	43	06085	37.2628239	-121.940002	Santa Clara County
20780	Fee-for-Service	1225349715	1225349715	1	1	TIMOTHY A RAISSIAN M.D.	4/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	475 S DOBSON RD	None	CHANDLER	AZ	85224	5605	00	None	33.29768043	-111.8761089	Maricopa County
20785	Fee-for-Service	1700097540	1700097540	1	2	THE NORTHEAST COMMUNITY CLNC	5/31/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5420 N FIGUEROA STREET	None	LOS ANGELES	CA	90042	4118	19	06037	34.10779213	-118.196385	Los Angeles County
20796	Fee-for-Service	1477628519	1477628519	1	1	TRAN, MYHANH T OD	11/6/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	EYESMILE OPTOMETRY	1752 E CARSON ST	None	CARSON	CA	90745	2506	19	06037	33.83164817	-118.2409337	Los Angeles County
20831	Fee-for-Service	1104937408	1104937408	1	1	TAHOE EMERG PHYSICIANS	9/23/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL CORPORATION	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
20873	Fee-for-Service	1689888943	1689888943	1	1	TRUONG, HAI V MD	3/24/2010	390200000X	NA	Other	026	PHYSICIANS	101864	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
20890	Fee-for-Service	1356826655	1356826655	1	1	TOP RATED HOME HEALTH, INC	3/24/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	10523 BURBANK BLVD	STE 217	NORTH HOLLYWOOD	CA	91601	2239	19	06037	34.17216449	-118.36017	Los Angeles County
20915	Fee-for-Service	1336589985	1336589985	1	1	TRAN, NAM PHUONG T MD	5/10/2021	207L00000X	NA	Other	026	PHYSICIANS	170462	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
20929	Fee-for-Service	1427437813	1427437813	1	1	TENNANT, RACHAEL S MD	11/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147455	41	Internal Medicine	0	In state provider	None	33758 YUCAIPA BLVD	None	YUCAIPA	CA	92399	2243	36	06071	34.03407872	-117.0672458	San Bernardino County
20953	Fee-for-Service	1649272568	1649272568	1	1	TRAN, SON THE	11/30/1992	207L00000X	NA	Other	026	PHYSICIANS	70556	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
21007	Fee-for-Service	1104935568	1104935568	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	575 M ST	None	CRESCENT CITY	CA	95531	2827	08	06015	41.75660863	-124.1952852	Del Norte County
21050	Fee-for-Service	1538503339	1538503339	1	1	TAN, AI-YUI M MD	11/8/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	182797	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
21155	Fee-for-Service	1548534670	1548534670	1	1	TURNER, APRIL OT	1/3/2022	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	7313 WHITTIER AVE	None	WHITTIER	CA	90602	1132	19	06037	33.975027	-118.043219	Los Angeles County
21291	Fee-for-Service	1992814321	1992814321	1	1	THRIFTY DRUG STORE 5923	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	1621 SYCAMORE AVE	None	HERCULES	CA	94547	1707	07	06013	38.00942776	-122.2686385	Contra Costa County
21328	Fee-for-Service	1811081847	1811081847	1	1	TRIMMER, BRIAN M MD	5/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	1155 MILL STREET	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
21334	Fee-for-Service	1366614216	1366614216	1	1	THRUPP, LAURI D MD	3/22/1976	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	25108	41	Internal Medicine	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
21338	Fee-for-Service	1417009168	1417009168	1	1	TRAN, CHERRIE ANN S OD	2/1/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4767 WHITTIER BLVD	None	LOS ANGELES	CA	90022	3027	19	06037	34.02209019	-118.1651148	Los Angeles County
21374	Fee-for-Service	1831202092	1831202092	1	1	TAI, JENNY C DO	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	8494	01	General Practice	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
21397	Fee-for-Service	1114540374	1114540374	1	1	TOTAL RENAL CARE INC	6/3/2022	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1237 E MAIN ST	None	ALHAMBRA	CA	91801	4114	19	06037	34.10129883	-118.1140327	Los Angeles County
21456	Fee-for-Service	1720041908	1720041908	1	1	TOTAL RENAL CARE, INC	9/1/1996	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	8319 ALONDRA BLVD	None	PARAMOUNT	CA	90723	4403	19	06037	33.88929852	-118.153908	Los Angeles County
21457	Fee-for-Service	1013335108	1013335108	1	1	TEDJA, MARILYNN MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149108	41	Internal Medicine	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
21508	Fee-for-Service	1487949772	1487949772	1	1	THOMPSON, ALISON L LCSW	4/15/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	94265	-	NOT APPLICABLE	0	In state provider	None	3939 ATLANTIC AVE	SUITE 102	LONG BEACH	CA	90807	3535	19	06037	33.830073	-118.1851065	Los Angeles County
21553	Fee-for-Service	1538350343	1538350343	1	1	TODA, AUDREY C MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105188	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
21578	Fee-for-Service	1164517249	1164517249	1	1	THAI, TRUNG M MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54617	36	Psychiatry	0	In state provider	None	101 THE CITY DR S	BLDG 3	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
21584	Fee-for-Service	1801233788	1801233788	1	2	TERI LEE ARMSTEAD	6/30/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	12943 WOODHILL STREET	None	VICTORVILLE	CA	92392	0571	36	06071	34.4857929	-117.3963371	San Bernardino County
21597	Fee-for-Service	1013045129	1013045129	1	1	TSANG, LESLIE A DO	10/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9411	36	Psychiatry	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
21605	Fee-for-Service	1760845440	1760845440	1	1	TIMBIE, CLARE M MD	7/5/2022	2084N0402X	NA	Neurology	026	PHYSICIANS	152983	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
21616	Fee-for-Service	1013015783	1013015783	1	1	TWOGOOD, TODD A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 N 7TH ST	None	BISMARCK	ND	58501	4439	00	None	46.808109	-100.782261	Burleigh County
21695	Fee-for-Service	1437190147	1437190147	1	1	TARLETON, GUY W MD	6/4/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	80855	66	Emergency Medicine (Urgent Care)	0	In state provider	None	351 S PATTERSON AVE	None	SANTA BARBARA	CA	93111	2403	42	06083	34.43295562	-119.8098287	Santa Barbara County
21698	Fee-for-Service	1710132980	1710132980	1	1	THONGCHAROEN, MARUT K	9/15/2020	207R00000X	NA	Other	026	PHYSICIANS	141591	41	Internal Medicine	0	In state provider	None	2800 BENEDICT DR	None	SAN LEANDRO	CA	94577	6840	01	06001	37.71593435	-122.131151	Alameda County
21699	Fee-for-Service	1598950677	1598950677	1	1	TALBOTT, VANESSA A MD	10/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132022	28	Proctology (colon and rectal)	0	In state provider	None	3838 CALIFORNIA ST	STE 616	SAN FRANCISCO	CA	94118	1508	38	06075	37.78591809	-122.4575439	San Francisco County
21707	Fee-for-Service	1174632608	1174632608	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05559	387 E AVENIDA DE LOS ARB	None	THOUSAND OAKS	CA	91360	2933	56	06111	34.21782115	-118.8699959	Ventura County
21714	Fee-for-Service	1770692162	1770692162	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5649	6939 LINDA VISTA RD	None	SAN DIEGO	CA	92111	6305	37	06073	32.7855222	-117.1707068	San Diego County
21740	Fee-for-Service	1902128028	1902128028	1	1	TOM, WYNNSON W MD	1/31/2012	207L00000X	NA	Other	026	PHYSICIANS	101740	05	Anesthesiology	0	In state provider	None	2601 E CHAPMAN AVENUE	None	ORANGE	CA	92869	3206	30	06059	33.78785251	-117.826365	Orange County
21745	Fee-for-Service	1235150822	1235150822	1	1	TRUONG, HIEN N MD	4/20/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	53015	40	Pediatrics	0	In state provider	None	2593 S KING RD	STE 4	SAN JOSE	CA	95122	1880	43	06085	37.31897012	-121.8226795	Santa Clara County
21767	Fee-for-Service	1861886582	1861886582	1	1	TANSEY, JOELLE S NP	1/24/2023	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
21876	Fee-for-Service	1801233788	1801233788	1	2	TERI LEE ARMSTEAD	6/30/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	12943 WOODHILL STREET	None	VICTORVILLE	CA	92392	0571	36	06071	34.4857929	-117.3963371	San Bernardino County
21902	Fee-for-Service	1760758726	1760758726	1	1	THORNTON, AMANDA V MD	12/4/2019	207R00000X	NA	Other	026	PHYSICIANS	120230	77	Infectious Disease	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
21958	Fee-for-Service	1851561807	1851561807	1	2	TATULIAN, KARMEN S MD	11/17/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	101992	-	NOT APPLICABLE	0	In state provider	None	9140 VAN NUYS BLVD	SUITE 211	PANORAMA CITY	CA	91402	6727	19	06037	34.236603	-118.4502215	Los Angeles County
21987	Fee-for-Service	1598950677	1598950677	1	1	TALBOTT, VANESSA A MD	10/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132022	02	General Surgery	0	In state provider	None	3838 CALIFORNIA ST	STE 616	SAN FRANCISCO	CA	94118	1508	38	06075	37.78591809	-122.4575439	San Francisco County
21991	Fee-for-Service	1386753804	1386753804	1	1	THRIFTY PAYLESS INC	8/16/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	107 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	19	06037	33.89491137	-118.2079985	Los Angeles County
22015	Fee-for-Service	1811903131	1811903131	1	1	TABER, BRIAN J MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	61051	66	Emergency Medicine (Urgent Care)	0	In state provider	None	301 E 13TH ST	None	MERCED	CA	95340	6211	24	06047	37.29248035	-120.4730619	Merced County
22027	Fee-for-Service	1073580320	1073580320	3	1	TAMALPAIS PEDIATRICS	10/10/2023	193400000X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	5 BON AIR ROAD	STE 105	LARKSPUR	CA	94939	1137	21	06041	37.9438204	-122.5395357	Marin County
22041	Fee-for-Service	1104966126	1104966126	1	1	TURAKHIA, ATUR V MD	8/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	100063	36	Psychiatry	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
22047	Fee-for-Service	1518391275	1518391275	1	1	TRAN, ARTHUR-QUAN M MD	10/11/2019	207VX0201X	NA	Obstetrics & Gynecology	026	PHYSICIANS	125897	15	Obstetrics (D.O. only)	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
22049	Fee-for-Service	1285832410	1285832410	1	1	TRICHTER, STEPHEN M PSYD	3/3/2023	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
22054	Fee-for-Service	1952425803	1952425803	1	1	TSAI, WEN-YEE MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	112303	67	Endocrinology	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
22064	Fee-for-Service	1730143454	1730143454	1	5	THE REGENTS OF THE UNIVERSIT	2/4/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	27235 TOURNEY RD	1400	VALENCIA	CA	91355	5904	19	06037	34.41755702	-118.5772646	Los Angeles County
22091	Fee-for-Service	1285726307	1285726307	1	1	THOMAS B VADER, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 N MAIN ST	None	COUPEVILLE	WA	98239	3413	00	None	48.213756	-122.686102	Island County
22160	Fee-for-Service	1568771632	1568771632	1	2	TRI-DUNG G. HOANG MD, INC.	3/20/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	6540 STOCKTON BLVD	STE 3A	SACRAMENTO	CA	95823	1635	34	06067	38.507094	-121.434858	Sacramento County
22166	Fee-for-Service	1710325501	1710325501	1	1	TEWARI, SOWMYA MD	1/27/2024	2084P0804X	NA	Psychiatry	026	PHYSICIANS	154312	None	None	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
22167	Fee-for-Service	1205052990	1205052990	1	1	THIAGARAJAN, DEEPAK MD	1/10/2013	207R00000X	NA	Other	026	PHYSICIANS	113059	41	Internal Medicine	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
22169	Fee-for-Service	1770802746	1770802746	1	1	TSAO, RONALD MD	10/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138271	01	General Practice	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420 365 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
22175	Fee-for-Service	1497833149	1497833149	1	1	TAHERA, SABINA MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66789	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
22194	Fee-for-Service	1063686277	1063686277	1	1	TSAI, BERNETTE C MD	7/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110280	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
22212	Fee-for-Service	1952480170	1952480170	1	1	TORRANCE MEMORIAL MEDICAL	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CENTER	23326 HAWTHORNE BLVD	STE 100B	TORRANCE	CA	90505	3700	19	06037	33.814278	-118.351002	Los Angeles County
22228	Fee-for-Service	1962603530	1962603530	1	1	TAGGART, TRACY A MD	2/4/2022	208600000X	NA	General Surgery	026	PHYSICIANS	175274	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
22251	Fee-for-Service	1831593243	1831593243	1	1	TOTAL RENAL CARE INC	6/14/2017	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2700 GEARY BLVD	SUITE A	SAN FRANCISCO	CA	94118	3406	38	06075	37.78246712	-122.4483619	San Francisco County
22253	Fee-for-Service	1467595793	1467595793	1	1	TRUMAN MEDICAL CENTER INC	8/8/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL HILL	2301 HOLMES ST	None	KANSAS CITY	MO	64108	2640	00	None	39.08455286	-94.57578107	Jackson County
22264	Fee-for-Service	1740373174	1740373174	1	1	TIPLEA, LIDIA MD	2/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88088	13	Neurology (M.D. only)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
22291	Fee-for-Service	1578849527	1578849527	1	1	THAPAR, AKSHAY K MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125454	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1050 LINDEN AVENUE	None	LONG BEACH	CA	90813	3393	19	06037	33.78003775	-118.1866604	Los Angeles County
22301	Fee-for-Service	1811903131	1811903131	1	1	TABER, BRIAN J MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	61051	08	Family Practice	0	In state provider	None	301 E 13TH ST	None	MERCED	CA	95340	6211	24	06047	37.29248035	-120.4730619	Merced County
22309	Fee-for-Service	1639242589	1639242589	1	1	THOMAS, STEVEN J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	40379	08	Family Practice	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
22315	Fee-for-Service	1073580320	1073580320	3	1	TAMALPAIS PEDIATRICS	4/26/2024	193400000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	5 BON AIR ROAD	STE 105	LARKSPUR	CA	94939	1137	21	06041	37.9438204	-122.5395357	Marin County
22341	Fee-for-Service	1205891272	1205891272	1	1	THOMAS M FRANK MD	3/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2500 METRO HEALTH DR	None	CLEVELAND	OH	44109	0000	00	None	41.46242416	-81.69888235	Cuyahoga County
22349	Fee-for-Service	1730143454	1730143454	1	5	THE REGENTS OF THE UNIVERSIT	2/4/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	27235 TOURNEY RD	1400	VALENCIA	CA	91355	5904	19	06037	34.41755702	-118.5772646	Los Angeles County
22359	Fee-for-Service	1588630115	1588630115	1	1	THAETE, FRANK L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 LOTHROP ST	STE 3950	PITTSBURGH	PA	15213	2536	00	None	40.44188737	-79.96079711	Allegheny County
22383	Fee-for-Service	1265551238	1265551238	1	1	THOMPSON, DARLENE M LCSW	3/19/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1524 MCHENRY AVE	SUITE 370	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
22418	Fee-for-Service	1962034934	1962034934	1	1	TOMADA, ORION B PT	7/10/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1252 BROADWAY	SUITE B	PLACERVILLE	CA	95667	5806	09	06017	38.73128098	-120.7852781	El Dorado County
22429	Fee-for-Service	1720431018	1720431018	1	2	TEHRANI, FARAMARZ MD INC	1/25/2017	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	107378	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
22447	Fee-for-Service	1568771632	1568771632	1	2	TRI-DUNG G. HOANG MD, INC.	3/20/2020	207R00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	6540 STOCKTON BLVD	STE 3A	SACRAMENTO	CA	95823	1635	34	06067	38.507094	-121.434858	Sacramento County
22456	Fee-for-Service	1578589115	1578589115	1	1	TRAN, SANG D MD	5/14/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	167687	08	Family Practice	0	In state provider	None	13768 ROSWELL AVENUE	SUITE 118	CHINO	CA	91710	1402	36	06071	34.0038	-117.7218555	San Bernardino County
22461	Fee-for-Service	1770802746	1770802746	1	1	TSAO, RONALD MD	10/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138271	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420 365 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
22467	Fee-for-Service	1881256428	1881256428	1	1	TRAPUZZANO, ASHLEIGH PT	12/30/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
22475	Fee-for-Service	1831170216	1831170216	1	1	TYLER, KATREN R MD	7/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84694	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
22481	Fee-for-Service	1841202744	1841202744	1	1	THOMAS, KEVIN C MD	10/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	52385	01	General Practice	0	In state provider	None	7301 S WESTERN AVE	None	LOS ANGELES	CA	90047	2254	19	06037	33.973479	-118.309018	Los Angeles County
22501	Fee-for-Service	1952480170	1952480170	1	1	TORRANCE MEMORIAL MEDICAL	6/10/1993	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CENTER	23326 HAWTHORNE BLVD	STE 100B	TORRANCE	CA	90505	3700	19	06037	33.814278	-118.351002	Los Angeles County
22529	Fee-for-Service	1043861172	1043861172	1	1	TOTAL RENAL CARE INC	5/8/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1090 ATLANTIC AVE	None	LONG BEACH	CA	90813	3403	19	06037	33.780708	-118.185023	Los Angeles County
22543	Fee-for-Service	1467595793	1467595793	1	1	TRUMAN MEDICAL CENTER INC	8/8/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL HILL	2301 HOLMES ST	None	KANSAS CITY	MO	64108	2640	00	None	39.08455286	-94.57578107	Jackson County
22552	Fee-for-Service	1356308266	1356308266	1	1	TRACY, BRIAN D OD	6/1/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3000 L ST	STE 100	SACRAMENTO	CA	95816	5248	34	06067	38.570517	-121.4672175	Sacramento County
22570	Fee-for-Service	1457427767	1457427767	1	1	TEMPLETON IMAGING	2/1/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL CORPORATION, INC	262 POSADA LN	STE C	TEMPLETON	CA	93465	4057	40	06079	35.5535294	-120.7214694	San Luis Obispo County
22575	Fee-for-Service	1003813783	1003813783	1	1	TRIOLO, DONALD DPM	8/1/1984	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6699 ALVARADO RD	STE 2110	SAN DIEGO	CA	92120	5253	37	06073	32.77665383	-117.0540279	San Diego County
22590	Fee-for-Service	1366551806	1366551806	1	1	THRIFTY PAYLESS INC	10/29/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6378	8027 N CEDAR AVE	None	FRESNO	CA	93720	4827	10	06019	36.852633	-119.756908	Fresno County
22596	Fee-for-Service	1639242589	1639242589	1	1	THOMAS, STEVEN J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	40379	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
22603	Fee-for-Service	1073580320	1073580320	3	1	TAMALPAIS PEDIATRICS	5/11/2021	193400000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	5 BON AIR ROAD	STE 105	LARKSPUR	CA	94939	1137	21	06041	37.9438204	-122.5395357	Marin County
22629	Fee-for-Service	1225529167	1225529167	1	1	THEUS, MARCUS J MD	6/28/2023	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
22631	Fee-for-Service	1962462861	1962462861	1	1	TORREY NASH	1/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	645 E 5TH ST	None	WEISER	ID	83672	2202	00	None	44.248716	-116.9617265	Washington County
22665	Fee-for-Service	1124582309	1124582309	1	1	TURECEK, BRET E LPCC	8/5/2021	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23151 MOULTON PKWY	None	LAGUNA HILLS	CA	92653	1206	30	06059	33.62638366	-117.7305455	Orange County
22688	Fee-for-Service	1639270275	1639270275	1	1	THAI, DIEUMY MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	64401	01	General Practice	0	In state provider	None	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
22763	Fee-for-Service	1831170216	1831170216	1	1	TYLER, KATREN R MD	7/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84694	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
22769	Fee-for-Service	1841202744	1841202744	1	1	THOMAS, KEVIN C MD	10/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	52385	05	Anesthesiology	0	In state provider	None	7301 S WESTERN AVE	None	LOS ANGELES	CA	90047	2254	19	06037	33.973479	-118.309018	Los Angeles County
22791	Fee-for-Service	1538103502	1538103502	1	1	THOMAS, PATRICK J MD	11/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81138	20	Orthopedic Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
22797	Fee-for-Service	1871170167	1871170167	1	1	THOMAS, SHERIN MD	5/25/2023	390200000X	NA	Other	026	PHYSICIANS	20845	None	None	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
22804	Fee-for-Service	1245869601	1245869601	1	1	TALAMAYAN-PASCUA, ROXANNE M	8/21/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181262	08	Family Practice	0	In state provider	D	202 W WILLOW AVE	SUITE 502	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
22820	Fee-for-Service	1740493030	1740493030	1	1	TETRAULT, DEBRA D	8/26/2004	164X00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	8340 CEREUS CT	None	ANTELOPE	CA	95843	5174	34	06067	38.720754	-121.3536375	Sacramento County
22829	Fee-for-Service	1548455645	1548455645	1	1	TULLY, KAITLIN E PHD	11/17/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY STREET	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
22856	Fee-for-Service	1568590206	1568590206	1	1	TOWNSEND, TIFFANY C MD	7/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77397	None	None	0	In state provider	None	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
22863	Fee-for-Service	1609022383	1609022383	1	1	TANG, RONALD DO	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11008	None	None	0	In state provider	None	1505 WILSON TERRACE	STE 200	GLENDALE	CA	91206	4071	19	06037	34.14960934	-118.2313491	Los Angeles County
22865	Fee-for-Service	1063013183	1063013183	1	1	TOTORIS, KATHLEEN LCSW	3/20/2025	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6904 VILLAGE PARKWAY	None	DUBLIN	CA	94568	2406	01	06001	37.70726135	-121.9248393	Alameda County
22872	Fee-for-Service	1972254332	1972254332	1	2	TRIPLEAIM HEALTHCARE	12/7/2022	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
22895	Fee-for-Service	1073580320	1073580320	3	1	TAMALPAIS PEDIATRICS	9/8/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	5 BON AIR ROAD	STE 105	LARKSPUR	CA	94939	1137	21	06041	37.9438204	-122.5395357	Marin County
22909	Fee-for-Service	1265574867	1265574867	1	1	TOMINAGA, GAIL T MD	2/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	57834	02	General Surgery	0	In state provider	None	9888 GENESEE AVE	LJ-601	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
22911	Fee-for-Service	1306595715	1306595715	1	1	TAHOE FAMILY HEARING CLINIC,	10/27/2022	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2074 LAKE TAHOE BLVD	9	SOUTH LAKE TAHOE	CA	96150	6407	09	06017	38.91488542	-120.0019087	El Dorado County
22966	Fee-for-Service	1669581955	1669581955	1	1	THRIFTY PAYLESS INC	3/31/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	RITE AID #5388	2521 S 6TH ST	None	KLAMATH FALLS	OR	97601	4343	00	None	42.21200317	-121.7583644	Klamath County
22968	Fee-for-Service	1770509473	1770509473	1	1	TRAN, MICHAEL N MD	9/1/2000	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	84438	41	Internal Medicine	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
23045	Fee-for-Service	1114421534	1114421534	1	1	TRUONG, THU P MD	12/7/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173384	None	None	0	In state provider	None	1301 SHOREWAY RD	STE 100	BELMONT	CA	94002	4110	41	06081	37.5239043	-122.2667778	San Mateo County
23124	Fee-for-Service	1710118013	1710118013	1	1	TRAN, ALLEN N MD	10/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106512	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
23132	Fee-for-Service	1326095704	1326095704	1	1	TRUHLAR, SCOTT M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	RADIOLOGIC MED SERV PC	500 E. MARKET ST	None	IOWA CITY	IA	52245	0000	00	None	41.664114	-91.5284205	Johnson County
23195	Fee-for-Service	1932127610	1932127610	1	1	TEDE, NIKOLA H MD	4/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78399	40	Pediatrics	0	In state provider	None	2340 CLAY ST	FL 3	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
23218	Fee-for-Service	1437100351	1437100351	1	1	TABAK, MOSHE MD	4/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	40257	05	Anesthesiology	0	In state provider	None	2701 W ALAMEDA AVE	STE 203	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
23225	Fee-for-Service	1053436568	1053436568	1	1	TAUR, JOYCE W MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74755	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
23246	Fee-for-Service	1750863890	1750863890	1	1	TSAI, RUTH MSW LCSW	12/23/2022	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
23255	Fee-for-Service	1770509473	1770509473	1	1	TRAN, MICHAEL N MD	9/1/2000	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	84438	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
23266	Fee-for-Service	1447510854	1447510854	1	1	TIAN, SISI MD	9/1/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	126477	84	Surgery-Head and Neck	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
23285	Fee-for-Service	1770626921	1770626921	1	1	TYKO, LEONARD M II MD	7/1/2000	1223S0112X	NA	Dental Provider	026	PHYSICIANS	71195	84	Surgery-Head and Neck	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
23292	Fee-for-Service	1710273792	1710273792	1	1	TABANKIA, RAHA LCSW	11/19/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	62908	-	NOT APPLICABLE	0	In state provider	None	8140 SUNLAND BLVD	None	SUN VALLEY	CA	91352	3948	19	06037	34.21829866	-118.3696743	Los Angeles County
23308	Fee-for-Service	1710469622	1710469622	1	1	TEKERIAN, LARISSA T LCSW	12/18/2023	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
23395	Fee-for-Service	1932353133	1932353133	1	1	THRIFTY PAYLESS INC.	4/30/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PARMACY #06472	1035 W ORANGETHORPE AVE.	None	FULLERTON	CA	92833	4733	30	06059	33.85936074	-117.9431633	Orange County
23455	Fee-for-Service	1548294101	1548294101	1	1	TSAI, TONY MD	10/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96629	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
23484	Fee-for-Service	1932127610	1932127610	1	1	TEDE, NIKOLA H MD	4/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78399	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	2340 CLAY ST	FL 3	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
23502	Fee-for-Service	1588840730	1588840730	1	1	TANG, LAUREN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	680 N LAKE SHORE DR	STE 1000	CHICAGO	IL	60611	8709	00	None	41.89498774	-87.61585515	Cook County
23554	Fee-for-Service	1447510854	1447510854	1	1	TIAN, SISI MD	9/1/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	126477	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
23556	Fee-for-Service	1417271743	1417271743	1	1	TSAI, CHIH-HUI	5/31/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
23557	Fee-for-Service	1487874954	1487874954	1	1	TALLEY, ELIZABETH M MD	6/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	85079	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
23568	Fee-for-Service	1245247048	1245247048	1	1	TANG, ROBERT E DPM	2/8/2015	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	560 JENEVEIN AVE	None	SAN BRUNO	CA	94066	4408	41	06081	37.62353466	-122.4114981	San Mateo County
23614	Fee-for-Service	1912901430	1912901430	1	1	TONG, EUGENE MD	5/9/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	1504 N WISHON AVE	None	FRESNO	CA	93728	1827	10	06019	36.763497	-119.8010405	Fresno County
23647	Fee-for-Service	1356349831	1356349831	1	1	TAYLOR, STEPHEN P MD	1/24/1996	208800000X	NA	Other	026	PHYSICIANS	30433	34	Urology and Urological Surgery	0	In state provider	None	2222 EAST ST	STE 250	CONCORD	CA	94520	2096	07	06013	37.98125538	-122.0329375	Contra Costa County
23662	Fee-for-Service	1568844645	1568844645	1	1	THOMPSON-MAYNEZ, LISA S MD	11/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152823	None	None	0	In state provider	None	33758 YUCAIPA BLVD	None	YUCAIPA	CA	92399	2243	36	06071	34.03407872	-117.0672458	San Bernardino County
23666	Fee-for-Service	1427168202	1427168202	1	1	THRIFTY PAYLESS INC	9/23/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06219	5128 E 2ND ST	None	LONG BEACH	CA	90803	5322	19	06037	33.76040894	-118.1353932	Los Angeles County
23693	Fee-for-Service	1629085568	1629085568	1	1	THRIFTY PAYLESS INC	2/11/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6072	2801 K ST	None	SACRAMENTO	CA	95816	5120	34	06067	38.572947	-121.46904	Sacramento County
23719	Fee-for-Service	1376641076	1376641076	1	1	THOMPSON, RICHARD F MD	12/22/1972	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	29326	08	Family Practice	0	In state provider	None	596 CARROLL ST	None	SUNNYVALE	CA	94086	6207	43	06085	37.36853041	-122.0305901	Santa Clara County
23732	Fee-for-Service	1669520458	1669520458	1	1	TURLA, JOHN V MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	49988	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
23735	Fee-for-Service	1447801105	1447801105	1	1	TEMPLETON UNIFIED SCHOOL	7/1/2019	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	960 OLD COUNTY ROAD	None	TEMPLETON	CA	93465	5063	40	06079	35.54467655	-120.7107917	San Luis Obispo County
23788	Fee-for-Service	1891992202	1891992202	1	1	TOLENTINO, MARIA C DO	5/25/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	10619	08	Family Practice	0	In state provider	None	1601 N MONTE VISTA AVE	None	CLAREMONT	CA	91711	6601	19	06037	34.112259	-117.698539	Los Angeles County
23793	Fee-for-Service	1457734014	1457734014	1	1	TAN, ALVIN C OD	9/28/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	311 WINSTON STREET	None	LOS ANGELES	CA	90013	1519	19	06037	34.0454147	-118.2447356	Los Angeles County
23835	Fee-for-Service	1467757401	1467757401	1	1	TAN, CLAUDETTE L MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115039	40	Pediatrics	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
23864	Fee-for-Service	1528080504	1528080504	1	1	TOLER, DOUGLAS R MD	12/31/1986	207P00000X	NA	Other	026	PHYSICIANS	59406	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 W E ST	None	TEHACHAPI	CA	93561	1607	15	06029	35.13009994	-118.4488237	Kern County
23890	Fee-for-Service	1649534389	1649534389	1	1	THEKKEKAROTT KURUVILA, ARUN	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2640 E BARNETT RD	E333	MEDFORD	OR	97504	4301	00	None	42.31645852	-122.834421	Jackson County
23915	Fee-for-Service	1013979814	1013979814	1	3	TURBOW, ROBERT M MD	8/26/2019	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	69024	40	Pediatrics	0	In state provider	None	1400 CHURCH	BLDG 8	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
23981	Fee-for-Service	1295238038	1295238038	1	1	TRAN, ANTHONY MD	11/6/2023	208VP0000X	NA	Other	026	PHYSICIANS	191405	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
24060	Fee-for-Service	1225208721	1225208721	1	1	TORRELINO, VINCENT M PT	6/8/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6640 ALTON PARKWAY	None	IRVINE	CA	92618	3734	30	06059	33.65911992	-117.7737909	Orange County
24150	Fee-for-Service	1942471941	1942471941	1	2	TRUNG MINH NGUYEN, MD, INC	8/15/2022	156FX1100X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	11180 WARNER AVENUE	SUITE 151	FOUNTAIN VALLEY	CA	92708	7515	30	06059	33.71632048	-117.9334575	Orange County
24204	Fee-for-Service	1003839671	1003839671	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05890	1400 LINDA MAR BLVD	None	PACIFICA	CA	94044	4327	41	06081	37.59528768	-122.5031221	San Mateo County
24205	Fee-for-Service	1043306830	1043306830	1	1	TANASUWANKASEM, JUNE P NP	10/18/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
24212	Fee-for-Service	1912915067	1912915067	1	1	TSENG, ANTHONY MD	12/24/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85565	08	Family Practice	0	In state provider	None	866 PLUMAS ST	None	YUBA CITY	CA	95991	4022	51	06101	39.14154171	-121.6177237	Sutter County
24214	Fee-for-Service	1851697205	1851697205	1	1	TRIM, JULIE G PHD	9/8/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
24225	Fee-for-Service	1598874984	1598874984	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1854 CORONADO AVE	None	SAN DIEGO	CA	92154	2007	37	06073	32.5765305	-117.093987	San Diego County
24280	Fee-for-Service	1659383461	1659383461	1	1	TAMURA, DOUGLAS Y MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72165	02	General Surgery	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
24285	Fee-for-Service	1811144041	1811144041	1	1	TAKAHASHI, KENICHI LMFT	10/26/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2940 SUMMIT STREET	SUITE 2D	OAKLAND	CA	94609	3416	01	06001	37.81849213	-122.2647718	Alameda County
24292	Fee-for-Service	1972128338	1972128338	1	1	TURNER, BRIANA CCC-SLP	12/4/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	621 W MICHELTORENA ST	STE B	SANTA BARBARA	CA	93101	4195	42	06083	34.41914194	-119.7157341	Santa Barbara County
24321	Fee-for-Service	1144684424	1144684424	1	1	TAM, GORDON DO	1/9/2019	207R00000X	NA	Other	026	PHYSICIANS	16415	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
24339	Fee-for-Service	1083778864	1083778864	1	1	TUBIOLO, VINCENT C MD	10/1/2001	207K00000X	NA	Other	026	PHYSICIANS	75698	41	Internal Medicine	0	In state provider	None	2320 BATH ST	STE 303	SANTA BARBARA	CA	93105	4384	42	06083	34.43082689	-119.7223032	Santa Barbara County
24380	Fee-for-Service	1063742450	1063742450	1	1	TOSTO, LORI R CRNA	7/18/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	825 DELBON AVENUE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
24401	Fee-for-Service	1083763346	1083763346	1	1	TRAN, MINH C MD	10/1/1995	207R00000X	NA	Other	026	PHYSICIANS	78401	41	Internal Medicine	0	In state provider	None	108000 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	0000	33	06065	33.90433148	-117.4745063	Riverside County
24445	Fee-for-Service	1558011296	1558011296	1	1	TURNER, BRITTANY NP	4/23/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 OLIVE AVE	STE 5	REDLANDS	CA	92373	5268	36	06071	34.05492419	-117.1784739	San Bernardino County
24537	Fee-for-Service	1598705170	1598705170	1	1	TEPERSON, ANDREW L, MD	6/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65304	40	Pediatrics	0	In state provider	None	1224 E AVENUE S	STE A	PALMDALE	CA	93550	6180	19	06037	34.55794829	-118.1054823	Los Angeles County
24567	Fee-for-Service	1659383461	1659383461	1	1	TAMURA, DOUGLAS Y MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72165	89	Surgery-Traumatic	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
24600	Fee-for-Service	1871882555	1871882555	1	1	TRAN, CHRISTINA N T MD	6/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136575	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1350 W COVINA BLVD	None	SAN DIMAS	CA	91773	3219	19	06037	34.09906108	-117.8343639	Los Angeles County
24602	Fee-for-Service	1679068084	1679068084	1	1	THOMPSON, TOYIN LMFT	9/29/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1414 4TH ST	None	CORONADO	CA	92118	1906	37	06073	32.6927737	-117.1708716	San Diego County
24603	Fee-for-Service	1124345046	1124345046	1	1	TRAN, KHOA N MD	6/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119701	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
24627	Fee-for-Service	1083778864	1083778864	1	1	TUBIOLO, VINCENT C MD	10/1/2001	207K00000X	NA	Other	026	PHYSICIANS	75698	03	Allergy	0	In state provider	None	2320 BATH ST	STE 303	SANTA BARBARA	CA	93105	4384	42	06083	34.43082689	-119.7223032	Santa Barbara County
24637	Fee-for-Service	1952746604	1952746604	1	1	TOOLE, RYAN M DO	9/27/2019	207L00000X	NA	Other	026	PHYSICIANS	16399	05	Anesthesiology	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
24642	Fee-for-Service	1316367436	1316367436	1	1	TRAN, BYRON M MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145057	01	General Practice	0	In state provider	None	115 MALL DR	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
24771	Fee-for-Service	1376881847	1376881847	1	1	TSOVINAR TEKKELIAN MD INC	3/16/2021	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1251 S GLENDALE AVE	None	GLENDALE	CA	91205	3204	19	06037	34.13049413	-118.2524892	Los Angeles County
24777	Fee-for-Service	1043771348	1043771348	1	1	TARABISHY, NOOR MD	10/5/2023	207P00000X	NA	Other	026	PHYSICIANS	189789	None	None	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
24782	Fee-for-Service	1912469446	1912469446	1	1	TANG, MICHAEL MD	6/13/2023	207R00000X	NA	Other	026	PHYSICIANS	182335	None	None	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
24792	Fee-for-Service	1952796765	1952796765	1	1	TAON, MATTHEW CZAR D MD	2/14/2018	207R00000X	NA	Other	026	PHYSICIANS	146282	30	Radiology	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
24808	Fee-for-Service	1497938336	1497938336	1	1	THRIFTY PAYLESS INC	3/12/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4455 MANCHESTER AVE	None	ENCINITAS	CA	92024	4934	37	06073	33.03683267	-117.2389121	San Diego County
24826	Fee-for-Service	1598705170	1598705170	1	1	TEPERSON, ANDREW L, MD	6/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65304	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1224 E AVENUE S	STE A	PALMDALE	CA	93550	6180	19	06037	34.55794829	-118.1054823	Los Angeles County
24856	Fee-for-Service	1659383461	1659383461	1	1	TAMURA, DOUGLAS Y MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72165	85	Surgery-Pediatric	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
24877	Fee-for-Service	1093192874	1093192874	1	1	TABUENCA, ANDREA C PHD	12/6/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
24880	Fee-for-Service	1689007957	1689007957	2	1	TRINITY TRANSPORTATION LLC	4/7/2020	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3701 STOCKER	100A	LOS ANGELES	CA	90008	5145	19	06037	34.00687315	-118.3375934	Los Angeles County
24911	Fee-for-Service	1831724053	1831724053	1	1	THE REDDING RANCHERIA	5/28/2020	261QF0400X	NA	Federally Qualified Health Center	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	0	In state provider	None	4174 ASHBY CT	None	SHASTA LAKE	CA	96019	9215	45	06089	40.68061138	-122.3714032	Shasta County
24932	Fee-for-Service	1316367436	1316367436	1	1	TRAN, BYRON M MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145057	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 MALL DR	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
24936	Fee-for-Service	1891729935	1891729935	1	1	TING, JENNIFER MD	7/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	62961	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
24962	Fee-for-Service	1760748040	1760748040	1	1	TORRES, STEPHANIE L LMFT	10/31/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12021 JACARANDA AVE	SUITE 203	HESPERIA	CA	92345	4978	36	06071	34.46963618	-117.263267	San Bernardino County
24973	Fee-for-Service	1801861190	1801861190	1	1	TRI CITY HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
24975	Fee-for-Service	1184701039	1184701039	1	1	TAKAHASHI, JOHN I MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	44108	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
25023	Fee-for-Service	1073510533	1073510533	1	1	TAHA, SAMINA H MD	10/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54837	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
25039	Fee-for-Service	1184612764	1184612764	1	1	THE QUEEN'S MEDICAL CENTER	8/11/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2499	00	None	21.30800017	-157.8550765	Honolulu County
25051	Fee-for-Service	1235214057	1235214057	1	1	TUENG T SHEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	325 9TH AVE	MS 359110	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
25107	Fee-for-Service	1134427289	1134427289	1	1	THYME HOLDINGS LLC	6/7/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	4525 W TULARE AVENUE	None	VISALIA	CA	93277	1560	54	06107	36.319518	-119.341242	Tulare County
25198	Fee-for-Service	1831724053	1831724053	1	1	THE REDDING RANCHERIA	5/28/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	4174 ASHBY CT	None	SHASTA LAKE	CA	96019	9215	45	06089	40.68061138	-122.3714032	Shasta County
25205	Fee-for-Service	1558545277	1558545277	1	1	TONG, CATHY C MD	10/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102106	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
25250	Fee-for-Service	1265420806	1265420806	1	1	TIORAN, TERESA A DO	8/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	7113	41	Internal Medicine	0	In state provider	None	2620 EDITH AVE	None	REDDING	CA	96001	3043	45	06089	40.5714494	-122.3975292	Shasta County
25251	Fee-for-Service	1346444668	1346444668	1	1	TOBIAS, TERRENCE P MD	9/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104310	30	Radiology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
25261	Fee-for-Service	1801861190	1801861190	1	1	TRI CITY HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
25326	Fee-for-Service	1184612764	1184612764	1	1	THE QUEEN'S MEDICAL CENTER	8/11/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2499	00	None	21.30800017	-157.8550765	Honolulu County
25327	Fee-for-Service	1366826547	1366826547	1	1	TAM, CZE-JA N NP	9/5/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
25331	Fee-for-Service	1457344483	1457344483	1	1	TSAI, CHRISTOPHER K MD	2/11/2022	208800000X	NA	Other	026	PHYSICIANS	54843	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
25352	Fee-for-Service	1124635560	1124635560	1	1	TUMLOS, RACHEL GAYLE R LMFT	12/21/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4199 CAMPUS DR	SUITE 550, OFFICE 57	IRVINE	CA	92612	4684	30	06059	33.650775	-117.838296	Orange County
25381	Fee-for-Service	1265896344	1265896344	1	1	TOY, MORGAN A MD	3/19/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	154001	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
25405	Fee-for-Service	1225109135	1225109135	1	1	TAMADDON, KIRK A MD	7/1/1998	208800000X	NA	Other	026	PHYSICIANS	64053	34	Urology and Urological Surgery	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
25450	Fee-for-Service	1184887838	1184887838	1	1	TSAI, JACK S. MD	9/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109309	08	Family Practice	0	In state provider	None	1301 WEST 12TH STREET	None	LONG BEACH	CA	90813	2720	19	06037	33.78201945	-118.2088381	Los Angeles County
25505	Fee-for-Service	1265455604	1265455604	1	1	THARA RANI DAMODARAN M.D.	5/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3491 S MERCY RD	STE 103	GILBERT	AZ	85297	0433	00	None	33.285735	-111.747726	Maricopa County
25517	Fee-for-Service	1447264023	1447264023	1	1	TOLENTINO, DAVID C MD	7/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140968	05	Anesthesiology	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
25528	Fee-for-Service	1023053105	1023053105	1	1	TANSON, GABRIEL K MD	3/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	32550	01	General Practice	0	In state provider	None	4873 WEST LANE	SUITE A	STOCKTON	CA	95210	4548	39	06077	37.99861886	-121.289451	San Joaquin County
25538	Fee-for-Service	1689823809	1689823809	1	1	TRAN, THUY H OD INC	8/24/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12549 FOOTHILL BLVD	None	RANCHO CUCAMONGA	CA	91739	9317	36	06071	34.103448	-117.5314725	San Bernardino County
25542	Fee-for-Service	1295721736	1295721736	2	1	THOMAS SHILTON CORP	1/19/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	90 N ASHWOOD	None	VENTURA	CA	93003	1810	56	06111	34.27593896	-119.2394708	Ventura County
25621	Fee-for-Service	1346202850	1346202850	1	1	TOLIVER, KEVIN T MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	76523	05	Anesthesiology	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
25682	Fee-for-Service	1568461812	1568461812	2	1	THOMAS, MICHAEL D MD	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	1	Border provider	None	2650 N TENAYA WAY	STE 301	LAS VEGAS	NV	89128	1112	00	None	36.20804839	-115.2501292	Clark County
25727	Fee-for-Service	1366519183	1366519183	1	1	TRAN, PHUONG MD	2/1/1999	207R00000X	NA	Other	026	PHYSICIANS	62180	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
25761	Fee-for-Service	1992994248	1992994248	1	1	TRAN, PATRICK H MD	6/1/2000	207R00000X	NA	Other	026	PHYSICIANS	39065	41	Internal Medicine	0	In state provider	None	1053 R ST	None	FRESNO	CA	93721	1312	10	06019	36.74038639	-119.7827527	Fresno County
25762	Fee-for-Service	1487966727	1487966727	1	1	TANG, DEREK M MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140340	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
25766	Fee-for-Service	1457551681	1457551681	1	1	TAYLOR, SARAH E MD	11/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116716	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
25843	Fee-for-Service	1457304602	1457304602	1	1	THOMPSON, JAMES D MD	8/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	87625	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1499 W 1ST ST	None	SAN PEDRO	CA	90732	3255	19	06037	33.74333957	-118.3093406	Los Angeles County
25875	Fee-for-Service	1902429228	1902429228	1	1	TREGASKIS, DAVID DO	3/19/2025	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	1093 ROYAL COURT	None	MEDFORD	OR	97504	8383	00	None	42.34017467	-122.8666022	Jackson County
25877	Fee-for-Service	1215287867	1215287867	1	1	THOMPSON, ERA M LCSW	6/17/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	83416	-	NOT APPLICABLE	0	In state provider	None	100 EAST WARDLOW ROAD	None	LONG BEACH	CA	90807	4417	19	06037	33.8188341	-118.1923297	Los Angeles County
25903	Fee-for-Service	1003965658	1003965658	1	2	TABIBZADEH, KAMROOZ H MD	10/31/1992	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	57734	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	THE MATERNITY CLINIC	6618 VAN NUYS BLVD	None	VAN NUYS	CA	91405	4617	19	06037	34.19123738	-118.4487091	Los Angeles County
25916	Fee-for-Service	1164820510	1164820510	1	1	THANDI, PARDEEP S MD	3/18/2022	207P00000X	NA	Other	026	PHYSICIANS	172540	None	None	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
25925	Fee-for-Service	1609103399	1609103399	1	1	TOURNEY PLAZA SURGICAL	10/11/2011	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	27420 TOURNEY RD	SUITE 160	VALENCIA	CA	91355	5631	19	06037	34.42122797	-118.5787489	Los Angeles County
25994	Fee-for-Service	1740202381	1740202381	1	1	TROY SCHAFF MD	7/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 BROADWAY N	None	FARGO	ND	58102	3641	00	None	46.885068	-96.7872375	Cass County
26013	Fee-for-Service	1679673222	1679673222	1	1	TYLER, LAMONT DO	6/24/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18504	None	None	0	In state provider	None	2888 COCHRAN STREET	None	SIMI VALLEY	CA	93065	2782	56	06111	34.27898255	-118.7378325	Ventura County
26016	Fee-for-Service	1457382798	1457382798	1	1	TEXAS HEALTH PRESBYTERIAN	1/24/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL KAUFMAN	850 ED HALL DRIVE	None	KAUFMAN	TX	75142	1861	00	None	32.59112105	-96.31828654	Kaufman County
26055	Fee-for-Service	1992994248	1992994248	1	1	TRAN, PATRICK H MD	6/1/2000	207R00000X	NA	Other	026	PHYSICIANS	39065	01	General Practice	0	In state provider	None	1053 R ST	None	FRESNO	CA	93721	1312	10	06019	36.74038639	-119.7827527	Fresno County
26123	Fee-for-Service	1114290178	1114290178	1	1	TEDJA-YEN, PINPIN P NP	10/9/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43112 N 15TH STREET	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
26155	Fee-for-Service	1861083362	1861083362	1	1	TOWVER, YENI LCSW	4/22/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	433 CALLAN AVE	309	SAN LEANDRO	CA	94577	4641	01	06001	37.72706807	-122.1519034	Alameda County
26165	Fee-for-Service	1558584094	1558584094	1	1	TRI-CITY HLTH CTR-MOWRY	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	2299 MOWRY AVE	STE 3B	FREMONT	CA	94538	1621	01	06001	37.55671415	-121.9817758	Alameda County
26168	Fee-for-Service	1689936163	1689936163	1	1	TRUONG, TAMMY DO	9/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12799	None	None	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
26171	Fee-for-Service	1699126078	1699126078	1	1	TABIKH, MEHYO I MD	4/11/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158432	08	Family Practice	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
26240	Fee-for-Service	1154142545	1154142545	1	1	TORRES, DESTINEE NP	12/2/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2230 W CHAPMAN AVE	212	ORANGE	CA	92868	2316	30	06059	33.78787947	-117.8766225	Orange County
26263	Fee-for-Service	1265973416	1265973416	1	1	TSAI, KAREN MD	6/7/2022	207RE0101X	NA	Endocrinology	026	PHYSICIANS	157548	None	None	0	In state provider	None	209 FAIR OAKS AVE	None	SOUTH PASADENA	CA	91030	1814	19	06037	34.12341	-118.1503065	Los Angeles County
26289	Fee-for-Service	1003941683	1003941683	1	3	TARZANA TREATMENT CENTERS	3/19/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	5190 ATLANTIC AVENUE	None	LONG BEACH	CA	90805	6510	19	06037	33.850449	-118.1848215	Los Angeles County
26304	Fee-for-Service	1457382798	1457382798	1	1	TEXAS HEALTH PRESBYTERIAN	1/24/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL KAUFMAN	850 ED HALL DRIVE	None	KAUFMAN	TX	75142	1861	00	None	32.59112105	-96.31828654	Kaufman County
26308	Fee-for-Service	1396834040	1396834040	1	1	TERRY HINKSON	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	RAPID CITY EMERGENCY SER	353 FAIRMONT BLVD	None	RAPID CITY	SD	57701	0000	00	None	44.05854729	-103.2246985	Pennington County
26332	Fee-for-Service	1144811738	1144811738	1	1	TLT CARE ENTERPRISE LLC	3/16/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	9249 DALBERG STREET	None	BELLFLOWER	CA	90706	2120	19	06037	33.90688777	-118.1369041	Los Angeles County
26350	Fee-for-Service	1942451760	1942451760	1	2	TAYLOR, JAMES E PSYD	10/17/2023	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	C.	1660 W LINNE RD	J-15	TRACY	CA	95377	8024	39	06077	37.69589443	-121.4467076	San Joaquin County
26361	Fee-for-Service	1801388673	1801388673	1	1	TARABAY, JANA MD	3/29/2022	207ZP0102X	NA	Other	026	PHYSICIANS	174570	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
26364	Fee-for-Service	1366970832	1366970832	1	1	TAVAKKOLI, MONTREH MD	3/4/2025	207R00000X	NA	Other	026	PHYSICIANS	None	68	Hematology	0	In state provider	None	25550 HAWTHORNE BLVD	STE 209	TORRANCE	CA	90505	6832	19	06037	33.79398714	-118.3491878	Los Angeles County
26371	Fee-for-Service	1316196892	1316196892	1	1	THE PATHOLOGY GROUP INC	3/17/2009	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
26380	Fee-for-Service	1639113269	1639113269	1	1	TAKETA, RICHARD M MD INC	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	23741	30	Radiology	0	In state provider	None	355 PLACENTIA AVE	None	NEWPORT BEACH	CA	92663	3311	30	06059	33.62672719	-117.9312941	Orange County
26429	Fee-for-Service	1891039707	1891039707	1	1	TAHER, PEDRAM MD	9/25/2013	207R00000X	NA	Other	026	PHYSICIANS	105998	83	Rheumatology	0	In state provider	None	4133 MOHR AVE	STE A	PLEASANTON	CA	94566	4750	01	06001	37.68195698	-121.8737212	Alameda County
26482	Fee-for-Service	1548212079	1548212079	1	1	THERESA E. GUINS MD	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	601 CHILDRENS LN	None	NORFOLK	VA	23507	1910	00	None	36.8619664	-76.30130371	Norfolk city
26531	Fee-for-Service	1871955708	1871955708	1	1	TAFOYA, SALVADOR CRNA	12/5/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
26535	Fee-for-Service	1649839077	1649839077	1	1	TJAHJADI, JASEN MD	8/17/2022	390200000X	NA	Other	026	PHYSICIANS	176433	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
26559	Fee-for-Service	1710941091	1710941091	1	1	TAN, FANG MD INC	12/1/2002	207W00000X	NA	Ophthalmology	026	PHYSICIANS	81026	18	Ophthalmology	0	In state provider	None	1895 MOWRY AVE	SUITE 101A	FREMONT	CA	94538	1708	01	06001	37.55909066	-121.9799265	Alameda County
26561	Fee-for-Service	1215146642	1215146642	1	1	TAYLOR, ZACHARY D MD	9/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95154	41	Internal Medicine	0	In state provider	None	2801 K ST	STE 520	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
26577	Fee-for-Service	1003941683	1003941683	1	3	TARZANA TREATMENT CENTERS	3/19/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	5190 ATLANTIC AVENUE	None	LONG BEACH	CA	90805	6510	19	06037	33.850449	-118.1848215	Los Angeles County
26614	Fee-for-Service	1790744795	1790744795	1	1	TCHAKMAKJIAN, LEVON MD	11/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144411	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3352	48	06095	38.26109552	-122.0470245	Solano County
26643	Fee-for-Service	1780002162	1780002162	1	1	TANG, SHARON MD	7/30/2020	207P00000X	NA	Other	026	PHYSICIANS	167638	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
26652	Fee-for-Service	1366970832	1366970832	1	1	TAVAKKOLI, MONTREH MD	3/4/2025	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	25550 HAWTHORNE BLVD	STE 209	TORRANCE	CA	90505	6832	19	06037	33.79398714	-118.3491878	Los Angeles County
26705	Fee-for-Service	1871859892	1871859892	1	1	TSO, GEOFFREY J MD	2/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128184	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
26716	Fee-for-Service	1376032342	1376032342	1	1	TRUONG, ADAM MD	10/21/2023	208C00000X	NA	General Surgery	026	PHYSICIANS	154596	None	None	0	In state provider	None	10 CONGRESS STREET	200	PASADENA	CA	91105	3023	19	06037	34.13396893	-118.1528162	Los Angeles County
26742	Fee-for-Service	1366821498	1366821498	1	2	TORRES, ROSALICIA D MD	2/25/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	171749	None	None	0	In state provider	None	204 E.BEACH ST	None	WATSONVILLE	CA	95076	4809	44	06087	36.91224802	-121.7541363	Santa Cruz County
26747	Fee-for-Service	1194293142	1194293142	1	1	THEODORE, YVETTE H NP	12/3/2018	363LG0600X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
26748	Fee-for-Service	1992818496	1992818496	1	1	THEODORE L SPANGLER, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1320 MERCY DR NW	None	CANTON	OH	44708	2614	00	None	40.81240185	-81.39702198	Stark County
26766	Fee-for-Service	1306306204	1306306204	1	1	TAM, JOLINDA OD	4/8/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	STE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
26776	Fee-for-Service	1700133683	1700133683	1	1	TALLEY, ANGELICA T LCSW	5/25/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17111 BEACH BLVD	STE 205	HUNTINGTON BEACH	CA	92647	5947	30	06059	33.713937	-117.9892085	Orange County
26859	Fee-for-Service	1356804926	1356804926	1	1	TONG, ALEXANDER A	8/31/2022	208M00000X	NA	Other	026	PHYSICIANS	177987	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
26865	Fee-for-Service	1003941683	1003941683	1	3	TARZANA TREATMENT CENTERS	3/19/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	5190 ATLANTIC AVENUE	None	LONG BEACH	CA	90805	6510	19	06037	33.850449	-118.1848215	Los Angeles County
26884	Fee-for-Service	1396861530	1396861530	1	1	TSUKUDA, RAYMOND K DPM	5/19/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
26944	Fee-for-Service	1033478276	1033478276	1	1	THOMAS, MATTHEW B MD	7/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1165 MONTGOMERY DRIVE	None	SONOMA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma
26980	Fee-for-Service	1922430578	1922430578	1	1	TEJEDA, MARIA LMFT	6/5/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
27026	Fee-for-Service	1346776648	1346776648	1	1	TOM, YOONGI MD	1/18/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180375	None	None	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
27038	Fee-for-Service	1114454998	1114454998	1	1	TANG, QUI N CNM	2/5/2019	282NW0100X	NA	Hospitals	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
27040	Fee-for-Service	1730940586	1730940586	1	1	TROXELL, KATIE A PHD	7/10/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	625 S FAIR OAKS AVE	#325	PASADENA	CA	91105	2675	19	06037	34.134894	-118.1504155	Los Angeles County
27059	Fee-for-Service	1770510018	1770510018	1	1	TAHERPOUR, ROKHSAN S MD	3/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77434	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
27101	Fee-for-Service	1538137054	1538137054	1	1	TRAN, MINOU P	3/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	68773	None	None	0	In state provider	None	3816 WOODRUFF AVE	STE 204	LONG BEACH	CA	90808	2145	19	06037	33.828102	-118.1165525	Los Angeles County
27113	Fee-for-Service	1609216712	1609216712	1	1	TEMECULA VALLEY NEUROSURGERY	9/1/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	25150 HANCOCK AVENUE	SUITE 210	MURRIETA	CA	92562	5989	33	06065	33.56635084	-117.1823956	Riverside County
27158	Fee-for-Service	1821012287	1821012287	2	1	THANGAVEL, MURUGESA M MD	3/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34117	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	0001	19	06037	34.06373445	-118.443537	Los Angeles County
27160	Fee-for-Service	1528640026	1528640026	1	1	THRIVE PSYCHOLOGICAL SERVICE	11/22/2022	261QM0801X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	S	3200 E GUASTI RD	#100	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
27177	Fee-for-Service	1770853566	1770853566	1	1	TENNANT, AUBREY A PT	5/5/2023	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
27191	Fee-for-Service	1508991928	1508991928	1	1	TRAN, MINH Q MD	8/4/2020	207T00000X	NA	General Surgery	026	PHYSICIANS	95464	14	Neurological Surgery	0	In state provider	None	202 W WILLOW AVE.	SUITE 202	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
27240	Fee-for-Service	1649409996	1649409996	1	1	TRINH, THANH T OD	4/15/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	36 YOKUTS AVE	STE 1	STOCKTON	CA	95207	5713	39	06077	37.99833959	-121.3074229	San Joaquin County
27281	Fee-for-Service	1487643193	1487643193	2	1	TAYLOR, ROBERT A MD	10/1/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	130196	14	Neurological Surgery	0	In state provider	None	1700 N ROSE AVE	STE 470	OXNARD	CA	93030	7659	56	06111	34.21746	-119.155545	Ventura County
27289	Fee-for-Service	1255413324	1255413324	1	1	TJAHJADI, CYNTHIA OD	3/1/1995	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1339 W WHITTIER BLVD	None	LA HABRA	CA	90631	3612	30	06059	33.93933652	-117.9612375	Orange County
27329	Fee-for-Service	1881710861	1881710861	1	1	TARZANA TREATMENT CENTER	12/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	FMLY MED CLNC- LANCASTER	907 W LANCASTER BLVD	None	LANCASTER	CA	93534	2305	19	06037	34.69735779	-118.1471724	Los Angeles County
27346	Fee-for-Service	1720136138	1720136138	1	1	TANSON, ELVIS E DO	12/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	7605	01	General Practice	0	In state provider	None	4873 WEST LANE	SUITE A	STOCKTON	CA	95210	4548	39	06077	37.99861886	-121.289451	San Joaquin County
27358	Fee-for-Service	1114372372	1114372372	1	1	TANCIOCO, VIRGINIA C MD	9/9/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	153395	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
27396	Fee-for-Service	1366946501	1366946501	1	1	TOOSI, KAVIAN MD	7/15/2021	207P00000X	NA	Other	026	PHYSICIANS	164391	None	None	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
27450	Fee-for-Service	1528640026	1528640026	1	1	THRIVE PSYCHOLOGICAL SERVICE	11/22/2022	261QM0801X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	S	3200 E GUASTI RD	#100	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
27519	Fee-for-Service	1740338649	1740338649	1	1	TUNNEY, CAROL A CNM	10/18/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4405 VANDEVER AVE	None	SAN DIEGO	CA	92120	3315	37	06073	32.78765609	-117.09908	San Diego County
27524	Fee-for-Service	1982862090	1982862090	1	1	TUN, NELSON N MD	9/1/2010	390200000X	NA	Other	026	PHYSICIANS	111700	41	Internal Medicine	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
27554	Fee-for-Service	1891028171	1891028171	1	1	THE NORTHEAST COMMUNITY	12/14/2011	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CLINIC	4455 W 117 ST	SUITE 300	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
27565	Fee-for-Service	1811343056	1811343056	1	1	TOVAR, ALEXIS MD	4/29/2023	207LP3000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
27567	Fee-for-Service	1487643193	1487643193	2	1	TAYLOR, ROBERT A MD	10/1/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	130196	13	Neurology (M.D. only)	0	In state provider	None	1700 N ROSE AVE	STE 470	OXNARD	CA	93030	7659	56	06111	34.21746	-119.155545	Ventura County
27578	Fee-for-Service	1710030911	1710030911	1	1	TRAN, KEVIN H OD	12/15/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9041 MAGNOLIA AVE	201	RIVERSIDE	CA	92503	3900	33	06065	33.92541585	-117.4378266	Riverside County
27616	Fee-for-Service	1881710861	1881710861	1	1	TARZANA TREATMENT CENTER	12/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	FMLY MED CLNC- LANCASTER	907 W LANCASTER BLVD	None	LANCASTER	CA	93534	2305	19	06037	34.69735779	-118.1471724	Los Angeles County
27636	Fee-for-Service	1730129958	1730129958	1	1	TANG, SHIH T MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53200	41	Internal Medicine	0	In state provider	None	1085 N HARBOR BLVD	None	ANAHEIM	CA	92801	2417	30	06059	33.85017	-117.924238	Orange County
27693	Fee-for-Service	1770804353	1770804353	1	1	TAYLOR, SHOOK-MING DO	4/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3001 ST ROSE PARKWAY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
27715	Fee-for-Service	1508379017	1508379017	1	5	TRI-STATE COMMUNITY	3/2/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	11328 BARTLETT AVE	UNIT 3	ADELANTO	CA	92301	1913	36	06071	34.57921051	-117.417186	San Bernardino County
27723	Fee-for-Service	1568802262	1568802262	1	1	TRAN PHARMACY INC	8/1/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9856 WESTMINSTER AVE	STE 123	GARDEN GROVE	CA	92844	2907	30	06059	33.75945049	-117.956592	Orange County
27768	Fee-for-Service	1316024243	1316024243	1	1	TERESI, MARCI J MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64195	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
27771	Fee-for-Service	1023559051	1023559051	1	1	THAKORE, SONALI M NP	2/22/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
27775	Fee-for-Service	1225754104	1225754104	1	1	TORIGGINO, NICOLE A CRNA	6/1/2023	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
27780	Fee-for-Service	1356837546	1356837546	1	1	THAI TRAN OPTOMETRY CORPORAT	10/22/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1500 ADAMS AVE	SUITE 102	COSTA MESA	CA	92626	3864	30	06059	33.67333707	-117.9208053	Orange County
27798	Fee-for-Service	1720519671	1720519671	1	1	TSUI, BRIAN MD	1/31/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	158692	None	None	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
27820	Fee-for-Service	1548687429	1548687429	1	1	TRAN, VIVAN H DO	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14236	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
27843	Fee-for-Service	1891028171	1891028171	1	1	THE NORTHEAST COMMUNITY	12/14/2011	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CLINIC	4455 W 117 ST	SUITE 300	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
27859	Fee-for-Service	1134236938	1134236938	1	1	TIWANA, AJITPAL S MD	7/1/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	42864	None	None	0	In state provider	None	2635 G ST	None	BAKERSFIELD	CA	93301	2813	15	06029	35.38360448	-119.0223416	Kern County
27907	Fee-for-Service	1881710861	1881710861	1	1	TARZANA TREATMENT CENTER	10/20/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	FMLY MED CLNC- LANCASTER	907 W LANCASTER BLVD	None	LANCASTER	CA	93534	2305	19	06037	34.69735779	-118.1471724	Los Angeles County
27924	Fee-for-Service	1730129958	1730129958	1	1	TANG, SHIH T MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53200	02	General Surgery	0	In state provider	None	1085 N HARBOR BLVD	None	ANAHEIM	CA	92801	2417	30	06059	33.85017	-117.924238	Orange County
27929	Fee-for-Service	1053478990	1053478990	1	1	TETZLAFF, MICHAEL T MD	7/14/2020	207ZD0900X	NA	Other	026	PHYSICIANS	168623	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
27957	Fee-for-Service	1558726166	1558726166	1	1	TUMBER, MANDEEP K PHD	3/15/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2008 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
27958	Fee-for-Service	1417088121	1417088121	2	1	TOWN SQUARE PHARMACY INC	3/12/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	81709 DR CARREON BLVD	SUITE E3	INDIO	CA	92201	5589	33	06065	33.70733082	-116.2400326	Riverside County
27975	Fee-for-Service	1851379853	1851379853	1	1	TAYLOR, RACHEL E LMFT	7/15/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	45445 PORTOLA AVENUE	SUITE 2 B	PALM DESERT	CA	92260	4844	33	06065	33.7186073	-116.3737698	Riverside County
28002	Fee-for-Service	1508379017	1508379017	1	5	TRI-STATE COMMUNITY	3/2/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	11328 BARTLETT AVE	UNIT 3	ADELANTO	CA	92301	1913	36	06071	34.57921051	-117.417186	San Bernardino County
28005	Fee-for-Service	1487691622	1487691622	1	2	TSENG, ZIAN H MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70651	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
28043	Fee-for-Service	1922104710	1922104710	1	1	THE OAKS SURGERY CENTER LP	1/10/2003	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	40740 CALIFORNIA OAKS RD	None	MURRIETA	CA	92562	5727	33	06065	33.570007	-117.2048629	Riverside County
28051	Fee-for-Service	1578598173	1578598173	1	1	TIMOTHY S WILSON, DO	1/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	347 N KUAKINI STREET	None	HONOLULU	HI	96817	0000	00	None	21.32247447	-157.8564644	Honolulu County
28055	Fee-for-Service	1306034269	1306034269	1	1	TSAY, ELIZABETH M MD	12/3/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	425 E BONITA AVE	STE 110B	SAN DIMAS	CA	91773	2541	19	06037	34.1067183	-117.8003816	Los Angeles County
28057	Fee-for-Service	1316024243	1316024243	1	1	TERESI, MARCI J MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64195	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
28058	Fee-for-Service	1316990724	1316990724	1	1	TRNAVSKYHOBBS, DEBRA L MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62275	41	Internal Medicine	0	In state provider	None	3230 BEARD RD	SUITE 1	NAPA	CA	94558	3673	28	06055	38.3216968	-122.2953847	Napa County
28085	Fee-for-Service	1619952397	1619952397	1	4	TUOLUMNE MEWUK INDIAN HEALTH	5/17/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	18670 CARTER ST	None	TUOLUMNE	CA	95379	0000	55	06109	37.96149491	-120.236264	Tuolumne County
28100	Fee-for-Service	1699984484	1699984484	1	1	THERAPEUTIC LIVING CENTERS	10/21/1994	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR THE BLIND	17026 RINALDI ST	None	GRANADA HILLS	CA	91344	3543	19	06037	34.27928047	-118.5032565	Los Angeles County
28105	Fee-for-Service	1750900635	1750900635	1	1	TRAN, CUONG D MD	4/26/2023	390200000X	NA	Other	026	PHYSICIANS	176890	None	None	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
28125	Fee-for-Service	1740460070	1740460070	1	1	TANA, MICHELE M MD	4/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	96944	10	Gastroenterology (M.D. only)	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
28131	Fee-for-Service	1891028171	1891028171	1	1	THE NORTHEAST COMMUNITY	12/14/2011	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CLINIC	4455 W 117 ST	SUITE 300	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
28158	Fee-for-Service	1568549376	1568549376	1	1	TORCHIZY-NEJAD, ALIREZA	9/30/1991	207N00000X	NA	Dermatology	026	PHYSICIANS	48550	07	Dermatology	0	In state provider	None	633 N CENTRAL AVE	STE 101	GLENDALE	CA	91203	1807	19	06037	34.155054	-118.2579675	Los Angeles County
28166	Fee-for-Service	1497291009	1497291009	1	1	TURNER, MARCELLE LCSW	10/7/2021	390200000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
28195	Fee-for-Service	1881710861	1881710861	1	1	TARZANA TREATMENT CENTER	12/1/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	FMLY MED CLNC- LANCASTER	907 W LANCASTER BLVD	None	LANCASTER	CA	93534	2305	19	06037	34.69735779	-118.1471724	Los Angeles County
28248	Fee-for-Service	1174768964	1174768964	1	1	TARIN-LOPEZ, MARIA G OD	7/9/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2623 SPRINGS RD	None	VALLEJO	CA	94591	5712	48	06095	38.10591447	-122.2076385	Solano County
28252	Fee-for-Service	1619935251	1619935251	1	2	THE REGENTS OF THE UNIVERSIT	3/23/2020	208600000X	NA	General Surgery	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1250 W 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
28283	Fee-for-Service	1043998370	1043998370	1	1	TERVOORT, MARISA BIRTH DOUL	8/4/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	37	06073	0	0	None
28348	Fee-for-Service	1316990724	1316990724	1	1	TRNAVSKYHOBBS, DEBRA L MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62275	45	Nephrology (Renal-Kidney)	0	In state provider	None	3230 BEARD RD	SUITE 1	NAPA	CA	94558	3673	28	06055	38.3216968	-122.2953847	Napa County
28374	Fee-for-Service	1619952397	1619952397	1	4	TUOLUMNE MEWUK INDIAN HEALTH	2/7/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	18670 CARTER ST	None	TUOLUMNE	CA	95379	0000	55	06109	37.96149491	-120.236264	Tuolumne County
28398	Fee-for-Service	1891207445	1891207445	1	1	TRIMAN MEDICAL TRANSPORT INC	8/21/2019	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1420 E COOLEY DR	200A	COLTON	CA	92324	3981	36	06071	34.05447252	-117.305001	San Bernardino County
28416	Fee-for-Service	1548404304	1548404304	1	1	TRAN, ANH T MD	3/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106588	41	Internal Medicine	0	In state provider	None	9191 WESTMINISTER BLVD	None	GARDEN GROVE	CA	92844	2751	30	06059	33.75950574	-117.9684615	Orange County
28420	Fee-for-Service	1891028171	1891028171	1	1	THE NORTHEAST COMMUNITY	9/20/2012	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CLINIC	4455 W 117 ST	SUITE 300	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
28452	Fee-for-Service	1689361123	1689361123	1	1	TRANSFORMING TRAUMA COUNSELI	1/21/2024	251S00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	NG	4624 ARLINGTON AVE	None	RIVERSIDE	CA	92504	2702	33	06065	33.94615854	-117.40365	Riverside County
28464	Fee-for-Service	1972189942	1972189942	1	1	TANG, PHIEN MD	6/23/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	180945	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
28532	Fee-for-Service	1619935251	1619935251	1	2	THE REGENTS OF THE UNIVERSIT	6/28/2019	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	84	Surgery-Head and Neck	0	In state provider	None	1250 W 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
28552	Fee-for-Service	1003855875	1003855875	1	1	TILLER, JENNIFER D MD	2/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89241	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
28571	Fee-for-Service	1760797740	1760797740	1	1	TAHBAZ, AMIR A MD	9/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113662	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
28576	Fee-for-Service	1295114197	1295114197	1	1	TRIKAMJI, BHAVESH V MD	7/24/2020	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	151933	13	Neurology (M.D. only)	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
28636	Fee-for-Service	1760892806	1760892806	1	1	THAKKAR, NEHAL MD	4/6/2022	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
28643	Fee-for-Service	1053326637	1053326637	1	1	TAFOYA, PAUL P MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 EAST THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
28650	Fee-for-Service	1609066018	1609066018	1	1	TOLENTINO, ARTURO M MD	3/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107809	41	Internal Medicine	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
28683	Fee-for-Service	1730742289	1730742289	1	1	THOMPSON, RICHARD C MD	6/20/2023	207L00000X	NA	Other	026	PHYSICIANS	181487	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
28691	Fee-for-Service	1922290915	1922290915	1	1	TALWAR, SANDEEP MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	53199	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2773 HARRIS ST	STE A & D	EUREKA	CA	95503	4866	12	06023	40.78052829	-124.1363953	Humboldt County
28727	Fee-for-Service	1285746768	1285746768	1	1	TSE, FRANCIS H MD APC	7/1/1967	No Taxonomy Provided	NA	None	026	PHYSICIANS	22522	05	Anesthesiology	0	In state provider	None	817 COFFEE ROAD	SUITE C3	MODESTO	CA	95355	4241	50	06099	37.655235	-120.975616	Stanislaus County
28741	Fee-for-Service	1053008219	1053008219	1	1	TOOBAIE, ASRA MD	9/23/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	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
28774	Fee-for-Service	1740291301	1740291301	1	1	TABATABAI, MEHER F MD	5/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	38282	77	Infectious Disease	0	In state provider	INC	3633 MARTIN LUTHER KING	STE 2	LYNWOOD	CA	90262	3510	19	06037	33.93010498	-118.2018728	Los Angeles County
28838	Fee-for-Service	1003855875	1003855875	1	1	TILLER, JENNIFER D MD	2/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89241	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
28847	Fee-for-Service	1154668184	1154668184	1	1	TOTAL RENAL CARE INC	7/26/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	614 TULLY RD	STE 30	SAN JOSE	CA	95111	1048	43	06085	37.30851705	-121.8465917	Santa Clara County
28861	Fee-for-Service	1154517688	1154517688	1	1	TAMBRA, SHOUIEB MD	8/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99094	41	Internal Medicine	0	In state provider	None	222 W 39TH AVENUE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
28966	Fee-for-Service	1649990268	1649990268	1	1	TRAN, SHERRY NP	10/24/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
29007	Fee-for-Service	1316149206	1316149206	1	1	TAI, WAIMEI A MD	7/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106682	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
29061	Fee-for-Service	1043381395	1043381395	1	1	THOMAS, THOMAS C MD	9/30/1991	174400000X	NA	Other	026	PHYSICIANS	67068	05	Anesthesiology	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
29079	Fee-for-Service	1619997467	1619997467	1	1	THAIK, CYNTHIA MD	2/19/2025	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	82312	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5300 LENNOX AVE	105	BAKERSFIELD	CA	93309	1662	15	06029	35.35899025	-119.0625824	Kern County
29094	Fee-for-Service	1346260148	1346260148	1	1	TSAI, JOANNE E MD	3/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93497	None	None	0	In state provider	None	401 BICENTENNIAL WY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
29131	Fee-for-Service	1417036146	1417036146	1	1	THOMPSON, DOROTHY L MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71472	40	Pediatrics	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
29149	Fee-for-Service	1154517688	1154517688	1	1	TAMBRA, SHOUIEB MD	8/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99094	45	Nephrology (Renal-Kidney)	0	In state provider	None	222 W 39TH AVENUE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
29159	Fee-for-Service	1952570541	1952570541	1	1	TOTAL RENAL CARE, INC	6/17/2009	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	14135 MAIN ST	UNIT 501	HESPERIA	CA	92345	8097	36	06071	34.42669852	-117.354483	San Bernardino County
29208	Fee-for-Service	1487466231	1487466231	1	1	THORNTON, JESSICA PT	2/4/2025	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2170 BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795324	-118.122705	Los Angeles County
29213	Fee-for-Service	1407899354	1407899354	1	1	TIEGS, JAMES R MD	2/12/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	36523	30	Radiology	0	In state provider	None	293 S MAIN ST	STE 100	ORANGE	CA	92868	3806	30	06059	33.7842	-117.8672725	Orange County
29223	Fee-for-Service	1922042068	1922042068	1	1	TATESHIMA, SATOSHI MD	4/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105145	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
29227	Fee-for-Service	1134297492	1134297492	1	1	THE FIRST MEDICAL CENTER	4/1/2009	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	INC	11841 SOUTH STREET	None	CERRITOS	CA	90703	6825	19	06037	33.85850849	-118.080567	Los Angeles County
29249	Fee-for-Service	1437109816	1437109816	1	1	THOMAS MCDOWELL ANDERSON	1/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1740 W TAYLOR ST	None	CHICAGO	IL	60612	7232	00	None	41.8692353	-87.67061005	Cook County
29258	Fee-for-Service	1982120499	1982120499	1	1	TOLEDO, TEREZA	6/30/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
29304	Fee-for-Service	1700264322	1700264322	1	1	TANCO, JASON C	6/26/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
29311	Fee-for-Service	1164500674	1164500674	1	2	TRANSITIONAL HOSPITALS CORPO	11/2/2021	282E00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	1	Border provider	FLAMINGO	2250 E FLAMINGO RD	None	LAS VEGAS	NV	89119	5170	00	None	36.11476578	-115.1215888	Clark County
29320	Fee-for-Service	1295281285	1295281285	1	1	TUSTIN NEWPORT PHARMACY INC	8/1/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13400 NEWPORT AVE	None	TUSTIN	CA	92780	3753	30	06059	33.74478322	-117.815252	Orange County
29322	Fee-for-Service	1417171760	1417171760	1	1	TORRES, EDWARDO MD	1/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	90084	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVENUE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
29350	Fee-for-Service	1447335146	1447335146	1	1	THC - ORANGE COUNTY INC	9/1/2001	282E00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	KINDRED HOSPITAL - LA	5525 W SLAUSON AVE	None	LOS ANGELES	CA	90056	1047	19	06037	33.98912847	-118.3784926	Los Angeles County
29359	Fee-for-Service	1922083120	1922083120	1	1	TUMMALA, SRINIVAS MD	6/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52831	30	Radiology	0	In state provider	None	10833 LECONTE AVE	None	LOS ANGELES	CA	90095	0001	19	06037	34.06373445	-118.443537	Los Angeles County
29366	Fee-for-Service	1285711580	1285711580	1	1	TANG, HOONG-YEE MD	7/12/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	25665	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
29421	Fee-for-Service	1609379387	1609379387	1	1	TAN, WILLIAM W MD	8/11/2020	207L00000X	NA	Other	026	PHYSICIANS	153997	05	Anesthesiology	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
29516	Fee-for-Service	1134297492	1134297492	1	1	THE FIRST MEDICAL CENTER	4/1/2009	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC	11841 SOUTH STREET	None	CERRITOS	CA	90703	6825	19	06037	33.85850849	-118.080567	Los Angeles County
29522	Fee-for-Service	1114091253	1114091253	1	1	TURNER,DANIEL	7/2/1998	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ANG MEDICAL SUPPLY	7277 HAYVENHURST AVE	STE B-14	VAN NUYS	CA	91406	2860	19	06037	34.20317268	-118.4937001	Los Angeles County
29566	Fee-for-Service	1609953538	1609953538	1	1	TUCH, ADRIENNE P MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69193	40	Pediatrics	0	In state provider	None	555 CASTRO ST	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38946454	-122.0815711	Santa Clara County
29574	Fee-for-Service	1528419678	1528419678	1	1	TORRES, VERENICE LCSW	10/8/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 NORTH BEGONIA AVE.	SUITE 1009	ONTARIO	CA	91762	4274	36	06071	34.076493	-117.672147	San Bernardino County
29597	Fee-for-Service	1417071242	1417071242	1	1	TSENG, WILLIAM W MD	6/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	94446	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
29599	Fee-for-Service	1164500674	1164500674	1	2	TRANSITIONAL HOSPITALS CORPO	11/2/2021	282E00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	1	Border provider	FLAMINGO	2250 E FLAMINGO RD	None	LAS VEGAS	NV	89119	5170	00	None	36.11476578	-115.1215888	Clark County
29665	Fee-for-Service	1164531554	1164531554	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05915	2140 CONTRA COSTA BLVD	None	PLEASANT HILL	CA	94523	3788	07	06013	37.94719064	-122.0601142	Contra Costa County
29675	Fee-for-Service	1831870120	1831870120	1	1	THOMAS, KAITLYN T DC	4/3/2025	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1390 W H ST	STE C	OAKDALE	CA	95361	3529	50	06099	37.75817442	-120.8617244	Stanislaus County
29703	Fee-for-Service	1831596402	1831596402	1	1	TECLE, TSION LCSW	11/9/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
29741	Fee-for-Service	1669472643	1669472643	1	1	TARQUINO, MARIO F MD	12/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	6130 ELTON AVE	None	LAS VEGAS	NV	89107	2538	00	None	36.17198653	-115.225452	Clark County
29752	Fee-for-Service	1174672596	1174672596	1	1	TRAN, DEAN DO	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	7372	41	Internal Medicine	0	In state provider	None	5353 G ST	None	CHINO	CA	91710	5249	36	06071	34.00987149	-117.6880905	San Bernardino County
29763	Fee-for-Service	1326133687	1326133687	2	1	THE VIDAL WOMANS MEDICAL CLI	2/5/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2100 E ANAHEIM ST	STE B	LONG BEACH	CA	90804	3419	19	06037	33.7825725	-118.1663865	Los Angeles County
29772	Fee-for-Service	1700033503	1700033503	1	1	TUAZON, NICOLE N LMFT	9/16/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91601	3186	19	06037	34.1665161	-118.3755868	Los Angeles County
29802	Fee-for-Service	1134297492	1134297492	1	1	THE FIRST MEDICAL CENTER	4/1/2009	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	INC	11841 SOUTH STREET	None	CERRITOS	CA	90703	6825	19	06037	33.85850849	-118.080567	Los Angeles County
29873	Fee-for-Service	1346358793	1346358793	1	1	TRESTMAN, KENNETH G MD	1/31/1990	207RP1001X	NA	Pulmonology	026	PHYSICIANS	69663	41	Internal Medicine	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
29886	Fee-for-Service	1871941716	1871941716	1	1	TINY STEPS DEVELOPMENTAL SER	10/24/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	VICES, A PSYCHOLOGICAL C	12522 MOORPARK ST	106	STUDIO CITY	CA	91604	1355	19	06037	34.15033253	-118.406061	Los Angeles County
29911	Fee-for-Service	1982620985	1982620985	1	1	THOMPSON, DONOVAN MD	7/28/2022	207P00000X	NA	Other	026	PHYSICIANS	131391	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
29913	Fee-for-Service	1942706213	1942706213	1	1	TRAN, JONATHAN DO	6/13/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	21227	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
29923	Fee-for-Service	1982959243	1982959243	1	1	THENAPPAN, ANNAPOORANI	2/16/2006	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	63969	40	Pediatrics	0	In state provider	MD INC	1701 E CESAR E CHAVEZ AV	SUITE 128	LOS ANGELES	CA	90033	2464	19	06037	34.05112725	-118.2173921	Los Angeles County
29985	Fee-for-Service	1619383478	1619383478	1	1	TERVO, KARI E PHD	7/31/2014	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
30010	Fee-for-Service	1609846088	1609846088	1	1	THE GREENWICH HOSPITAL	4/23/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5 PERRYRIDGE RD	None	GREENWICH	CT	06830	4697	00	None	41.034546	-73.62967651	Western Connecticut Planning Region
30051	Fee-for-Service	1326133687	1326133687	2	1	THE VIDAL WOMANS MEDICAL CLI	2/5/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2100 E ANAHEIM ST	STE B	LONG BEACH	CA	90804	3419	19	06037	33.7825725	-118.1663865	Los Angeles County
30095	Fee-for-Service	1962046920	1962046920	1	1	TRANQUILITY TRANSPORTATION L	7/11/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LC	2667 CAMINO DEL RIO SOUT	301-12	SAN DIEGO	CA	92108	3707	37	06073	32.76979794	-117.1355701	San Diego County
30114	Fee-for-Service	1760453781	1760453781	1	1	THOMSON,JAMES F MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1102 E LOCUST	None	EMMETT	ID	83617	0000	00	None	43.87907647	-116.4858255	Gem County
30132	Fee-for-Service	1922408475	1922408475	1	1	TAYLOR-SANTOS, SHERRYANN C	10/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137173	15	Obstetrics (D.O. only)	0	In state provider	MD	43112 15TH ST WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
30159	Fee-for-Service	1346358793	1346358793	1	1	TRESTMAN, KENNETH G MD	1/31/1990	207RP1001X	NA	Pulmonology	026	PHYSICIANS	69663	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
30164	Fee-for-Service	1003381609	1003381609	1	1	TRUSTED CAREGIVER AND	2/7/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	CONSULTING SERVICES LLC	506 N ROYAL ST	None	ANAHEIM	CA	92806	3235	30	06059	33.84607886	-117.8730584	Orange County
30174	Fee-for-Service	1871941716	1871941716	1	1	TINY STEPS DEVELOPMENTAL SER	10/24/2018	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	VICES, A PSYCHOLOGICAL C	12522 MOORPARK ST	106	STUDIO CITY	CA	91604	1355	19	06037	34.15033253	-118.406061	Los Angeles County
30193	Fee-for-Service	1043297484	1043297484	1	1	TOM-LERMAN, JEANNETTE MD	3/18/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86415	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
30221	Fee-for-Service	1265414627	1265414627	1	1	TUCHLER, ROBERT E MD	11/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88340	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
30230	Fee-for-Service	1467563064	1467563064	1	1	TARAKJIAN, DENIS G MD	8/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	43922	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
30237	Fee-for-Service	1609984889	1609984889	1	2	THE WASHINGTON HOSPITAL	6/14/2016	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	155 WILSON AVENUE	None	WASHINGTON	PA	15301	3336	00	None	40.18297389	-80.24677018	Washington County
30242	Fee-for-Service	1346499621	1346499621	1	1	TIMBERLAKE PHARMACY	10/23/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	TIMBERLAKE PHARMACY	8120 TIMBERLAKE WAY	STE 108	SACRAMENTO	CA	95823	5413	34	06067	38.461023	-121.41414	Sacramento County
30254	Fee-for-Service	1467862672	1467862672	1	1	TRAN, VU T MD	7/1/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	17142	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
30278	Fee-for-Service	1528725686	1528725686	1	1	THUKU, JANE W	1/27/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4314 HERNANDEZ STREET	None	JURUPA VALLEY	CA	92509	3335	33	06065	34.00962225	-117.4553629	Riverside County
30284	Fee-for-Service	1598064834	1598064834	1	1	TRANG, HUONG Q OD	10/15/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9972 BOLSA AVE	STE 105	WESTMINSTER	CA	92683	6069	30	06059	33.74482609	-117.9554597	Orange County
30285	Fee-for-Service	1336533447	1336533447	1	1	TINT, NYEIN A MD	1/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143086	41	Internal Medicine	0	In state provider	None	9190 HAVEN AVE	None	RANCHO CUCAMONGA	CA	91730	5431	36	06071	34.086816	-117.5758865	San Bernardino County
30296	Fee-for-Service	1609846088	1609846088	1	1	THE GREENWICH HOSPITAL	8/13/2004	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5 PERRYRIDGE RD	None	GREENWICH	CT	06830	4697	00	None	41.034546	-73.62967651	Western Connecticut Planning Region
30304	Fee-for-Service	1447785704	1447785704	1	1	TSAI, TIMOTHY DO	9/9/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20059	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
30307	Fee-for-Service	1548688435	1548688435	1	1	TSAI, DAVID MD	8/16/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	139925	70	Clinic (mixed specialty)	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	42	06083	34.42887662	-119.7237878	Santa Barbara County
30309	Fee-for-Service	1013001650	1013001650	1	1	TENCH, WILLIAM D MD	8/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	33702	22	Pathology (M.D. only)	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
30341	Fee-for-Service	1326133687	1326133687	2	1	THE VIDAL WOMANS MEDICAL CLI	2/5/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	2100 E ANAHEIM ST	STE B	LONG BEACH	CA	90804	3419	19	06037	33.7825725	-118.1663865	Los Angeles County
30348	Fee-for-Service	1588919377	1588919377	1	1	TSOI, HOLLIS PSYD	4/2/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2373 COLORADO BOULEVARD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
30353	Fee-for-Service	1861584823	1861584823	1	1	TEEL, DEVANIE S MD	7/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80110	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
30359	Fee-for-Service	1821506478	1821506478	1	1	THOMAS, ALYSHA D LMFT	3/1/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	119549	-	NOT APPLICABLE	0	In state provider	None	1100 NORTH D ST	None	SAN BERNARDINO	CA	92410	3425	36	06071	34.119711	-117.291936	San Bernardino County
30381	Fee-for-Service	1275633216	1275633216	1	1	TRAN, PETER P MD	2/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97444	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
30393	Fee-for-Service	1124199153	1124199153	1	1	THAI, KIM D MD	9/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	75037	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
30410	Fee-for-Service	1619921103	1619921103	1	1	THONDAPU, RAMAKRISHNA R	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	39339	05	Anesthesiology	0	In state provider	None	2848 PARK AVE	STE B	MERCED	CA	95348	3375	24	06047	37.31338491	-120.4725729	Merced County
30423	Fee-for-Service	1063407815	1063407815	1	1	TAN, GLENN K MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72131	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3570 WILSHIRE BLVD	STE 350	LOS ANGELES	CA	90010	2304	19	06037	34.06167802	-118.3026041	Los Angeles County
30439	Fee-for-Service	1558455295	1558455295	1	1	TILL, KIM C LCSW	2/28/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27713	-	NOT APPLICABLE	0	In state provider	None	5 MAREBLU	STE 100, 200, 250	ALISO VIEJO	CA	92656	3014	30	06059	33.57250566	-117.7027366	Orange County
30442	Fee-for-Service	1831666825	1831666825	1	1	TEJEDA, KAYLIE CRNA	9/23/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
30447	Fee-for-Service	1528155132	1528155132	1	1	THIRUMALAI, SHANTIS S MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	53060	13	Neurology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
30494	Fee-for-Service	1679651459	1679651459	1	1	TSUZUKI, AKIKO MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64186	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
30510	Fee-for-Service	1114063575	1114063575	1	1	TEJURA, K B MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30962	40	Pediatrics	0	In state provider	None	760 WASHBURN AVE	None	CORONA	CA	92882	3303	33	06065	33.87374678	-117.5678721	Riverside County
30538	Fee-for-Service	1942257605	1942257605	1	1	TIRUMALASETTY, JYOTHI MD	1/29/2020	207K00000X	NA	Other	026	PHYSICIANS	164641	41	Internal Medicine	0	In state provider	None	2336 SANTA MONICA BLVD	SUITE 304	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
30548	Fee-for-Service	1306879036	1306879036	1	1	TABBAA, MUMTAZ G MD	9/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	54688	10	Gastroenterology (M.D. only)	0	In state provider	ADVANCED GASTRO OF MC	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
30550	Fee-for-Service	1548311723	1548311723	1	1	TUCKMAN, ALAN J MD	5/11/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	89353	36	Psychiatry	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
30566	Fee-for-Service	1528725686	1528725686	1	1	THUKU, JANE W	1/27/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4314 HERNANDEZ STREET	None	JURUPA VALLEY	CA	92509	3335	33	06065	34.00962225	-117.4553629	Riverside County
30573	Fee-for-Service	1114065802	1114065802	1	1	TEMPLE GARDEN HOMES IV	7/30/2002	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5120 BALDWIN AVE	None	TEMPLE CITY	CA	91780	3901	19	06037	34.09568585	-118.0497057	Los Angeles County
30625	Fee-for-Service	1396175360	1396175360	1	1	TRUJILLO, ARTURO M LMFT	3/15/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7121 MAGNOLIA AVE	J	RIVERSIDE	CA	92504	3805	33	06065	33.9455319	-117.4027101	Riverside County
30642	Fee-for-Service	1093014318	1093014318	1	1	TSAO, CHRISTINA S T MD	4/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136963	41	Internal Medicine	0	In state provider	None	2710 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78449066	-124.1414748	Humboldt County
30688	Fee-for-Service	1780116707	1780116707	1	1	THOMAS-BOISVERT, KELSEY I MD	11/23/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	170027	08	Family Practice	0	In state provider	None	15503 VENTURA BLVD	240, 340, 350	ENCINO	CA	91436	3115	19	06037	34.15483303	-118.4722163	Los Angeles County
30709	Fee-for-Service	1063407815	1063407815	1	1	TAN, GLENN K MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72131	05	Anesthesiology	0	In state provider	None	3570 WILSHIRE BLVD	STE 350	LOS ANGELES	CA	90010	2304	19	06037	34.06167802	-118.3026041	Los Angeles County
30728	Fee-for-Service	1124141049	1124141049	1	1	TREAIS, LYN MARIE MD	3/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86960	08	Family Practice	0	In state provider	None	3 COURT ST	None	WOODLAND	CA	95695	3111	57	06113	38.67888652	-121.783788	Yolo County
30760	Fee-for-Service	1396262713	1396262713	1	1	TSANG, JOYCE C	5/2/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
30767	Fee-for-Service	1942377809	1942377809	1	1	TSAI, PETER M MD	5/31/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	60961	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
30845	Fee-for-Service	1497023907	1497023907	1	1	TURNER, JOSHUA PT	11/1/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
30868	Fee-for-Service	1932351475	1932351475	1	1	TEAM NURSES HOME HEALTH	4/7/2011	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1815 N D STREET	None	SAN BERNARDINO	CA	92405	3909	36	06071	34.13168893	-117.2918413	San Bernardino County
30884	Fee-for-Service	1669627238	1669627238	1	1	TAN, TINGTING MD	9/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109526	41	Internal Medicine	0	In state provider	None	1600 N ROSE AVE	None	OXNARD	CA	92404	4836	56	06111	34.21700406	-119.1582582	Ventura County
30886	Fee-for-Service	1942345939	1942345939	1	1	THE CHILDRENS CLINIC	1/1/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	1301 WEST 12TH ST	None	LONG BEACH	CA	90813	2720	19	06037	33.78201945	-118.2088381	Los Angeles County
30905	Fee-for-Service	1245210368	1245210368	1	1	TRIPLETT, JOHNNY L MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53390	None	None	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
30920	Fee-for-Service	1104009117	1104009117	1	1	TAKAKI, KENNETH P DO	5/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10221	66	Emergency Medicine (Urgent Care)	0	In state provider	None	12401 E WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
30949	Fee-for-Service	1720195621	1720195621	1	1	THAI, HENRY MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67724	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
30986	Fee-for-Service	1508838350	1508838350	1	1	TEAFORD, PATRICIA A MD	9/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
31038	Fee-for-Service	1700380516	1700380516	1	1	TARABICHI, MAJD MD	7/6/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	185430	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
31067	Fee-for-Service	1487200515	1487200515	1	1	THERACARE PSYCHOLOGY AND WEL	5/20/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	265 S RANDOLPH AVE	STE 120	BREA	CA	92821	5798	30	06059	33.91513051	-117.8897392	Orange County
31071	Fee-for-Service	1053450627	1053450627	1	1	TABIBI, REZA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1615 DELAWARE ST	None	LONGVIEW	WA	98632	2367	00	None	46.1309207	-122.9408931	Cowlitz County
31087	Fee-for-Service	1194188854	1194188854	1	1	TAHOE FOREST HOSPITAL	11/3/2016	207X00000X	NA	Orthopedic Surgery	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10051 LAKE AVE	SUITE 3	TRUCKEE	CA	96161	4870	29	06057	39.32550268	-120.2025066	Nevada County
31089	Fee-for-Service	1376742973	1376742973	1	1	TAYLOR, CANDICE E MD	9/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107657	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
31115	Fee-for-Service	1760584759	1760584759	1	1	TIBB, DALIP S MD	10/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	65379	01	General Practice	0	In state provider	None	2075 SAN JAQUIN HILL RD	None	NEWPORT BEACH	CA	92660	6505	30	06059	33.61676129	-117.869325	Orange County
31128	Fee-for-Service	1649230418	1649230418	1	1	TAYLOR, CLARIBEL P MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	70013	10	Gastroenterology (M.D. only)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
31146	Fee-for-Service	1295333029	1295333029	1	1	TIGER & LION INC	3/16/2023	332H00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1251 S BEACH BLVD STE F	None	LA HABRA	CA	90631	6397	30	06059	33.91578584	-117.9693143	Orange County
31147	Fee-for-Service	1912066903	1912066903	1	1	TORRES, MICHELL L LCSW	11/10/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
31164	Fee-for-Service	1356336101	1356336101	1	1	THOMAS, GEORGE P MD INC	10/1/1983	193200000X	NA	Other	026	PHYSICIANS	35801	41	Internal Medicine	0	In state provider	None	622 W DUARTE RD	STE 302	ARCADIA	CA	91007	9278	19	06037	34.12645266	-118.0521552	Los Angeles County
31178	Fee-for-Service	1942345939	1942345939	1	1	THE CHILDRENS CLINIC	1/1/2012	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	1301 WEST 12TH ST	None	LONG BEACH	CA	90813	2720	19	06037	33.78201945	-118.2088381	Los Angeles County
31258	Fee-for-Service	1255813762	1255813762	1	1	TABUENCA, KRISTA B PHD	4/18/2023	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 UCLA MEDICAL PLAZA	3300	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
31310	Fee-for-Service	1205056033	1205056033	1	2	TERESA MEDICAL CENTER	7/18/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	635 S WESTLAKE AVE	STE 204	LOS ANGELES	CA	90057	3505	19	06037	34.05780431	-118.2744707	Los Angeles County
31349	Fee-for-Service	1073008306	1073008306	1	1	TURAN, NEFIZE MD	3/13/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	None	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
31352	Fee-for-Service	1487200515	1487200515	1	1	THERACARE PSYCHOLOGY AND WEL	2/28/2025	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	265 S RANDOLPH AVE	STE 120	BREA	CA	92821	5798	30	06059	33.91513051	-117.8897392	Orange County
31379	Fee-for-Service	1487064937	1487064937	1	1	TAYLOR, ROCHELLE L CCC-SLP	9/20/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	27192 NEWPORT ROAD	SUITE 1	MENIFEE	CA	92584	7387	33	06065	33.68506045	-117.1855215	Riverside County
31416	Fee-for-Service	1649230418	1649230418	1	1	TAYLOR, CLARIBEL P MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	70013	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
31461	Fee-for-Service	1942345939	1942345939	1	1	THE CHILDRENS CLINIC	1/1/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	1301 WEST 12TH ST	None	LONG BEACH	CA	90813	2720	19	06037	33.78201945	-118.2088381	Los Angeles County
31484	Fee-for-Service	1306918156	1306918156	1	1	TRAN, SERENE N MD	10/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86305	None	None	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
31499	Fee-for-Service	1093745135	1093745135	1	1	TOMLIN, JASON A MD	2/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79376	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
31506	Fee-for-Service	1326465436	1326465436	1	1	TARIQ, MUSADDIQ MD	7/27/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	175534	None	None	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
31515	Fee-for-Service	1487039640	1487039640	1	1	TRAN, HUNG Q MD	7/23/2024	2086S0122X	NA	General Surgery	026	PHYSICIANS	None	24	Plastic Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
31519	Fee-for-Service	1346366739	1346366739	1	1	TENENBAUM, MAX MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	56303	01	General Practice	0	In state provider	None	2631 POMONA BLVD	None	POMONA	CA	91768	3270	19	06037	34.0565605	-117.7968758	Los Angeles County
31541	Fee-for-Service	1659356376	1659356376	1	1	TRINIDAD, CARLO A OT	2/9/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1535 RIVER PARK DR	STE 1000	SACRAMENTO	CA	95815	4601	34	06067	38.600334	-121.4361675	Sacramento County
31594	Fee-for-Service	1205056033	1205056033	1	2	TERESA MEDICAL CENTER	7/18/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	635 S WESTLAKE AVE	STE 204	LOS ANGELES	CA	90057	3505	19	06037	34.05780431	-118.2744707	Los Angeles County
31639	Fee-for-Service	1467419226	1467419226	1	1	TANNENBAUM, JAIME E MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	67321	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
31686	Fee-for-Service	1174262927	1174262927	1	1	TELLIER, ADAM M LCSW	3/1/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
31708	Fee-for-Service	1124137542	1124137542	1	1	THRIFTY PAYLESS	1/1/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6207	3141 E PACIFIC COAST HWY	None	CORONA DEL MAR	CA	92625	0000	30	06059	33.59714581	-117.8715145	Orange County
31735	Fee-for-Service	1073580320	1073580320	3	2	TAMALPAIS PEDIATRICS	10/10/2023	208000000X	NA	Pediatric Primary Care	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	F AFFILIATE	251 VINTAGE WAY	None	NOVATO	CA	94945	5004	21	06041	38.08622342	-122.5511869	Marin County
31770	Fee-for-Service	1568799096	1568799096	1	1	TOTALCARE MEDICAL SUPPLY	10/19/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	7365 CARNELIAN STREET	SUITE 112	RANCHO CUCAMONGA	CA	91730	1158	36	06071	34.12038413	-117.6160525	San Bernardino County
31801	Fee-for-Service	1487039640	1487039640	1	1	TRAN, HUNG Q MD	7/23/2024	2086S0122X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
31807	Fee-for-Service	1346366739	1346366739	1	1	TENENBAUM, MAX MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	56303	08	Family Practice	0	In state provider	None	2631 POMONA BLVD	None	POMONA	CA	91768	3270	19	06037	34.0565605	-117.7968758	Los Angeles County
31849	Fee-for-Service	1215008149	1215008149	1	1	TSOU, ELI S MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90831	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
31854	Fee-for-Service	1568853778	1568853778	1	1	TATICK, NICOLE C LCSW	9/23/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
31890	Fee-for-Service	1598167462	1598167462	1	1	TORRES, CARYN LMFT	5/27/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	719 SAN BENITO STREET	SUITE F	HOLLISTER	CA	95023	1111	35	06069	36.84904855	-121.4020859	San Benito County
31892	Fee-for-Service	1396877080	1396877080	1	1	TERANDO, ALICIA M MD	6/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96086	78	Neoplastic Diseases/Oncology	0	In state provider	None	1328 22ND ST	None	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
31927	Fee-for-Service	1467775809	1467775809	1	1	TEITELBAUM, GEORGE P MD INC	1/26/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	45097	30	Radiology	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
31981	Fee-for-Service	1942308135	1942308135	2	1	TARIQ, NAILA A MD	6/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	1225 HANCOCK ROAD	SUITE B	BULLHEAD CITY	AZ	86442	5961	00	None	35.108307	-114.6055365	Mohave County
31994	Fee-for-Service	1750494191	1750494191	1	1	TAYLOR, RUTH A NP	12/19/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	9164	-	NOT APPLICABLE	0	In state provider	None	3550 Q ST	STE 101	BAKERSFIELD	CA	93301	1645	15	06029	35.391978	-119.0105025	Kern County
32009	Fee-for-Service	1669441358	1669441358	2	1	TUAN, KAREN P MD	7/30/2011	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80796	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	929 CLAY ST	STE 305	SAN FRANCISCO	CA	94108	1570	38	06075	37.79398652	-122.4083496	San Francisco County
32023	Fee-for-Service	1073580320	1073580320	3	2	TAMALPAIS PEDIATRICS	4/26/2024	208000000X	NA	Pediatric Primary Care	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	F AFFILIATE	251 VINTAGE WAY	None	NOVATO	CA	94945	5004	21	06041	38.08622342	-122.5511869	Marin County
32056	Fee-for-Service	1184630485	1184630485	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5992	1030 S WHITE RD	None	SAN JOSE	CA	95127	3812	43	06085	37.35796288	-121.8207543	Santa Clara County
32063	Fee-for-Service	1083723431	1083723431	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1935 N ST	None	NEWMAN	CA	95360	1419	50	06099	37.31018634	-121.0193592	Stanislaus County
32167	Fee-for-Service	1427379817	1427379817	1	1	TRAN, SINH H MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130328	36	Psychiatry	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
32174	Fee-for-Service	1184441552	1184441552	1	1	TAM, SHAUN PT	1/10/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
32210	Fee-for-Service	1003941683	1003941683	1	1	TARZANA TREATMENT CENTERS, I	8/30/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC,	5190 ATLANTIC AVE	None	LONG BEACH	CA	90805	6510	19	06037	33.850449	-118.1848215	Los Angeles County
32216	Fee-for-Service	1467775809	1467775809	1	1	TEITELBAUM, GEORGE P MD INC	1/26/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	45097	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
32238	Fee-for-Service	1174730824	1174730824	1	1	TILLMAN, SYLVIA E OD	11/19/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
32272	Fee-for-Service	1992725758	1992725758	1	1	TINGLE, LINDA 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	4242 MEDICAL DR	STE 3100	SAN ANTONIO	TX	78229	5642	00	None	29.51345208	-98.56843947	Bexar County
32277	Fee-for-Service	1740707009	1740707009	1	1	TALIAFERRO, KIKI L LMFT	8/20/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
32308	Fee-for-Service	1790598837	1790598837	1	1	TOOR, GURLEEN NP	2/18/2025	207V00000X	NA	Obstetrics & Gynecology	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16167 SISKIYOU ROAD	SUITE A	APPLE VALLEY	CA	92307	0837	36	06071	34.54496692	-117.2664417	San Bernardino County
32311	Fee-for-Service	1073580320	1073580320	3	2	TAMALPAIS PEDIATRICS	2/25/2019	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	F AFFILIATE	251 VINTAGE WAY	None	NOVATO	CA	94945	5004	21	06041	38.08622342	-122.5511869	Marin County
32313	Fee-for-Service	1730390675	1730390675	1	1	THOMAS, BEJOY G MD	8/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	96741	05	Anesthesiology	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
32337	Fee-for-Service	1629306329	1629306329	1	1	TSUHA-MCNIEL, TOMIKO	12/27/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
32357	Fee-for-Service	1265626360	1265626360	1	2	THOMPSON, JOTIKA P MD	2/9/2018	207R00000X	NA	Other	026	PHYSICIANS	146990	None	None	0	In state provider	None	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	19	06037	34.05362775	-118.2661889	Los Angeles County
32418	Fee-for-Service	1750344305	1750344305	1	1	TRAN, HUY T MD	9/3/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	92933	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
32422	Fee-for-Service	1598290108	1598290108	1	1	TORRES, DAVE S MD	4/23/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169603	None	None	0	In state provider	None	1011 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72827776	-121.2904066	Placer County
32431	Fee-for-Service	1174134530	1174134530	1	1	T.L.C. NON EMERGENCY MEDICAL	3/14/2021	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TRANSPORTATION	327 E AVE K-4	None	LANCASTER	CA	93535	4500	19	06037	34.67505276	-118.1249533	Los Angeles County
32433	Fee-for-Service	1912051012	1912051012	1	1	TORRALVA, PHILLIP R MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61208	05	Anesthesiology	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
32464	Fee-for-Service	1538141619	1538141619	1	1	TROIA-CANCIO,PAOLA V MD	8/17/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72026	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
32493	Fee-for-Service	1548326283	1548326283	1	1	THAIYANANTHAN, NANDHITHA MD	12/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104377	29	Pulmonary Diseases (M.D. only)	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
32498	Fee-for-Service	1619217288	1619217288	1	1	THAN, NHAT T H DO	3/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13584	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6601 WHITE FEATHER ROAD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
32561	Fee-for-Service	1326711540	1326711540	1	1	TONNU, KIEU M CRNA	8/9/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
32568	Fee-for-Service	1013940543	1013940543	1	1	TAWADROUS FOUAD DM	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	25706	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1148 SAN BERNARDINO RD	None	UPLAND	CA	91786	4943	36	06071	34.10140903	-117.6359301	San Bernardino County
32572	Fee-for-Service	1851787717	1851787717	1	1	TUN, MAY T MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154392	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
32600	Fee-for-Service	1073580320	1073580320	3	2	TAMALPAIS PEDIATRICS	5/11/2021	208000000X	NA	Pediatric Primary Care	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	F AFFILIATE	251 VINTAGE WAY	None	NOVATO	CA	94945	5004	21	06041	38.08622342	-122.5511869	Marin County
32617	Fee-for-Service	1346358835	1346358835	1	1	TIEN, PHYLLIS C MD	5/4/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	77758	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
32642	Fee-for-Service	1174274443	1174274443	1	1	THOMPKINS, ASHLEY LCSW	1/6/2025	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
32692	Fee-for-Service	1477612059	1477612059	1	1	TRUONG, DIANE G MD	11/30/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	75494	40	Pediatrics	0	In state provider	SPECIALTY MEDICAL CLINIC	9844 GENESEE AVE	STE 400	LA JOLLA	CA	92037	1209	37	06073	32.883714	-117.2266425	San Diego County
32695	Fee-for-Service	1306088059	1306088059	1	1	TOTAL RENAL CARE	8/5/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2723 W TEMPLE ST	None	LOS ANGELES	CA	90026	4723	19	06037	34.07316839	-118.2762807	Los Angeles County
32706	Fee-for-Service	1649450982	1649450982	1	1	TRIEU, SANDY MD	8/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	100915	01	General Practice	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
32721	Fee-for-Service	1194788273	1194788273	1	1	TOTAL RENAL CARE, INC	3/1/1996	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	5720 STONERIDGE MALL RD	STE 160	PLEASANTON	CA	94588	2882	01	06001	37.69247085	-121.9301884	Alameda County
32724	Fee-for-Service	1205915337	1205915337	1	1	TON, BINH T MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65924	41	Internal Medicine	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
32744	Fee-for-Service	1093292716	1093292716	1	1	TRAN, JONATHAN CNP	3/19/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2037 VERDUGO BLVD	None	MONTROSE	CA	91020	1626	19	06037	34.20478879	-118.2210421	Los Angeles County
32752	Fee-for-Service	1538141619	1538141619	1	1	TROIA-CANCIO,PAOLA V MD	8/17/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72026	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
32753	Fee-for-Service	1154925642	1154925642	1	1	THIBEAULT, PAUL L LMFT	5/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
32778	Fee-for-Service	1093824427	1093824427	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15025 OLYMPIC DR	None	CLEARLAKE	CA	95422	9526	17	06033	38.96178976	-122.6305418	Lake County
32779	Fee-for-Service	1548326283	1548326283	1	1	THAIYANANTHAN, NANDHITHA MD	12/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104377	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
32801	Fee-for-Service	1720018765	1720018765	1	1	TALEGHANI, NOUSHAFARIN N	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64565	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
32804	Fee-for-Service	1912105586	1912105586	1	1	THURAISINGHAM, DHILAN A MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111767	05	Anesthesiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
32965	Fee-for-Service	1629325246	1629325246	1	1	TORRES, MELISSA LMFT	8/29/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25 SAN JUAN GRADE RD	106	SALINAS	CA	93906	2052	27	06053	36.7178357	-121.6540586	Monterey County
32969	Fee-for-Service	1356856132	1356856132	1	1	TEDLA, TILKSEW A NP	4/1/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3751 E SHIELDS AVE	None	FRESNO	CA	93726	0000	10	06019	36.7796958	-119.7618088	Fresno County
32970	Fee-for-Service	1962877407	1962877407	1	1	THE RANCH RECOVERY CENTERS,	12/21/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	12890 QUINTA WAY	None	DESERT HOT SPRING	CA	92240	4852	33	06065	33.95486583	-116.4761192	Riverside County
32980	Fee-for-Service	1518313600	1518313600	1	1	THRIFTY PAYLESS INC	10/12/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	600 34TH ST	None	BAKERSFIELD	CA	93301	2208	15	06029	35.39051746	-119.008422	Kern County
33020	Fee-for-Service	1063068930	1063068930	1	1	TAHOE FOREST HOSPITAL DISTRI	2/28/2020	207Q00000X	NA	Adult Primary Care	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CLINICS PRIMARY CARE	10956 DONNER PASS RD	STE 360	TRUCKEE	CA	96161	4860	29	06057	39.32625521	-120.2012059	Nevada County
33025	Fee-for-Service	1962858100	1962858100	1	1	THEA FLEMING	11/21/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 CHICAGO AVE	None	MINNEAPOLIS	MN	55404	4518	00	None	44.95666589	-93.26255996	Hennepin County
33026	Fee-for-Service	1871685164	1871685164	1	1	TALEBZADEH, NOJAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	64127	None	None	0	In state provider	None	246 F ST	None	CHULA VISTA	CA	91910	2818	37	06073	32.64190447	-117.0774204	San Diego County
33041	Fee-for-Service	1538141619	1538141619	1	1	TROIA-CANCIO,PAOLA V MD	8/17/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72026	77	Infectious Disease	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
33047	Fee-for-Service	1679766117	1679766117	1	1	TRAM, BICH N CRNA	8/16/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
33104	Fee-for-Service	1053785949	1053785949	1	1	TAYLOR, JOAN N CNP	1/27/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
33124	Fee-for-Service	1467649871	1467649871	1	1	TURNER, MARK CO	8/27/2008	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	3433 BROADWAY ST	#B3	AMERICAN CANYON	CA	94503	1229	28	06055	38.17023187	-122.2533805	Napa County
33170	Fee-for-Service	1184149189	1184149189	1	1	TRAN, NGUYEN V T MD	12/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151089	01	General Practice	0	In state provider	None	850 E WASHINGTON ST	None	COLTON	CA	92324	8101	36	06071	34.04819847	-117.3132225	San Bernardino County
33208	Fee-for-Service	1477533792	1477533792	1	1	TODD, WILLIAM R DPM	12/1/1986	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1511 CLEMENT ST	None	SAN FRANCISCO	CA	94118	1031	38	06075	37.7823969	-122.475506	San Francisco County
33209	Fee-for-Service	1023043478	1023043478	1	1	TONG, IAN L MD	8/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84913	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
33211	Fee-for-Service	1134680713	1134680713	1	1	TIEE, MADELINE MD	7/8/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	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
33230	Fee-for-Service	1487629473	1487629473	1	1	TORRES, JUAN G MD	4/15/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	50648	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
33248	Fee-for-Service	1548478100	1548478100	1	1	TRUONG, DENNIS V MD	9/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113564	66	Emergency Medicine (Urgent Care)	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5695	35	06069	36.83504962	-121.3858245	San Benito County
33276	Fee-for-Service	1548271901	1548271901	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05766	18112 CULVER DR	None	IRVINE	CA	92612	2730	30	06059	33.66405275	-117.8272722	Orange County
33298	Fee-for-Service	1730143454	1730143454	1	3	THE REGENTS OF THE UNIVERSIT	9/25/2020	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1223 16TH ST	1100	SANTA MONICA	CA	90404	1217	19	06037	34.02773198	-118.4862675	Los Angeles County
33308	Fee-for-Service	1730837659	1730837659	1	1	TARASENKO, MARYNA CNP	8/25/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
33318	Fee-for-Service	1003217886	1003217886	1	1	TABILA-GUGLIELMI, KRISTINA	1/1/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	MD	555 TACHEVAH DR	SUITE 2E-107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
33408	Fee-for-Service	1063515187	1063515187	1	1	TILLOTSON, KIMBERLY NMW	10/1/1999	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	16051 KASOTA RD	STE 400	APPLE VALLEY	CA	92307	2215	36	06071	34.543368	-117.2667825	San Bernardino County
33422	Fee-for-Service	1043331630	1043331630	1	1	THE WEST OAKLAND HEALTH	2/29/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	COUNCIL	700 ADELINE STREET	None	OAKLAND	CA	94607	2608	01	06001	37.80430011	-122.2879962	Alameda County
33442	Fee-for-Service	1326195520	1326195520	1	1	TEMPLE ANDREW RATCLIFFE M.D.	9/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4402	00	None	29.508012	-98.578683	Bexar County
33451	Fee-for-Service	1235271065	1235271065	1	1	THE LOS ANGELES FREE CLINIC	2/1/2000	261QC1500X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HOLLYWOOD HEALTH CENTER	6043 HOLLYWOOD BLVD	None	HOLLYWOOD	CA	90028	5411	19	06037	34.1016835	-118.321569	Los Angeles County
33483	Fee-for-Service	1952327132	1952327132	1	1	TSOH, JANICE Y PHD	8/27/2021	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
33494	Fee-for-Service	1740523695	1740523695	1	1	TOWNSEND, LAURA A	12/27/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
33517	Fee-for-Service	1134657646	1134657646	1	1	TIEN, AUDRIS M DPM	7/8/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	16405 SAND CANYON AVE	STE 270	IRVINE	CA	92618	3792	30	06059	33.66098519	-117.7747816	Orange County
33522	Fee-for-Service	1437269354	1437269354	1	1	THE BREAST CARE CENTER	5/13/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	OF ORANGE COUNTY INC	230 S MAIN ST	STE 100	ORANGE	CA	92868	3851	30	06059	33.785154	-117.867318	Orange County
33529	Fee-for-Service	1912088139	1912088139	1	1	TAI, L MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	56076	08	Family Practice	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
33540	Fee-for-Service	1255528964	1255528964	1	1	TURKIS, MARTIN E OD INC	9/14/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2773 HARRIS ST	STE H	EUREKA	CA	95503	4866	12	06023	40.78052829	-124.1363953	Humboldt County
33544	Fee-for-Service	1811450075	1811450075	1	1	TRAN, TY MD	8/1/2023	390200000X	NA	Other	026	PHYSICIANS	179560	None	None	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
33579	Fee-for-Service	1932130697	1932130697	1	1	TSAI, SEAN I MD	5/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	7930	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
33585	Fee-for-Service	1730143454	1730143454	1	3	THE REGENTS OF THE UNIVERSIT	9/25/2020	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1223 16TH ST	1100	SANTA MONICA	CA	90404	1217	19	06037	34.02773198	-118.4862675	Los Angeles County
33607	Fee-for-Service	1003217886	1003217886	1	1	TABILA-GUGLIELMI, KRISTINA	1/1/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	01	General Practice	0	In state provider	MD	555 TACHEVAH DR	SUITE 2E-107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
33683	Fee-for-Service	1114960192	1114960192	1	1	TATSUYAMA, JED J MD	6/12/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65606	08	Family Practice	0	In state provider	None	6000 J STREET	None	SACRAMENTO	CA	95819	2605	34	06067	38.56329	-121.426353	Sacramento County
33711	Fee-for-Service	1093924888	1093924888	1	1	THERAPEUTIC LIVING	3/9/2005	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTERS FOR THE BLIND	23710 COMMUNITY ST	None	WEST HILLS	CA	91304	3003	19	06037	34.2216623	-118.6441282	Los Angeles County
33724	Fee-for-Service	1780758383	1780758383	1	1	TRAN, TRINH H MD	5/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	70513	08	Family Practice	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
33741	Fee-for-Service	1235271065	1235271065	1	1	THE LOS ANGELES FREE CLINIC	9/21/2007	261QC1500X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	HOLLYWOOD HEALTH CENTER	6043 HOLLYWOOD BLVD	None	HOLLYWOOD	CA	90028	5411	19	06037	34.1016835	-118.321569	Los Angeles County
33752	Fee-for-Service	1164050993	1164050993	1	1	TRAN, TU M MD	7/10/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
33755	Fee-for-Service	1740677145	1740677145	1	1	THOMAS EMERGENCY GRP	12/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
33791	Fee-for-Service	1881354561	1881354561	1	1	TRANG ARDELEAN, LINDA NP	3/5/2023	163W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
33816	Fee-for-Service	1225131030	1225131030	1	1	TOLENTINO, ARMINDA S MD	4/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	54365	None	None	0	In state provider	None	930 SUNNYSLOPE RD	STE E3	HOLLISTER	CA	95023	5638	35	06069	36.83909681	-121.3851338	San Benito County
33832	Fee-for-Service	1699194142	1699194142	1	2	THAI, JULIE	7/14/2020	390200000X	NA	Other	026	PHYSICIANS	138066	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
33846	Fee-for-Service	1093137762	1093137762	1	1	TERI INC	10/27/2013	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1658 ANZA AVE	None	VISTA	CA	92084	3233	37	06073	33.22479102	-117.2326467	San Diego County
33860	Fee-for-Service	1740351873	1740351873	1	1	TANUS, TONNY MD	9/30/1994	207K00000X	NA	Other	026	PHYSICIANS	79901	41	Internal Medicine	0	In state provider	None	130 N VILLA ST	STE B	PORTERVILLE	CA	93257	3218	54	06107	36.06836492	-119.0306711	Tulare County
33864	Fee-for-Service	1518225325	1518225325	1	1	TOPACIO, ANTONIO G MD	5/23/2022	207R00000X	NA	Other	026	PHYSICIANS	133757	None	None	0	In state provider	None	4955 VAN NUYS BLVD	SUITE 308	SHERMAN OAKS	CA	91403	1811	19	06037	34.160805	-118.4487295	Los Angeles County
33866	Fee-for-Service	1811230535	1811230535	1	1	TUZOVIC, MIRELA MD	6/5/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	131891	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
33896	Fee-for-Service	1356429997	1356429997	1	1	TANG, ANNE MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30112	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
33946	Fee-for-Service	1891954376	1891954376	1	1	TEJWANI, NATASHA A	1/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130530	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
33989	Fee-for-Service	1750490702	1750490702	1	1	TAYLOR, RANDY MD	12/7/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	42157	-	NOT APPLICABLE	0	In state provider	None	1147 S ALVARADO ST	None	LOS ANGELES	CA	90006	4100	19	06037	34.04901396	-118.2816075	Los Angeles County
33998	Fee-for-Service	1659889632	1659889632	1	1	TOTAL RENAL CARE INC	3/13/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	966 E AVE	None	CHICO	CA	95926	1309	04	06007	0	0	None
34001	Fee-for-Service	1386219558	1386219558	1	3	TELEMEDICINE URGENT CARE INC	8/23/2024	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	5888 EDINGER AVE	None	HUNTINGTON BEACH	CA	92649	1705	30	06059	33.72993249	-118.0255995	Orange County
34028	Fee-for-Service	1235271065	1235271065	1	1	THE LOS ANGELES FREE CLINIC	2/1/2000	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HOLLYWOOD HEALTH CENTER	6043 HOLLYWOOD BLVD	None	HOLLYWOOD	CA	90028	5411	19	06037	34.1016835	-118.321569	Los Angeles County
34039	Fee-for-Service	1760142590	1760142590	1	1	THOMAS, DEBRA A LMFT	5/28/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
34077	Fee-for-Service	1265663611	1265663611	1	1	TRIMBLE, KEILA J MD	3/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106977	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
34083	Fee-for-Service	1407306665	1407306665	1	3	TIMOTHY S. JOHNSTON, M.D. PC	11/17/2022	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	3170 COLLINS DR	B	MERCED	CA	95348	3132	24	06047	37.320606	-120.476544	Merced County
34088	Fee-for-Service	1912970195	1912970195	1	1	TUMBAGA, PURIFICACION MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55443	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
34099	Fee-for-Service	1164527883	1164527883	1	1	TIYYAGURA, LAKSHMA R	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	56285	41	Internal Medicine	0	In state provider	None	1805 N CALIFORNIA ST	309	STOCKTON	CA	95204	6037	39	06077	37.9711691	-121.2894221	San Joaquin County
34125	Fee-for-Service	1285021659	1285021659	1	1	TRISHA, SHIRIN MD	9/19/2022	207R00000X	NA	Other	026	PHYSICIANS	176154	None	None	0	In state provider	None	ONE MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
34146	Fee-for-Service	1558998906	1558998906	1	1	TRIVEDI, MEHUL D	11/9/2023	208M00000X	NA	Other	026	PHYSICIANS	186699	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
34245	Fee-for-Service	1659880623	1659880623	1	1	TRINH, KIMBERLY NP	1/25/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
34253	Fee-for-Service	1760915581	1760915581	1	1	TAFOYA, CHELSEA A MD	6/23/2021	207P00000X	NA	Other	026	PHYSICIANS	163026	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
34286	Fee-for-Service	1215103304	1215103304	1	3	TORRES, REBECCA MD AMC	11/14/2014	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1605 S RIVERSIDE AVE	STE B	RIALTO	CA	92376	7707	36	06071	34.072578	-117.3701815	San Bernardino County
34318	Fee-for-Service	1235271065	1235271065	1	1	THE LOS ANGELES FREE CLINIC	2/1/2000	261QC1500X	NA	Other	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HOLLYWOOD HEALTH CENTER	6043 HOLLYWOOD BLVD	None	HOLLYWOOD	CA	90028	5411	19	06037	34.1016835	-118.321569	Los Angeles County
34369	Fee-for-Service	1407306665	1407306665	1	3	TIMOTHY S. JOHNSTON, M.D. PC	11/17/2022	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3170 COLLINS DR	B	MERCED	CA	95348	3132	24	06047	37.320606	-120.476544	Merced County
34370	Fee-for-Service	1457614919	1457614919	1	1	TRAN, DONNA	10/18/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	13020	None	None	0	In state provider	None	104 E OLIVE AVE	STE 100	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
34387	Fee-for-Service	1164527883	1164527883	1	1	TIYYAGURA, LAKSHMA R	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	56285	10	Gastroenterology (M.D. only)	0	In state provider	None	1805 N CALIFORNIA ST	309	STOCKTON	CA	95204	6037	39	06077	37.9711691	-121.2894221	San Joaquin County
34390	Fee-for-Service	1992753222	1992753222	1	1	TARRANT COUNTY HOSPITAL	7/27/2007	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	DISTRICT	1500 SOUTH MAIN STREET	None	FORT WORTH	TX	76104	4917	00	None	32.72717074	-97.32642896	Tarrant County
34433	Fee-for-Service	1730143454	1730143454	1	4	THE REGENTS OF THE UNIVERSIT	2/4/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
34565	Fee-for-Service	1598399917	1598399917	1	1	TRINITY MEDICAL MULTI-SPECIA	1/20/2021	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	LTY GROUP INC.	31625 DE PORTOLA RD	SUITE 101	TEMECULA	CA	92592	2770	33	06065	33.48359715	-117.1048345	Riverside County
34568	Fee-for-Service	1346315371	1346315371	1	1	TRAN, NHIEN V CA	2/8/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	730 STORY RD	STE 2	SAN JOSE	CA	95122	2624	43	06085	37.3292404	-121.8586317	Santa Clara County
34583	Fee-for-Service	1235314600	1235314600	1	1	TRACY, BRIAN D OD	6/1/2003	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3000 L ST	STE 100	SACRAMENTO	CA	95816	5248	34	06067	38.570517	-121.4672175	Sacramento County
34588	Fee-for-Service	1447336375	1447336375	1	1	THOMAS, MEGHAN M MD	11/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	83061	01	General Practice	0	In state provider	None	4663 SCOTTS VALLEY DR	None	SCOTTS VALLEY	CA	95066	3943	44	06087	37.04973619	-122.0157773	Santa Cruz County
34622	Fee-for-Service	1154392363	1154392363	1	1	THOMAS, MARC A MD	1/5/2009	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LN	STE 100	LAS VEGAS	NV	89106	4812	00	None	36.16257648	-115.170696	Clark County
34625	Fee-for-Service	1316361538	1316361538	1	1	TEHRANI, SEPEHR S MD	11/9/2020	207L00000X	NA	Other	026	PHYSICIANS	152981	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
34637	Fee-for-Service	1326094392	1326094392	1	1	TAXERA, GARY R OD	3/6/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1245 THARP RD	None	YUBA CITY	CA	95993	2640	51	06101	39.14499709	-121.6484309	Sutter County
34654	Fee-for-Service	1881766616	1881766616	1	1	TAN, PATRICIA Y MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	56297	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
34656	Fee-for-Service	1891955803	1891955803	1	1	TRAVIS, TALITHA S MD	5/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	106432	None	None	0	In state provider	None	1411 EAST 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
34659	Fee-for-Service	1407306665	1407306665	1	3	TIMOTHY S. JOHNSTON, M.D. PC	11/17/2022	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3170 COLLINS DR	B	MERCED	CA	95348	3132	24	06047	37.320606	-120.476544	Merced County
34676	Fee-for-Service	1164527883	1164527883	1	1	TIYYAGURA, LAKSHMA R	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	56285	01	General Practice	0	In state provider	None	1805 N CALIFORNIA ST	309	STOCKTON	CA	95204	6037	39	06077	37.9711691	-121.2894221	San Joaquin County
34677	Fee-for-Service	1992753222	1992753222	1	1	TARRANT COUNTY HOSPITAL	7/27/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	DISTRICT	1500 SOUTH MAIN STREET	None	FORT WORTH	TX	76104	4917	00	None	32.72717074	-97.32642896	Tarrant County
34701	Fee-for-Service	1649499385	1649499385	1	1	TRAN, LIEN N MD	6/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94826	31	Roentgenology, Radiology (M.D. only)	0	In state provider	None	10833 LE CONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
34712	Fee-for-Service	1871523639	1871523639	1	1	TING, GRACE DPM	2/21/2003	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	27 W MAIN ST	STE G	ALHAMBRA	CA	91801	3500	19	06037	34.09489351	-118.1274697	Los Angeles County
34718	Fee-for-Service	1730143454	1730143454	1	4	THE REGENTS OF THE UNIVERSIT	2/4/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
34732	Fee-for-Service	1407227986	1407227986	1	1	TOTAL RENAL CARE INC	8/27/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1424 E WHITMORE AVE	None	CERES	CA	95307	9215	50	06099	37.59480254	-120.97161	Stanislaus County
34756	Fee-for-Service	1730599135	1730599135	1	1	THIGPEN, JOYCE LCSW	12/15/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
34841	Fee-for-Service	1649532516	1649532516	1	1	TAKOS, JEFFREY R MD	9/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146392	36	Psychiatry	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
34853	Fee-for-Service	1598399917	1598399917	1	1	TRINITY MEDICAL MULTI-SPECIA	1/20/2021	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	LTY GROUP INC.	31625 DE PORTOLA RD	SUITE 101	TEMECULA	CA	92592	2770	33	06065	33.48359715	-117.1048345	Riverside County
34871	Fee-for-Service	1225270200	1225270200	1	1	TAKADO, RIE LMFT	12/6/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
34888	Fee-for-Service	1497059216	1497059216	1	1	TEMPLEMAN, JAMES R JR MD	7/27/2017	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	115450	38	Geriatrics	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
34918	Fee-for-Service	1831445949	1831445949	1	1	TIMS, ALLISON M DO	10/15/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15887	08	Family Practice	0	In state provider	None	1755 COURT STREET	None	REDDING	CA	96001	1721	45	06089	40.58041248	-122.3945221	Shasta County
35003	Fee-for-Service	1821140393	1821140393	1	1	TSAI, MARK C AC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	TOTAL WELLNESS HEALTH	542 BROADWAY	STE R	CHULA VISTA	CA	91910	5304	37	06073	32.62945575	-117.0889026	San Diego County
35004	Fee-for-Service	1720752090	1720752090	1	1	THIRD OPTOMETRIC CARE OF CAL	10/10/2024	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	R	1850 RIVERSIDE AVE	SUITE 220	RIALTO	CA	92376	8082	36	06071	34.132905	-117.3704675	San Bernardino County
35024	Fee-for-Service	1952410367	1952410367	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5513	501 S GAFFEY ST	None	SAN PEDRO	CA	90731	2437	19	06037	33.73919051	-118.2923681	Los Angeles County
35028	Fee-for-Service	1407323579	1407323579	1	1	TUSTIN PREMIER PHARMACY INC	12/20/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	217 S TUSTIN ST	None	ORANGE	CA	92866	2321	30	06059	33.785685	-117.835714	Orange County
35045	Fee-for-Service	1902874837	1902874837	1	1	THOMAS, BENOY J MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76506	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
35090	Fee-for-Service	1104991090	1104991090	1	1	TALAVERA, MARK G MD	5/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	54613	41	Internal Medicine	0	In state provider	None	1680 E 120TH STREET	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
35094	Fee-for-Service	1497269864	1497269864	1	1	TRAN, QUANG D CNP	2/27/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1800 WILSHIRE BLVD	None	LOS ANGELES	CA	90057	3602	19	06037	34.0565363	-118.2728437	Los Angeles County
35109	Fee-for-Service	1295828952	1295828952	1	1	TRUONG, HANH	7/18/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
35134	Fee-for-Service	1407869639	1407869639	1	1	TOLAN, AURORA L MD	5/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	77878	40	Pediatrics	0	In state provider	None	6011 PACIFIC BLVD	STE 116	HUNTINGTON PARK	CA	90255	2959	19	06037	33.9869767	-118.2252886	Los Angeles County
35137	Fee-for-Service	1912936782	1912936782	1	1	TIMAJCHI, HELEN CRNA	4/6/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
35138	Fee-for-Service	1598399917	1598399917	1	1	TRINITY MEDICAL MULTI-SPECIA	1/20/2021	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	LTY GROUP INC.	31625 DE PORTOLA RD	SUITE 101	TEMECULA	CA	92592	2770	33	06065	33.48359715	-117.1048345	Riverside County
35142	Fee-for-Service	1104240928	1104240928	1	1	TRAN, PHUONG Q MD	2/8/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152612	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
35222	Fee-for-Service	1578955605	1578955605	1	1	TRAN, MINI T OD	5/28/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4240 KEARNY MESA RD #101	None	SAN DIEGO	CA	92111	3769	37	06073	32.81857281	-117.1491983	San Diego County
35253	Fee-for-Service	1881791135	1881791135	1	1	TRINH, TIEN MD	7/19/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79654	41	Internal Medicine	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
35264	Fee-for-Service	1124220876	1124220876	1	1	TORRES, APRIL LCSW	9/5/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	101741	-	NOT APPLICABLE	0	In state provider	None	12021 S WILMINGTON AVE	BUILDING 18, SUITE 300	LOS ANGELES	CA	90059	3019	19	06037	33.922575	-118.2391785	Los Angeles
35278	Fee-for-Service	1073918710	1073918710	1	1	THE HANDSEL GROUP,LLC	7/16/2014	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	14122 HUBBARD STREET	None	SYLMAR	CA	91342	4712	19	06037	34.29827364	-118.4405312	Los Angeles County
35341	Fee-for-Service	1356629794	1356629794	1	1	TURNING POINT OF CENTRAL	12/16/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA INC	851 NORTH STANFORD AVE	None	LINDSAY	CA	93247	1700	54	06107	36.212076	-119.0797395	Tulare County
35350	Fee-for-Service	1205831583	1205831583	1	1	TARZANA ENDOCRINE & MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GRP	18370 BURBANK BLVD	STE 601	TARZANA	CA	91356	2831	19	06037	34.17173059	-118.5331881	Los Angeles County
35367	Fee-for-Service	1801329636	1801329636	1	1	TRAN, BILLY K MD	10/6/2021	207L00000X	NA	Other	026	PHYSICIANS	170842	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
35378	Fee-for-Service	1104991090	1104991090	1	1	TALAVERA, MARK G MD	5/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	54613	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1680 E 120TH STREET	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
35396	Fee-for-Service	1609196187	1609196187	1	1	TINLOY, JENNIFER P DO	8/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13861	41	Internal Medicine	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
35496	Fee-for-Service	1225686942	1225686942	1	1	THE DOCTORS CHOICE HOME	2/22/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE INC	3434 TRUXTUN AVE	SUITE 270	BAKERSFIELD	CA	93301	3044	15	06029	35.37393792	-119.0422332	Kern County
35525	Fee-for-Service	1033281886	1033281886	1	1	TAVARES, VALERIE A MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	53930	01	General Practice	0	In state provider	None	4785 N 1ST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
35553	Fee-for-Service	1114205432	1114205432	1	1	TRILOGY EYE MEDICAL GROUP	9/20/2013	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	207 S SANTA ANITA ST	SUITE P-25	SAN GABRIEL	CA	91776	1145	19	06037	34.10072807	-118.1066296	Los Angeles County
35608	Fee-for-Service	1922333723	1922333723	1	1	TEMECULA MEDICAL CORPORATION	6/15/2022	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	41715 WINCHESTER RD	SUITE 101	TEMECULA	CA	92590	4808	33	06065	33.51843041	-117.1680022	Riverside County
35638	Fee-for-Service	1700967023	1700967023	1	1	TALLUTO, CHRISTOPHER J	2/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91173	41	Internal Medicine	0	In state provider	MD	795 EL CAMNINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
35664	Fee-for-Service	1104991090	1104991090	1	1	TALAVERA, MARK G MD	5/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	54613	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1680 E 120TH STREET	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
35695	Fee-for-Service	1497866016	1497866016	1	1	TESAR, CHARLES B MD	3/31/1989	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	46482	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
35704	Fee-for-Service	1770197659	1770197659	1	1	THE FRESNO CENTER	10/20/2021	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	4855 E KINGS CANYON RD	None	FRESNO	CA	93727	3811	10	06019	36.73603005	-119.7335333	Fresno County
35739	Fee-for-Service	1912098732	1912098732	1	1	THE MEDICINE CABINET,IN	2/1/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	228 E ANAHEIM ST	None	WILMINGTON	CA	90744	4516	19	06037	33.78008174	-118.2602137	Los Angeles County
35774	Fee-for-Service	1689853012	1689853012	1	1	TORRES, AIDA ALICIA	3/22/2007	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	669 E ALLUVIAL AVE	None	FRESNO	CA	93720	2513	10	06019	36.84449702	-119.7733424	Fresno County
35781	Fee-for-Service	1548456155	1548456155	1	1	THOMAS, KIRON MD	12/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	127448	30	Radiology	0	In state provider	None	1700 MT VERNON AVENUE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
35791	Fee-for-Service	1588611867	1588611867	2	1	TRUONG, VU T MD	12/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	80779	41	Internal Medicine	0	In state provider	None	1775 W LINCOLN AVE	None	ANAHEIM	CA	92801	6715	30	06059	33.83260148	-117.945333	Orange County
35810	Fee-for-Service	1922068832	1922068832	1	1	THOMAS ROBERTS 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	500 WALTER ST NE	STE 104	ALBUQUERQUE	NM	87102	2541	00	None	35.08716551	-106.6401923	Bernalillo County
35843	Fee-for-Service	1114205432	1114205432	1	1	TRILOGY EYE MEDICAL GROUP	9/20/2013	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	24	Plastic Surgery	0	In state provider	INC	207 S SANTA ANITA ST	SUITE P-25	SAN GABRIEL	CA	91776	1145	19	06037	34.10072807	-118.1066296	Los Angeles County
35866	Fee-for-Service	1164046330	1164046330	1	1	TOYAMA, HANNAH PHD	5/24/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
35875	Fee-for-Service	1700097540	1700097540	1	3	THE NORTHEAST COMMUNITY CLNC	7/18/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4455 W 117TH ST	SUITE 200	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
35881	Fee-for-Service	1881815405	1881815405	1	1	TAJALLI, TANIA R MD	4/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95807	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
35894	Fee-for-Service	1184772998	1184772998	1	1	TUNG, AITING MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66662	41	Internal Medicine	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
35907	Fee-for-Service	1144255019	1144255019	1	1	TRAN, MARY A	4/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	6925	08	Family Practice	0	In state provider	None	10741 WESTMINSTER AVE	100	GARDEN GROVE	CA	92843	4790	30	06059	33.75970747	-117.9415305	Orange County
35948	Fee-for-Service	1649084740	1649084740	1	1	TRAN, CHRISTINE D OT	2/25/2025	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	667 LIGHTHOUSE AVE	201	PACIFIC GROVE	CA	93950	2644	27	06053	36.62205802	-121.9200608	Monterey County
35954	Fee-for-Service	1326075284	1326075284	1	1	THOMAS, JEFFREY P LCSW	6/13/1999	101YP2500X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	9850 GENESEE AVE	STE 910	LA JOLLA	CA	92037	1220	37	06073	32.882913	-117.226341	San Diego County
35974	Fee-for-Service	1528143179	1528143179	1	1	THC-ORANGE COUNTY LLC	9/1/2001	282E00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	200 HOSPITAL CIR	None	WESTMINSTER	CA	92683	3910	30	06059	33.76352239	-117.9958997	Orange County
35984	Fee-for-Service	1497866016	1497866016	1	1	TESAR, CHARLES B MD	3/31/1989	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	46482	04	Otology, Laryngology, Rhinology	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
35987	Fee-for-Service	1245620293	1245620293	1	1	TSANG, BETTY P DO	6/11/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	14953	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
35992	Fee-for-Service	1619988300	1619988300	1	1	THAKRAN, RAJENDER S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55039	05	Anesthesiology	0	In state provider	None	14762 KINAI RD	None	APPLE VALLEY	CA	92307	5120	36	06071	34.51999443	-117.2514763	San Bernardino County
36004	Fee-for-Service	1609914712	1609914712	1	1	TERRY, CRYSTAL D MD	7/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	55047	05	Anesthesiology	0	In state provider	None	2070 CLINTON AVE	None	ALAMEDA	CA	94501	4399	01	06001	37.76333626	-122.253868	Alameda County
36011	Fee-for-Service	1013951425	1013951425	1	1	TAN, VIVIAN L MD	8/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79793	05	Anesthesiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
36025	Fee-for-Service	1134581754	1134581754	1	1	TEIMORZADEH, MARIAM DO	1/17/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17344	08	Family Practice	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
36069	Fee-for-Service	1548456155	1548456155	1	1	THOMAS, KIRON MD	12/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	127448	13	Neurology (M.D. only)	0	In state provider	None	1700 MT VERNON AVENUE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
36091	Fee-for-Service	1023097789	1023097789	1	1	TASHJIAN,HARRY JOSEPH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	250 THOMPSON ST	None	ST PAUL	MN	55102	2370	00	None	44.94428014	-93.10733608	Ramsey County
36130	Fee-for-Service	1114205432	1114205432	1	1	TRILOGY EYE MEDICAL GROUP	9/20/2013	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	INC	207 S SANTA ANITA ST	SUITE P-25	SAN GABRIEL	CA	91776	1145	19	06037	34.10072807	-118.1066296	Los Angeles County
36140	Fee-for-Service	1528269602	1528269602	2	1	TOOR, KIRAN DEEP MD	10/9/2024	207R00000X	NA	Other	026	PHYSICIANS	98023	41	Internal Medicine	0	In state provider	None	16236 N LAKE ST	None	MADERA	CA	93638	1615	20	06039	36.984411	-120.0563285	Madera County
36149	Fee-for-Service	1548292923	1548292923	1	2	TERAN, SILVIA MD	7/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	87012	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	45 NIELSON STREET	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7925859	Santa Cruz County
36156	Fee-for-Service	1689277550	1689277550	1	1	THOUGHTFUL HOME HEALTH INC	6/30/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4119 W BURBANK BLVD	STE 140	BURBANK	CA	91505	2122	19	06037	34.1730175	-118.3553514	Los Angeles County
36163	Fee-for-Service	1831149970	1831149970	1	1	TAYYAB, NEIL A MD	7/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94408	20	Orthopedic Surgery	0	In state provider	None	4130 LA JOLLA VILLAGE DR	STE 306	LA JOLLA	CA	92037	1481	37	06073	32.87194345	-117.2173414	San Diego County
36166	Fee-for-Service	1740252519	1740252519	1	1	TALIAFERRO, EDWARD 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	11601 MONTGOMERY BLVD NE	None	ALBUQUERQUE	NM	87111	0000	00	None	35.1307765	-106.509231	Bernalillo County
36167	Fee-for-Service	1700097540	1700097540	1	3	THE NORTHEAST COMMUNITY CLNC	9/4/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4455 W 117TH ST	SUITE 200	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
36193	Fee-for-Service	1962606913	1962606913	2	1	THOMPSON, CALEB MD	7/19/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	110277	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1304 ELLA ST	STE A	SAN LUIS OBISPO	CA	93401	4100	40	06079	35.27704692	-120.6496857	San Luis Obispo County
36203	Fee-for-Service	1386219558	1386219558	1	4	TELEMEDICINE URGENT CARE INC	8/23/2024	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	17612 17TH STREET	None	TUSTIN	CA	92780	1962	30	06059	33.75971515	-117.8250351	Orange County
36304	Fee-for-Service	1043577570	1043577570	1	1	TSE, GARY G MD	6/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	128278	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
36453	Fee-for-Service	1700097540	1700097540	1	3	THE NORTHEAST COMMUNITY CLNC	7/18/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4455 W 117TH ST	SUITE 200	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
36459	Fee-for-Service	1871929612	1871929612	1	1	TWIN TOWN CORPORATION	7/8/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	HERMAN OAKS	4940 VAN NUYS BLVD	STE 201	SHERMAN OAKS	CA	91403	1700	19	06037	34.160589	-118.4486715	Los Angeles County
36490	Fee-for-Service	1689764128	1689764128	1	1	TESFAY, ZELALEM MD	1/31/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	76854	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	A MEDICAL CORPORATION	7215 PACIFIC BLVD	None	WALNUT PARK	CA	90255	5829	19	06037	33.97370679	-118.2253201	Los Angeles County
36504	Fee-for-Service	1285082297	1285082297	1	1	TORRES, ROXANA S LMFT	9/29/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
36537	Fee-for-Service	1740524958	1740524958	1	1	TRAN, ALAN THAI MD INC	5/1/2000	208200000X	NA	General Surgery	026	PHYSICIANS	None	24	Plastic Surgery	0	In state provider	None	7631 WYOMING STREET	SUITE 206	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
36558	Fee-for-Service	1144301409	1144301409	1	1	TERRENCE CHUN	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CHILDRENS UNIV MD GRP	4500 SAND POINT WAY	NE# 100	SEATTLE	WA	98105	0000	00	None	47.66165594	-122.2864502	King County
36571	Fee-for-Service	1134201494	1134201494	1	1	TAYLOR, DANIEL L MD	12/31/1992	207R00000X	NA	Other	026	PHYSICIANS	45822	41	Internal Medicine	0	In state provider	None	39275 MISSION BLVD	STE 201	FREMONT	CA	94539	3061	01	06001	37.56249949	-121.9589332	Alameda County
36649	Fee-for-Service	1306169693	1306169693	1	1	TAYLOR, GREGORY A CRNA	11/14/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
36676	Fee-for-Service	1427191931	1427191931	1	1	TU, SHIAO HENG CA	2/8/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	709 N HILL ST	STE 7	LOS ANGELES	CA	90012	2352	19	06037	34.06103994	-118.2404034	Los Angeles County
36720	Fee-for-Service	1972058949	1972058949	1	1	THORNTON, COLE PT	1/16/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
36728	Fee-for-Service	1619231693	1619231693	1	1	TRUONG, TRESCA OD	10/5/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
36745	Fee-for-Service	1548282650	1548282650	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 6023	1551 FARMERS LN	None	SANTA ROSA	CA	95405	7525	49	06097	38.43414	-122.6901645	Sonoma County
36751	Fee-for-Service	1306088018	1306088018	1	1	TURIY, YULIYA MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108764	None	None	0	In state provider	None	790 WILLOW ST	STE 150	LONG BEACH	CA	90806	2735	19	06037	33.80426489	-118.1825796	Los Angeles County
36788	Fee-for-Service	1972008217	1972008217	1	1	TUAN M HOANG DDS, INC	11/7/2019	1223S0112X	NA	Dental Provider	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	16045 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	1544	30	06059	33.72971615	-117.9548048	Orange County
36793	Fee-for-Service	1922060409	1922060409	1	1	TSCHIRHART, DONALD L MD	1/1/1999	207ZC0500X	NA	Other	026	PHYSICIANS	61014	22	Pathology (M.D. only)	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
36797	Fee-for-Service	1740268713	1740268713	1	2	TORRANCE MEMORIAL	3/23/1994	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CTR SNF/DP	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
36811	Fee-for-Service	1861675506	1861675506	1	1	TEXAS CHILDRENS PHYSICIAN	3/25/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	2	Out of state provider	GROUP INC	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
36819	Fee-for-Service	1336407402	1336407402	1	1	TY, DANIE V MD	1/7/2019	261QU0200X	NA	Other	026	PHYSICIANS	120302	66	Emergency Medicine (Urgent Care)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
36828	Fee-for-Service	1740524958	1740524958	1	1	TRAN, ALAN THAI MD INC	5/1/2000	208200000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	7631 WYOMING STREET	SUITE 206	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
36861	Fee-for-Service	1134201494	1134201494	1	1	TAYLOR, DANIEL L MD	12/31/1992	207R00000X	NA	Other	026	PHYSICIANS	45822	08	Family Practice	0	In state provider	None	39275 MISSION BLVD	STE 201	FREMONT	CA	94539	3061	01	06001	37.56249949	-121.9589332	Alameda County
36890	Fee-for-Service	1508813379	1508813379	2	2	TRI STATE CARE FLIGHT LLC	1/25/2016	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	2	Out of state provider	None	1809 LAGUNA DRIVE	None	PARKER	AZ	85344	6338	00	None	34.140699	-114.287301	La Paz County
36917	Fee-for-Service	1003286279	1003286279	1	1	TUMBERIAN, TINA K LMFT	2/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
36940	Fee-for-Service	1326231630	1326231630	1	1	TEKOLA, ABRAHAM MD INC	10/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	50974	08	Family Practice	0	In state provider	CARMICHAEL MEDICAL	5740 WINDMILL WAY	STE 5	CARMICHAEL	CA	95608	1379	34	06067	38.647494	-121.330044	Sacramento County
36942	Fee-for-Service	1619940103	1619940103	1	1	TIEN, MARTIN C MD	9/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	66457	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
36954	Fee-for-Service	1376352948	1376352948	1	1	TUNE MARRIAGE & FAMILY THERA	1/22/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19712 MACARTHUR BLVD	110	IRVINE	CA	92612	2407	30	06059	33.65788122	-117.8626278	Orange County
36984	Fee-for-Service	1497008403	1497008403	1	2	TAI, CHRISTIANA P MD	8/26/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	127247	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
36988	Fee-for-Service	1811771280	1811771280	1	1	TARA NOWAKHTAR OBGYN MEDICAL	9/14/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	None	None	0	In state provider	CORPORATION	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
36989	Fee-for-Service	1982655932	1982655932	2	1	TRAINER, MARLIN J DO	7/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	9092	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
37052	Fee-for-Service	1902191042	1902191042	1	1	TORRES, SERGIO A MD	8/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140524	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
37141	Fee-for-Service	1942616388	1942616388	1	1	TRIBULL, ASHLEY J MD	2/4/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	159484	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
37183	Fee-for-Service	1538344601	1538344601	1	1	TAN, MING MD	1/9/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	45686	77	Infectious Disease	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
37189	Fee-for-Service	1902434244	1902434244	1	1	TANAKA, ADAM C MD	3/4/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	None	None	0	In state provider	None	622 W DUARTE RD	101	ARCADIA	CA	91007	7606	19	06037	34.12645266	-118.0521552	Los Angeles County
37193	Fee-for-Service	1992209514	1992209514	1	1	THOMAS, LOGAN W MD	6/3/2022	390200000X	NA	Other	026	PHYSICIANS	165505	None	None	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
37200	Fee-for-Service	1538250519	1538250519	1	2	THE MEDICINE CABINET, INC	6/7/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7119 RITA AVE	G	HUNTINGTON PARK	CA	90255	4781	19	06037	33.974847	-118.2238875	Los Angeles County
37213	Fee-for-Service	1295844710	1295844710	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	471 3RD ST	None	SAN RAFAEL	CA	94901	3576	21	06041	37.97087459	-122.5182842	Marin County
37281	Fee-for-Service	1568974244	1568974244	1	2	THRIVE COMMUNITY FAMILY THER	3/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	403 W 11TH STREET	SUITE A	TRACY	CA	95376	3816	39	06077	37.7397483	-121.4314943	San Joaquin County
37325	Fee-for-Service	1962440263	1962440263	1	1	TAY, DAVID T MD	2/28/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	63140	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
37379	Fee-for-Service	1144724311	1144724311	1	1	THOMPSON, NICOLE	5/10/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
37449	Fee-for-Service	1578121729	1578121729	1	1	TENORIO, RAQUEL AU	3/5/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
37517	Fee-for-Service	1316194434	1316194434	1	1	TAN, LOREEN MD	11/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118220	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
37543	Fee-for-Service	1386219558	1386219558	1	1	TELEMEDICINE URGENT CARE INC	5/13/2024	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	1640 2ND ST	209	NORCO	CA	92860	2969	33	06065	33.9095707	-117.5600056	Riverside County
37592	Fee-for-Service	1053849711	1053849711	1	1	TETWILER, MICHAEL L MD	9/22/2020	390200000X	NA	Other	026	PHYSICIANS	158105	None	None	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
37599	Fee-for-Service	1932498680	1932498680	1	1	TU, ELEAIN M MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125363	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
37606	Fee-for-Service	1124115282	1124115282	2	1	TRICOUNTY MED TRANSP INC	6/15/2009	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TRICOUNTY MED TRANSP INC	659 E. DINUBA AVE	None	REEDLEY	CA	93654	3533	10	06019	36.58966351	-119.441754	Fresno County
37611	Fee-for-Service	1497864854	1497864854	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1208 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3411	19	06037	33.89230917	-118.2964932	Los Angeles County
37722	Fee-for-Service	1821230467	1821230467	1	1	TAN, LAREN D W MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113182	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
37724	Fee-for-Service	1326016296	1326016296	1	1	TAVAKOLI, SIRPA A MD	6/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	87373	36	Psychiatry	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
37728	Fee-for-Service	1174060768	1174060768	1	1	TORRANCE SURGICAL ALLIANCE,	5/15/2024	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	INC	21250 HAWTHORNE BLVD	SUITE 430	TORRANCE	CA	90503	5506	19	06037	33.83566432	-118.3531683	Los Angeles County
37774	Fee-for-Service	1295197200	1295197200	1	1	TASHKANDI, PEYMAN DO	10/12/2021	2084P0804X	NA	Psychiatry	026	PHYSICIANS	16618	None	None	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
37780	Fee-for-Service	1245239367	1245239367	1	1	THOMAS, SACHDEV P	9/12/2018	207RH0003X	NA	Oncology	026	PHYSICIANS	55745	78	Neoplastic Diseases/Oncology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
37787	Fee-for-Service	1629736236	1629736236	1	1	TROLLMAN, PAYTON M PT	1/5/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1902 ROYALTY DRIVE	SUITE 220	POMONA	CA	91767	3056	19	06037	34.07791925	-117.746146	Los Angeles County
37812	Fee-for-Service	1013112986	1013112986	1	1	TUY, BENJAMIN E MD	10/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146860	20	Orthopedic Surgery	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
37813	Fee-for-Service	1184388001	1184388001	1	1	TOMKE, TEJAL A PT	3/12/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	146 N MAAG AVE	STE B	OAKDALE	CA	95361	2249	50	06099	37.77365727	-120.8319425	Stanislaus County
37814	Fee-for-Service	1215573613	1215573613	1	1	TOURO UNIVERSITY MEDICAL GRO	11/25/2020	207QS1201X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	None	1805 N CALIFORNIA ST	201	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
37817	Fee-for-Service	1568817575	1568817575	1	1	TRAN, CHRISTINE MD	5/28/2019	390200000X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
37851	Fee-for-Service	1295776722	1295776722	1	1	TRAN, MAI B DO	2/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9565	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
37874	Fee-for-Service	1689614349	1689614349	1	1	TROXELL, ROBERT R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8TH AVE + C ST	None	SALT LAKE CTY	UT	84143	0001	00	None	40.779063	-111.8805548	Salt Lake County
37925	Fee-for-Service	1609195981	1609195981	1	1	TRAN, JADE C MD	12/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112503	None	None	0	In state provider	None	25845 BARTON ROAD	SUITE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
37928	Fee-for-Service	1730323189	1730323189	1	1	TLC MED TRANSPORT, LLC	7/2/2009	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	6312 RIVERDALE ST	None	SAN DIEGO	CA	92120	3310	37	06073	32.78895874	-117.099639	San Diego County
37940	Fee-for-Service	1508307380	1508307380	1	1	TRUE CARE HOSPICE OF	6/4/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	NORTHERN CALIFORNIA INC	6375 AUBURN BLVD	SUITE 100	CITRUS HEIGHTS	CA	95621	5203	34	06067	38.682846	-121.3153785	Sacramento County
37977	Fee-for-Service	1477502797	1477502797	1	1	TORRANCE MEMORIAL MEDICA	6/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TORRANCE RADIOLOGY MEDIC	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
37985	Fee-for-Service	1508379017	1508379017	1	9	TRI-STATE COMMUNITY	4/18/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1532 SAN BERNARDINO AVE	SUITE A2	POMONA	CA	91767	3559	19	06037	34.0758525	-117.7200855	Los Angeles County
38002	Fee-for-Service	1679900559	1679900559	1	1	TOLUCA CONGREGATE LIVING,INC	3/10/2016	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6339 MARY ELLEN AVENUE	None	VAN NUYS	CA	91401	2521	19	06037	34.18599002	-118.4192857	Los Angeles County
38006	Fee-for-Service	1689170722	1689170722	1	1	TORRES, DOLORES MD	8/21/2023	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	164781	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
38013	Fee-for-Service	1396790325	1396790325	1	1	THE CHARLOTTE-MECKLENBURG HO	10/25/2021	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	600 HOSPITAL DR	None	MONROE	NC	28112	6000	00	None	34.975647	-80.5222935	Union County
38067	Fee-for-Service	1245239367	1245239367	1	1	THOMAS, SACHDEV P	9/12/2018	207RH0003X	NA	Oncology	026	PHYSICIANS	55745	68	Hematology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
38100	Fee-for-Service	1215573613	1215573613	1	1	TOURO UNIVERSITY MEDICAL GRO	11/25/2020	207QS1201X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	None	1805 N CALIFORNIA ST	201	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
38127	Fee-for-Service	1508379017	1508379017	1	10	TRI-STATE COMMUNITY	4/22/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	540 N SAN JACINTO STREET	SUITE I	HEMET	CA	92543	3154	33	06065	33.755229	-116.9586405	Riverside County
38154	Fee-for-Service	1154447381	1154447381	1	1	THOMPSON, BRUCE W NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4405 VANDEVER AVE	None	SAN DIEGO	CA	92120	3315	37	06073	32.78765609	-117.09908	San Diego County
38167	Fee-for-Service	1366873481	1366873481	1	1	TRAN, TONY	4/16/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
38193	Fee-for-Service	1124021175	1124021175	1	1	TRIPPI, DANA L DO	5/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
38212	Fee-for-Service	1760420434	1760420434	1	1	TANTISIRA, KELAN G MD	1/15/2021	207RP1001X	NA	Pulmonology	026	PHYSICIANS	67143	None	None	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
38223	Fee-for-Service	1073771697	1073771697	1	2	TEEL, KARYN MD	8/16/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	116614	18	Ophthalmology	0	In state provider	None	751 DAILY DR	STE 110	CAMARILLO	CA	93010	6077	56	06111	34.21880533	-119.0593374	Ventura County
38228	Fee-for-Service	1508307380	1508307380	1	1	TRUE CARE HOSPICE OF	6/4/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	NORTHERN CALIFORNIA INC	6375 AUBURN BLVD	SUITE 100	CITRUS HEIGHTS	CA	95621	5203	34	06067	38.682846	-121.3153785	Sacramento County
38233	Fee-for-Service	1861819476	1861819476	1	1	TSUTSUMI, ROGER DPM INC	2/13/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	7111 MAGNOLIA AVE	SUITE 100	RIVERSIDE	CA	92504	3863	33	06065	33.94569495	-117.402456	Riverside County
38238	Fee-for-Service	1750959433	1750959433	1	1	TAVASSOL, PANTEHA DO	7/4/2024	207P00000X	NA	Other	026	PHYSICIANS	22265	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
38264	Fee-for-Service	1477502797	1477502797	1	1	TORRANCE MEMORIAL MEDICA	6/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	TORRANCE RADIOLOGY MEDIC	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
38266	Fee-for-Service	1205924057	1205924057	1	1	THOMAS W. SPHEERIS M.D.	9/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	98-1079 MOANALUA RD	None	AIEA	HI	96701	4713	00	None	21.38373524	-157.937629	Honolulu County
38285	Fee-for-Service	1508379017	1508379017	1	9	TRI-STATE COMMUNITY	4/18/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1532 SAN BERNARDINO AVE	SUITE A2	POMONA	CA	91767	3559	19	06037	34.0758525	-117.7200855	Los Angeles County
38300	Fee-for-Service	1396790325	1396790325	1	1	THE CHARLOTTE-MECKLENBURG HO	10/25/2021	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	600 HOSPITAL DR	None	MONROE	NC	28112	6000	00	None	34.975647	-80.5222935	Union County
38308	Fee-for-Service	1629349832	1629349832	1	1	TYAGI, KINSHOO PT	5/18/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
38319	Fee-for-Service	1013924455	1013924455	1	1	TSENG, CONRAD J MD	8/23/2005	207RE0101X	NA	Endocrinology	026	PHYSICIANS	74027	41	Internal Medicine	0	In state provider	None	99 N LA CIENGA BLVD	STE 107	BEVERLY HILLS	CA	90211	2283	19	06037	34.06736471	-118.3763201	Los Angeles County
38324	Fee-for-Service	1952057630	1952057630	1	1	TERRY, ROCIO LCSW	11/3/2023	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
38342	Fee-for-Service	1417407354	1417407354	1	1	TRUONG, AMY LAC	1/22/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
38375	Fee-for-Service	1760009674	1760009674	1	1	TERRY, DANIEL	2/22/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
38388	Fee-for-Service	1376529396	1376529396	1	1	TANJI, JEFFREY L MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	51304	08	Family Practice	0	In state provider	None	2825 J ST	FL 4	SACRAMENTO	CA	95816	4300	34	06067	38.573757	-121.468248	Sacramento County
38389	Fee-for-Service	1215573613	1215573613	1	1	TOURO UNIVERSITY MEDICAL GRO	11/25/2020	207QS1201X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	None	1805 N CALIFORNIA ST	201	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
38396	Fee-for-Service	1295130193	1295130193	1	1	TRAFFICANTE, MARA CCC-SLP	9/14/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	7128 PACIFIC BLVD	2ND FLOOR, SUITE I	HUNTINGTON PARK	CA	90255	4776	19	06037	33.97494243	-118.2251099	Los Angeles County
38405	Fee-for-Service	1558775320	1558775320	1	1	TOUMEH, JOUMANA S MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145056	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
38410	Fee-for-Service	1619938412	1619938412	1	1	THOMPSON, PETER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5102 W CAMPBELL AVE	None	PHOENIX	AZ	85031	1703	00	None	33.502932	-112.171095	Maricopa County
38414	Fee-for-Service	1508379017	1508379017	1	10	TRI-STATE COMMUNITY	4/22/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	540 N SAN JACINTO STREET	SUITE I	HEMET	CA	92543	3154	33	06065	33.755229	-116.9586405	Riverside County
38419	Fee-for-Service	1053552604	1053552604	1	1	TONGBAI, DANIEL S MD	8/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94582	05	Anesthesiology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
38426	Fee-for-Service	1043468846	1043468846	1	1	TUROCY, JOHN F MD	6/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88472	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
38434	Fee-for-Service	1497072128	1497072128	1	1	TA, THUC N D MD	6/15/2010	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	111839	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 S WELLS RD	STE 100	VENTURA	CA	93004	1378	56	06111	34.29321532	-119.1597424	Ventura County
38452	Fee-for-Service	1992788293	1992788293	2	1	TOVEY, ROBERT J OD	11/19/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 NORTH BRAND BLVD	SUITE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
38467	Fee-for-Service	1033138342	1033138342	1	1	TANNER, KORINA A MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133122	01	General Practice	0	In state provider	None	2 MEDICAL PLAZA	STE 130	ROSEVILLE	CA	95661	3038	31	06061	38.76507948	-121.2477476	Placer County
38519	Fee-for-Service	1033296645	1033296645	1	1	TONG, KHANH KRISTINE OD INC	9/1/2001	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	KHANH KRISTINE TONG OD I	9651 BOLSA AVE	# A	WESTMINSTER	CA	92683	5906	30	06059	33.7450406	-117.960403	Orange County
38530	Fee-for-Service	1114556321	1114556321	1	1	TATEM, ALEXIA R	3/21/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	186605	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
38543	Fee-for-Service	1568641660	1568641660	1	1	THOMAS, JOSEPH L MD	4/26/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84749	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
38567	Fee-for-Service	1568485092	1568485092	1	1	TURNER, RICHARD K MD	7/31/1985	207P00000X	NA	Other	026	PHYSICIANS	50980	08	Family Practice	0	In state provider	OAKLAND HOSPITAL	2648 E 14TH ST	None	OAKLAND	CA	94601	1506	01	06001	37.78093089	-122.2316571	Alameda County
38581	Fee-for-Service	1295844629	1295844629	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5647	4840 NIAGARA AVE	None	SAN DIEGO	CA	92107	3115	37	06073	32.74437141	-117.2490182	San Diego County
38606	Fee-for-Service	1063657138	1063657138	1	1	TUSTIN HOSP & MED CENTER	3/31/1998	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	14662 NEWPORT AVE	None	TUSTIN	CA	92780	3153	30	06059	33.73088521	-117.8293385	Orange County
38612	Fee-for-Service	1013924455	1013924455	1	1	TSENG, CONRAD J MD	8/23/2005	207RE0101X	NA	Endocrinology	026	PHYSICIANS	74027	67	Endocrinology	0	In state provider	None	99 N LA CIENGA BLVD	STE 107	BEVERLY HILLS	CA	90211	2283	19	06037	34.06736471	-118.3763201	Los Angeles County
38639	Fee-for-Service	1891101424	1891101424	1	1	TAM, SHARON S MD	9/2/2017	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	124634	10	Gastroenterology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
38651	Fee-for-Service	1841351434	1841351434	1	1	THEMISTOCLES, ROSANA D	3/18/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	CRNA	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
38662	Fee-for-Service	1740232875	1740232875	1	1	TERRADO, CECILIA R MD	8/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84282	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
38674	Fee-for-Service	1275910291	1275910291	1	1	THOMAS, ANN L MD	10/22/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	145330	18	Ophthalmology	0	In state provider	None	2720 LOW CT	None	FAIRFIELD	CA	94534	9771	48	06095	38.23580279	-122.0858445	Solano County
38720	Fee-for-Service	1619270923	1619270923	1	1	THOMPSON, JACOB D DPM	9/16/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
38726	Fee-for-Service	1881020626	1881020626	1	1	TWIN TOWN CORPORATION	11/19/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	24953 PASEO DE VALENCIA	1B	LAGUNA HILLS	CA	92653	4340	30	06059	33.60028568	-117.7010887	Orange County
38738	Fee-for-Service	1336180140	1336180140	1	1	TUMAKAY, CESAR J MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	6644	08	Family Practice	0	In state provider	None	5600 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2537	19	06037	33.991695	-118.2252015	Los Angeles County
38745	Fee-for-Service	1295186765	1295186765	1	1	THIES, MARIA DO	2/23/2023	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	17345	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
38771	Fee-for-Service	1285640573	1285640573	1	1	THRIFTY PAYLESS INC	2/8/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6346	211 CHERRY AVE	None	LONG BEACH	CA	90802	3930	19	06037	33.76698422	-118.1679747	Los Angeles County
38797	Fee-for-Service	1841475464	1841475464	1	1	TUOLUMNE COE	3/13/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	175 FAIRVIEW LN	None	SONORA	CA	95370	4809	55	06109	37.97889249	-120.3913563	Tuolumne County
38806	Fee-for-Service	1427126648	1427126648	1	1	TOLEDO-NADER, CAROLL	1/7/1985	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	41486	24	Plastic Surgery	0	In state provider	APC	345 F ST	STE 110	CHULA VISTA	CA	91910	2632	37	06073	32.64088085	-117.081699	San Diego County
38824	Fee-for-Service	1841216801	1841216801	1	1	TRAN, DU Q MD	5/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	51921	01	General Practice	0	In state provider	None	10090 WESTMINSTER AVE	None	GARDEN GROVE	CA	92843	4721	30	06059	33.7594287	-117.9532148	Orange County
38845	Fee-for-Service	1093975617	1093975617	1	1	TADOKORO, DOREEN Y DO	6/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12044	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	815 DR MARTIN LUTHER	None	BAKERSFIELD	CA	93307	1365	15	06029	35.3655	-118.985202	Kern County
38852	Fee-for-Service	1366865636	1366865636	1	1	TREE OF LIFE FOR HEALTHY	7/2/2015	No Taxonomy Provided	NA	None	052	ALTERNATIVE BIRTH CENTERS - SPECIALTY CLINIC	-	-	NOT APPLICABLE	0	In state provider	BIRTHING AND PARENTING	617 SAXONY PLACE	SUITE 103	ENCINITAS	CA	92024	2797	37	06073	33.05482353	-117.285912	San Diego County
38855	Fee-for-Service	1568485092	1568485092	1	1	TURNER, RICHARD K MD	7/31/1985	207P00000X	NA	Other	026	PHYSICIANS	50980	66	Emergency Medicine (Urgent Care)	0	In state provider	OAKLAND HOSPITAL	2648 E 14TH ST	None	OAKLAND	CA	94601	1506	01	06001	37.78093089	-122.2316571	Alameda County
38870	Fee-for-Service	1891135844	1891135844	1	1	TOM, KATHY P DO	9/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15176	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
38878	Fee-for-Service	1881771798	1881771798	1	1	TOIG, GARY S MD	3/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	46719	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	401 WARREN ST	STE 300	REDWOOD CITY	CA	94063	1536	41	06081	37.48729928	-122.2318924	San Mateo County
38944	Fee-for-Service	1154505774	1154505774	1	1	TURNBULL, JOHN H MD	3/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107174	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	BOX 0648	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
38949	Fee-for-Service	1740232875	1740232875	1	1	TERRADO, CECILIA R MD	8/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84282	10	Gastroenterology (M.D. only)	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
38967	Fee-for-Service	1417914268	1417914268	1	1	TSAI-TULAGAN, BERTHA F	9/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9673	40	Pediatrics	0	In state provider	DO	3020 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
39012	Fee-for-Service	1215461645	1215461645	1	1	TO, JACQUELINE MD	2/9/2021	207R00000X	NA	Other	026	PHYSICIANS	160368	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
39023	Fee-for-Service	1336180140	1336180140	1	1	TUMAKAY, CESAR J MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	6644	30	Radiology	0	In state provider	None	5600 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2537	19	06037	33.991695	-118.2252015	Los Angeles County
39054	Fee-for-Service	1609065135	1609065135	1	1	TORRES, MICHELLE B MD	7/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103113	05	Anesthesiology	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
39085	Fee-for-Service	1841475464	1841475464	1	1	TUOLUMNE COE	1/10/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	175 FAIRVIEW LN	None	SONORA	CA	95370	4809	55	06109	37.97889249	-120.3913563	Tuolumne County
39086	Fee-for-Service	1487237624	1487237624	1	1	TSAI, CHIN L	7/1/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	22306	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
39093	Fee-for-Service	1124180484	1124180484	1	1	THOMAS BECK	11/5/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	767 ARBOR DR	None	COUPEVILLE	WA	98239	9540	00	None	48.18223726	-122.5880527	Island County
39106	Fee-for-Service	1972817559	1972817559	1	1	TRUSSO, AMY F	6/18/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	405 PRIMROSE RD	SUITE 202	BURLINGAME	CA	94010	4064	41	06081	37.57898499	-122.3495049	San Mateo County
39124	Fee-for-Service	1023476397	1023476397	1	1	TRUJILLO, CELINA M NP	1/17/2017	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3814 AUBURN BLVD	STE 72	SACRAMENTO	CA	95821	2123	34	06067	38.639034	-121.375305	Sacramento County
39130	Fee-for-Service	1790218089	1790218089	1	1	TOOMASIAN, CORY J MD	8/3/2020	207P00000X	NA	Other	026	PHYSICIANS	157060	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
39150	Fee-for-Service	1801891452	1801891452	1	1	TRUONG, BENJAMIN Q MD	1/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	48412	08	Family Practice	0	In state provider	None	9014 GARVEY AVE	STE I	ROSEMEAD	CA	91770	5306	19	06037	34.0625937	-118.0725204	Los Angeles County
39179	Fee-for-Service	1427572908	1427572908	1	1	TOULOUSE DIALYSIS LLC	1/18/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3501 E CAPITOL EXPY	None	SAN JOSE	CA	95122	1024	43	06085	37.34738359	-121.8248751	Santa Clara County
39219	Fee-for-Service	1306934435	1306934435	1	1	TIMOTHY P BUMANN D.O.	1/3/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6250 US HIGHWAY 83	None	ABILENE	TX	79606	5215	00	None	32.36672455	-99.74276583	Taylor County
39236	Fee-for-Service	1093730491	1093730491	1	1	TSE, EDMUND K MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74931	41	Internal Medicine	0	In state provider	None	808 S FAIR OAKS AVE	None	PASADENA	CA	91105	2601	19	06037	34.131942	-118.1503315	Los Angeles County
39269	Fee-for-Service	1497971865	1497971865	1	1	TIBOR, LISA M MD	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	106811	20	Orthopedic Surgery	0	In state provider	None	85 SIERA PARK RD	None	MAMMOTH LAKES	CA	93546	0660	26	06051	37.64575895	-118.9638914	Mono County
39282	Fee-for-Service	1194170738	1194170738	1	1	TSAI, NINA MD	4/27/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	151318	None	None	0	In state provider	None	210 N GARFIELD AVE	SUITE 316	MONTEREY PARK	CA	91754	1746	19	06037	34.064181	-118.122834	Los Angeles County
39289	Fee-for-Service	1982898151	1982898151	1	1	TSAI, BENJAMIN MD	4/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102869	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
39316	Fee-for-Service	1043602105	1043602105	1	1	TOTAL RENAL CARE, INC	11/7/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4651 CORPORATE CT	None	BAKERSFIELD	CA	90067	2001	15	06029	35.31226598	-119.1321112	Kern County
39326	Fee-for-Service	1013978428	1013978428	1	1	TOUTOUNJIAN, RAPHAEL MD	8/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80457	41	Internal Medicine	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
39352	Fee-for-Service	1982751756	1982751756	1	2	THANKACHEN, SANJAI M MD	8/21/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	103818	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
39359	Fee-for-Service	1124285424	1124285424	1	1	TRAN, HONG-PHUC T MD	3/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106085	None	None	0	In state provider	None	200 MEDICAL PLAZA DR	STE 365	LOS ANGELES	CA	90024	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
39388	Fee-for-Service	1528090818	1528090818	1	2	TRUONG, DAVID M MD	4/26/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	74460	41	Internal Medicine	0	In state provider	None	10900 WARNER AVE	STE 201	FOUNTAIN VALLEY	CA	92708	3846	30	06059	33.71628153	-117.9388215	Orange County
39455	Fee-for-Service	1760451611	1760451611	1	1	TALREJA, DEEPAK R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1708 OLD DONATION PKWY	None	VIRGINIA BEACH	VA	23454	3064	00	None	36.86645406	-76.02614972	Virginia Beach city
39457	Fee-for-Service	1205817673	1205817673	1	1	TASHER, DEAN C JR MD INC	12/30/1997	207R00000X	NA	Other	026	PHYSICIANS	22852	41	Internal Medicine	0	In state provider	None	488 E VALLEY PKWY	STE 411	ESCONDIDO	CA	92025	3380	37	06073	33.12523814	-117.0769715	San Diego County
39467	Fee-for-Service	1396068573	1396068573	1	1	TAGHAVI, MARGARET S H MD	4/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115423	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
39500	Fee-for-Service	1275616310	1275616310	1	1	TREVINO, RICHARD J	12/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	29426	None	None	0	In state provider	None	175 N JACKSON AVE	STE 200	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
39501	Fee-for-Service	1174693493	1174693493	1	4	THE WECARE GROUP	11/27/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	500 B ST	SUITE A	SCOTIA	CA	95565	0500	12	06023	40.48208192	-124.1017987	Humboldt County
39505	Fee-for-Service	1114932712	1114932712	1	1	THE REGENTS OF THE UNIVE	12/5/2018	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2660 W COVELL BLVD	None	DAVIS	CA	95616	5645	57	06113	38.56101005	-121.7821776	Yolo County
39513	Fee-for-Service	1063045391	1063045391	1	1	THE SIGNATURE RESIDENCE INC	3/19/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2727 WAVECREST DR	None	CORONA DEL MAR	CA	92625	1326	30	06059	33.6084957	-117.8669646	Orange County
39525	Fee-for-Service	1093730491	1093730491	1	1	TSE, EDMUND K MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74931	45	Nephrology (Renal-Kidney)	0	In state provider	None	808 S FAIR OAKS AVE	None	PASADENA	CA	91105	2601	19	06037	34.131942	-118.1503315	Los Angeles County
39540	Fee-for-Service	1154472785	1154472785	1	2	THAYAPRAN, NALLATHAMBY MD	7/14/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	66422	01	General Practice	0	In state provider	None	202 WILLOW AVE	STE 102	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
39556	Fee-for-Service	1891766069	1891766069	1	1	TSANG, STEPHEN M MD INC	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69792	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	APC	1530 BESSIE AVE	STE 103	TRACY	CA	95376	3080	39	06077	37.74570848	-121.4330255	San Joaquin County
39618	Fee-for-Service	1215204557	1215204557	3	1	THE PHARMACY ONE, INC.	4/29/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10244 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2602	19	06037	33.90197511	-118.1143754	Los Angeles County
39644	Fee-for-Service	1649622564	1649622564	1	1	TELENG, BRITTANY C	11/15/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	43112 N 15TH ST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
39669	Fee-for-Service	1114116779	1114116779	1	1	TRINDADE, MICHAEL C D MD	8/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	100677	20	Orthopedic Surgery	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
39678	Fee-for-Service	1528090818	1528090818	1	2	TRUONG, DAVID M MD	4/26/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	74460	10	Gastroenterology (M.D. only)	0	In state provider	None	10900 WARNER AVE	STE 201	FOUNTAIN VALLEY	CA	92708	3846	30	06059	33.71628153	-117.9388215	Orange County
39684	Fee-for-Service	1477504736	1477504736	1	1	TALKE, PEKKA O MD	9/30/1990	207L00000X	NA	Other	026	PHYSICIANS	49102	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	# 648	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
39732	Fee-for-Service	1679011209	1679011209	2	1	TOTAL FOOT & ANKLE CENTER	8/21/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3838 SHERMAN DR	STE 9	RIVERSIDE	CA	92503	4001	33	06065	33.92678822	-117.4368632	Riverside County
39749	Fee-for-Service	1235464082	1235464082	2	1	THRIFTY MED SUPPLY INC	6/5/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	21120 REDWOOD RD	None	CASTRO VALLEY	CA	94546	5922	01	06001	37.69240156	-122.0737209	Alameda County
39777	Fee-for-Service	1396374187	1396374187	1	1	TAKHAR, JASKIRAT MD	5/30/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
39788	Fee-for-Service	1174693493	1174693493	1	4	THE WECARE GROUP	11/27/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	500 B ST	SUITE A	SCOTIA	CA	95565	0500	12	06023	40.48208192	-124.1017987	Humboldt County
39807	Fee-for-Service	1013176213	1013176213	1	1	TSENG, WILL MD	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	105896	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2520 SAMARITAN DR	SUITE 210	SAN JOSE	CA	95124	4106	43	06085	37.25213274	-121.9501476	Santa Clara County
39830	Fee-for-Service	1154472785	1154472785	1	2	THAYAPRAN, NALLATHAMBY MD	7/14/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	66422	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	202 WILLOW AVE	STE 102	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
39865	Fee-for-Service	1659572261	1659572261	1	1	TSAI, HENRY TUNG-YUN MD	8/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99606	68	Hematology	0	In state provider	None	44105 15TH ST W	STE 207	LANCASTER	CA	93534	4090	19	06037	34.684218	-118.1568465	Los Angeles County
39884	Fee-for-Service	1134356025	1134356025	1	1	TRAN, TIMOTHY T T MD	12/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
39943	Fee-for-Service	1174085492	1174085492	1	1	TER-ZAKARIAN, ANNA MD	3/18/2025	207RH0003X	NA	Oncology	026	PHYSICIANS	178247	41	Internal Medicine	0	In state provider	None	209 FAIR OAKS AVE	None	SOUTH PASADENA	CA	91030	1814	19	06037	34.12341	-118.1503065	Los Angeles County
39967	Fee-for-Service	1619952397	1619952397	1	8	TUOLUMNE MEWUK INDIAN HEALTH	8/8/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CENTER, INC	18670 CARTER ST	None	TUOLUMNE	CA	95379	9637	55	06109	37.96149491	-120.236264	Tuolumne County
40006	Fee-for-Service	1669082129	1669082129	1	1	TRINH, ALEX CRNA	8/24/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
40027	Fee-for-Service	1376531574	1376531574	1	1	TRAYNOR, ANDREA J MD	10/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	72844	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
40035	Fee-for-Service	1003897075	1003897075	1	1	TWO, JINTAU E	1/31/1990	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15888 MAIN ST	STE 112A	HESPERIA	CA	92345	3467	36	06071	34.42375898	-117.3163823	San Bernardino County
40037	Fee-for-Service	1972800084	1972800084	1	1	TRANSITIONS HOSPICE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	333 N SANTA ANITA AVE	UNIT 4	ARCADIA	CA	91006	2810	19	06037	34.14447	-118.031608	Los Angeles County
40070	Fee-for-Service	1740746718	1740746718	1	1	TRUST IN FAITH HOME	4/15/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE INC	20944 SHERMAN WAY	SUITE 215	CANOGA PARK	CA	91303	3645	19	06037	34.20095151	-118.5900435	Los Angeles County
40117	Fee-for-Service	1154472785	1154472785	1	2	THAYAPRAN, NALLATHAMBY MD	7/14/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	66422	41	Internal Medicine	0	In state provider	None	202 WILLOW AVE	STE 102	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
40152	Fee-for-Service	1659572261	1659572261	1	1	TSAI, HENRY TUNG-YUN MD	8/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99606	41	Internal Medicine	0	In state provider	None	44105 15TH ST W	STE 207	LANCASTER	CA	93534	4090	19	06037	34.684218	-118.1568465	Los Angeles County
40155	Fee-for-Service	1275544389	1275544389	1	1	TAKEKUMA, HIROMI C DO	7/31/1990	207R00000X	NA	Other	026	PHYSICIANS	6021	08	Family Practice	0	In state provider	None	305 HAWTHORNE AVE	None	OAKLAND	CA	94609	3102	01	06001	37.82069197	-122.2612006	Alameda County
40173	Fee-for-Service	1932489952	1932489952	1	1	TRAN, ANGELA M MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130392	41	Internal Medicine	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
40178	Fee-for-Service	1720442106	1720442106	1	1	TAPPY, ERRYN MD	9/17/2023	207VF0040X	NA	Obstetrics & Gynecology	026	PHYSICIANS	185290	None	None	0	In state provider	None	100 WIGET LN	207	WALNUT CREEK	CA	94598	5988	07	06013	37.92514495	-122.0237725	Contra Costa County
40215	Fee-for-Service	1174933204	1174933204	1	1	THOMAS, NISHINA A MD	10/11/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	154908	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
40218	Fee-for-Service	1508002619	1508002619	1	1	TAMAROON, GEETHA M DO	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10662	41	Internal Medicine	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
40232	Fee-for-Service	1811953607	1811953607	1	1	TIFFANY K BEE MD	10/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	877 JEFFERSON AVE	None	MEMPHIS	TN	38103	2807	00	None	35.14259562	-90.03187321	Shelby County
40283	Fee-for-Service	1568642718	1568642718	1	1	THE TERRACE STREET MEDICAL	8/5/2008	193400000X	NA	Other	026	PHYSICIANS	83428	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	CORPORATION	2005 LAKE CHABOT ROAD	SUITE 260	CASTRO VALLEY	CA	94546	5390	01	06001	37.72759277	-122.1270984	Alameda County
40286	Fee-for-Service	1972677375	1972677375	1	1	TRAVERSO, MICHAEL D LMFT	6/16/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	441 N MAIN ST	None	ALTURAS	CA	96101	3457	25	06049	41.48803571	-120.542554	Modoc County
40316	Fee-for-Service	1174512669	1174512669	1	1	TRAVIS C ENGAR, D.O.	9/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 N HOSPITAL DR	None	PRICE	UT	84501	4218	00	None	39.605337	-110.832525	Carbon County
40317	Fee-for-Service	1255384095	1255384095	1	1	THOENI, RUEDI F.L.	10/31/1990	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	29821	30	Radiology	0	In state provider	None	1001 POTRERO AVE	# 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
40326	Fee-for-Service	1972800084	1972800084	1	1	TRANSITIONS HOSPICE, INC	6/30/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	333 N SANTA ANITA AVE	UNIT 4	ARCADIA	CA	91006	2810	19	06037	34.14447	-118.031608	Los Angeles County
40351	Fee-for-Service	1932548377	1932548377	1	1	THAKKAR, HAPPY MD	11/25/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	143351	06	Cardiovascular Disease (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
40360	Fee-for-Service	1578719787	1578719787	1	1	THAMPI, SHEILA MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	111383	78	Neoplastic Diseases/Oncology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
40364	Fee-for-Service	1285184135	1285184135	1	1	TRAN, TRANG T NP	6/3/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
40380	Fee-for-Service	1023578721	1023578721	1	1	TONG, JULIA MD	9/22/2022	207R00000X	NA	Other	026	PHYSICIANS	177557	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
40412	Fee-for-Service	1528018116	1528018116	1	1	TREDREA, COLIN R MD	5/16/2008	207L00000X	NA	Other	026	PHYSICIANS	46312	05	Anesthesiology	0	In state provider	None	2288 AUBURN BLVD	SUITE 201	SACRAMENTO	CA	95821	1618	34	06067	38.625345	-121.4114985	Sacramento County
40441	Fee-for-Service	1659572261	1659572261	1	1	TSAI, HENRY TUNG-YUN MD	8/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99606	78	Neoplastic Diseases/Oncology	0	In state provider	None	44105 15TH ST W	STE 207	LANCASTER	CA	93534	4090	19	06037	34.684218	-118.1568465	Los Angeles County
40463	Fee-for-Service	1780297812	1780297812	1	1	THE BEST HOME HEALTH AGENCY	3/29/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	6356 VAN NUYS BLVD	SUITE 227	VAN NUYS	CA	91401	2754	19	06037	34.185861	-118.4487045	Los Angeles County
40467	Fee-for-Service	1760423560	1760423560	1	1	THU, AUNG MD	10/27/2022	207R00000X	NA	Other	026	PHYSICIANS	70925	None	None	0	In state provider	None	1 HOAG DRIVE	None	NEWPORT BEACH	CA	92663	3663	30	06059	33.62421676	-117.9309656	Orange County
40496	Fee-for-Service	1346399789	1346399789	1	1	TAIRU-CASWELL, BOLALE O PT	4/13/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
40515	Fee-for-Service	1972732295	1972732295	1	1	TRUONG, TRINH T N MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	85629	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
40548	Fee-for-Service	1508379017	1508379017	1	1	TRI-STATE COMMUNITY	8/9/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER	11499 BARTLETT AVE	None	ADELANTO	CA	92301	1902	36	06071	34.57915154	-117.414216	San Bernardino County
40600	Fee-for-Service	1346280401	1346280401	1	1	THOMAS, FREDERICK N MD	9/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	40388	41	Internal Medicine	0	In state provider	None	2500 W FLORENCE AVE	None	LOS ANGELES	CA	90043	5144	19	06037	33.97456052	-118.3207725	Los Angeles County
40619	Fee-for-Service	1518924364	1518924364	1	1	TOMSHINE, PATRICA NP	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3300 OAKDALE AVE N	None	ROBBINSDALE	MN	55422	2926	00	None	45.01443093	-93.32190604	Hennepin County
40620	Fee-for-Service	1720267735	1720267735	1	1	TOOLWORKS	12/17/2007	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	TOOLWORKS	25 KEARNY STREET	STE 400	SAN FRANCISCO	CA	94108	5518	38	06075	37.78828764	-122.4035834	San Francisco County
40628	Fee-for-Service	1215398474	1215398474	1	1	TOVALIN, MIRNA CNP	2/14/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
40634	Fee-for-Service	1467000760	1467000760	1	1	TAYLOR, SHONI NP	8/3/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1902 ORANGE TREE LN	SUITE 200	REDLANDS	CA	92374	2888	36	06071	34.06785293	-117.2179967	San Bernardino County
40646	Fee-for-Service	1508443987	1508443987	1	1	TUNG, KELLY DO	10/1/2024	208M00000X	NA	Other	026	PHYSICIANS	21827	70	Clinic (mixed specialty)	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
40648	Fee-for-Service	1578719787	1578719787	1	1	THAMPI, SHEILA MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	111383	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
40652	Fee-for-Service	1932548377	1932548377	1	1	THAKKAR, HAPPY MD	11/25/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	143351	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
40686	Fee-for-Service	1265060271	1265060271	1	1	THI, WILLIAM J MD	9/3/2024	207L00000X	NA	Other	026	PHYSICIANS	185749	05	Anesthesiology	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
40703	Fee-for-Service	1376814004	1376814004	1	1	THE LITTLE VILLAGE	6/19/2015	193400000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SPECIALIZED COUNSELING	204 PROVIDENCE MINE RD	STE 111	NEVADA CITY	CA	95959	8748	29	06057	39.25014736	-121.0297624	Nevada County
40731	Fee-for-Service	1982228987	1982228987	1	1	TORABI, TARA MD	6/24/2024	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	189211	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
40771	Fee-for-Service	1811130743	1811130743	1	1	TAN, ERIC W MD	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136124	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
40796	Fee-for-Service	1790894186	1790894186	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	295 W MAIN ST	None	WOODLAND	CA	95695	3891	57	06113	38.67760235	-121.7973081	Yolo County
40808	Fee-for-Service	1386091437	1386091437	1	1	TENG, TESHU LAC	12/5/2022	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	2140 PERALTA BLVD.	112	FREMONT	CA	94536	5210	01	06001	37.56246001	-121.988792	Alameda County
40835	Fee-for-Service	1508379017	1508379017	1	1	TRI-STATE COMMUNITY	4/9/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER	11499 BARTLETT AVE	None	ADELANTO	CA	92301	1902	36	06071	34.57915154	-117.414216	San Bernardino County
40873	Fee-for-Service	1407940075	1407940075	1	1	TEJEDA, FRANCISCO J MD	4/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	66885	01	General Practice	0	In state provider	None	144 W HOBSONWAY	None	BLYTHE	CA	92225	1617	33	06065	33.61020177	-114.5977621	Riverside County
40887	Fee-for-Service	1346280401	1346280401	1	1	THOMAS, FREDERICK N MD	9/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	40388	01	General Practice	0	In state provider	None	2500 W FLORENCE AVE	None	LOS ANGELES	CA	90043	5144	19	06037	33.97456052	-118.3207725	Los Angeles County
40896	Fee-for-Service	1639886534	1639886534	1	1	TARESH, JASON PT	6/3/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1044 MANGROVE AVE	None	CHICO	CA	95926	3509	04	06007	39.74053676	-121.8373879	Butte County
40931	Fee-for-Service	1144741463	1144741463	1	1	TURNMIRE, DONALD A LMFT	4/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2350 W SHAW AVE	SUITE 116	FRESNO	CA	93711	3400	10	06019	36.80841045	-119.834577	Fresno County
40935	Fee-for-Service	1578719787	1578719787	1	1	THAMPI, SHEILA MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	111383	68	Hematology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
40941	Fee-for-Service	1184144222	1184144222	1	1	TIRATH, ANKITA	6/1/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	184263	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
40972	Fee-for-Service	1144228909	1144228909	1	1	TAN, PETER X MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	69134	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
40987	Fee-for-Service	1245509256	1245509256	1	1	TRUONG, MY-LINH DO	2/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12057	01	General Practice	0	In state provider	None	65 N MADISON AVE	SUITE 800	PASADENA	CA	91101	2038	19	06037	34.14705803	-118.1384317	Los Angeles County
41050	Fee-for-Service	1083104079	1083104079	1	1	TENZERA, ANITA LMFT	1/18/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	512 REDONDO AVE	C	LONG BEACH	CA	90814	1552	19	06037	33.77296884	-118.1523961	Los Angeles County
41053	Fee-for-Service	1063631158	1063631158	1	1	TAM, BONNIE O MD	5/7/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	94623	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
41098	Fee-for-Service	1609138767	1609138767	1	1	TRING, ELEANOR DO	1/7/2021	207R00000X	NA	Other	026	PHYSICIANS	18139	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
41118	Fee-for-Service	1366782252	1366782252	1	1	TILP, VANESSA B CNM	6/24/2014	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
41122	Fee-for-Service	1508379017	1508379017	1	1	TRI-STATE COMMUNITY	8/9/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER	11499 BARTLETT AVE	None	ADELANTO	CA	92301	1902	36	06071	34.57915154	-117.414216	San Bernardino County
41192	Fee-for-Service	1417101908	1417101908	1	1	TOM YANG, M.D., INC.	11/25/2008	193400000X	NA	Other	026	PHYSICIANS	88613	None	None	0	In state provider	None	503 S WATSON ST	None	VISALIA	CA	93277	2641	54	06107	36.326106	-119.2962105	Tulare County
41195	Fee-for-Service	1841487683	1841487683	1	1	TEDESCO, MAUREEN M MD	7/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88244	02	General Surgery	0	In state provider	None	625 LINCOLN AVE	None	SAN JOSE	CA	95126	3704	43	06085	37.31809479	-121.9082315	Santa Clara County
41223	Fee-for-Service	1881843050	1881843050	1	1	TANAKA, SCOTT K MD	11/26/2014	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	129847	None	None	0	In state provider	None	6403 COYLE AVE	SUITE 170	CARMICHAEL	CA	95608	0363	34	06067	38.668347	-121.3148745	Sacramento County
41240	Fee-for-Service	1053694331	1053694331	1	1	TOOLE, CHELSEA PT	5/17/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1850 N RIVERSIDE AVE	240	RIALTO	CA	92376	8071	36	06071	34.132905	-117.3704675	San Bernardino County
41255	Fee-for-Service	1043256035	1043256035	1	1	TANNER, CAROLINE M MD	1/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	68771	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
41263	Fee-for-Service	1922117449	1922117449	1	1	THRIFTY DRUG STORE 5761	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	3325 S BRISTOL ST	None	SANTA ANA	CA	92704	7245	30	06059	33.701796	-117.8854225	Orange County
41304	Fee-for-Service	1801531413	1801531413	1	1	TRUONG, BETH D CNP	8/3/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2455 SAN RAMON VALLEY BL	None	SAN RAMON	CA	94583	1601	07	06013	37.77494737	-121.9771019	Contra Costa County
41305	Fee-for-Service	1174009948	1174009948	1	1	TRAN REIN, VALERIE OD	10/13/2021	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
41359	Fee-for-Service	1073672648	1073672648	1	1	TANG, CHRIS W MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66586	20	Orthopedic Surgery	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
41412	Fee-for-Service	1871812495	1871812495	1	1	TARPLEY, JASON W MD	9/10/2021	2085N0700X	NA	MRI Provider	026	PHYSICIANS	120475	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
41424	Fee-for-Service	1568161586	1568161586	1	1	TARCISIO C. DIAZ, MD, A MEDI	4/6/2023	174400000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	CAL CORPORATION	900 S MAIN ST.	100	CORONA	CA	92882	3401	33	06065	33.87190191	-117.5669613	Riverside County
41431	Fee-for-Service	1992753305	1992753305	1	1	TINDALL, MARK L MD	1/31/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	33092	20	Orthopedic Surgery	0	In state provider	None	108 N D ST	None	PORTERVILLE	CA	93257	3621	54	06107	36.06700098	-119.0184252	Tulare County
41443	Fee-for-Service	1073676243	1073676243	1	3	TIBURCIO VASQUEZ HEALTH	2/18/2025	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE VAN	22331 MISSION BLVD	None	HAYWARD	CA	94541	3911	01	06001	37.67442187	-122.0867356	Alameda County
41475	Fee-for-Service	1568497980	1568497980	1	1	TORRES, LUIS MD	11/26/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	155254	36	Psychiatry	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
41499	Fee-for-Service	1649337536	1649337536	1	1	TRUONG, ALISHA A OD	2/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
41534	Fee-for-Service	1205102522	1205102522	1	1	THEOBALD, NICHOLAS CRNA	4/9/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
41535	Fee-for-Service	1407918303	1407918303	1	1	TYLER, JAN M LCSW	4/17/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PKWY	BLDG C	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
41551	Fee-for-Service	1265617807	1265617807	1	1	TAHER, MUFFADAL A MD	3/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108439	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
41553	Fee-for-Service	1568480929	1568480929	2	1	TAKEI, GLENN K MD	3/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	35093	20	Orthopedic Surgery	0	In state provider	None	931 BUENA VISTA STREET	SUITE 505	DUARTE	CA	91010	1727	19	06037	34.141635	-117.9775755	Los Angeles County
41556	Fee-for-Service	1730143454	1730143454	1	8	THE REGENTS OF THE UNIVERSIT	3/16/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1223 16TH ST	2101	SANTA MONICA	CA	90404	1217	19	06037	34.02773198	-118.4862675	Los Angeles County
41610	Fee-for-Service	1407059751	1407059751	1	1	TAN, JEFFREY P MD	4/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	98579	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
41611	Fee-for-Service	1538225016	1538225016	1	1	THOMPSON, RONALD J CRNA	6/3/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
41615	Fee-for-Service	1831320779	1831320779	1	1	TORRE, KIRA LMFT	7/10/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
41631	Fee-for-Service	1396176020	1396176020	1	1	TOTAL RENAL CARE INC.	7/2/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3001 HEALTH CARE WAY	BUILD E, STE 102	MODESTO	CA	95350	8503	50	06099	37.70867855	-121.0523055	Stanislaus County
41650	Fee-for-Service	1407261167	1407261167	1	1	TAICHER, CHRISTOPHER L MD	7/6/2020	207P00000X	NA	Other	026	PHYSICIANS	158688	66	Emergency Medicine (Urgent Care)	0	In state provider	None	555 EAST HARDY STREET	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
41664	Fee-for-Service	1093924912	1093924912	1	1	THERAPEUTIC LIVING CENTERS	4/17/2006	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR THE BLIND INC	7937 LINDLEY AVE	None	RESEDA	CA	91335	2122	19	06037	34.2149632	-118.5273746	Los Angeles County
41668	Fee-for-Service	1700893559	1700893559	1	1	TASAKI, MITCHELL N MD	1/6/2020	208600000X	NA	General Surgery	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	None	1885 MAIN ST	STE. 206	WAILUKU	HI	96793	1819	00	None	20.88816574	-156.4999766	Maui County
41681	Fee-for-Service	1568991289	1568991289	1	1	TRUONG, ON P OT	6/22/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 ROSEMEAD BLVD	#102	ROSEMEAD	CA	91770	1933	19	06037	34.07930385	-118.0732531	Los Angeles County
41688	Fee-for-Service	1083879480	1083879480	1	1	TOMASELLO, JASON M MD	3/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
41690	Fee-for-Service	1821684028	1821684028	1	1	TSE, AMY T OD	2/17/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 LAGUNA ROAD	SUITE C	FULLERTON	CA	92835	3634	30	06059	33.89326085	-117.9300987	Orange County
41730	Fee-for-Service	1073676243	1073676243	1	3	TIBURCIO VASQUEZ HEALTH	2/18/2025	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE VAN	22331 MISSION BLVD	None	HAYWARD	CA	94541	3911	01	06001	37.67442187	-122.0867356	Alameda County
41808	Fee-for-Service	1043337223	1043337223	1	1	TZENG, THOMAS S MD INC	5/19/2010	208G00000X	NA	General Surgery	026	PHYSICIANS	37994	33	Thoracic Surgery	0	In state provider	None	9200 COLIMA ROAD	SUITE 100	WHITTIER	CA	90605	1814	19	06037	33.95015827	-118.0054753	Los Angeles County
41815	Fee-for-Service	1861770885	1861770885	1	1	TERRY, AMANDA R MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118540	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
41843	Fee-for-Service	1730143454	1730143454	1	8	THE REGENTS OF THE UNIVERSIT	3/16/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	32	Radiation Therapy (D.O. only)	0	In state provider	None	1223 16TH ST	2101	SANTA MONICA	CA	90404	1217	19	06037	34.02773198	-118.4862675	Los Angeles County
41860	Fee-for-Service	1396854758	1396854758	1	1	THRIFTY PAYLESS INC.	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05903	1320 W HILLSDALE BLVD	None	SAN MATEO	CA	94403	3125	41	06081	37.53301697	-122.3273558	San Mateo County
41951	Fee-for-Service	1831146281	1831146281	1	1	TRIPLER AMRY MEDICAL CENTER	5/8/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 JARRETT WHITE RD	None	TRIPLER AMC	HI	96859	5000	00	None	21.362022	-157.8896505	Honolulu County
41958	Fee-for-Service	1316088099	1316088099	2	1	TRI-VALLEY HOME HEALTH CARE	11/6/2012	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	1231 W ROBINHOOD DR	SUITE D-5	STOCKTON	CA	95207	5506	39	06077	37.9992686	-121.3219878	San Joaquin County
41963	Fee-for-Service	1629377098	1629377098	1	1	THOMAS, JAMES MD	3/14/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
41979	Fee-for-Service	1467450676	1467450676	1	1	TONGSON, ROBERTO C MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	54183	41	Internal Medicine	0	In state provider	None	212 BASSETT ST	None	KING CITY	CA	93930	2943	27	06053	36.21248918	-121.1247675	Monterey County
41985	Fee-for-Service	1720077852	1720077852	1	1	TABILA, RODOLFO T MD	9/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	38544	01	General Practice	0	In state provider	FIRST INTERGRATED CARE M	1339 W WILLOW ST	None	LONG BEACH	CA	90810	3116	19	06037	33.80441648	-118.2098295	Los Angeles County
41993	Fee-for-Service	1891820080	1891820080	1	1	TILLEY, IAN B MD	10/1/2007	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	94720	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1500-30 S OLIVE ST	None	LOS ANGELES	CA	90015	3023	19	06037	34.03568676	-118.2649769	Los Angeles County
41999	Fee-for-Service	1134779788	1134779788	1	1	THERAPYMED HOME HEALTH	3/19/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES	151 N SUNRISE AVE	SUITE 1116	ROSEVILLE	CA	95661	2924	31	06061	38.74746043	-121.2655348	Placer County
42008	Fee-for-Service	1508379017	1508379017	1	8	TRI-STATE COMMUNITY	8/21/2024	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	11273 LAUREL CANYON BLVD	SUITE 2	SAN FERNANDO	CA	91340	4357	19	06037	34.27498293	-118.4494282	Los Angeles County
42011	Fee-for-Service	1497302525	1497302525	1	1	TSE, SANDY H NP	3/22/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	24241 HAWTHORNE BLVD	SUITE 201	TORRANCE	CA	90505	6504	19	06037	33.802578	-118.351229	Los Angeles County
42059	Fee-for-Service	1841402567	1841402567	1	1	TANGE, MICHAEL V	1/13/1994	174400000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3855 PRINCETON DR	None	SANTA ROSA	CA	95405	7061	49	06097	38.443581	-122.675679	Sonoma County
42061	Fee-for-Service	1821114083	1821114083	1	1	TIU, MICHELLE E OD	8/29/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5475 E LA PALMA AVE	None	ANAHEIM	CA	92807	2075	30	06059	33.85997926	-117.7958236	Orange County
42082	Fee-for-Service	1285196998	1285196998	1	1	TAKANIKOS, ALEXANDRA S CNP	11/27/2019	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
42086	Fee-for-Service	1609404235	1609404235	1	1	TAMBOLI, CYRUS H DO	8/24/2023	208M00000X	NA	Other	026	PHYSICIANS	21543	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
42097	Fee-for-Service	1043337223	1043337223	1	1	TZENG, THOMAS S MD INC	5/19/2010	208G00000X	NA	General Surgery	026	PHYSICIANS	37994	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	9200 COLIMA ROAD	SUITE 100	WHITTIER	CA	90605	1814	19	06037	33.95015827	-118.0054753	Los Angeles County
42132	Fee-for-Service	1730143454	1730143454	1	8	THE REGENTS OF THE UNIVERSIT	3/16/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1223 16TH ST	2101	SANTA MONICA	CA	90404	1217	19	06037	34.02773198	-118.4862675	Los Angeles County
42170	Fee-for-Service	1861539199	1861539199	1	1	TO, TO-QUYEN H OD INC	10/1/1999	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	16120 MONTEREY ST	None	MORGAN HILL	CA	95037	5404	43	06085	37.11423982	-121.6436841	Santa Clara County
42175	Fee-for-Service	1972973840	1972973840	1	1	TORRES & UYUNI A	10/22/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	PROFESSIONAL MEDICAL COR	4566 E FLORENCE AVE	STE 1	CUDAHY	CA	90201	4345	19	06037	33.97001847	-118.1859258	Los Angeles County
42231	Fee-for-Service	1619210028	1619210028	1	1	THOMPSON, COREY J LPCC	4/4/2022	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	308 W STATE ST	STE 3D	REDLANDS	CA	92373	4653	36	06071	34.05649746	-117.18603	San Bernardino County
42233	Fee-for-Service	1639836315	1639836315	1	1	TORREZ, MARYLOU LMFT	10/6/2023	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
42235	Fee-for-Service	1770160400	1770160400	1	1	TSUI, TSZ KUEN K MD	11/13/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	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
42239	Fee-for-Service	1881880110	1881880110	1	1	TANTAYANUBUTR, BEN MD	4/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95887	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
42250	Fee-for-Service	1225186166	1225186166	1	1	TO, AMIEY K C OD	9/10/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2055 KELLOGG AVENUE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
42296	Fee-for-Service	1508379017	1508379017	1	8	TRI-STATE COMMUNITY	6/12/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	11273 LAUREL CANYON BLVD	SUITE 2	SAN FERNANDO	CA	91340	4357	19	06037	34.27498293	-118.4494282	Los Angeles County
42314	Fee-for-Service	1316953607	1316953607	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2130 E HIGHLAND AVE	None	SAN BERNARDINO	CA	92404	4628	36	06071	34.13586745	-117.2411423	San Bernardino County
42327	Fee-for-Service	1548269087	1548269087	1	1	TRAN, JEAN G MD	2/18/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	175369	None	None	0	In state provider	None	10402 WESTMINSTER AVE	STE 100C	GARDEN GROVE	CA	92843	4862	30	06059	33.75951204	-117.9478527	Orange County
42341	Fee-for-Service	1952387755	1952387755	1	1	THOMPSON, ERIC C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
42462	Fee-for-Service	1972973840	1972973840	1	1	TORRES & UYUNI A	10/22/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	PROFESSIONAL MEDICAL COR	4566 E FLORENCE AVE	STE 1	CUDAHY	CA	90201	4345	19	06037	33.97001847	-118.1859258	Los Angeles County
42468	Fee-for-Service	1376873877	1376873877	1	1	TERAN, SHANE P LCSW	2/18/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1307 W 6TH ST	212C	CORONA	CA	92882	1642	33	06065	33.87790309	-117.589666	Riverside County
42481	Fee-for-Service	1255811527	1255811527	1	1	TA, THUY H RCP	9/11/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
42503	Fee-for-Service	1588640676	1588640676	1	1	THOMPSON, MICHAEL CRNA	10/18/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
42505	Fee-for-Service	1710179486	1710179486	1	1	THANG, VAN D MD	9/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98274	41	Internal Medicine	0	In state provider	None	480 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13286634	-121.6142652	Sutter County
42538	Fee-for-Service	1629142518	1629142518	1	1	TANG, DEBRA L MD	1/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	70179	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
42552	Fee-for-Service	1922600329	1922600329	1	1	TL HEALTH CARE FOUNDATION	5/1/2025	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1418 S SAN GABRIEL BLVD	SUITE B	SAN GABRIEL	CA	91776	4605	19	06037	34.082541	-118.090754	Los Angeles County
42559	Fee-for-Service	1134478910	1134478910	1	1	THACKABERRY, JESSICA L MD	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128967	36	Psychiatry	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
42584	Fee-for-Service	1508379017	1508379017	1	8	TRI-STATE COMMUNITY	6/12/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	11273 LAUREL CANYON BLVD	SUITE 2	SAN FERNANDO	CA	91340	4357	19	06037	34.27498293	-118.4494282	Los Angeles County
42589	Fee-for-Service	1528026002	1528026002	1	1	TZACHANIS, DIMITRIOS MD	12/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55514	68	Hematology	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
42615	Fee-for-Service	1023143344	1023143344	1	1	TAY, EMERALD S MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72223	41	Internal Medicine	0	In state provider	None	222 E VALLEY BLVD	None	SAN GABRIEL	CA	91776	3596	19	06037	34.07979597	-118.0973304	Los Angeles County
42635	Fee-for-Service	1114043270	1114043270	1	1	TURPIN, SUSAN M NP	5/29/2019	363LP0222X	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
42638	Fee-for-Service	1912756305	1912756305	1	1	TULARE HEALTHCARE INC	7/10/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	858 N CHERRY ST	STE A	TULARE	CA	93274	2243	54	06107	36.22014749	-119.337642	Tulare County
42661	Fee-for-Service	1902079221	1902079221	1	1	TORRES-EATON, NADIA PSYD	10/12/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1201 W ORANGE AVENUE	None	ORANGE	CA	92868	4203	30	06059	33.66439809	-118.0058968	Orange
42662	Fee-for-Service	1356450886	1356450886	1	1	THRIFTY DRUG STORE 6042	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	420 GRASS VALLEY HWY	None	AUBURN	CA	95603	3714	31	06061	38.9051613	-121.0764219	Placer County
42679	Fee-for-Service	1639176282	1639176282	1	1	TANG, ANDREW H MD	6/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	54689	41	Internal Medicine	0	In state provider	None	2155 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7038	09	06017	38.91235187	-119.9983501	El Dorado County
42694	Fee-for-Service	1386833929	1386833929	1	1	TRONCOSO, ARIEL L MD	2/8/2015	2084F0202X	NA	Psychiatry	026	PHYSICIANS	30831	36	Psychiatry	0	In state provider	None	1080 EMELINE AVENUE	None	SANTA CRUZ	CA	95060	1966	44	06087	36.99191102	-122.0176744	Santa Cruz County
42695	Fee-for-Service	1952369191	1952369191	1	1	THAKER, KUNTAL M MD	5/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55334	41	Internal Medicine	0	In state provider	None	2850 COMMERCIAL CROSSING	None	SANTA CRUZ	CA	95065	1702	44	06087	36.98796413	-121.9825327	Santa Cruz County
42708	Fee-for-Service	1366236911	1366236911	1	1	TAVARES, STACY L POSTPARTUM	5/2/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	50	06099	0	0	None
42751	Fee-for-Service	1912932088	1912932088	1	1	TOORKEY, BEHNAZ MD	12/20/2022	207ZP0102X	NA	Other	026	PHYSICIANS	52357	None	None	0	In state provider	None	2374 E PACIFICA PLACE	None	RANCHO DOMINGUEZ	CA	90220	6214	19	06037	33.84864797	-118.2240829	Los Angeles County
42783	Fee-for-Service	1942328174	1942328174	1	1	TRAN, CAM HUONG Q MD	4/2/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	93840	08	Family Practice	0	In state provider	None	10090 WESTMINSTER AVE	None	GARDEN GROVE	CA	92843	4721	30	06059	33.7594287	-117.9532148	Orange County
42786	Fee-for-Service	1427041060	1427041060	1	1	TILKIAN, ARA G MD	1/1/1982	207ZC0500X	NA	Other	026	PHYSICIANS	21218	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	15243 VANOWEN ST	STE 202	VAN NUYS	CA	91405	3645	19	06037	34.19394848	-118.4654115	Los Angeles County
42787	Fee-for-Service	1053129924	1053129924	1	1	THERAPY ERA LICENSED CLINICA	1/15/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	L SOCIAL WORKER PC	641 HIGUERA ST	STE 220	SAN LUIS OBISPO	CA	93401	3548	40	06079	35.27821723	-120.6655382	San Luis Obispo County
42842	Fee-for-Service	1922600329	1922600329	1	1	TL HEALTH CARE FOUNDATION	5/1/2025	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1418 S SAN GABRIEL BLVD	SUITE B	SAN GABRIEL	CA	91776	4605	19	06037	34.082541	-118.090754	Los Angeles County
42849	Fee-for-Service	1124281605	1124281605	1	1	TUMEH, PAUL C MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104736	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	STE 450	LOS ANGELES	CA	90095	6957	19	06037	34.06527974	-118.4462792	Los Angeles County
42874	Fee-for-Service	1528026002	1528026002	1	1	TZACHANIS, DIMITRIOS MD	12/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55514	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
42889	Fee-for-Service	1346263357	1346263357	1	1	TAN, CHEE H MD	11/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111014	18	Ophthalmology	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
42892	Fee-for-Service	1053756452	1053756452	1	1	THIMMAPPA, VIKRUM A MD	9/1/2019	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	163276	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
42907	Fee-for-Service	1508379017	1508379017	1	3	TRI-STATE COMMUNITY	3/3/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER	540 N SAN JACINTO ST	SUITE P	HEMET	CA	92543	3154	33	06065	33.755229	-116.9586405	Riverside County
42908	Fee-for-Service	1154312635	1154312635	1	1	TEASLEY, LAURA A MD	8/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89517	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
42915	Fee-for-Service	1932441714	1932441714	1	1	TINDALL, RHONNA	3/20/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6308 LOOKOUT PASS WAY	None	ROCKLIN	CA	95765	4547	31	06061	38.80187922	-121.2835873	Placer County
42917	Fee-for-Service	1083840896	1083840896	1	1	TOTAL RENAL CARE INC	3/10/2010	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2517 JENSEN AVENUE	None	SANGER	CA	93657	2489	10	06019	36.70675948	-119.572677	Fresno County
42920	Fee-for-Service	1710939863	1710939863	1	1	TOTAL RENAL CARE, INC	8/22/2006	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ASH TREE DIALYSIS	2666 N GROVE INDUSTRIAL	STE 106	FRESNO	CA	93727	1552	10	06019	36.774414	-119.7299905	Fresno County
42927	Fee-for-Service	1851695712	1851695712	1	1	TODD, NICHOLAS W DPM	4/1/2015	No Taxonomy Provided	NA	None	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
42928	Fee-for-Service	1144220997	1144220997	1	1	TRUE, WAYNE S MD	2/1/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	62330	08	Family Practice	0	In state provider	None	6699 ALVARADO RD	STE 2307	SAN DIEGO	CA	92120	5241	37	06073	32.77665383	-117.0540279	San Diego County
42929	Fee-for-Service	1154918456	1154918456	1	1	TELLEZ, LAURA A NP	4/15/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
42981	Fee-for-Service	1952369191	1952369191	1	1	THAKER, KUNTAL M MD	5/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55334	10	Gastroenterology (M.D. only)	0	In state provider	None	2850 COMMERCIAL CROSSING	None	SANTA CRUZ	CA	95065	1702	44	06087	36.98796413	-121.9825327	Santa Cruz County
43038	Fee-for-Service	1881865178	1881865178	1	1	TAHERY, HAMID R MD	5/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102906	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	21013 SHERMAN WAY	STE 4	CANOGA PARK	CA	91303	3675	19	06037	34.20113934	-118.591226	Los Angeles County
43056	Fee-for-Service	1689905846	1689905846	1	1	TY, ANTONETTE T	2/8/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	50 E FOOTHILL BLVD	STE 100	ARCADIA	CA	91006	2314	19	06037	34.15096965	-118.0295442	Los Angeles County
43089	Fee-for-Service	1386022176	1386022176	1	1	TONG, LANA X MD	1/13/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	162330	07	Dermatology	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
43125	Fee-for-Service	1750490702	1750490702	1	2	TAYLOR, RANDY MD	3/11/2020	207R00000X	NA	Other	026	PHYSICIANS	42157	41	Internal Medicine	0	In state provider	None	140 NORTH ORANGE AVE	STE 100	WEST COVINA	CA	91790	2032	19	06037	34.07369406	-117.9431173	Los Angeles County
43143	Fee-for-Service	1053420471	1053420471	1	1	THRIFTY PAYLESS INC	9/9/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	640 EDITH AVE	None	CORNING	CA	96021	2349	52	06103	39.92954666	-122.1976003	Tehama County
43162	Fee-for-Service	1528026002	1528026002	1	1	TZACHANIS, DIMITRIOS MD	12/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55514	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
43180	Fee-for-Service	1194916668	1194916668	1	1	TORRES, TOMAS LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8253 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	7671	36	06071	34.10363411	-117.5643979	San Bernardino County
43182	Fee-for-Service	1053756452	1053756452	1	1	THIMMAPPA, VIKRUM A MD	9/1/2019	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	163276	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
43197	Fee-for-Service	1508379017	1508379017	1	3	TRI-STATE COMMUNITY	3/3/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER	540 N SAN JACINTO ST	SUITE P	HEMET	CA	92543	3154	33	06065	33.755229	-116.9586405	Riverside County
43200	Fee-for-Service	1316043300	1316043300	1	1	TERBELL, HEATHER I MD	8/26/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80887	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
43202	Fee-for-Service	1932441714	1932441714	1	1	TINDALL, RHONNA	3/20/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6308 LOOKOUT PASS WAY	None	ROCKLIN	CA	95765	4547	31	06061	38.80187922	-121.2835873	Placer County
43210	Fee-for-Service	1801677786	1801677786	1	1	THE EMINENCE GROUP INC.	11/29/2023	347C00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3780 KILROY AIRPORT WAY	200	LONG BEACH	CA	90806	2457	19	06037	33.80733529	-118.1450095	Los Angeles County
43285	Fee-for-Service	1669892154	1669892154	1	1	TOYAMA, ADAM CRNA	11/8/2021	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
43334	Fee-for-Service	1063531531	1063531531	1	1	TOLENTINO, MILIE MARIE L MD	12/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97078	08	Family Practice	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
43363	Fee-for-Service	1679641427	1679641427	1	1	TANAKA, LAURENCE K MD	4/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	34455	66	Emergency Medicine (Urgent Care)	0	In state provider	INC	4060 4TH AVE	STE 445	SAN DIEGO	CA	92103	2194	37	06073	32.75053673	-117.1616539	San Diego County
43392	Fee-for-Service	1295845360	1295845360	1	1	TRAN, LAWRENCE D MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	34193	08	Family Practice	0	In state provider	None	2211 W MAGNOLIA BLVD	STE 230	BURBANK	CA	91506	1762	19	06037	34.1728873	-118.3320905	Los Angeles County
43401	Fee-for-Service	1790087864	1790087864	1	1	THACH, TERILYN INC	11/5/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2419 E VALLEY PKWY	None	ESCONDIDO	CA	92027	2932	37	06073	33.14155803	-117.0430009	San Diego County
43406	Fee-for-Service	1689068264	1689068264	1	1	TUCKER, JERITT R PHD	1/14/2020	103TC1900X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	NG	700 S FLOWER ST	STE 1000	LOS ANGELES	CA	90017	4112	19	06037	34.04794414	-118.2594392	Los Angeles County
43461	Fee-for-Service	1013979814	1013979814	1	1	TURBOW, ROBERT M MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	69024	None	None	0	In state provider	None	101 THE CITY DR S	BLDG 29A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
43533	Fee-for-Service	1528167293	1528167293	1	1	THOMSON,JOHN B MD	2/1/2001	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	69960	08	Family Practice	0	In state provider	None	475 PIONEER AVE	STE 400	WOODLAND	CA	95776	4905	57	06113	38.67357823	-121.7456787	Yolo County
43623	Fee-for-Service	1073526729	1073526729	1	1	TRAPNELL, JAMES G MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	77272	01	General Practice	0	In state provider	None	1144 SONOMA AVE	STE 119	SANTA ROSA	CA	95405	4812	49	06097	38.441097	-122.6989755	Sonoma County
43647	Fee-for-Service	1679641427	1679641427	1	1	TANAKA, LAURENCE K MD	4/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	34455	02	General Surgery	0	In state provider	INC	4060 4TH AVE	STE 445	SAN DIEGO	CA	92103	2194	37	06073	32.75053673	-117.1616539	San Diego County
43679	Fee-for-Service	1295845360	1295845360	1	1	TRAN, LAWRENCE D MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	34193	01	General Practice	0	In state provider	None	2211 W MAGNOLIA BLVD	STE 230	BURBANK	CA	91506	1762	19	06037	34.1728873	-118.3320905	Los Angeles County
43715	Fee-for-Service	1427585843	1427585843	1	1	TU, ANGIE DO	2/2/2025	208M00000X	NA	Other	026	PHYSICIANS	23265	41	Internal Medicine	0	In state provider	None	1700 PRAIRIE CITY RD	None	FOLSOM	CA	95630	9594	34	06067	38.652012	-121.166901	Sacramento County
43782	Fee-for-Service	1417024415	1417024415	1	1	TORRES, FRANCISCO R MD	9/22/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45342	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
43794	Fee-for-Service	1316951577	1316951577	1	1	TRAN, PHILLIP H MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	55091	30	Radiology	0	In state provider	None	FRESNO & R STREETS	None	FRESNO	CA	93721	0000	10	06019	36.741663	-119.7841005	Fresno County
43857	Fee-for-Service	1720233356	1720233356	1	1	TRAN, KY M MD INC	10/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53142	41	Internal Medicine	0	In state provider	None	4332 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3564	30	06059	33.80293995	-118.057394	Orange County
43910	Fee-for-Service	1073526729	1073526729	1	1	TRAPNELL, JAMES G MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	77272	08	Family Practice	0	In state provider	None	1144 SONOMA AVE	STE 119	SANTA ROSA	CA	95405	4812	49	06097	38.441097	-122.6989755	Sonoma County
43970	Fee-for-Service	1336271204	1336271204	1	1	TURNER, ALICE M MD	12/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96035	40	Pediatrics	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
43973	Fee-for-Service	1447773759	1447773759	1	1	TELLO DE ROSAS, IRENE S LCSW	8/28/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
43975	Fee-for-Service	1932588076	1932588076	1	1	TEMPLE, JASON S LMFT	11/21/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
44007	Fee-for-Service	1689731648	1689731648	1	1	TEHRANI, TARANEH MD	12/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	92554	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
44037	Fee-for-Service	1154741858	1154741858	1	1	TAN, ANNA M M DPM	9/17/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1135 S SUNSET AVE	STE 200	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
44058	Fee-for-Service	1538340948	1538340948	1	1	TINTOR, JINA LCSW	7/23/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	85318	-	NOT APPLICABLE	0	In state provider	None	2330 BEVERLY BLVD	None	LOS ANGELES	CA	90057	2220	19	06037	34.0681396	-118.2738016	Los Angeles County
44071	Fee-for-Service	1417024415	1417024415	1	1	TORRES, FRANCISCO R MD	9/22/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45342	13	Neurology (M.D. only)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
44107	Fee-for-Service	1144626714	1144626714	1	1	TALBERT ANESTHESIA GROUP	10/11/2014	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	7677 CENTER ST	SUITE 104	HUNTINGTON BEACH	CA	92647	3030	30	06059	33.736257	-117.995535	Orange County
44113	Fee-for-Service	1023080157	1023080157	1	1	TRIADAFILOPOULOS, GEORGE	3/20/1990	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	45948	10	Gastroenterology (M.D. only)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
44118	Fee-for-Service	1225138498	1225138498	1	1	TORRES-CIFUENTES G A MD	2/25/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70962	02	General Surgery	0	In state provider	None	16500 VENTURA BLVD	STE 360	ENCINO	CA	91436	2016	19	06037	34.15756758	-118.4926374	Los Angeles County
44145	Fee-for-Service	1699238311	1699238311	1	1	TAHMASSIAN, SEVAN LMFT	1/7/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	138 N BRAND BLVD	STE 303	GLENDALE	CA	91203	4621	19	06037	34.147755	-118.2549335	Los Angeles County
44154	Fee-for-Service	1811383490	1811383490	1	2	TEJEDA, YOLANDA SANTANA MD	8/9/2018	390200000X	NA	Other	026	PHYSICIANS	146892	40	Pediatrics	0	In state provider	None	2101 STONE	SUITE 100	WEST SACRAMENTO	CA	95691	4056	57	06113	38.56318049	-121.5379228	Yolo County
44227	Fee-for-Service	1023034568	1023034568	1	1	TENG, WANG MD	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	75686	02	General Surgery	0	In state provider	None	24411 HEALTH CENTER DR	SUITE 350	LAGUNA HILLS	CA	92653	3687	30	06059	33.6087201	-117.7076948	Orange County
44253	Fee-for-Service	1689312688	1689312688	1	1	TRI TECH RX, INC.	7/20/2022	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	910 BROADWAY	STE 105	SANTA MONICA	CA	90401	2795	19	06037	34.0191491	-118.488608	Los Angeles County
44289	Fee-for-Service	1437492006	1437492006	1	1	THOMSON, CHRIS MD A	8/23/2013	207RC0200X	NA	Other	026	PHYSICIANS	66058	66	Emergency Medicine (Urgent Care)	0	In state provider	PROFESSIONAL CORPORATION	1303 E HERNDON AVE	None	FRESNO	CA	93720	9860	10	06019	36.83626596	-119.7674879	Fresno County
44294	Fee-for-Service	1689731648	1689731648	1	1	TEHRANI, TARANEH MD	12/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	92554	45	Nephrology (Renal-Kidney)	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
44360	Fee-for-Service	1760047708	1760047708	1	1	TORRANCE POST ACUTE LLC	10/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	22520 MAPLE AVE	None	TORRANCE	CA	90505	2705	19	06037	33.822936	-118.340112	Los Angeles County
44373	Fee-for-Service	1477961696	1477961696	1	1	TOTAL RENAL CARE INC	8/2/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	35 CASA STREET	SUITE 110	SAN LUIS OBISPO	CA	93405	1818	40	06079	35.29359615	-120.6654304	San Luis Obispo County
44410	Fee-for-Service	1689080251	1689080251	1	1	TRUONG, THONG DPM INC	12/19/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	670 RIO LINDO AVE	STE 1000	CHICO	CA	95926	1832	04	06007	39.75339021	-121.847691	Butte County
44420	Fee-for-Service	1326369554	1326369554	1	1	TANG, NANCY Z MD	7/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140842	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
44421	Fee-for-Service	1013536721	1013536721	1	1	TCHOUAPI, PIERRE-CAROLE T MD	10/23/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
44434	Fee-for-Service	1619952397	1619952397	1	3	TUOLUMNE MEWUK INDIAN HEALTH	10/30/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	17555 TUOLUMNE ROAD	None	TUOLUMNE	CA	95379	9701	55	06109	37.96300157	-120.2557319	Tuolumne County
44475	Fee-for-Service	1841467701	1841467701	1	1	TONG, ALLEN K MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105605	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
44492	Fee-for-Service	1649562406	1649562406	1	1	TITTLER, ETHAN H MD	7/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136715	18	Ophthalmology	0	In state provider	None	36 YOKUTS AVE	SUITE 1	STOCKTON	CA	95207	5713	39	06077	37.99833959	-121.3074229	San Joaquin County
44514	Fee-for-Service	1043365034	1043365034	1	7	THE HEARING AID CENTER	4/1/2001	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	5100 N SIXTH ST	STE 120	FRESNO	CA	93710	7506	10	06019	36.810666	-119.763204	Fresno County
44528	Fee-for-Service	1376613323	1376613323	1	1	TSENG, I-WEN DO	12/12/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7167	08	Family Practice	0	In state provider	None	2231 SOUTH WESTERN AVE	None	LOS ANGELES	CA	90018	1302	19	06037	34.03512469	-118.3090138	Los Angeles County
44538	Fee-for-Service	1780697987	1780697987	1	1	TAYLOR, EARL MD INC	1/1/1979	208600000X	NA	General Surgery	026	PHYSICIANS	24898	02	General Surgery	0	In state provider	None	2075 EDGEWATER CT	None	STOCKTON	CA	95204	3862	39	06077	37.96024553	-121.3430327	San Joaquin County
44585	Fee-for-Service	1386650679	1386650679	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5654	3081 CLAIREMONT DR	# B	SAN DIEGO	CA	92117	6802	37	06073	32.79586872	-117.193333	San Diego County
44611	Fee-for-Service	1821205741	1821205741	1	1	TIMTIMAN, MARISOL C MD	6/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116520	36	Psychiatry	0	In state provider	None	391 TAYLOR BLVD	None	PLEASANT HILL	CA	94523	2294	07	06013	37.96119614	-122.070409	Contra Costa County
44652	Fee-for-Service	1497257935	1497257935	1	1	TENDER HEART HOSPICE INC	3/24/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4355 E LOWELL ST	STE H	ONTARIO	CA	91761	2225	36	06071	34.052364	-117.556587	San Bernardino County
44677	Fee-for-Service	1033365390	1033365390	1	1	TARPLEE, ALLISON M MD	11/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97599	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
44681	Fee-for-Service	1720152044	1720152044	1	1	TOUNKEL, SVETLANA MD	3/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74201	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
44691	Fee-for-Service	1508975954	1508975954	1	1	THRIFTY PAYLESS INC	2/11/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6256	25710 BARTON RD	None	LOMA LINDA	CA	92354	3874	36	06071	34.04849345	-117.2429955	San Bernardino County
44702	Fee-for-Service	1427127174	1427127174	1	1	TAVARUA MEDICAL & MENTAL	12/11/1990	261QP2300X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	SERVICES	8207 WHITTIER BLVD	None	PICO RIVERA	CA	90660	2521	19	06037	34.00669483	-118.0961646	Los Angeles County
44718	Fee-for-Service	1962409813	1962409813	2	1	TLC SKILLED HEALTH CARE	3/14/2014	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PROVIDERS INC	3250 WILSHIRE BLVD	SUITE 1008	LOS ANGELES	CA	90010	1577	19	06037	34.06176363	-118.2932622	Los Angeles County
44722	Fee-for-Service	1619952397	1619952397	1	3	TUOLUMNE MEWUK INDIAN HEALTH	5/17/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	17555 TUOLUMNE ROAD	None	TUOLUMNE	CA	95379	9701	55	06109	37.96300157	-120.2557319	Tuolumne County
44738	Fee-for-Service	1730287400	1730287400	1	1	TISHLER, DAVID MD	9/30/1985	2080P0207X	NA	Hematology	026	PHYSICIANS	42126	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
44748	Fee-for-Service	1740035302	1740035302	1	1	TRESIDDER, SUNSHINE A	5/6/2025	No Taxonomy Provided	NA	None	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	4677 VALLEY EAST BLVD.	SUITE 2	ARCATA	CA	95521	4630	12	06023	40.90085428	-124.0816212	Humboldt County
44756	Fee-for-Service	1265616429	1265616429	1	1	TIRMIZI, OMAR MD APC	7/29/2010	207RP1001X	NA	Pulmonology	026	PHYSICIANS	53175	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	4340 OVERLAND AVE	None	CULVER CITY	CA	90230	4117	19	06037	34.01096615	-118.3997058	Los Angeles County
44762	Fee-for-Service	1164531612	1164531612	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 6108	11230 DONNER PASS RD	None	TRUCKEE	CA	96161	4808	29	06057	39.32608992	-120.2051036	Nevada County
44770	Fee-for-Service	1902563935	1902563935	1	1	TRAN, JUSTIN NP	1/12/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2000 STOCKTON BLVD	2300	SACRAMENTO	CA	95817	1348	34	06067	38.559222	-121.462362	Sacramento County
44831	Fee-for-Service	1164461539	1164461539	1	1	THIEL, ARTHUR E MD	11/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	44007	20	Orthopedic Surgery	0	In state provider	None	25455 BARTON RD	None	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
44901	Fee-for-Service	1194924233	1194924233	1	1	TO, DAT D MD	10/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93559	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
44926	Fee-for-Service	1386110070	1386110070	1	1	TONG, JACKLIN H NP	10/17/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
44929	Fee-for-Service	1326057050	1326057050	1	1	TESTORI, ALESSANDRO MD	12/8/2021	207R00000X	NA	Other	026	PHYSICIANS	114033	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
44936	Fee-for-Service	1497257935	1497257935	1	1	TENDER HEART HOSPICE INC	3/24/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4355 E LOWELL ST	STE H	ONTARIO	CA	91761	2225	36	06071	34.052364	-117.556587	San Bernardino County
45028	Fee-for-Service	1780206557	1780206557	1	1	TEN ACRES PHARMACY	1/8/2021	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2930 FREEPORT BLVD	None	SACRAMENTO	CA	95818	3843	34	06067	38.551599	-121.4889165	Sacramento County
45043	Fee-for-Service	1265616429	1265616429	1	1	TIRMIZI, OMAR MD APC	7/29/2010	207RP1001X	NA	Pulmonology	026	PHYSICIANS	53175	41	Internal Medicine	0	In state provider	None	4340 OVERLAND AVE	None	CULVER CITY	CA	90230	4117	19	06037	34.01096615	-118.3997058	Los Angeles County
45068	Fee-for-Service	1346556891	1346556891	1	1	TSEENG, TZE LYN S MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130520	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
45070	Fee-for-Service	1386882181	1386882181	1	1	TASH, MATTHEW B MD	9/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121611	05	Anesthesiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
45073	Fee-for-Service	1174675540	1174675540	1	1	TRAN, THU-NGA T MD	10/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	56492	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
45098	Fee-for-Service	1215103304	1215103304	1	1	TORRES, REBECCA MD AMC	11/14/2014	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1530 WEST 6TH STREET	SUITE 109	CORONA	CA	92882	2784	33	06065	33.87842412	-117.5950761	Riverside County
45156	Fee-for-Service	1073682928	1073682928	1	1	TERZIAN, BERJ	8/22/1986	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	819 S ALVARADO ST	None	LOS ANGELES	CA	90057	4018	19	06037	34.05432673	-118.2782216	Los Angeles County
45197	Fee-for-Service	1629145461	1629145461	1	1	TSUYUKI, CHRISTIE E NP	9/4/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5 CENTERPOINTE DR	None	LA PALMA	CA	90623	1050	30	06059	33.86168254	-118.0308375	Orange County
45213	Fee-for-Service	1629243837	1629243837	1	1	TAKESITA, KEN MD	10/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84860	34	Urology and Urological Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
45254	Fee-for-Service	1104118561	1104118561	1	1	TYMCHUK, CHRISTOPHER N MD	5/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96133	77	Infectious Disease	0	In state provider	None	200 MEDICAL PLAZA DR	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
45265	Fee-for-Service	1306002951	1306002951	1	1	TAGLIAMONTE, SOPHIE PSYD	9/5/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
45347	Fee-for-Service	1568013142	1568013142	1	1	THAI, DAVID NP	6/21/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
45349	Fee-for-Service	1881703270	1881703270	1	1	THRIFTY PAYLESS INC	2/21/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	40 E MAIN ST	None	QUINCY	CA	95971	9701	32	06063	39.93762107	-120.9360846	Plumas County
45472	Fee-for-Service	1619318532	1619318532	1	1	THORNHILL, LAURA N MD	4/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	136805	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
45473	Fee-for-Service	1508379017	1508379017	1	6	TRI-STATE COMMUNITY	3/2/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	4137 VERDUGO RD	None	LOS ANGELES	CA	90065	3820	19	06037	34.1261475	-118.2319835	Los Angeles County
45498	Fee-for-Service	1861828600	1861828600	1	1	TWIN TOWN CORPORATION	6/5/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	3828 CARSON ST.	100	TORRANCE	CA	90503	5805	19	06037	33.8313391	-118.3540075	Los Angeles County
45519	Fee-for-Service	1407039787	1407039787	1	1	THOMPSON, ELIZABETH M PHD	6/14/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	801 CRESCENT WAY	SUITE 3	ARCATA	CA	95521	6781	12	06023	40.85906241	-124.0735719	Humboldt County
45541	Fee-for-Service	1104118561	1104118561	1	1	TYMCHUK, CHRISTOPHER N MD	5/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96133	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA DR	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
45542	Fee-for-Service	1689820433	1689820433	1	1	THOMPSON, MICHAEL L MD	12/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106083	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
45571	Fee-for-Service	1245625219	1245625219	1	1	TSUI, TIMOTHY O MD	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151300	01	General Practice	0	In state provider	None	8841 GARVEY AVE	None	ROSEMEAD	CA	91770	3358	19	06037	34.06276591	-118.07587	Los Angeles County
45587	Fee-for-Service	1407504681	1407504681	1	1	TO, JEANETTE N PSYD	3/25/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	STE 209	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
45596	Fee-for-Service	1164663746	1164663746	1	1	TANGLAO, ROSELINE B	5/27/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	254 E 228TH ST	None	CARSON	CA	90745	4813	19	06037	33.81887538	-118.2720961	Los Angeles County
45599	Fee-for-Service	1730143454	1730143454	1	7	THE REGENTS OF THE UNIVERSIT	3/15/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	200 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
45618	Fee-for-Service	1639880321	1639880321	1	1	THOMAS, SUSAN NP	4/13/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
45621	Fee-for-Service	1104361542	1104361542	1	1	TAMSE, RENALD C F	5/18/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
45706	Fee-for-Service	1639130206	1639130206	1	1	TOTAL RENAL CARE, INC	1/14/1982	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	COVINA COMM DIALYSIS CTR	1547 W GARVEY AVE N	None	WEST COVINA	CA	91790	2139	19	06037	34.0727883	-117.9396694	Los Angeles County
45708	Fee-for-Service	1134401672	1134401672	1	1	THEROITH, KENDRA LMFT	1/4/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	448 E FOOTHILL BLVD	SUITE 210	SAN DIMAS	CA	91773	1221	19	06037	34.12329312	-117.799182	Los Angeles County
45740	Fee-for-Service	1891098505	1891098505	1	2	THOMPSON, DAVID C MD	5/3/2019	208600000X	NA	General Surgery	026	PHYSICIANS	28583	02	General Surgery	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
45748	Fee-for-Service	1366457293	1366457293	1	1	TEHRANCHI, FATIMA MD	8/24/2004	207R00000X	NA	Other	026	PHYSICIANS	38233	41	Internal Medicine	0	In state provider	None	2900 WHIPPLE AVE	STE 130	REDWOOD CITY	CA	94062	2844	41	06081	37.4783072	-122.2551089	San Mateo County
45756	Fee-for-Service	1831280882	1831280882	2	1	TESORIERO, LINDA J MD	7/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72924	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
45761	Fee-for-Service	1508379017	1508379017	1	6	TRI-STATE COMMUNITY	3/2/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	4137 VERDUGO RD	None	LOS ANGELES	CA	90065	3820	19	06037	34.1261475	-118.2319835	Los Angeles County
45819	Fee-for-Service	1316509748	1316509748	1	1	TAM, YUEN SIN LARISSA LPCC	6/6/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
45834	Fee-for-Service	1407902471	1407902471	1	1	TAM T TRAN	2/1/2011	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	696 E SANTA CLARA ST	#104	SAN JOSE	CA	95112	1911	43	06085	37.34280728	-121.876519	Santa Clara County
45855	Fee-for-Service	1447464904	1447464904	1	1	TARZI,SID	4/18/2011	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	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
45861	Fee-for-Service	1174528350	1174528350	1	2	TRAN, JOHN T MD	10/29/2019	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	88474	-	NOT APPLICABLE	0	In state provider	None	515 SOUTH CEDAR AVENUE	None	FRESNO	CA	93702	2908	10	06019	36.73744912	-119.7543742	Fresno County
45881	Fee-for-Service	1043658636	1043658636	1	1	TAIT, LAURA MD	7/26/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	167322	None	None	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
45885	Fee-for-Service	1730143454	1730143454	1	7	THE REGENTS OF THE UNIVERSIT	3/15/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
45915	Fee-for-Service	1417972571	1417972571	1	1	TRACHTENBERG, JOEL MD	10/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5122 COTTONWOOD LN	None	SALT LAKE CTY	UT	84117	7102	00	None	40.65862458	-111.8253189	Salt Lake County
45931	Fee-for-Service	1326196387	1326196387	1	1	THAYER, ALEXANDER K MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68688	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
45935	Fee-for-Service	1073856837	1073856837	1	1	TAHERI, NIMA MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131464	None	None	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
45963	Fee-for-Service	1326722158	1326722158	1	1	TOROK, HANNAH R AU	11/16/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
45977	Fee-for-Service	1871619346	1871619346	1	1	TORREBLANCA, JOSE F DO	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	10109	40	Pediatrics	0	In state provider	None	10001 CALIFORNIA AVE	None	SOUTH GATE	CA	90280	6005	19	06037	33.94353626	-118.207669	Los Angeles County
45996	Fee-for-Service	1023350501	1023350501	1	1	TITTIGER, MINDY E MD	9/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152749	41	Internal Medicine	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
45999	Fee-for-Service	1063761963	1063761963	1	1	TAM, LOK K LCSW	2/14/2023	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
46010	Fee-for-Service	1053572396	1053572396	1	1	TRAN, PAUL H MD	10/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122353	24	Plastic Surgery	0	In state provider	None	23823 VALENCIA BLVD	SUITE 220	VALENCIA	CA	91355	2103	19	06037	34.41347743	-118.5523087	Los Angeles County
46073	Fee-for-Service	1073546909	1073546909	1	1	THOMAS, GEORGE V MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73843	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	RM B-186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
46082	Fee-for-Service	1598923237	1598923237	1	1	TAM, CANDICE R MD	11/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103756	05	Anesthesiology	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
46113	Fee-for-Service	1659780120	1659780120	1	1	TOTAL RENAL CARE INC	7/11/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	5807 AVALON BLVD	None	LOS ANGELES	CA	90011	5303	19	06037	33.989589	-118.2652365	Los Angeles County
46140	Fee-for-Service	1417391517	1417391517	1	1	TYTGAT, ANNICK J LMFT	7/11/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	74710 CA-111	SUITE 102	PALM DESERT	CA	92260	3820	33	06065	33.72136847	-116.3616075	Riverside County
46149	Fee-for-Service	1346429552	1346429552	1	1	THOMPSON, JUSTIN DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3100 CHANNING WAY	None	IDAHO FALLS	ID	83404	7533	00	None	43.470198	-111.9901955	Bonneville County
46165	Fee-for-Service	1316441181	1316441181	1	1	TANG, MAYCKY DO	12/10/2021	207R00000X	NA	Other	026	PHYSICIANS	19140	None	None	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
46174	Fee-for-Service	1730143454	1730143454	1	7	THE REGENTS OF THE UNIVERSIT	3/15/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	32	Radiation Therapy (D.O. only)	0	In state provider	None	200 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
46216	Fee-for-Service	1922700285	1922700285	1	1	THE EMPOWERMENT CENTER	1/26/2024	172V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	27262 VIA INDUSTRIA	None	TEMECULA	CA	92590	3751	33	06065	33.50898524	-117.1835791	Riverside County
46243	Fee-for-Service	1568985091	1568985091	1	1	THRIFTY PAYLESS INC	11/13/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	30551 GATEWAY PLACE	None	RANCHO MISSION VI	CA	92694	1855	30	06059	33.52103292	-117.6175632	Orange County
46244	Fee-for-Service	1689791576	1689791576	1	1	TRIEU, THANH C MD	6/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	84890	30	Radiology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
46249	Fee-for-Service	1184754384	1184754384	1	2	TAYLOR, PETER A DO	5/23/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	8588	30	Radiology	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
46263	Fee-for-Service	1699886945	1699886945	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1207 E GRAND AVE	None	ARROYO GRANDE	CA	93420	2419	40	06079	35.12051316	-120.6007177	San Luis Obispo County
46273	Fee-for-Service	1215215686	1215215686	1	1	TRINH, BICH N OD	5/29/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
46297	Fee-for-Service	1922208529	1922208529	1	1	TRAN, NINH H MD INC	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70342	03	Allergy	0	In state provider	None	750 EL CAMINO REAL	None	SAN CARLOS	CA	94070	3106	41	06081	37.50520868	-122.2579558	San Mateo County
46298	Fee-for-Service	1134774086	1134774086	1	1	TRANSFORMATIONS CARE INC	11/30/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	17921 S AVERY PL	None	GARDENA	CA	90248	3710	19	06037	33.86727722	-118.3017973	Los Angeles County
46320	Fee-for-Service	1295895498	1295895498	1	1	TRAN, QUOC T MD	10/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76581	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
46326	Fee-for-Service	1093027146	1093027146	1	1	TERRACCIANO, GARRETT J MD	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	125305	40	Pediatrics	0	In state provider	None	6235 N FRESNO ST	STE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
46349	Fee-for-Service	1134264831	1134264831	1	1	TRAN, THANH Q MD	5/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52468	13	Neurology (M.D. only)	0	In state provider	None	439 O'FARRELL ST	None	SAN FRANCISCO	CA	94102	2009	38	06075	37.78589862	-122.4120158	San Francisco County
46385	Fee-for-Service	1023185303	1023185303	1	1	TANAMACHI, KYLE	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
46433	Fee-for-Service	1568693695	1568693695	1	1	TIMSINA, PANKAJ MD	9/5/2023	207QS1201X	NA	Adult Primary Care	026	PHYSICIANS	187900	None	None	0	In state provider	None	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	57	06113	38.66314048	-121.794696	Yolo County
46498	Fee-for-Service	1376528257	1376528257	1	1	TURNIPSEED, SAMUEL D MD	2/28/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64997	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
46541	Fee-for-Service	1700097540	1700097540	1	1	THE NORTHEAST COMMUNITY CLNC	9/18/2008	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	200 E ANAHEIM STREET	None	WILMINGTON	CA	90744	4516	19	06037	33.78003976	-118.2608958	Los Angeles County
46566	Fee-for-Service	1548701287	1548701287	1	1	TAREK EZZEDDINE MD INC	11/13/2018	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	10841 WHITE OAK AVE	SUITE 103	RANCHO CUCAMONGA	CA	91730	3817	36	06071	34.10467596	-117.5661881	San Bernardino County
46583	Fee-for-Service	1922208529	1922208529	1	1	TRAN, NINH H MD INC	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70342	09	Gynecology (D.O. only)	0	In state provider	None	750 EL CAMINO REAL	None	SAN CARLOS	CA	94070	3106	41	06081	37.50520868	-122.2579558	San Mateo County
46625	Fee-for-Service	1417233735	1417233735	1	1	TABRIZI, ROBERT MD	10/17/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	166566	None	None	0	In state provider	None	315 MERCY AVE	STE 400	MERCED	CA	95340	8363	24	06047	37.33874349	-120.467493	Merced County
46653	Fee-for-Service	1023592763	1023592763	1	1	TOTAL RENAL CARE INC	6/30/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2551 E WASHINGTON BLVD	None	PASADENA	CA	91107	1446	19	06037	34.16917147	-118.0975455	Los Angeles County
46710	Fee-for-Service	1346605284	1346605284	1	1	THON, NATALIE M NP	12/1/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
46761	Fee-for-Service	1699966804	1699966804	1	1	TAFT, WESLEY W MD	2/26/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	104308	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
46776	Fee-for-Service	1396311080	1396311080	1	1	TURLEY, MEGAN E LCSW	2/28/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11230 SORRENTO VALLEY RD	STE 220	SAN DIEGO	CA	92121	1300	37	06073	32.90734306	-117.2281918	San Diego County
46787	Fee-for-Service	1376528257	1376528257	1	1	TURNIPSEED, SAMUEL D MD	2/28/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64997	41	Internal Medicine	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
46812	Fee-for-Service	1871128595	1871128595	1	1	TIRADO, GABRIELA A CNM	10/17/2023	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
46826	Fee-for-Service	1700097540	1700097540	1	1	THE NORTHEAST COMMUNITY CLNC	9/18/2008	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	200 E ANAHEIM STREET	None	WILMINGTON	CA	90744	4516	19	06037	33.78003976	-118.2608958	Los Angeles County
46832	Fee-for-Service	1528087145	1528087145	1	1	TORRES, VILMA I MD	3/31/1985	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	43598	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
46854	Fee-for-Service	1124280920	1124280920	1	1	TREAT, ERIC G MD	9/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107172	34	Urology and Urological Surgery	0	In state provider	None	10833 LE CONTE AVE	B7-240	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
46871	Fee-for-Service	1922208529	1922208529	1	1	TRAN, NINH H MD INC	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70342	01	General Practice	0	In state provider	None	750 EL CAMINO REAL	None	SAN CARLOS	CA	94070	3106	41	06081	37.50520868	-122.2579558	San Mateo County
46882	Fee-for-Service	1336769546	1336769546	1	1	TAMPARON-ROSETTE, JOVANNE M	7/26/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	183630	None	None	0	In state provider	D	15425 LOS GATOS BLVD	120	LOS GATOS	CA	95032	2553	43	06085	37.24444696	-121.9589876	Santa Clara County
46894	Fee-for-Service	1851805626	1851805626	1	1	TULLER, BROCK LMFT	4/8/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3939 ATLANTIC AVE	SUITE 102	LONG BEACH	CA	90807	3535	19	06037	33.830073	-118.1851065	Los Angeles County
46895	Fee-for-Service	1740499193	1740499193	1	1	TUMMALA, SANJEEV MD	12/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	53683	41	Internal Medicine	0	In state provider	None	701 EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
46904	Fee-for-Service	1255835906	1255835906	1	1	TAHOE FOREST HOSPITAL	8/27/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10978 DONNER PASS RD	None	TRUCKEE	CA	96161	0433	29	06057	39.32616692	-120.2026317	Nevada County
46912	Fee-for-Service	1588907901	1588907901	1	1	TUNG, CHESTER C DO	9/1/2016	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	14855	None	None	0	In state provider	None	17051 SIERRA LAKES PKWY	STE 101	FONTANA	CA	92336	1274	36	06071	34.13797332	-117.4324372	San Bernardino County
46944	Fee-for-Service	1083733380	1083733380	1	1	TREUSDELL, SARAH E LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43112 15TH STREET WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
46965	Fee-for-Service	1598168585	1598168585	1	1	TAYLOR, NICOLE L	12/7/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
46969	Fee-for-Service	1881608321	1881608321	1	1	TSE, YARDY MD	2/28/1996	207N00000X	NA	Dermatology	026	PHYSICIANS	82156	None	None	0	In state provider	None	477 N EL CAMINO REAL	STE B303	ENCINITAS	CA	92024	1331	37	06073	33.05700866	-117.262449	San Diego County
47014	Fee-for-Service	1891757217	1891757217	1	1	TARJAN, DEENA S MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	55154	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ADVANCED CA MED CTR INC	1934 VIA CASA ALTA	None	LA JOLLA	CA	92037	5730	37	06073	32.84086385	-117.2538388	San Diego County
47019	Fee-for-Service	1194015404	1194015404	1	1	TRAN, HUY D MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116977	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
47033	Fee-for-Service	1306243209	1306243209	1	1	TOTAL RENAL CARE INC	10/26/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2080 CENTURY PARK E	SUITE 210	LOS ANGELES	CA	90067	2001	19	06037	34.05887194	-118.4122914	Los Angeles County
47069	Fee-for-Service	1902282304	1902282304	1	1	TAGHAVI, PEJMAN MD	6/12/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	168835	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
47098	Fee-for-Service	1235440819	1235440819	1	1	TUBILLEJA-ARONE, JOALA MARTH	8/16/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16967	08	Family Practice	0	In state provider	A DO	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
47116	Fee-for-Service	1700097540	1700097540	1	1	THE NORTHEAST COMMUNITY CLNC	9/18/2008	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	200 E ANAHEIM STREET	None	WILMINGTON	CA	90744	4516	19	06037	33.78003976	-118.2608958	Los Angeles County
47149	Fee-for-Service	1992913222	1992913222	1	1	TANG, YI MD	2/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109154	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
47156	Fee-for-Service	1104833821	1104833821	2	1	TRAN, THUY T OD	12/6/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2500 MILVIA ST	STE 208	BERKELEY	CA	94704	2636	01	06001	37.86338897	-122.2698455	Alameda County
47162	Fee-for-Service	1962581421	1962581421	2	1	TRAN, THAO	8/2/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	684 N FIRST ST	None	SAN JOSE	CA	95112	5109	43	06085	37.34878646	-121.8998454	Santa Clara County
47165	Fee-for-Service	1255835906	1255835906	1	1	TAHOE FOREST HOSPITAL	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10978 DONNER PASS RD	None	TRUCKEE	CA	96161	0433	29	06057	39.32616692	-120.2026317	Nevada County
47184	Fee-for-Service	1740499193	1740499193	1	1	TUMMALA, SANJEEV MD	12/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	53683	10	Gastroenterology (M.D. only)	0	In state provider	None	701 EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
47190	Fee-for-Service	1639135510	1639135510	1	1	TRACY MEDICAL GROUP	3/5/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	530 W EATON AVE	SUITE K	TRACY	CA	95376	3455	39	06077	37.74328351	-121.433886	San Joaquin County
47207	Fee-for-Service	1356524508	1356524508	1	1	TOPACIO, RUTH G MD INC	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44817	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	9604 E ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	6769	19	06037	33.87472842	-118.1288599	Los Angeles County
47229	Fee-for-Service	1689254716	1689254716	1	1	TRAN, HUNG	4/11/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20657	08	Family Practice	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
47292	Fee-for-Service	1518164110	1518164110	1	1	THAIYANANTHAN, GOWRIHARA	8/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99924	14	Neurological Surgery	0	In state provider	MD	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
47300	Fee-for-Service	1891757217	1891757217	1	1	TARJAN, DEENA S MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	55154	41	Internal Medicine	0	In state provider	ADVANCED CA MED CTR INC	1934 VIA CASA ALTA	None	LA JOLLA	CA	92037	5730	37	06073	32.84086385	-117.2538388	San Diego County
47336	Fee-for-Service	1669400602	1669400602	1	1	TAVARI, JAVID D MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	6273	41	Internal Medicine	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
47345	Fee-for-Service	1972677292	1972677292	1	1	TERDIMAN, JOSEPH F MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	32393	01	General Practice	0	In state provider	PERMANENTE MED GRP	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
47381	Fee-for-Service	1598854044	1598854044	1	1	TRIBHUWAN, SHASHIKALA R	6/20/2014	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	46690	40	Pediatrics	0	In state provider	None	1800 WESTERN AVE	STE 403	SAN BERNARDINO	CA	92411	1355	36	06071	34.1315778	-117.3182453	San Bernardino County
47415	Fee-for-Service	1669550315	1669550315	1	1	TRYTHALL, WILLIAM S MD	9/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84413	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
47427	Fee-for-Service	1174693881	1174693881	1	1	TIEU, KEVIN KHAI MD APC	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77268	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	16543 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	2343	30	06059	33.72276183	-117.9547129	Orange County
47432	Fee-for-Service	1003994609	1003994609	1	1	TANG, SUSAN S S MD	12/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	66984	42	Nuclear Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
47449	Fee-for-Service	1699944298	1699944298	1	1	TSAI, CLARK S MD INC	12/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76192	18	Ophthalmology	0	In state provider	None	2225 PORT CHICAGO HWY	None	CONCORD	CA	94520	2051	07	06013	37.98176172	-122.0311946	Contra Costa County
47493	Fee-for-Service	1356524508	1356524508	1	1	TOPACIO, RUTH G MD INC	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44817	41	Internal Medicine	0	In state provider	None	9604 E ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	6769	19	06037	33.87472842	-118.1288599	Los Angeles County
47526	Fee-for-Service	1417980202	1417980202	1	1	TEXAS HEALTH HARRIS	11/2/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	METHODIST HOSPITAL SW	6100 HARRIS PKWY	None	FORT WORTH	TX	76132	4101	00	None	32.65824014	-97.41948078	Tarrant County
47560	Fee-for-Service	1194472654	1194472654	1	1	TACHIKI, KRISTEN K LCSW	10/5/2023	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
47591	Fee-for-Service	1811992761	1811992761	1	1	TAYLOR, JOHN MD	11/30/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	STE 101	5565 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3020	37	06073	32.77978322	-117.0094766	San Diego County
47629	Fee-for-Service	1801057302	1801057302	1	1	TIRCE, CHRISTOPHER G MD	8/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105440	05	Anesthesiology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
47645	Fee-for-Service	1891856340	1891856340	1	1	TSANG, ALOYISUS MD	1/8/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	80123	41	Internal Medicine	0	In state provider	None	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	19	06037	34.06704253	-118.3835029	Los Angeles County
47657	Fee-for-Service	1871126086	1871126086	1	1	TAIWO, ABAYOMI LCSW	3/18/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2221 LINCOLN PARK	None	LOS ANGELES	CA	90031	2920	19	06037	34.07105982	-118.202527	Los Angeles County
47664	Fee-for-Service	1497811012	1497811012	1	1	TAHOE FOREST HOSPITAL	7/23/1999	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10875 PIONEER TRAIL	None	TRUCKEE	CA	96161	0235	29	06057	39.33575474	-120.1815614	Nevada County
47667	Fee-for-Service	1093255432	1093255432	1	1	TAWEESEDT, PAHNWAT T MD	6/28/2023	208M00000X	NA	Other	026	PHYSICIANS	178686	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
47742	Fee-for-Service	1598869018	1598869018	1	1	TADROS, GEORGETTE MD	2/28/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	42125	40	Pediatrics	0	In state provider	None	931 BUENA VISTA ST	STE 202	DUARTE	CA	91010	1713	19	06037	34.141635	-117.9775755	Los Angeles County
47758	Fee-for-Service	1265791743	1265791743	1	1	TORGERSON, SHANE L MD	6/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121091	None	None	0	In state provider	None	7500 HOSPITAL DR	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
47766	Fee-for-Service	1518054915	1518054915	1	1	TOURAH, MORAD MD	12/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	54059	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2550 N HOLLYWOOD WAY	STE 209	BURBANK	CA	91505	5019	19	06037	34.195086	-118.348892	Los Angeles County
47773	Fee-for-Service	1437445079	1437445079	1	1	TRAN, NGOC H OD	4/18/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	848 E GARVEY AVE	STE B	MONTEREY PARK	CA	91755	3064	19	06037	34.06247991	-118.1103709	Los Angeles County
47782	Fee-for-Service	1356524508	1356524508	1	1	TOPACIO, RUTH G MD INC	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44817	01	General Practice	0	In state provider	None	9604 E ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	6769	19	06037	33.87472842	-118.1288599	Los Angeles County
47788	Fee-for-Service	1811484975	1811484975	1	1	TANG, MICHELLE MD	7/18/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	163602	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
47798	Fee-for-Service	1548767759	1548767759	1	1	THONG, SALENA Z OD	12/6/2019	152W00000X	NA	Other	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
47800	Fee-for-Service	1700897105	1700897105	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5708	9940 SIERRA AVE	None	FONTANA	CA	92335	6721	36	06071	34.072254	-117.435697	San Bernardino County
47814	Fee-for-Service	1417980202	1417980202	1	1	TEXAS HEALTH HARRIS	12/1/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	METHODIST HOSPITAL SW	6100 HARRIS PKWY	None	FORT WORTH	TX	76132	4101	00	None	32.65824014	-97.41948078	Tarrant County
47830	Fee-for-Service	1669534467	1669534467	1	1	TSAI, DIANA YI TI MD	12/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	72927	41	Internal Medicine	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	6203	43	06085	37.37715796	-122.0651926	Santa Clara County
47854	Fee-for-Service	1124551502	1124551502	1	1	THOMSON, KAROLINA E MD	10/19/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	161217	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
47868	Fee-for-Service	1790733673	1790733673	1	1	TASTO, JESSICA ANN Y OD	5/31/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
47888	Fee-for-Service	1962465955	1962465955	1	1	TAN, ALFRED E MD	9/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	48933	08	Family Practice	0	In state provider	None	5720 STONERIDGE MALL RD	STE 330	PLEASANTON	CA	94588	2895	01	06001	37.69247085	-121.9301884	Alameda County
47919	Fee-for-Service	1346902947	1346902947	1	1	TEER, ANMOL K	12/2/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2652 EL CAMINO REAL	None	SANTA CLARA	CA	95051	3041	43	06085	37.35228637	-121.9754073	Santa Clara County
47948	Fee-for-Service	1164447736	1164447736	1	1	THOM, DAVID H MD	8/31/1990	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53458	08	Family Practice	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
47951	Fee-for-Service	1497811012	1497811012	1	1	TAHOE FOREST HOSPITAL	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10875 PIONEER TRAIL	None	TRUCKEE	CA	96161	0235	29	06057	39.33575474	-120.1815614	Nevada County
47981	Fee-for-Service	1346649928	1346649928	1	1	TANGCHAIBURANA, SAMANTHA NP	12/24/2019	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16300 ROSCOE BLVD	STE 1-A	VAN NUYS	CA	91406	1258	19	06037	34.22128033	-118.4884471	Los Angeles County
48066	Fee-for-Service	1508252305	1508252305	1	1	THOMPSON, STEPHANY E LCSW	5/31/2024	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
48078	Fee-for-Service	1114102993	1114102993	1	1	TER-POGHOSYAN, ZARINE M MD	12/22/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	101387	None	None	0	In state provider	None	12507 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	3135	19	06037	34.18670353	-118.405791	Los Angeles County
48116	Fee-for-Service	1578022463	1578022463	1	1	TUTARYEBWA, LEONARD K MD	12/7/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	176035	None	None	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
48147	Fee-for-Service	1588694673	1588694673	1	1	TALAMINI, MARK A MD	6/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51961	02	General Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
48151	Fee-for-Service	1164566311	1164566311	1	1	TRAN, DANA D MD	10/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80528	41	Internal Medicine	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
48237	Fee-for-Service	1164447736	1164447736	1	1	THOM, DAVID H MD	8/31/1990	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53458	01	General Practice	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
48278	Fee-for-Service	1215046628	1215046628	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	37435 MAIN ST	None	BURNEY	CA	96013	4372	45	06089	40.88908436	-121.653655	Shasta County
48281	Fee-for-Service	1699842559	1699842559	1	1	TRAN, KIM HUONG T MD	12/1/1997	207R00000X	NA	Other	026	PHYSICIANS	62924	41	Internal Medicine	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
48331	Fee-for-Service	1487702346	1487702346	1	1	TYAU, EDWARD S MD	1/2/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67818	02	General Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
48352	Fee-for-Service	1366071169	1366071169	1	1	TU, DARLENE	11/5/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	176754	36	Psychiatry	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
48357	Fee-for-Service	1740366277	1740366277	1	1	TSOU, CHRISTINE C MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63085	41	Internal Medicine	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
48365	Fee-for-Service	1841309218	1841309218	1	1	THRIFTY PAYLESS INC	1/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5618	7224 BROADWAY	None	LEMON GROVE	CA	91945	1501	37	06073	32.74266182	-117.042247	San Diego County
48386	Fee-for-Service	1316983877	1316983877	1	1	TRAN, TIFFANY U MD INC	11/10/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	79948	None	None	0	In state provider	None	27800 MEDICAL CENTER RD	SUITE 144	MISSION VIEJO	CA	92691	6447	30	06059	33.55952733	-117.6645199	Orange County
48403	Fee-for-Service	1821162199	1821162199	1	1	TRAN, QUANG Q CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	ZEN ACUPUNCTURE & HERBAL	9840 HIBERT ST	STE B1	SAN DIEGO	CA	92131	1071	37	06073	32.91412139	-117.1139102	San Diego County
48410	Fee-for-Service	1053679035	1053679035	1	1	TWEED, JESSE O MD	12/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127569	40	Pediatrics	0	In state provider	None	14114 BUISNESS CENTER DR	SUITE A	MORENO VALLEY	CA	92553	9113	33	06065	33.9148002	-117.2714647	Riverside County
48441	Fee-for-Service	1164566311	1164566311	1	1	TRAN, DANA D MD	10/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80528	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
48449	Fee-for-Service	1275564213	1275564213	2	1	THENAPPAN, ANNAPOORANI MD	9/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	63969	40	Pediatrics	0	In state provider	None	1701 E CESAR E CHAVEZ AV	STE 128	LOS ANGELES	CA	90033	2483	19	06037	34.05112725	-118.2173921	Los Angeles County
48485	Fee-for-Service	1326543513	1326543513	1	1	TRTCHOUNIAN, ANNA MD	10/18/2023	207P00000X	NA	Other	026	PHYSICIANS	190716	None	None	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
48523	Fee-for-Service	1407318348	1407318348	1	1	TRUJILLO, MICHAEL J MD	9/6/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176825	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
48545	Fee-for-Service	1508991712	1508991712	1	1	TRUSSELL, CAROL A	6/20/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1850 DOUGLAS BLVD	STE 992	ROSEVILLE	CA	95661	3639	31	06061	38.74415734	-121.2570324	Placer County
48553	Fee-for-Service	1992996243	1992996243	2	1	TRLSM GROUP INC	12/12/2022	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ACY	23101 SHERMAN PL	101	WEST HILLS	CA	91307	2003	19	06037	34.20099112	-118.6297991	Los Angeles County
48572	Fee-for-Service	1801905252	1801905252	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06104	807 S MAIN ST	None	YREKA	CA	96097	3374	47	06093	41.72562934	-122.638453	Siskiyou County
48583	Fee-for-Service	1124137641	1124137641	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05439	4633 SANTA MONICA BLVD	None	LOS ANGELES	CA	90029	1803	19	06037	34.09089435	-118.2903759	Los Angeles County
48619	Fee-for-Service	1487702346	1487702346	1	1	TYAU, EDWARD S MD	1/2/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67818	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
48668	Fee-for-Service	1891859823	1891859823	1	1	TAYLOR, CATHERINE W LMFT	9/13/2021	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
48694	Fee-for-Service	1962943563	1962943563	1	1	TSO, DAVID K MD	11/18/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161451	30	Radiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
48710	Fee-for-Service	1831355569	1831355569	1	1	THAKUR, SHANTANU K MD	10/4/2013	2081P0301X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	119550	25	Physical Medicine and Rehabilitation	0	In state provider	None	43112 15TH STREET WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
48720	Fee-for-Service	1326160763	1326160763	1	1	TIVORSAK, TANYA L MD	6/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115723	30	Radiology	0	In state provider	None	3700 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
48735	Fee-for-Service	1861442493	1861442493	1	1	TORREY BERGMAN M.D.	10/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4801 W 81ST ST	STE 108	MINNEAPOLIS	MN	55437	1111	00	None	44.85623947	-93.34035	Hennepin County
48745	Fee-for-Service	1063743524	1063743524	1	1	TRUEL, SHANA M LPCC	1/6/2020	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6840 INDIANA AVE	275	RIVERSIDE	CA	92506	4279	33	06065	33.94246965	-117.3926366	Riverside County
48764	Fee-for-Service	1801148242	1801148242	1	1	TAMPLEN, MATTHEW MD	11/30/2018	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	130441	84	Surgery-Head and Neck	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
48781	Fee-for-Service	1366925687	1366925687	1	1	TORRES, MIREYA LCSW	2/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9390 8TH AVE	None	HESPERIA	CA	92345	3447	36	06071	34.4215725	-117.3185826	San Bernardino County
48795	Fee-for-Service	1982174942	1982174942	1	1	TAULBEE, ELIZABETH LCSW	12/3/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	Z TAULBEE, LCSW	665 F ST	UNIT A	ARCATA	CA	95521	6365	12	06023	40.86666737	-124.0854964	Humboldt County
48815	Fee-for-Service	1972905685	1972905685	1	1	TSAI, YUN CHAN ALEX LMFT	6/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1303 SAN CARLOS AVE	None	SAN CARLOS	CA	94070	2317	41	06081	37.50572931	-122.2621879	San Mateo County
48867	Fee-for-Service	1427538057	1427538057	1	1	TANGESTANIPOOR, ARDALAN MD	9/1/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	179521	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
48891	Fee-for-Service	1760675763	1760675763	1	1	TSAI, CHRISTOPHER K MD INC	9/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54843	None	None	0	In state provider	None	1175 E ARROW HWY	STE E	UPLAND	CA	91786	5525	36	06071	34.09981647	-117.636003	San Bernardino County
48935	Fee-for-Service	1063068930	1063068930	1	2	TAHOE FOREST HOSPITAL DISTRI	2/28/2020	193200000X	NA	Other	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CLINICS PRIMARY CARE	10956 DONNER PASS RD	STE 110	TRUCKEE	CA	96161	4860	29	06057	39.32625521	-120.2012059	Nevada County
48960	Fee-for-Service	1316078389	1316078389	1	1	TRAN, ANDY	1/2/2019	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	41	Internal Medicine	0	In state provider	None	14221 EUCLID ST	STE F	GARDEN GROVE	CA	92843	4991	30	06059	33.757191	-117.937638	Orange County
48972	Fee-for-Service	1407280803	1407280803	1	1	TRAN, MELODY L MD	6/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145003	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
49000	Fee-for-Service	1336258821	1336258821	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	836 ORANGE AVE	None	CORONADO	CA	92118	2619	37	06073	32.68811587	-117.1787057	San Diego County
49033	Fee-for-Service	1750469532	1750469532	1	1	TRAUNER, KENNETH B MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	72844	20	Orthopedic Surgery	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
49036	Fee-for-Service	1538429527	1538429527	1	1	TENENBAUM, JOSEPH B MD	2/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127093	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
49052	Fee-for-Service	1497814644	1497814644	1	1	TSUYE, KYLE	1/11/2013	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
49143	Fee-for-Service	1669581948	1669581948	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05627	439 SANTA FE DR	None	ENCINITAS	CA	92024	5134	37	06073	33.0361617	-117.2833358	San Diego County
49195	Fee-for-Service	1730143454	1730143454	1	2	THE REGENTS OF THE UNIVERSIT	11/30/2015	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	3951 KATELLA AVE	STE 102	LOS ALAMITOS	CA	90702	3303	30	06059	33.80318745	-118.06398	Orange County
49222	Fee-for-Service	1285993451	1285993451	1	1	TEHRANI, BENJAMIN J DPM	7/25/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	9375 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1418	19	06037	34.2395322	-118.3939944	Los Angeles County
49246	Fee-for-Service	1356995047	1356995047	1	1	TA, CRISTINA T OD	3/3/2021	152WL0500X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	STE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
49263	Fee-for-Service	1366699274	1366699274	1	1	TRAN, TAYLOR T MD	8/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104566	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
49266	Fee-for-Service	1225362908	1225362908	1	1	THOMPSON, CASSANDRA OD	5/20/2011	No Taxonomy Provided	NA	None	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
49273	Fee-for-Service	1457409351	1457409351	1	1	TAN, CHU-IY, MD	10/7/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41082	66	Emergency Medicine (Urgent Care)	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
49293	Fee-for-Service	1841651429	1841651429	1	1	TAWFIK, SANDRA A F	3/16/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	420 B ST	None	YUBA CITY	CA	95991	5070	51	06101	39.13415904	-121.6121453	Sutter County
49295	Fee-for-Service	1962724153	1962724153	1	1	TRINH, KEVIN H MD	7/19/2019	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	142866	25	Physical Medicine and Rehabilitation	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
49311	Fee-for-Service	1851463681	1851463681	1	1	TICERASKIN, SANDRA K MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80791	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
49350	Fee-for-Service	1619010121	1619010121	2	1	TUFFT, ROBERT DAVID MD	8/5/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	38113	41	Internal Medicine	0	In state provider	None	401 29TH ST	STE 202	OAKLAND	CA	94609	3581	01	06001	37.81771119	-122.2648299	Alameda County
49368	Fee-for-Service	1326238460	1326238460	1	1	TELLEZ, ANTONIA LMFT	4/18/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10737 LAUREL ST	220	RANCHO CUCAMONGA	CA	91730	3837	36	06071	34.10515337	-117.570867	San Bernardino County
49386	Fee-for-Service	1245632033	1245632033	1	1	TOM, CYNTHIA MD	9/13/2021	208C00000X	NA	General Surgery	026	PHYSICIANS	138001	None	None	0	In state provider	None	6121 N THESTA ST	202	FRESNO	CA	93710	8603	10	06019	36.82493955	-119.783139	Fresno County
49425	Fee-for-Service	1437242831	1437242831	1	1	THOUSAND CRANES PHARMACY	8/1/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1832 BUCHANAN ST	STE 203	SAN FRANCISCO	CA	94115	3252	38	06075	37.78696345	-122.4300353	San Francisco County
49443	Fee-for-Service	1790806131	1790806131	1	1	TANG, NING MD	8/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109252	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
49464	Fee-for-Service	1427793371	1427793371	1	1	TIMOTHY S. JOHNSTON, M.D. PC	5/13/2022	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3180 COLLINS DR	STE A	MERCED	CA	95348	3161	24	06047	37.32165459	-120.4760862	Merced County
49477	Fee-for-Service	1730143454	1730143454	1	2	THE REGENTS OF THE UNIVERSIT	11/30/2015	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	3951 KATELLA AVE	STE 102	LOS ALAMITOS	CA	90702	3303	30	06059	33.80318745	-118.06398	Orange County
49500	Fee-for-Service	1861548117	1861548117	1	1	THAYER, CRAIG R	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	62641	02	General Surgery	0	In state provider	None	3105 CEDAR RAVINE RD	STE 101	PLACERVILLE	CA	95667	6561	09	06017	38.72626462	-120.7945035	El Dorado County
49526	Fee-for-Service	1770532244	1770532244	1	1	TAM, BETTY M MD	5/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86417	41	Internal Medicine	0	In state provider	None	5575 W LAS POSITAS BLVD	STE 130	PLEASANTON	CA	94588	5800	01	06001	37.69214859	-121.8796532	Alameda County
49534	Fee-for-Service	1043448194	1043448194	1	1	TUNG, KA-WAH MD	7/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130862	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
49536	Fee-for-Service	1053321471	1053321471	1	1	TANDON, RAJEEV L MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67764	30	Radiology	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
49550	Fee-for-Service	1427222686	1427222686	1	1	TONG, CANDICE T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115724	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1500 FLORIDA AVENUE	None	MODESTO	CA	95350	4408	50	06099	37.665738	-120.9962205	Stanislaus County
49578	Fee-for-Service	1306805296	1306805296	1	1	TOTAL RENAL CARE, INC	10/14/1998	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ANTIOCH DIALYSIS CENTER	3100 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4001	07	06013	38.0015683	-121.8383255	Contra Costa County
49584	Fee-for-Service	1962724153	1962724153	1	1	TRINH, KEVIN H MD	7/19/2019	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	142866	41	Internal Medicine	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
49633	Fee-for-Service	1285708123	1285708123	1	1	TSAI, FAUSAN S MD	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88770	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
49638	Fee-for-Service	1780885665	1780885665	1	1	TOMSICK, SCOTT D MD	2/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
49664	Fee-for-Service	1689847881	1689847881	1	1	TRAN, JANE L MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107724	30	Radiology	0	In state provider	None	2 WEST FERN AVENUE	None	REDLANDS	CA	92373	5619	36	06071	34.05016907	-117.1793443	San Bernardino County
49763	Fee-for-Service	1730143454	1730143454	1	2	THE REGENTS OF THE UNIVERSIT	11/30/2015	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	32	Radiation Therapy (D.O. only)	0	In state provider	None	3951 KATELLA AVE	STE 102	LOS ALAMITOS	CA	90702	3303	30	06059	33.80318745	-118.06398	Orange County
49792	Fee-for-Service	1255060455	1255060455	1	1	TPIRC MEDICAL FOUNDATION, IN	7/10/2023	2080P0201X	NA	Neurology	022	PHYSICIANS GROUP	-	43	Pediatric Allergy	0	In state provider	None	2067 W VISTA WAY	250	VISTA	CA	92083	6034	37	06073	33.18505594	-117.285958	San Diego County
49818	Fee-for-Service	1912097544	1912097544	1	1	TABIN, GEOFFREY C MD	9/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150659	18	Ophthalmology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
49835	Fee-for-Service	1033571872	1033571872	1	1	TOURJE, CAITLIN D MD	9/13/2021	207LP2900X	NA	Other	026	PHYSICIANS	172179	None	None	0	In state provider	None	1100 PASEO CAMARILLO	None	CAMARILLO	CA	93010	6073	56	06111	34.22086527	-119.0555438	Ventura County
49845	Fee-for-Service	1881666956	1881666956	1	1	TADLOCK, MATTHEW D MD	12/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	54740	02	General Surgery	0	In state provider	None	1500 SAN PABLO	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
49846	Fee-for-Service	1720334279	1720334279	1	1	TA, LUYEN VAN MD INC	5/18/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	37356	None	None	0	In state provider	None	341 9TH ST	STE A	OAKLAND	CA	94607	4211	01	06001	37.79976002	-122.2706799	Alameda County
49850	Fee-for-Service	1316914930	1316914930	1	1	TANNEN, RICHARD C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 W MAIN ST	None	LEWISVILLE	TX	75057	3641	00	None	33.04625049	-97.0047135	Denton County
49851	Fee-for-Service	1962459479	1962459479	1	2	THE VALLEY CLINICA MEDICA GE	3/5/1996	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	NERAL, MEDICAL CENTER, I	8646 WOODMAN AVE	None	ARLETA	CA	91331	6503	19	06037	34.22767939	-118.4340728	Los Angeles County
49885	Fee-for-Service	1225563752	1225563752	1	1	TMH PSYCHOTHERAPY CORPORATIO	6/15/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	N	1605 HOPE ST	335	SOUTH PASADENA	CA	91030	2628	19	06037	34.11679363	-118.150088	Los Angeles County
49935	Fee-for-Service	1144921727	1144921727	1	1	TAN, MAEBEL CNP	9/19/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	403 W ADAMS BLVD	FOURTH FLOOR	LOS ANGELES	CA	90007	2664	19	06037	34.02741539	-118.2743622	Los Angeles County
49936	Fee-for-Service	1891123527	1891123527	1	1	THE MEDICINE CABINET INC	8/1/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3270 TWEEDY BLVD	SUITE C	SOUTH GATE	CA	90280	4372	19	06037	33.94495337	-118.2130252	Los Angeles County
49967	Fee-for-Service	1609296680	1609296680	1	1	TSENG, WENDY WAN-TING MD	5/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148016	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
49988	Fee-for-Service	1407306665	1407306665	1	2	TIMOTHY S. JOHNSTON, M.D. PC	11/12/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	3180 COLLINS	STE A	MERCED	CA	95348	3161	24	06047	37.32165459	-120.4760862	Merced County
50058	Fee-for-Service	1528216033	1528216033	1	1	TRIANA ROJAS, WILLIAM A	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116060	41	Internal Medicine	0	In state provider	None	115 MALL DR	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
50080	Fee-for-Service	1710054036	1710054036	1	1	TAO, MARY R MD	1/15/2013	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	834 E 4TH STREET	UNIT 2	LONG BEACH	CA	90802	7210	19	06037	33.77169691	-118.1819254	Los Angeles County
50081	Fee-for-Service	1255060455	1255060455	1	1	TPIRC MEDICAL FOUNDATION, IN	7/10/2023	2080P0201X	NA	Neurology	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	2067 W VISTA WAY	250	VISTA	CA	92083	6034	37	06073	33.18505594	-117.285958	San Diego County
50106	Fee-for-Service	1073655692	1073655692	1	1	TAFT CITY SCHOOL DISTRICT	4/10/1999	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	820 6TH ST	None	TAFT	CA	93268	2306	15	06029	35.14882336	-119.4568887	Kern County
50108	Fee-for-Service	1275891285	1275891285	1	1	TSAI, JERRY C MD	12/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119173	02	General Surgery	0	In state provider	None	975 MAPLE ST	None	REDWOOD CITY	CA	94063	2057	41	06081	37.48822836	-122.2226601	San Mateo County
50138	Fee-for-Service	1962459479	1962459479	1	2	THE VALLEY CLINICA MEDICA GE	3/5/1996	261QP2300X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	NERAL, MEDICAL CENTER, I	8646 WOODMAN AVE	None	ARLETA	CA	91331	6503	19	06037	34.22767939	-118.4340728	Los Angeles County
50141	Fee-for-Service	1003033754	1003033754	2	1	TANCINCO, GLORY C MD	11/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	50519	05	Anesthesiology	0	In state provider	None	2105 BEVERLY BLVD	#111	LOS ANGELES	CA	90057	2216	19	06037	34.06682861	-118.2706286	Los Angeles County
50155	Fee-for-Service	1073933057	1073933057	1	1	TANG, MICHAEL DO	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2306	00	None	36.132948	-115.136874	Clark County
50197	Fee-for-Service	1053436501	1053436501	1	1	TRUBY, AMY E LMFT	10/3/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	OFEEDBACK	406 BERRY ST.	None	MOUNT SHASTA	CA	96067	9768	47	06093	41.31043471	-122.3135681	Siskiyou County
50223	Fee-for-Service	1013146364	1013146364	1	1	THORSELL, ASHLEY A MD	12/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117652	67	Endocrinology	0	In state provider	None	77 CASA STREET	SUITE 108	SAN LUIS OBISPO	CA	93405	5804	40	06079	35.29306786	-120.6650709	San Luis Obispo County
50277	Fee-for-Service	1407306665	1407306665	1	2	TIMOTHY S. JOHNSTON, M.D. PC	3/30/2022	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3180 COLLINS	STE A	MERCED	CA	95348	3161	24	06047	37.32165459	-120.4760862	Merced County
50299	Fee-for-Service	1730567223	1730567223	1	1	TAYLOR, CHERI L AU	2/24/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2 UPPER RAGSDALE DR	STE B-270	MONTEREY	CA	93940	7845	27	06053	36.57940327	-121.8142876	Monterey County
50303	Fee-for-Service	1215968474	1215968474	1	1	TABSH, KHALIL M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37937	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
50318	Fee-for-Service	1902291883	1902291883	1	1	TSE, BRIAN MD	8/12/2021	207L00000X	NA	Other	026	PHYSICIANS	145458	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
50345	Fee-for-Service	1679864243	1679864243	1	1	TRAPP, ANN CNP	1/20/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8101 GREENBACK LN	None	FAIR OAKS	CA	95628	2502	34	06067	38.679237	-121.261662	Sacramento County
50377	Fee-for-Service	1144298704	1144298704	1	1	THOMPSON, KELLY L CRNA	10/25/2010	No Taxonomy Provided	NA	None	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
50381	Fee-for-Service	1114911013	1114911013	1	1	THOMSEN, TODD	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
50396	Fee-for-Service	1093246696	1093246696	1	1	TO, WENDY J MD	10/5/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	169672	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
50402	Fee-for-Service	1336534106	1336534106	1	1	TROGGIO, TOREY MD	8/13/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	144731	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	127 BROADWAY	STE 200	SANTA MONICA	CA	90401	2330	19	06037	34.01334753	-118.4957836	Los Angeles County
50428	Fee-for-Service	1962459479	1962459479	1	2	THE VALLEY CLINICA MEDICA GE	3/5/1996	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NERAL, MEDICAL CENTER, I	8646 WOODMAN AVE	None	ARLETA	CA	91331	6503	19	06037	34.22767939	-118.4340728	Los Angeles County
50448	Fee-for-Service	1144866468	1144866468	1	1	TRUEHEALTHCARE	10/26/2020	282N00000X	NA	Hospitals	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	520 I	None	LOS BANOS	CA	93635	3419	24	06047	37.06145969	-120.8489778	Merced County
50452	Fee-for-Service	1740391382	1740391382	1	1	TIPLER, KAREN E MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86452	08	Family Practice	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
50454	Fee-for-Service	1467498238	1467498238	1	1	TANG, KIMBERLY CRNA	4/9/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1200 N STATE ST	STE 14-901	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
50465	Fee-for-Service	1952643512	1952643512	1	1	TRUONG NEUROSCIENCE	12/19/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INSTITUTE INC	9940 TALBERT AVENUE	SUITE 204	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166347	-117.955494	Orange County
50516	Fee-for-Service	1619302841	1619302841	1	1	TRAN, TIFFANY CRNA	6/2/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
50522	Fee-for-Service	1427057405	1427057405	1	1	TWILIGHT HAVEN INC	6/3/2011	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1717 S WINERY AVE	None	FRESNO	CA	93727	5011	10	06019	36.725877	-119.7319305	Fresno County
50537	Fee-for-Service	1679535207	1679535207	1	1	TURNER,CRAIG MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3580 WEST 9000 SOUTH	None	WEST JORDAN	UT	84088	8812	00	None	40.590153	-111.974634	Salt Lake County
50538	Fee-for-Service	1265858971	1265858971	1	1	TOTAH, LYNDA NP	9/15/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	301 VICTORIA STREET	None	COSTA MESA	CA	92627	1995	30	06059	33.65258952	-117.9121545	Orange County
50559	Fee-for-Service	1417963703	1417963703	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	27350 SUN CITY BLVD	None	SUN CITY	CA	92586	5506	33	06065	33.71440653	-117.1938931	Riverside County
50566	Fee-for-Service	1407306665	1407306665	1	2	TIMOTHY S. JOHNSTON, M.D. PC	11/12/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3180 COLLINS	STE A	MERCED	CA	95348	3161	24	06047	37.32165459	-120.4760862	Merced County
50614	Fee-for-Service	1780639344	1780639344	1	1	TUMMALA, PRABHAKAR MD	5/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89858	02	General Surgery	0	In state provider	None	16850 BEAR VALLEY ROAD	None	VICTORVILLE	CA	92395	5795	36	06071	34.47092468	-117.2977236	San Bernardino County
50632	Fee-for-Service	1407434798	1407434798	1	1	TCM HOME HEALTH INC	12/22/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	18321 VENTURA BLVD	STE 820	TARZANA	CA	91356	4263	19	06037	34.16710334	-118.5318618	Los Angeles County
50642	Fee-for-Service	1396249538	1396249538	1	1	TRAN, WEN-CHING MD	3/18/2021	208M00000X	NA	Other	026	PHYSICIANS	166014	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
50714	Fee-for-Service	1962459479	1962459479	1	2	THE VALLEY CLINICA MEDICA GE	3/5/1996	261QP2300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	NERAL, MEDICAL CENTER, I	8646 WOODMAN AVE	None	ARLETA	CA	91331	6503	19	06037	34.22767939	-118.4340728	Los Angeles County
50725	Fee-for-Service	1720017502	1720017502	1	1	TAMAGNA, ELLEN I MD	5/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	33394	67	Endocrinology	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
50757	Fee-for-Service	1255532958	1255532958	1	1	TRAN, RAYMOND P MD	12/11/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	98024	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
50785	Fee-for-Service	1689607020	1689607020	1	1	TENENHAUS, MAYER MD	2/28/1992	208200000X	NA	General Surgery	026	PHYSICIANS	52624	02	General Surgery	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
50850	Fee-for-Service	1295783215	1295783215	1	1	TIENDA, JUAN B L OD	1/31/1988	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2445 CESAR CHAVEZ AVE	None	LOS ANGELES	CA	90033	0001	19	06037	34.04621866	-118.2063886	Los Angeles County
50884	Fee-for-Service	1417480328	1417480328	1	1	TRINH, EMILY MD	6/28/2020	207P00000X	NA	Other	026	PHYSICIANS	159264	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
50902	Fee-for-Service	1780639344	1780639344	1	1	TUMMALA, PRABHAKAR MD	5/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89858	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16850 BEAR VALLEY ROAD	None	VICTORVILLE	CA	92395	5795	36	06071	34.47092468	-117.2977236	San Bernardino County
50936	Fee-for-Service	1013099746	1013099746	1	1	TAN, KWAN T MD	1/1/1993	207R00000X	NA	Other	026	PHYSICIANS	74232	41	Internal Medicine	0	In state provider	None	6900 LINCOLN AVE	None	BUENA PARK	CA	90620	4148	30	06059	33.83179154	-118.012518	Orange County
50962	Fee-for-Service	1922386945	1922386945	1	1	TRAEDER, TAMARA LMFT	12/4/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	832 SCHOOL STREET	SUITE 1	NAPA	CA	94559	2828	28	06055	38.29628067	-122.2886221	Napa County
51014	Fee-for-Service	1386031086	1386031086	1	1	TESFAYE, TSIGEREDA CNP	12/6/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25272 MARGUERITE PKWY	None	MISSION VIEJO	CA	92692	2901	30	06059	33.59591616	-117.6586221	Orange County
51055	Fee-for-Service	1033346978	1033346978	1	1	TANG, LAWTON W MD MEDICAL	11/16/2009	193400000X	NA	Other	026	PHYSICIANS	104375	24	Plastic Surgery	0	In state provider	CORPORATION	1044 S FAIR OAKS AVENUE	#101	PASADENA	CA	91105	2622	19	06037	34.12819088	-118.1502923	Los Angeles County
51063	Fee-for-Service	1841273356	1841273356	1	1	TEBBERND, TOOD W. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
51145	Fee-for-Service	1801917554	1801917554	1	1	THAKUR, NICKLESH DO	8/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	9158	13	Neurology (M.D. only)	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
51172	Fee-for-Service	1013470822	1013470822	1	1	TRINH, VAN	7/10/2024	207L00000X	NA	Other	026	PHYSICIANS	20229	05	Anesthesiology	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
51180	Fee-for-Service	1700225711	1700225711	1	1	TAMAYO-MURILLO, DORATHY E MD	7/6/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	152645	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
51190	Fee-for-Service	1780639344	1780639344	1	1	TUMMALA, PRABHAKAR MD	5/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89858	01	General Practice	0	In state provider	None	16850 BEAR VALLEY ROAD	None	VICTORVILLE	CA	92395	5795	36	06071	34.47092468	-117.2977236	San Bernardino County
51191	Fee-for-Service	1073933602	1073933602	1	1	TRG BUSINESS CONSULTING	11/20/2014	305S00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	DYNAMICS INC	7840 MISSION CENTER CT	SUITE 102	SAN DIEGO	CA	92108	1320	37	06073	32.77329297	-117.155687	San Diego County
51196	Fee-for-Service	1588925861	1588925861	1	1	TING, MARK BRYAN G MD	6/30/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	131596	36	Psychiatry	0	In state provider	None	1060 W SIERRA AVE	STE 105	FRESNO	CA	93711	2063	10	06019	36.83009575	-119.8099386	Fresno County
51247	Fee-for-Service	1588686497	1588686497	1	1	THRIFTY PAYLESS INC	2/27/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5674	405 W MAIN ST	None	BRAWLEY	CA	92227	2244	13	06025	32.97865645	-115.547913	Imperial County
51285	Fee-for-Service	1508401423	1508401423	1	1	TRESTLES LLC	10/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6248 66TH AVE	None	SACRAMENTO	CA	95823	2733	34	06067	38.491506	-121.431609	Sacramento County
51320	Fee-for-Service	1306801790	1306801790	1	1	TENG, MING MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55185	30	Radiology	0	In state provider	None	220 OYSTER POINT BLVD	None	S SAN FRANCISCO	CA	94080	1911	41	06081	37.66234961	-122.3918346	San Mateo County
51338	Fee-for-Service	1811013071	1811013071	1	1	THOMPSON, JENNIFER L CRNA	6/1/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	23861 MCBEAN PKWY	STE. B18	VALENCIA	CA	91355	4456	19	06037	34.39567343	-118.5542698	Los Angeles County
51444	Fee-for-Service	1982108973	1982108973	1	1	THOMAS, RICKY J MD	6/30/2021	207P00000X	NA	Other	026	PHYSICIANS	164361	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
51492	Fee-for-Service	1811368251	1811368251	1	1	TRAN, HIEN	10/15/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5871 PINE AVE	SUITE 230	CHINO HILLS	CA	91709	6545	36	06071	33.94767013	-117.6754339	San Bernardino County
51505	Fee-for-Service	1518058155	1518058155	2	1	THIEME, GARY A MD	7/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
51521	Fee-for-Service	1093720609	1093720609	1	1	TOIYABE INDIAN HEALTH PROJEC	3/27/2020	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	T, INC.	250 N SEE VEE LN	None	BISHOP	CA	93514	8130	14	06027	37.365066	-118.410912	Inyo County
51534	Fee-for-Service	1386219558	1386219558	1	5	TELEMEDICINE URGENT CARE INC	1/14/2025	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	1272 CENTER CRT DR	STE 105	COVINA	CA	91724	3667	19	06037	34.07289566	-117.864007	Los Angeles County
51556	Fee-for-Service	1295758639	1295758639	1	1	T H CHOI AMC	11/3/2006	193200000X	NA	Other	026	PHYSICIANS	70132	67	Endocrinology	0	In state provider	None	3772 KATELLA AVENUE	SUITE 107	LOS ALAMITOS	CA	90720	3108	30	06059	33.8029895	-118.0670445	Orange County
51585	Fee-for-Service	1811912769	1811912769	1	1	TAKAKUWA, KEVIN MD	1/8/2025	207P00000X	NA	Other	026	PHYSICIANS	87839	66	Emergency Medicine (Urgent Care)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
51606	Fee-for-Service	1225105240	1225105240	1	1	TULLY, WILLIAN P MD	11/29/1979	204D00000X	NA	Other	026	PHYSICIANS	22950	70	Clinic (mixed specialty)	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
51610	Fee-for-Service	1306801790	1306801790	1	1	TENG, MING MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55185	78	Neoplastic Diseases/Oncology	0	In state provider	None	220 OYSTER POINT BLVD	None	S SAN FRANCISCO	CA	94080	1911	41	06081	37.66234961	-122.3918346	San Mateo County
51660	Fee-for-Service	1558472464	1558472464	1	1	TERRAZAS, ALEXANDER MD	5/8/1993	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	39774	08	Family Practice	0	In state provider	None	245 TERRACINA BLVD	STE 208	REDLANDS	CA	92373	4851	36	06071	34.03858912	-117.2066515	San Bernardino County
51671	Fee-for-Service	1386219558	1386219558	1	2	TELEMEDICINE URGENT CARE INC	8/14/2024	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	5329 OFFICE CENTER CT	STE 224	BAKERSFIELD	CA	93309	5329	15	06029	35.3605026	-119.061931	Kern County
51673	Fee-for-Service	1730889825	1730889825	1	1	THE RELATIONSHIP ELEVATION A	6/9/2023	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ND LEARNING INSTITUTE	101 PARKSHORE DR	100	FOLSOM	CA	95630	4726	34	06067	38.656962	-121.1866875	Sacramento County
51682	Fee-for-Service	1518926187	1518926187	2	1	TMI PATHOLOGY ASSOCIATES	4/2/2008	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	15211 VANOWEN ST	STE 303	VAN NUYS	CA	91405	3657	19	06037	34.19395411	-118.4642527	Los Angeles County
51753	Fee-for-Service	1174993604	1174993604	1	1	TAYLOR ROSE, ARLENE CNP	3/28/2024	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
51764	Fee-for-Service	1366639775	1366639775	1	1	TORBETT, BRIAN CP	10/4/2005	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	16185 KAMAMA RD	None	APPLE VALLEY	CA	92307	1377	36	06071	34.54537747	-117.2686262	San Bernardino County
51805	Fee-for-Service	1124217781	1124217781	1	1	TRIER, DARIN A MD	2/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101741	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 OLD RIVER ROAD	None	BAKERSFIELD	CA	93311	9781	15	06029	35.351487	-119.1143025	Kern County
51842	Fee-for-Service	1295758639	1295758639	1	1	T H CHOI AMC	11/3/2006	193200000X	NA	Other	026	PHYSICIANS	70132	41	Internal Medicine	0	In state provider	None	3772 KATELLA AVENUE	SUITE 107	LOS ALAMITOS	CA	90720	3108	30	06059	33.8029895	-118.0670445	Orange County
51880	Fee-for-Service	1548546815	1548546815	1	1	TRUXAW, KATHERINE L	1/13/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
51920	Fee-for-Service	1124719075	1124719075	1	1	TUK CONSULTING CORPORATION	6/21/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7837 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4033	30	06059	33.75930636	-117.9923157	Orange County
51922	Fee-for-Service	1134829179	1134829179	1	1	T&J UNLIMITED TRANSPORTATION	4/22/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	INC	840 W AVENUE J	A	LANCASTER	CA	93534	3427	19	06037	34.6893897	-118.1443748	Los Angeles County
51933	Fee-for-Service	1508209750	1508209750	1	1	TUN, SANDY MD	10/10/2024	207RH0002X	NA	Adult Primary Care	026	PHYSICIANS	131888	70	Clinic (mixed specialty)	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
51938	Fee-for-Service	1003279019	1003279019	1	1	TEITEL, YAKIRA MD	1/23/2020	390200000X	NA	Other	026	PHYSICIANS	151717	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
51959	Fee-for-Service	1932525060	1932525060	1	1	THAI, SUONG N CRNA	6/1/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
51960	Fee-for-Service	1730889825	1730889825	1	1	THE RELATIONSHIP ELEVATION A	6/9/2023	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ND LEARNING INSTITUTE	101 PARKSHORE DR	100	FOLSOM	CA	95630	4726	34	06067	38.656962	-121.1866875	Sacramento County
51969	Fee-for-Service	1730558636	1730558636	1	1	TADA, LAUREN T DO	12/13/2024	207R00000X	NA	Other	026	PHYSICIANS	15021	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
51995	Fee-for-Service	1558444182	1558444182	1	1	THERIOT, JUDE E MD	5/7/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	147978	13	Neurology (M.D. only)	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
52020	Fee-for-Service	1285076885	1285076885	1	1	THAMARASSERIL, SREEDEVI G MD	6/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138259	41	Internal Medicine	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
52024	Fee-for-Service	1558338582	1558338582	1	1	THOMAS JR., JOSEPH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3223 8TH ST	None	METAIRIE	LA	70002	1623	00	None	30.01636823	-90.15581839	Jefferson Parish
52045	Fee-for-Service	1326210527	1326210527	1	1	TUCKER, SUZANNE M MD	7/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149311	22	Pathology (M.D. only)	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
52053	Fee-for-Service	1750384665	1750384665	1	1	THOMAS A MATTIONI MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7301 E 2ND ST	STE 118	SCOTTSDALE	AZ	85251	0000	00	None	33.491178	-111.92427	Maricopa County
52055	Fee-for-Service	1487171831	1487171831	1	1	TABER, VALERIE LPCC	7/11/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	325 W HOSPITALITY LN	STE 200	SAN BERNARDINO	CA	92374	2861	36	06071	34.0658995	-117.29034	San Bernardino County
52061	Fee-for-Service	1538349899	1538349899	1	1	TRAINER, GABRIEL T MD	9/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111060	20	Orthopedic Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
52076	Fee-for-Service	1285165654	1285165654	1	1	TRAN, AN MD	9/9/2022	207LP3000X	NA	Other	026	PHYSICIANS	171787	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
52125	Fee-for-Service	1467459776	1467459776	1	2	TORRANCE MEMORIAL MED CT	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	MEDICAL CENTER	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
52147	Fee-for-Service	1669908463	1669908463	1	1	TAYLOR, CULLEN MD	10/4/2023	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	191090	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
52162	Fee-for-Service	1891146924	1891146924	1	1	TOURTELLOTTE, LEAH MD	7/25/2019	208M00000X	NA	Other	026	PHYSICIANS	158820	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
52181	Fee-for-Service	1073687844	1073687844	1	1	TOUTANT, CLAIRE MD	11/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	43113	36	Psychiatry	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
52190	Fee-for-Service	1346432721	1346432721	1	1	TULA TOP MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2801 N GANTENBEIN	None	PORTLAND	OR	97227	1623	00	None	45.54387841	-122.6696022	Multnomah County
52243	Fee-for-Service	1700097540	1700097540	1	5	THE NORTHEAST COMMUNITY CLNC	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1414 S GRAND AVE	SUITE 200	LOS ANGELES	CA	90015	3072	19	06037	34.03661142	-118.2657227	Los Angeles County
52265	Fee-for-Service	1356961726	1356961726	1	1	TRUECHOICE PHARMACY, LLC	1/27/2024	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	2410 HIGHWAY 95	None	BULLHEAD CITY	AZ	86442	7305	00	None	35.098209	-114.5975535	Mohave County
52290	Fee-for-Service	1184094591	1184094591	1	1	TEKEIAN, REBECCA B LPCC	6/15/2020	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
52297	Fee-for-Service	1194195719	1194195719	1	1	THAM, JANICE Y CNP	12/1/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
52306	Fee-for-Service	1154480630	1154480630	1	1	TAN, SIDHARTHA MD	12/4/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	181398	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
52338	Fee-for-Service	1235187378	1235187378	1	1	TURNER, STEVEN	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	415 WEST COLUMBIA ST	None	EVANSVILLE	IN	47710	1656	00	None	37.98486618	-87.56985734	Vanderburgh County
52365	Fee-for-Service	1861547317	1861547317	1	1	THALKEN, GREGORY L MD	7/22/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	162624	30	Radiology	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
52468	Fee-for-Service	1073687844	1073687844	1	1	TOUTANT, CLAIRE MD	11/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	43113	13	Neurology (M.D. only)	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
52530	Fee-for-Service	1700097540	1700097540	1	5	THE NORTHEAST COMMUNITY CLNC	3/13/2023	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1414 S GRAND AVE	SUITE 200	LOS ANGELES	CA	90015	3072	19	06037	34.03661142	-118.2657227	Los Angeles County
52571	Fee-for-Service	1730578592	1730578592	1	1	TOMA, HEATHER R	7/22/2016	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
52587	Fee-for-Service	1063711307	1063711307	1	1	TRAVERSO, MERCEDES D DO	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11491	40	Pediatrics	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
52591	Fee-for-Service	1043546112	1043546112	1	1	TANCHOCO, IMELDA T MD	11/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106359	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
52602	Fee-for-Service	1073804498	1073804498	1	1	TURNING POINT OF CENTRAL	5/23/2017	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA, INC	2731 WEST OLIVE AVE	None	FRESNO	CA	93728	2449	10	06019	36.75739849	-119.842812	Fresno County
52603	Fee-for-Service	1366552127	1366552127	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05587	8760 19TH ST	None	RANCHO CUCAMONGA	CA	91701	4608	36	06071	34.13384937	-117.6135871	San Bernardino County
52626	Fee-for-Service	1598750788	1598750788	1	1	THOMAS C YOUNG	8/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5002 COWHORN CREEK RD	None	TEXARKANA	TX	75503	9766	00	None	33.464763	-94.07803251	Bowie County
52746	Fee-for-Service	1033710819	1033710819	1	1	TREASURE CARE HOSPICE, INC	4/27/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4250 PENNSYLVANIA AVE	STE 203	LA CRESCENTA	CA	91214	3369	19	06037	34.224183	-118.2486845	Los Angeles County
52748	Fee-for-Service	1154362499	1154362499	1	1	TABRIZI, PEYMAN MD	3/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	63188	02	General Surgery	0	In state provider	PACIFIC COAST NEUROSURGI	999 N TUSTIN AVE	STE 109	SANTA ANA	CA	92705	6504	30	06059	33.754167	-117.834191	Orange County
52750	Fee-for-Service	1477745685	1477745685	1	1	TRIX, JOHN J 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
52763	Fee-for-Service	1629427976	1629427976	1	1	THORBURN, KRYSTAL M LCSW	4/2/2024	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
52776	Fee-for-Service	1457432718	1457432718	1	1	TERESA MASSAGIL	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CHILDRENS UNIVERSITY MD	4500 SAND POINT WAY	NE#100	SEATTLE	WA	98105	0000	00	None	47.66165594	-122.2864502	King County
52791	Fee-for-Service	1265638621	1265638621	1	1	TROJNAR, MEGHAN M DO	7/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10235	40	Pediatrics	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
52802	Fee-for-Service	1790217800	1790217800	1	1	TIEN, ANDY MD	1/8/2019	207R00000X	NA	Other	026	PHYSICIANS	157056	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
52817	Fee-for-Service	1700097540	1700097540	1	5	THE NORTHEAST COMMUNITY CLNC	9/23/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1414 S GRAND AVE	SUITE 200	LOS ANGELES	CA	90015	3072	19	06037	34.03661142	-118.2657227	Los Angeles County
52849	Fee-for-Service	1558470088	1558470088	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1333 S WINCHESTER BLVD	None	SAN JOSE	CA	95128	4343	43	06085	37.30005	-121.9500455	Santa Clara County
52856	Fee-for-Service	1801657820	1801657820	1	1	TRACEY, SHEAMONIQUE E BIRTH	2/6/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
52862	Fee-for-Service	1073837662	1073837662	1	1	TIGLAO, LAWRENCE C MD	2/15/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	118082	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
52869	Fee-for-Service	1245271519	1245271519	1	1	TRAN, HOAI THI T	11/1/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	IN FOCUS OPTOMETRY	15972 EUCLID ST	STE G	FOUNTAIN VALLEY	CA	92708	1133	30	06059	33.73124764	-117.9371902	Orange County
52913	Fee-for-Service	1932337136	1932337136	1	1	THOMAS, JEFFREY J MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115831	41	Internal Medicine	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
52950	Fee-for-Service	1144699273	1144699273	1	1	TRAHAN, ASHER PSYD	4/29/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
52961	Fee-for-Service	1205071677	1205071677	1	1	TAN,GEORGE MD	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103328	41	Internal Medicine	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
53031	Fee-for-Service	1154362499	1154362499	1	1	TABRIZI, PEYMAN MD	3/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	63188	14	Neurological Surgery	0	In state provider	PACIFIC COAST NEUROSURGI	999 N TUSTIN AVE	STE 109	SANTA ANA	CA	92705	6504	30	06059	33.754167	-117.834191	Orange County
53037	Fee-for-Service	1033710819	1033710819	1	1	TREASURE CARE HOSPICE, INC	4/27/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4250 PENNSYLVANIA AVE	STE 203	LA CRESCENTA	CA	91214	3369	19	06037	34.224183	-118.2486845	Los Angeles County
53059	Fee-for-Service	1205079522	1205079522	1	1	TOLBERT, GERALD MD	2/11/2025	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
53069	Fee-for-Service	1366828766	1366828766	1	2	TWILIGHT HOMES, INC.	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1463 W. SIERRA AVE	None	FRESNO	CA	93711	1906	10	06019	36.82998238	-119.8188121	Fresno County
53072	Fee-for-Service	1780866780	1780866780	1	2	TOLER, GARY	9/24/2024	332B00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	392 S TUSTIN ST	None	ORANGE	CA	92866	2502	30	06059	33.78258174	-117.8357676	Orange County
53111	Fee-for-Service	1962461418	1962461418	1	1	TOTAL RENAL CARE, INC	4/2/1997	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	21602 S VERMONT AVE	None	TORRANCE	CA	90502	1940	19	06037	33.83277105	-118.2902115	Los Angeles County
53116	Fee-for-Service	1821025032	1821025032	1	1	TRAN, DZU Q MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	83361	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2021 DIVISADERO ST	None	FRESNO	CA	93701	2013	10	06019	36.74332969	-119.7864594	Fresno County
53122	Fee-for-Service	1912914755	1912914755	1	1	TSAI, HO C MD	6/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84914	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
53133	Fee-for-Service	1699237164	1699237164	1	1	TURNEY, MARK D MFT INC	8/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5053 LA MART DR	SUITE 105	RIVERSIDE	CA	92507	5990	33	06065	33.95818206	-117.3320081	Riverside County
53142	Fee-for-Service	1912436601	1912436601	1	1	TRAN, DIANA M MD	4/27/2020	207R00000X	NA	Other	026	PHYSICIANS	157055	41	Internal Medicine	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
53190	Fee-for-Service	1063903243	1063903243	1	1	TERUEL, MARIA DO	11/16/2021	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	18103	None	None	0	In state provider	None	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	57	06113	38.66314048	-121.794696	Yolo County
53212	Fee-for-Service	1124280730	1124280730	1	1	TANAKA, HIDEAKI MD	8/15/2019	207P00000X	NA	Other	026	PHYSICIANS	163007	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
53228	Fee-for-Service	1962701102	1962701102	1	1	TAO, CHAD T MD	7/17/2017	207RC0200X	NA	Other	026	PHYSICIANS	123890	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2351 CLAY ST	STE 501	SAN FRANCISCO	CA	94115	1931	38	06075	37.79101512	-122.4316059	San Francisco County
53247	Fee-for-Service	1093790917	1093790917	1	1	TASHJIAN, DAVID MD	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	41281	40	Pediatrics	0	In state provider	None	1290 E SPRUCE AVE	STE 101	FRESNO	CA	93720	3371	10	06019	36.84170504	-119.7595073	Fresno County
53268	Fee-for-Service	1982766382	1982766382	1	1	TAN, TERENCE T MD	12/13/2020	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	47880	None	None	0	In state provider	None	3301 BEECHWOOD AVE	None	LYNWOOD	CA	90262	3301	19	06037	33.92961073	-118.2111703	Los Angeles County
53346	Fee-for-Service	1376937169	1376937169	1	1	THOMAS, SHAREN	6/4/2015	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2389 JOSIAH WING DRIVE	None	FAIRFIELD	CA	94533	8974	48	06095	38.29610437	-121.9756261	Solano County
53347	Fee-for-Service	1750568168	1750568168	1	1	TERRY, MICHAEL J MD	9/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126844	24	Plastic Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
53351	Fee-for-Service	1497388433	1497388433	1	1	TINIUS, JEFFREY	1/29/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
53357	Fee-for-Service	1982893574	1982893574	1	1	TAYLOR, JOHN D CPO	10/12/2015	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	463 BREWSTER AVE	SUITE 6	REDWOOD CITY	CA	94063	1783	41	06081	37.4919571	-122.2297604	San Mateo County
53372	Fee-for-Service	1518359512	1518359512	1	1	TULARE LOCAL HEALTH CARE	2/1/2015	282N00000X	NA	Hospitals	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	DISTRICT	869 N CHERRY STREET	None	TULARE	CA	93274	2207	54	06107	36.220932	-119.337698	Tulare County
53380	Fee-for-Service	1053426627	1053426627	1	1	TAYLOR, RICHARD W DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1508 COFFEE RD	STE B	MODESTO	CA	95355	3181	50	06099	37.665657	-120.975682	Stanislaus County
53403	Fee-for-Service	1073676243	1073676243	1	1	TIBURCIO VASQUEZ HEALTH	11/15/2006	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER-HAYWARD	22331 MISSION BLVD	None	HAYWARD	CA	94541	3911	01	06001	37.67442187	-122.0867356	Alameda County
53447	Fee-for-Service	1811982960	1811982960	1	1	THOMAS MARTIN MD	8/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 LOTHROP ST	None	PITTSBURGH	PA	15213	2536	00	None	40.44188737	-79.96079711	Allegheny County
53452	Fee-for-Service	1861501264	1861501264	1	1	THRIFTY PAYLESS INC	4/16/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6044	4010 MANZANITA AVE	None	CARMICHAEL	CA	95608	1724	34	06067	38.637297	-121.3269975	Sacramento County
53484	Fee-for-Service	1972923431	1972923431	1	1	THIRUVENGADAM, NIKHIL R MD	8/2/2021	390200000X	NA	Other	026	PHYSICIANS	147956	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
53497	Fee-for-Service	1356423396	1356423396	1	1	TRINH, KIM A MD	8/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87296	41	Internal Medicine	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
53514	Fee-for-Service	1346359882	1346359882	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11673 CHERRY AVE	None	FONTANA	CA	92337	0141	36	06071	34.04181931	-117.4866327	San Bernardino County
53515	Fee-for-Service	1962701102	1962701102	1	1	TAO, CHAD T MD	7/17/2017	207RC0200X	NA	Other	026	PHYSICIANS	123890	41	Internal Medicine	0	In state provider	None	2351 CLAY ST	STE 501	SAN FRANCISCO	CA	94115	1931	38	06075	37.79101512	-122.4316059	San Francisco County
53536	Fee-for-Service	1093790917	1093790917	1	1	TASHJIAN, DAVID MD	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	41281	07	Dermatology	0	In state provider	None	1290 E SPRUCE AVE	STE 101	FRESNO	CA	93720	3371	10	06019	36.84170504	-119.7595073	Fresno County
53545	Fee-for-Service	1922007913	1922007913	1	1	TIAN, YU MD	8/2/2005	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	6130 ELTON AVE	None	LAS VEGAS	NV	89017	2538	00	None	36.17198653	-115.225452	Clark County
53552	Fee-for-Service	1700097540	1700097540	1	7	THE NORTHEAST COMMUNITY CLNC	9/26/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4455 WEST 117TH ST	SUITE 105	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
53576	Fee-for-Service	1578753802	1578753802	1	1	THEKKE-KARUMATH, DINESH MD	2/8/2015	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
53605	Fee-for-Service	1619952397	1619952397	1	6	TUOLUMNE MEWUK INDIAN HEALTH	10/14/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1311 SANGUINETTI RD	SUITE C	SONORA	CA	95370	6210	55	06109	37.97447385	-120.3613052	Tuolumne County
53614	Fee-for-Service	1336242999	1336242999	1	1	TISHLER, KEVIN T MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73980	40	Pediatrics	0	In state provider	None	15092 IMPERIAL HWY	None	LA MIRADA	CA	90638	1301	19	06037	33.91710488	-118.009853	Los Angeles County
53635	Fee-for-Service	1376937169	1376937169	1	1	THOMAS, SHAREN	6/4/2015	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2389 JOSIAH WING DRIVE	None	FAIRFIELD	CA	94533	8974	48	06095	38.29610437	-121.9756261	Solano County
53636	Fee-for-Service	1740708478	1740708478	1	1	TRIMM, CASSIDY M PT	9/10/2017	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
53683	Fee-for-Service	1467409326	1467409326	1	1	TOLENTINO, CORITO S MD	2/28/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	48850	01	General Practice	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
53691	Fee-for-Service	1073676243	1073676243	1	1	TIBURCIO VASQUEZ HEALTH	11/15/2006	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER-HAYWARD	22331 MISSION BLVD	None	HAYWARD	CA	94541	3911	01	06001	37.67442187	-122.0867356	Alameda County
53695	Fee-for-Service	1356558209	1356558209	1	1	TABIBIAN, BEHNAM S MD	2/1/2001	193400000X	NA	Other	026	PHYSICIANS	61974	25	Physical Medicine and Rehabilitation	0	In state provider	PHYSICAL MED INST AMC	4849 VAN NUYS BLVD	STE 205	SHERMAN OAKS	CA	91403	2124	19	06037	34.159113	-118.4487465	Los Angeles County
53709	Fee-for-Service	1932288073	1932288073	1	1	TARASEWICZ, DARIUSZ G MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	84155	18	Ophthalmology	0	In state provider	None	340 S FARRELL DR	STE A105	PALM SPRINGS	CA	92262	7921	33	06065	33.81788398	-116.5180079	Riverside County
53727	Fee-for-Service	1114204666	1114204666	1	1	TATUM, JAMES M MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	117856	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
53749	Fee-for-Service	1265219992	1265219992	1	1	TRAN, PAUL PT	12/9/2024	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
53776	Fee-for-Service	1700140175	1700140175	1	1	TEMPLE CITY HEALTHCARE LLC	6/1/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5101 TYLER AVE	None	TEMPLE CITY	CA	91780	3682	19	06037	34.09818727	-118.02567	Los Angeles County
53784	Fee-for-Service	1649339235	1649339235	1	1	TJORNHOM, DIANE E MD	11/30/1991	207RR0500X	NA	Other	026	PHYSICIANS	73827	41	Internal Medicine	0	In state provider	UCSD MEDICAL DEPT MEDICI	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
53813	Fee-for-Service	1548467210	1548467210	1	1	TADROS, NADIA S MD	12/1/1997	207R00000X	NA	Other	026	PHYSICIANS	51471	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
53840	Fee-for-Service	1700097540	1700097540	1	7	THE NORTHEAST COMMUNITY CLNC	9/26/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4455 WEST 117TH ST	SUITE 105	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
53851	Fee-for-Service	1619955572	1619955572	1	1	THUNGA, ARUN K MD	7/22/2008	207L00000X	NA	Other	026	PHYSICIANS	102783	05	Anesthesiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
53859	Fee-for-Service	1669764429	1669764429	1	1	TAMAYO, STACY T LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43112 15TH STREET WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
53892	Fee-for-Service	1619952397	1619952397	1	6	TUOLUMNE MEWUK INDIAN HEALTH	5/17/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1311 SANGUINETTI RD	SUITE C	SONORA	CA	95370	6210	55	06109	37.97447385	-120.3613052	Tuolumne County
53912	Fee-for-Service	1255589891	1255589891	1	1	TRUONG, VINCENT V MD	10/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115725	41	Internal Medicine	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
53978	Fee-for-Service	1073676243	1073676243	1	1	TIBURCIO VASQUEZ HEALTH	11/15/2006	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER-HAYWARD	22331 MISSION BLVD	None	HAYWARD	CA	94541	3911	01	06001	37.67442187	-122.0867356	Alameda County
54030	Fee-for-Service	1316553886	1316553886	1	1	TREAT, JUSTIN OD	10/14/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	320 H ST	STE 4	MARYSVILLE	CA	95901	5834	58	06115	39.13837241	-121.5948806	Yuba County
54031	Fee-for-Service	1235181561	1235181561	1	1	THOMPSON, KENT W MD	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	51606	30	Radiology	0	In state provider	None	25405 HANCOCK AVE	STE 107	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
54126	Fee-for-Service	1811981590	1811981590	1	1	TOWNSEND, DWIGHT A MD	1/13/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	170995	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
54201	Fee-for-Service	1356450704	1356450704	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05638	1670 MAIN ST	None	RAMONA	CA	92065	5240	37	06073	33.03637248	-116.8787646	San Diego County
54203	Fee-for-Service	1255589891	1255589891	1	1	TRUONG, VINCENT V MD	10/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115725	13	Neurology (M.D. only)	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
54229	Fee-for-Service	1154752491	1154752491	1	1	TUFEKCIC, IVANA LMFT	9/21/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
54230	Fee-for-Service	1811230147	1811230147	1	1	TOLLIVORO, THEODORE A MD	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132935	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
54255	Fee-for-Service	1144455361	1144455361	1	1	TEJANI, EMILY F MD	10/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129789	36	Psychiatry	0	In state provider	None	1100 LARKSPUR LANDING CI	STE 150	LARKSPUR	CA	94939	1868	21	06041	37.94817177	-122.5100062	Marin County
54268	Fee-for-Service	1073676243	1073676243	1	1	TIBURCIO VASQUEZ HEALTH	3/3/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CENTER-HAYWARD	22331 MISSION BLVD	None	HAYWARD	CA	94541	3911	01	06001	37.67442187	-122.0867356	Alameda County
54282	Fee-for-Service	1396732343	1396732343	1	1	TOROK, EMESE NP	2/28/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	30	06059	33.62609529	-117.7293191	Orange County
54284	Fee-for-Service	1174636039	1174636039	1	2	TROY, ANN MD	10/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	41505	40	Pediatrics	0	In state provider	None	4000 CIVIC CENTER DR	SUITE 201	SAN RAFAEL	CA	94903	5232	21	06041	38.0041783	-122.538861	Marin County
54305	Fee-for-Service	1124018726	1124018726	1	1	TOLBERT, MARGARET M NP	11/8/2016	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
54307	Fee-for-Service	1720514102	1720514102	1	1	THE WIFEYS, P.C.	6/16/2021	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	NTER	4 HARRIS CT	STE A	MONTEREY	CA	93940	5798	27	06053	36.5799704	-121.8186278	Monterey County
54319	Fee-for-Service	1144885476	1144885476	1	1	THIRU, NAOMI W	8/3/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	7296 BLUE OAK ROAD	None	RIVERSIDE	CA	92507	0139	33	06065	34.01467567	-117.3044741	Riverside County
54334	Fee-for-Service	1396790689	1396790689	1	1	TOLMAN, JUSTIN M OD	9/4/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1245 THARP RD	None	YUBA CITY	CA	95993	2647	51	06101	39.14499709	-121.6484309	Sutter County
54382	Fee-for-Service	1255670469	1255670469	1	1	TOX MANAGEMENT LLC	12/4/2017	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	422 WEST NAKOMA DR	None	SAN ANTONIO	TX	78216	2623	00	None	29.55353958	-98.49967129	Bexar County
54391	Fee-for-Service	1578017174	1578017174	1	1	TSANG, HENRY	3/19/2025	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	17726	20	Orthopedic Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
54392	Fee-for-Service	1427212653	1427212653	1	1	TANG, CONNIE K MD	8/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104374	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
54414	Fee-for-Service	1467738963	1467738963	1	2	TAKANG, ERNEST NP	5/18/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
54438	Fee-for-Service	1275236515	1275236515	1	1	TONE, TORI N CCC-SLP	12/29/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
54447	Fee-for-Service	1144607094	1144607094	1	1	TEMPLE, JOHN L MD	9/26/2019	390200000X	NA	Other	026	PHYSICIANS	146919	41	Internal Medicine	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
54461	Fee-for-Service	1821493966	1821493966	1	1	TABLOEI, NIMA PT	3/2/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
54473	Fee-for-Service	1952440646	1952440646	1	1	TRINH, BANG X MD	2/6/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	94584	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
54535	Fee-for-Service	1043994528	1043994528	1	1	TOLEDO, SANDRA NP	7/12/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	601 S WESTMORELAND AVE	None	LOS ANGELES	CA	90005	3999	19	06037	34.06348495	-118.28845	Los Angeles County
54543	Fee-for-Service	1275913055	1275913055	1	1	TSAI, JOY MD	8/5/2024	367H00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
54566	Fee-for-Service	1972782894	1972782894	1	1	TANG, MINH T MD	7/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	100578	None	None	0	In state provider	None	250 W 5TH ST	None	HANFORD	CA	93230	5029	16	06031	36.32439821	-119.6472235	Kings County
54594	Fee-for-Service	1720514102	1720514102	1	1	THE WIFEYS, P.C.	1/18/2022	176B00000X	NA	Licensed Midwife	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NTER	4 HARRIS CT	STE A	MONTEREY	CA	93940	5798	27	06053	36.5799704	-121.8186278	Monterey County
54596	Fee-for-Service	1477335339	1477335339	1	1	TCMHUB INC.	12/1/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	39210 STATE ST	STE 117	FREMONT	CA	94538	1456	01	06001	37.54911562	-121.9827983	Alameda County
54605	Fee-for-Service	1144885476	1144885476	1	1	THIRU, NAOMI W	8/3/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	7296 BLUE OAK ROAD	None	RIVERSIDE	CA	92507	0139	33	06065	34.01467567	-117.3044741	Riverside County
54609	Fee-for-Service	1134310428	1134310428	1	1	TURNING POINT COMMUNITY PROG	3/28/2017	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	RAM	3120 FREEBOARD DRIVE	SUITE 103	WEST SACRAMENTO	CA	95691	5039	57	06113	38.5746747	-121.552383	Yolo County
54610	Fee-for-Service	1174549513	1174549513	3	1	THE SCOOTER STORE	12/4/2014	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	219 N SUNSET AVE	None	CITY OF INDUSTRY	CA	91744	3524	19	06037	34.03600187	-117.9730952	Los Angeles County
54619	Fee-for-Service	1306039755	1306039755	1	1	TIMMONS, JENNIFER M MD	8/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106587	08	Family Practice	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
54643	Fee-for-Service	1073705018	1073705018	1	1	TOTAL RENAL CARE INC	1/12/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	6121 N THESTA ST	SUITE 102	FRESNO	CA	93710	5294	10	06019	36.82493955	-119.783139	Fresno County
54672	Fee-for-Service	1558700534	1558700534	1	1	THAKER, MIHIR G DO	8/28/2020	208800000X	NA	Other	026	PHYSICIANS	16578	34	Urology and Urological Surgery	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
54675	Fee-for-Service	1962765172	1962765172	1	1	TANK, JAY D MD	4/5/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	154175	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
54717	Fee-for-Service	1518028729	1518028729	1	1	TALLER, JANOS MD	11/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	62642	02	General Surgery	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
54731	Fee-for-Service	1184914020	1184914020	1	1	TRAUBE, MATTHEW LMFT	10/9/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	806 MURRAY AVE	None	SAN LUIS OBISPO	CA	93405	1737	40	06079	35.29090647	-120.669507	San Luis Obispo County
54782	Fee-for-Service	1457855447	1457855447	1	1	TINAJERO, YOLANDA L MD	9/19/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166414	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
54822	Fee-for-Service	1093975617	1093975617	1	2	TADOKORO, DOREEN Y DO	12/19/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	12044	-	NOT APPLICABLE	0	In state provider	None	3550 Q ST	STE 101	BAKERSFIELD	CA	93301	1645	15	06029	35.391978	-119.0105025	Kern County
54834	Fee-for-Service	1811524317	1811524317	1	1	TEMKO, JAMIE E MD	10/1/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	190049	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8635 W 3RD ST	STE 485W	LOS ANGELES	CA	90048	6121	19	06037	34.07361928	-118.3803143	Los Angeles County
54859	Fee-for-Service	1780440065	1780440065	1	1	TRETTER, KYLE	5/30/2024	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
54868	Fee-for-Service	1588233134	1588233134	1	1	TRAN, HOA OD	10/22/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	554 E SAN BERNARDINO RD	SUITE 102	COVINA	CA	91723	1747	19	06037	34.09085021	-117.8800144	Los Angeles County
54883	Fee-for-Service	1952453185	1952453185	1	1	TURNQUEST, PAUL E MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	55994	41	Internal Medicine	0	In state provider	None	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
54956	Fee-for-Service	1407965858	1407965858	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1615 MAIN STREET	None	SUSANVILLE	CA	96130	4730	18	06035	40.41571584	-120.6497595	Lassen County
54957	Fee-for-Service	1386219558	1386219558	1	6	TELEMEDICINE URGENT CARE INC	1/14/2025	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	1884 EASTMAN AVE	STE 103	VENTURA	CA	93003	5764	56	06111	34.25559712	-119.2300522	Ventura County
55011	Fee-for-Service	1891883963	1891883963	1	1	TRAN, TRANG T OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	EYE Q OPTOMETRY, INC	7631 WYOMING ST	STE 101	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
55022	Fee-for-Service	1386964757	1386964757	1	1	TAYLOR, PHILLIP A MD	10/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144141	20	Orthopedic Surgery	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
55051	Fee-for-Service	1700964293	1700964293	1	1	TRINH, MICHELLE M MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96132	30	Radiology	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
55054	Fee-for-Service	1548297005	1548297005	1	1	TOPALOVSKI,MARGARET MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	PATHOLOGY ASSOCIATES	2450 TELSHOR BLVD	None	LAS CRUCES	NM	88011	0000	00	None	32.29238673	-106.7351331	Doña Ana County
55085	Fee-for-Service	1679525000	1679525000	1	1	TAYLOR, MARK A MD	9/1/2001	208G00000X	NA	General Surgery	026	PHYSICIANS	46339	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3941 J ST	STE 270	SACRAMENTO	CA	95819	3633	34	06067	38.570652	-121.4535465	Sacramento County
55093	Fee-for-Service	1831498161	1831498161	1	1	TAM, SANDY L MD	6/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113930	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
55095	Fee-for-Service	1326117839	1326117839	1	1	TRAN, TAMMY H OD A	3/27/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	3929 RIVERMARK PLZ	None	SANTA CLARA	CA	95054	4156	43	06085	37.39472004	-121.9458773	Santa Clara County
55173	Fee-for-Service	1568819050	1568819050	1	1	TAMESIS, JAMES FLORENCIO D M	1/26/2022	207R00000X	NA	Other	026	PHYSICIANS	172259	None	None	0	In state provider	D	2050 BLUE OAKS BLVD	None	ROSEVILLE	CA	94747	6506	31	06061	38.79182804	-121.3591888	Placer County
55198	Fee-for-Service	1619391315	1619391315	1	1	TRUE CARE FAMILY PHARMACY	11/18/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	22030 SHERMAN WAY	SUITE 100	CANOGA PARK	CA	91303	1897	19	06037	34.20099551	-118.6071615	Los Angeles County
55224	Fee-for-Service	1043329493	1043329493	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 E MANNING AVE	None	REEDLEY	CA	93654	2348	10	06019	36.60411347	-119.4393375	Fresno County
55289	Fee-for-Service	1881251999	1881251999	1	1	TYLER JOHN BUCHANAN	4/5/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1000 BOWER HILL RD	None	PITTSBURGH	PA	15243	1873	00	None	40.37744491	-80.06601413	Allegheny County
55305	Fee-for-Service	1538693155	1538693155	1	1	TEJWANI, ROHIT MD	7/23/2023	208800000X	NA	Other	026	PHYSICIANS	187987	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
55317	Fee-for-Service	1780211805	1780211805	1	1	TRAN, TINA DO	1/25/2024	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
55356	Fee-for-Service	1508151127	1508151127	1	1	TANG, JAMES YC MD	9/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127130	01	General Practice	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
55377	Fee-for-Service	1679525000	1679525000	1	1	TAYLOR, MARK A MD	9/1/2001	208G00000X	NA	General Surgery	026	PHYSICIANS	46339	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3941 J ST	STE 270	SACRAMENTO	CA	95819	3633	34	06067	38.570652	-121.4535465	Sacramento County
55419	Fee-for-Service	1790221646	1790221646	1	1	TRUST HOME MEDICAL LLC	9/28/2020	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	108 SOUTHERN OAKS DR	None	PLANT CITY	FL	33563	1446	00	None	28.02013948	-82.1430675	Hillsborough County
55429	Fee-for-Service	1679779508	1679779508	1	1	THOMAS, CHARLES S MD	8/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	98973	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
55443	Fee-for-Service	1184612210	1184612210	1	1	TZAN, CHYANSONG J MD	12/23/2011	207L00000X	NA	Other	026	PHYSICIANS	52948	05	Anesthesiology	0	In state provider	None	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1217	36	06071	34.131303	-117.3225325	San Bernardino County
55456	Fee-for-Service	1700180833	1700180833	1	1	THOMAS, NATASHA M MD	12/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128277	36	Psychiatry	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
55459	Fee-for-Service	1861718801	1861718801	1	1	TUN, AMY T MD	5/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111388	40	Pediatrics	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
55487	Fee-for-Service	1508379017	1508379017	1	4	TRI-STATE COMMUNITY	3/3/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	11888 BARTLETT AVE	None	ADELANTO	CA	92301	1709	36	06071	34.57927736	-117.4068692	San Bernardino County
55503	Fee-for-Service	1023031655	1023031655	1	1	TAM, MADELINE NP	10/1/2002	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2460 SAMARITAN DR	None	SAN JOSE	CA	95124	3907	43	06085	37.25105952	-121.948542	Santa Clara County
55518	Fee-for-Service	1629550918	1629550918	1	1	TOBAR, EMELY P LCSW	5/31/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5150 CANDLEWOOD ST	STE. 18J	LAKEWOOD	CA	90712	1928	19	06037	33.85362254	-118.1326815	Los Angeles County
55594	Fee-for-Service	1770690075	1770690075	1	1	THOMAS, TAMARA L MD	8/22/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63857	01	General Practice	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
55603	Fee-for-Service	1548899560	1548899560	1	1	TAKASHIMA, TIFFANY T OT	3/24/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
55673	Fee-for-Service	1053673392	1053673392	1	1	TODD, DEAN R MD	10/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129120	40	Pediatrics	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
55690	Fee-for-Service	1134296957	1134296957	1	1	TRIVEDI, NARENDRAKUMAR S	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	45186	05	Anesthesiology	0	In state provider	ATTN MGA OFFICE	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
55696	Fee-for-Service	1326329012	1326329012	1	1	TADAYON-NEJAD, REZA MD	12/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137573	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
55747	Fee-for-Service	1669434247	1669434247	1	1	THOMAS ARNOLD APPLEWHITE 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	615 S NEW BALLAS RD	None	SAINT LOUIS	MO	63141	8221	00	None	38.644902	-90.4462065	St. Louis County
55774	Fee-for-Service	1508379017	1508379017	1	4	TRI-STATE COMMUNITY	3/3/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	11888 BARTLETT AVE	None	ADELANTO	CA	92301	1709	36	06071	34.57927736	-117.4068692	San Bernardino County
55831	Fee-for-Service	1003094046	1003094046	1	1	TRAN, GENE L DO	4/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10573	13	Neurology (M.D. only)	0	In state provider	None	2701 W ALAMEDA AVE	# 202	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
55841	Fee-for-Service	1154496362	1154496362	1	1	TORABI, SARAH A CRNA	8/11/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
55861	Fee-for-Service	1033154026	1033154026	1	1	THE UNIVERSITY HOSPITAL	11/18/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	234 GOODMAN ST	None	CINCINNATI	OH	45219	2364	00	None	39.13677965	-84.5023814	Hamilton County
55908	Fee-for-Service	1174693493	1174693493	1	2	THE WECARE GROUP	8/16/2004	207Q00000X	NA	Adult Primary Care	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	321 VAN DUZEN ROAD	None	MAD RIVER	CA	95552	0004	53	06105	40.46004463	-123.5301743	Trinity County
56028	Fee-for-Service	1598876716	1598876716	1	1	TSO,SAN DO	3/23/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7328	08	Family Practice	0	In state provider	None	77 W MARCH LN	STE A	STOCKTON	CA	95207	5723	39	06077	37.99583483	-121.3064011	San Joaquin County
56053	Fee-for-Service	1104136803	1104136803	1	1	TYLER, MELINDA J MD	2/15/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	121668	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
56062	Fee-for-Service	1508379017	1508379017	1	4	TRI-STATE COMMUNITY	12/23/2022	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	MOBILE	11888 BARTLETT AVE	None	ADELANTO	CA	92301	1709	36	06071	34.57927736	-117.4068692	San Bernardino County
56070	Fee-for-Service	1013576644	1013576644	1	1	TRUONG, TIMOTHY MD	9/3/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	182560	18	Ophthalmology	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
56098	Fee-for-Service	1992292015	1992292015	1	1	TRAN, MICHELLE G DO	6/28/2023	390200000X	NA	Other	026	PHYSICIANS	21305	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
56107	Fee-for-Service	1881931897	1881931897	1	1	TIPTON, JAY I CRNA	3/18/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
56124	Fee-for-Service	1831532407	1831532407	1	1	THOMAS, SARAH S MD	6/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139193	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
56136	Fee-for-Service	1366494320	1366494320	1	1	TANASESCU, ADINA MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66943	None	None	0	In state provider	None	3810 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3302	30	06059	33.80299148	-118.0666755	Orange County
56139	Fee-for-Service	1801182860	1801182860	1	1	TABBA, LARAIB MD	7/11/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	124240	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
56152	Fee-for-Service	1033154026	1033154026	1	1	THE UNIVERSITY HOSPITAL	11/17/2001	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	234 GOODMAN ST	None	CINCINNATI	OH	45219	2364	00	None	39.13677965	-84.5023814	Hamilton County
56163	Fee-for-Service	1841268455	1841268455	1	1	TUN, KYAW MD	12/17/2007	207R00000X	NA	Other	026	PHYSICIANS	52119	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
56175	Fee-for-Service	1295800696	1295800696	1	1	TRUONG, DIEU NGA OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	14251 EUCLID ST	STE F101	GARDEN GROVE	CA	92843	4957	30	06059	33.755166	-117.937627	Orange County
56184	Fee-for-Service	1972655330	1972655330	1	1	TAKASUGI, TSUNEO MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38066	02	General Surgery	0	In state provider	MGA OFFICE	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
56187	Fee-for-Service	1619952397	1619952397	1	7	TUOLUMNE MEWUK INDIAN HEALTH	12/1/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5078 BULLION ST	STE 4	MARIPOSA	CA	95338	0000	22	06043	37.48819922	-119.967001	Mariposa County
56214	Fee-for-Service	1750336939	1750336939	1	1	TOROK, NATALIE J MD	1/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84961	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
56279	Fee-for-Service	1073905642	1073905642	1	1	TARZANA HOME HEALTH CARE	4/18/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	4869 TOPANGA CYN BLVD	SUITE 5	WOODLAND HILLS	CA	91364	4259	19	06037	34.156404	-118.605838	Los Angeles County
56332	Fee-for-Service	1821142092	1821142092	1	1	TRAN, JULIANE C MD	3/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	78400	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
56338	Fee-for-Service	1790991933	1790991933	1	1	THOMPKINS, AISHA S	1/6/2023	390200000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
56354	Fee-for-Service	1013545060	1013545060	1	1	TRAINER, MICHAEL MD	5/28/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	190124	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
56458	Fee-for-Service	1710369376	1710369376	1	1	TSARUMI, OMOTOLA	1/19/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	190998	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
56467	Fee-for-Service	1265562334	1265562334	1	1	TURNER, SUEBETH	5/14/2018	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	3458 LOMA VISTA RD	None	VENTURA	CA	93003	3026	56	06111	34.27656239	-119.2494074	Ventura County
56477	Fee-for-Service	1619952397	1619952397	1	7	TUOLUMNE MEWUK INDIAN HEALTH	12/1/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5078 BULLION ST	STE 4	MARIPOSA	CA	95338	0000	22	06043	37.48819922	-119.967001	Mariposa County
56478	Fee-for-Service	1073810180	1073810180	1	1	TRANSITIONS HOME HEALTH INC	12/19/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	23601 S AVALON	SUITE 207	CARSON	CA	90745	5520	19	06037	33.81087947	-118.2641079	Los Angeles County
56482	Fee-for-Service	1992333009	1992333009	1	1	TOM, MICHELE PT	1/27/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
56487	Fee-for-Service	1790746147	1790746147	1	1	TANG, KIM T MD	3/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78563	None	None	0	In state provider	None	24432 MUIRLANDS BLVD	STE 219	LAKE FOREST	CA	92630	3939	30	06059	33.62755212	-117.7028876	Orange County
56498	Fee-for-Service	1578593232	1578593232	1	3	TIERNEY, SEAN M DO	1/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	10991	66	Emergency Medicine (Urgent Care)	0	In state provider	None	800 E WASHINGTON BLVD	None	CRESCENT CITY	CA	95531	8359	08	06015	41.77272521	-124.1940494	Del Norte County
56508	Fee-for-Service	1952805384	1952805384	1	1	TRUONG, JENNY MD	10/11/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164393	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
56513	Fee-for-Service	1942555818	1942555818	1	1	TAI, AUDREY X DO	3/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14322	18	Ophthalmology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	4091	30	06059	33.78674051	-117.8888713	Orange County
56519	Fee-for-Service	1851331656	1851331656	1	1	TANYA SKAGER	12/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2615 FAIRWAY ST	None	DICKINSON	ND	58601	2590	00	None	46.88685143	-102.8241973	Stark County
56566	Fee-for-Service	1073905642	1073905642	1	1	TARZANA HOME HEALTH CARE	4/18/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	4869 TOPANGA CYN BLVD	SUITE 5	WOODLAND HILLS	CA	91364	4259	19	06037	34.156404	-118.605838	Los Angeles County
56575	Fee-for-Service	1841399516	1841399516	1	1	TILTON, ZOE A MD	7/25/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	83270	None	None	0	In state provider	None	475 PIONEER AVE	STE 400	WOODLAND	CA	95776	4905	57	06113	38.67357823	-121.7456787	Yolo County
56576	Fee-for-Service	1780878132	1780878132	1	1	TAFT, BONNIE P NP	8/1/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
56583	Fee-for-Service	1891299400	1891299400	1	1	TRIEU, MEGAN B MD	3/5/2021	207R00000X	NA	Other	026	PHYSICIANS	165428	None	None	0	In state provider	None	200 MEDICAL PLAZA	565	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
56599	Fee-for-Service	1154421089	1154421089	1	1	TANG, FRANK Q MD	7/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	38063	01	General Practice	0	In state provider	None	40690 CALIF OAKS RD	STE A	MURRIETA	CA	92562	5857	33	06065	33.57085341	-117.2044062	Riverside County
56608	Fee-for-Service	1437347721	1437347721	1	1	THE FRESNO CENTER	7/28/2020	2084P0800X	NA	Psychiatry	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	4855 E KINGS CANYON RD	None	FRESNO	CA	93727	3811	10	06019	36.73603005	-119.7335333	Fresno County
56648	Fee-for-Service	1235333030	1235333030	1	1	TSAI, KALYN DO	12/5/2007	207R00000X	NA	Other	026	PHYSICIANS	9344	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
56650	Fee-for-Service	1871509166	1871509166	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05456	11321 NATIONAL BLVD	None	LOS ANGELES	CA	90064	3726	19	06037	34.02568457	-118.4326115	Los Angeles County
56693	Fee-for-Service	1134634124	1134634124	1	1	TODRANK, KARA J	2/9/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
56705	Fee-for-Service	1619125481	1619125481	1	1	TUERK, MELANIE J MD	8/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105442	07	Dermatology	0	In state provider	None	2120 PROFESSIONAL DR	None	ROSEVILLE	CA	95661	3700	31	06061	38.74247397	-121.2508672	Placer County
56714	Fee-for-Service	1962799916	1962799916	1	1	TILTON, NICOLE M	9/13/2011	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
56761	Fee-for-Service	1679770564	1679770564	1	1	TRUONG, TUAN-ANH T MD	9/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	81454	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELL FLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
56778	Fee-for-Service	1013080050	1013080050	2	1	TX HEALTHCARE INC	9/21/2023	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1120 S. SHAMROCK AVE	UNIT A	MONROVIA	CA	91016	4242	19	06037	34.13980476	-117.9907497	Los Angeles County
56782	Fee-for-Service	1942578208	1942578208	1	1	TAMERAT, MARIAMAWIT MD	8/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118870	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
56838	Fee-for-Service	1548399207	1548399207	1	1	TSE, KAM-NIN	2/1/2008	1041C0700X	NA	Mental Health Outpatient Services	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	11721A TELEGRAPH RD	None	SANTA FE SPRINGS	CA	90048	6835	19	06037	33.94636792	-118.0833735	Los Angeles County
56885	Fee-for-Service	1003104035	1003104035	1	1	TANG, LAUREN NGHIA O D INC	9/13/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10440 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	1812	33	06065	33.91038747	-117.4638633	Riverside County
56892	Fee-for-Service	1154421089	1154421089	1	1	TANG, FRANK Q MD	7/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	38063	40	Pediatrics	0	In state provider	None	40690 CALIF OAKS RD	STE A	MURRIETA	CA	92562	5857	33	06065	33.57085341	-117.2044062	Riverside County
56893	Fee-for-Service	1336444702	1336444702	1	1	TONKABONI, DARIUSH H MD INC	9/2/2014	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	101281	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5524 ASSEMBLY COURT	None	SACRAMENTO	CA	95823	5422	34	06067	38.493306	-121.4392995	Sacramento County
56897	Fee-for-Service	1588310577	1588310577	1	1	TLCS, INC.	1/9/2025	251X00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	650 HOWE AVE.	BLDG. 400-A	SACRAMENTO	CA	95825	4732	34	06067	38.577294	-121.4146395	Sacramento County
56927	Fee-for-Service	1083315071	1083315071	1	1	TWELVE STARS INC	9/25/2024	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	9158 FLETCHER PARKWAY	None	LA MESA	CA	91942	3449	37	06073	32.79375522	-117.0022445	San Diego County
56954	Fee-for-Service	1336644749	1336644749	1	1	THOMAS, HORATIO R MD	9/12/2023	2085R0001X	NA	Other	026	PHYSICIANS	167000	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
56955	Fee-for-Service	1174984058	1174984058	1	1	THAUT, LANE C DO	10/11/2019	207P00000X	NA	Other	026	PHYSICIANS	17163	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1325 COTTONWOOD ST	None	WOODLAND	CA	95695	5131	57	06113	38.664027	-121.7933505	Yolo County
56975	Fee-for-Service	1659320497	1659320497	1	1	TWEED, ROSEMARIE DO	2/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	5397	40	Pediatrics	0	In state provider	None	14114 BUSINESS CENTER DR	STE A	MORENO VALLEY	CA	92553	9113	33	06065	33.9148002	-117.2714647	Riverside County
57002	Fee-for-Service	1639556228	1639556228	1	1	TENG, JUSTIN J MD	6/21/2019	390200000X	NA	Other	026	PHYSICIANS	147113	05	Anesthesiology	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
57005	Fee-for-Service	1982876785	1982876785	1	1	TRAN, HOAN V MD	11/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108850	10	Gastroenterology (M.D. only)	0	In state provider	None	111 RALEY BLVD	STE 100	CHICO	CA	95928	8347	04	06007	39.71601447	-121.790817	Butte County
57049	Fee-for-Service	1619295516	1619295516	1	1	TANDEM DIABETES CARE INC	8/4/2014	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	12400 HIGH BLUFF DR	None	SAN DIEGO	CA	92130	3077	37	06073	32.94419855	-117.2401999	San Diego County
57050	Fee-for-Service	1467615252	1467615252	2	1	THOMPSON, COLIN MD	5/2/2024	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
57068	Fee-for-Service	1174059505	1174059505	1	1	TALLEY, JULIA MD	3/12/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	187370	None	None	0	In state provider	None	119 S LOCUST ST	STE B	VISALIA	CA	93291	6251	54	06107	36.329382	-119.2937355	Tulare County
57069	Fee-for-Service	1063416493	1063416493	1	1	TEMPLEMAN, CLAIRE L MD	5/8/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79071	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
57074	Fee-for-Service	1679521280	1679521280	1	1	TONNU, ANH T OD	9/1/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	207 S SANTA ANITA ST	SUITE P-25	SAN GABRIEL	CA	91776	1145	19	06037	34.10072807	-118.1066296	Los Angeles County
57115	Fee-for-Service	1285620443	1285620443	2	1	TSAI, WILLIAM T DO	9/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	7115	08	Family Practice	0	In state provider	None	4950 SAN BERNARDINO ST	STE 218	MONTCLAIR	CA	91763	2328	36	06071	34.07768363	-117.6968874	San Bernardino County
57145	Fee-for-Service	1710193651	1710193651	1	1	TSENG, TOM S OD	9/2/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
57164	Fee-for-Service	1437226255	1437226255	1	1	TSAI, SHI-CHIN Y MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66790	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
57207	Fee-for-Service	1114284718	1114284718	1	1	THOR, JANA A DO	9/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11303	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1700 MOUNT VERNON AVENUE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
57225	Fee-for-Service	1730421579	1730421579	1	1	TRUSCOTT, LAUREL C MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124649	68	Hematology	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
57230	Fee-for-Service	1063696318	1063696318	1	1	TRADER, ANDREA C MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	87561	40	Pediatrics	0	In state provider	None	23 MAIN STREET	None	WINTERS	CA	95694	0674	57	06113	38.52163272	-121.9695765	Yolo County
57247	Fee-for-Service	1720405491	1720405491	1	4	TIBURCIO VASQUEZ HEALTH	2/2/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	19682 HESPERIAN BLVD	STE 101	HAYWARD	CA	94541	4752	01	06001	37.66812177	-122.1194688	Alameda County
57263	Fee-for-Service	1568705481	1568705481	1	1	THAO, LONG MD INC	5/6/2013	193400000X	NA	Other	026	PHYSICIANS	66867	08	Family Practice	0	In state provider	None	700 W OLIVE AVE	STE A	MERCED	CA	95348	2435	24	06047	37.31918006	-120.480202	Merced County
57273	Fee-for-Service	1992978753	1992978753	1	1	TREVOR SQUIRE	5/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4403 HARRISON BLVD	STE 300	OGDEN	UT	84403	3271	00	None	41.18328	-111.9536955	Weber County
57292	Fee-for-Service	1578943858	1578943858	1	1	THOMAS, GREGORY S DO	8/18/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16347	None	None	0	In state provider	None	8851 CENTER DR	STE 500	LA MESA	CA	91942	3033	37	06073	32.78189749	-117.0075062	San Diego County
57363	Fee-for-Service	1154472785	1154472785	1	1	THAYAPRAN, NALLATHAMBY MD	3/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66442	41	Internal Medicine	0	In state provider	INC	240 N PORTER RD	None	PORTERVILLE	CA	93257	3140	54	06107	36.07029982	-119.0391103	Tulare County
57369	Fee-for-Service	1720211519	1720211519	1	1	THAO, CHANG LCSW	2/23/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	73274	-	NOT APPLICABLE	0	In state provider	None	1352 COLUSA HWY	SUITE C	YUBA CITY	CA	95993	9147	51	06101	39.14177255	-121.635963	Sutter County
57379	Fee-for-Service	1992992986	1992992986	1	1	TEAGUE, WILLIAM E MD	7/9/2008	207P00000X	NA	Other	026	PHYSICIANS	101738	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 HOSPITAL RD	None	STOCKTON	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
57392	Fee-for-Service	1972159986	1972159986	1	1	THE ALLIANCE FOR COMMUNITY W	8/9/2024	251S00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	875 GEER RD	None	TURLOCK	CA	95380	3311	50	06099	37.50143162	-120.8489859	Stanislaus County
57428	Fee-for-Service	1043250145	1043250145	1	1	TANGHETTI, EMIL A MD	3/31/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	35422	07	Dermatology	0	In state provider	None	5601 J ST	None	SACRAMENTO	CA	95819	3948	34	06067	38.564901	-121.4344755	Sacramento County
57449	Fee-for-Service	1457662793	1457662793	1	1	TARNEJA, NEEL K MD	9/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130709	05	Anesthesiology	0	In state provider	None	3828 DELMAS TER	None	CULVER CITY	CA	90232	2713	19	06037	34.02308948	-118.3972101	Los Angeles County
57496	Fee-for-Service	1811006513	1811006513	1	1	TANDON, SHOBHA MD INC	12/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53643	18	Ophthalmology	0	In state provider	NEOVISION EYE CENTER	2500 HOSPITAL DR	STE 11	MOUNTAIN VIEW	CA	94040	4106	43	06085	37.36908	-122.081819	Santa Clara County
57510	Fee-for-Service	1295153930	1295153930	1	1	TRAVINSKY, BRIDGIT A MD	12/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140544	41	Internal Medicine	0	In state provider	None	5900 STATE FARM DR	None	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
57513	Fee-for-Service	1730421579	1730421579	1	1	TRUSCOTT, LAUREL C MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124649	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
57536	Fee-for-Service	1336309681	1336309681	1	1	TOOR, ASHISH MD	6/5/2009	207W00000X	NA	Ophthalmology	026	PHYSICIANS	106909	18	Ophthalmology	0	In state provider	None	3085 LOMA VISTA RD	None	VENTURA	CA	93003	2916	56	06111	34.2757721	-119.2550726	Ventura County
57537	Fee-for-Service	1720405491	1720405491	1	4	TIBURCIO VASQUEZ HEALTH	2/2/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	19682 HESPERIAN BLVD	STE 101	HAYWARD	CA	94541	4752	01	06001	37.66812177	-122.1194688	Alameda County
57545	Fee-for-Service	1427008028	1427008028	1	1	TOW-DER, ESTHER J MD	8/4/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	58918	None	None	0	In state provider	None	830 SCENIC DR	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
57602	Fee-for-Service	1184735391	1184735391	1	1	TAYLOR, JENNIFER M CNM	5/17/2022	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
57650	Fee-for-Service	1154472785	1154472785	1	1	THAYAPRAN, NALLATHAMBY MD	3/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66442	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	240 N PORTER RD	None	PORTERVILLE	CA	93257	3140	54	06107	36.07029982	-119.0391103	Tulare County
57725	Fee-for-Service	1154315828	1154315828	1	1	TANTAM MEDICAL GRP, INC	4/3/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	12555 GARDEN GROVE BLVD	STE 504	GARDEN GROVE	CA	92843	1903	30	06059	33.77450946	-117.913041	Orange County
57733	Fee-for-Service	1659870186	1659870186	1	1	TODD, SHANNON C CNP	6/1/2022	363LF0000X	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
57749	Fee-for-Service	1295701605	1295701605	1	1	TROUP, BRUCE N MD	10/31/1984	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	45104	30	Radiology	0	In state provider	None	1000 TRANCAS ST	None	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
57758	Fee-for-Service	1093290470	1093290470	1	1	TALAMI HEALTH CARE LLC	10/26/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 N HIGHLANDS AVE	SUITE E, F, G	NATIONAL CITY	CA	91950	1400	37	06073	32.68628093	-117.101769	San Diego County
57761	Fee-for-Service	1447501507	1447501507	1	1	TESSEMA, SINAFIKISH T	10/29/2014	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8554 LA MESA BLVD	None	LA MESA	CA	91942	9558	37	06073	32.76889956	-117.0129515	San Diego County
57795	Fee-for-Service	1265849475	1265849475	1	1	TRAN, TRUYET T OD	3/10/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
57796	Fee-for-Service	1114287331	1114287331	1	1	TON, DAVID R MD	5/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129309	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
57801	Fee-for-Service	1003499229	1003499229	1	1	TANUDJAJA, EDWARD MD	8/25/2024	207R00000X	NA	Other	026	PHYSICIANS	22406	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
57803	Fee-for-Service	1730421579	1730421579	1	1	TRUSCOTT, LAUREL C MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124649	78	Neoplastic Diseases/Oncology	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
57843	Fee-for-Service	1649424482	1649424482	1	1	TRUONG, JACQUELINE B DPM	1/19/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	309 E SECOND STREET	None	POMONA	CA	91766	1854	19	06037	34.05789396	-117.7476284	Los Angeles County
57860	Fee-for-Service	1871007617	1871007617	1	1	TOTAL RENAL CARE INC	5/2/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	400 N PALM AVE	None	WASCO	CA	93280	7610	15	06029	35.60310444	-119.3491867	Kern County
57874	Fee-for-Service	1598874901	1598874901	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5514	28100 S WESTERN AVE	None	SAN PEDRO	CA	90732	1248	19	06037	33.76411455	-118.3112108	Los Angeles County
57917	Fee-for-Service	1144654914	1144654914	1	1	TORRICER, HILARION TOLOSA P	8/3/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	T	8800 STOCKDALE HWY	150	BAKERSFIELD	CA	93311	1012	15	06029	35.35448783	-119.0995578	Kern County
57938	Fee-for-Service	1154472785	1154472785	1	1	THAYAPRAN, NALLATHAMBY MD	3/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66442	01	General Practice	0	In state provider	INC	240 N PORTER RD	None	PORTERVILLE	CA	93257	3140	54	06107	36.07029982	-119.0391103	Tulare County
57946	Fee-for-Service	1053310524	1053310524	1	1	TUPPO, EHAB E DO	12/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	7807	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
57973	Fee-for-Service	1992427512	1992427512	1	1	TOOR, HARVINDER S PT	10/10/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	23100 EUCALYPTUS AVE	SUITE C	MORENO VALLEY	CA	92553	5439	33	06065	33.93157977	-117.2598359	Riverside County
57986	Fee-for-Service	1396408761	1396408761	1	1	TACA, GREGORIO J	12/27/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	6000 FAIRWAY DR	STE 2	ROCKLIN	CA	95677	4244	31	06061	38.79220243	-121.2621624	Placer County
58058	Fee-for-Service	1174693493	1174693493	1	6	THE WECARE GROUP	10/10/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	115 MAIN STREET	None	SCOTIA	CA	95565	0000	12	06023	40.48420844	-124.1019968	Humboldt County
58157	Fee-for-Service	1366708802	1366708802	1	1	TAEFI, AMIR MD	12/16/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	142016	10	Gastroenterology (M.D. only)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
58180	Fee-for-Service	1043398886	1043398886	1	1	TEJARAHADI, INE M MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81558	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
58223	Fee-for-Service	1285006338	1285006338	1	1	TORRES-NESS, CRAIG R MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138641	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
58248	Fee-for-Service	1013546605	1013546605	1	1	TENCATI, MICHAEL J MD	3/6/2024	207R00000X	NA	Other	026	PHYSICIANS	186252	None	None	0	In state provider	None	1010 MURRAY AVE	None	SAN LUIS OBISPO	CA	93405	1806	40	06079	35.292168	-120.6658665	San Luis Obispo County
58264	Fee-for-Service	1891834461	1891834461	1	1	TONKIN, LEAH C MD	6/17/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	103822	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
58291	Fee-for-Service	1760619787	1760619787	1	1	TURGASEN, SARAH E MD	1/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113784	41	Internal Medicine	0	In state provider	None	4600 BROADWAY	STE 1100	SACRAMENTO	CA	95820	1527	34	06067	38.546127	-121.452669	Sacramento County
58295	Fee-for-Service	1366568750	1366568750	1	1	TAYLOR, LEILANI RN	10/28/1998	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	95	Registered nurse	0	In state provider	None	1160 EL SOLYO HEIGHTS DR	None	FELTON	CA	95018	9307	44	06087	37.07004806	-122.092673	Santa Cruz County
58306	Fee-for-Service	1831129543	1831129543	1	1	THERAPEUTIC RADIOLOGY	3/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MED ASSOCIATES, INC	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
58328	Fee-for-Service	1134418106	1134418106	1	1	TAPIA, LUCIA MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	84385	-	NOT APPLICABLE	0	In state provider	None	15305 RAYEN STREET	None	NORTH HILLS	CA	91343	5117	19	06037	34.23191048	-118.4657625	Los Angeles County
58345	Fee-for-Service	1174693493	1174693493	1	6	THE WECARE GROUP	10/10/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	115 MAIN STREET	None	SCOTIA	CA	95565	0000	12	06023	40.48420844	-124.1019968	Humboldt County
58355	Fee-for-Service	1477189421	1477189421	1	1	TAYLOR, KATHLEEN MD	10/22/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	189391	40	Pediatrics	0	In state provider	None	15975 HARBOR BOULEVARD	None	FOUNTAIN VALLEY	CA	92708	1303	30	06059	33.73140379	-117.9200162	Orange County
58361	Fee-for-Service	1558858928	1558858928	1	1	TORIO, NERISSA S CNP	1/24/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
58380	Fee-for-Service	1538588991	1538588991	1	1	TALEBI LIASI, AMIR H MD	7/11/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	139634	30	Radiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
58419	Fee-for-Service	1790869139	1790869139	1	1	TATE, ERIC M MD	1/22/2004	173000000X	NA	Other	026	PHYSICIANS	75199	None	None	0	In state provider	OASIS CARE MEDICAL GROUP	16660 S PARAMOUNT BLVD	SUITE 205	PARAMOUNT	CA	90723	5458	19	06037	33.882723	-118.1599535	Los Angeles County
58448	Fee-for-Service	1356391387	1356391387	1	1	TEAL,KEVIN R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	624 MATLOCK CENTER	CIRCLE	ARLINGTON	TX	76015	0000	00	None	32.70201291	-97.11436506	Tarrant County
58461	Fee-for-Service	1669829891	1669829891	1	1	TOBIN, ANASTACIA C LMFT	5/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92106	9001	37	06073	32.7537975	-117.1658298	San Diego County
58488	Fee-for-Service	1437111275	1437111275	1	1	TESSLER, LEAH F MD	11/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	52654	41	Internal Medicine	0	In state provider	None	1600 DIVISADERO AVE	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.78475261	-122.43973	San Francisco County
58497	Fee-for-Service	1831398346	1831398346	1	1	TAMAR-MATTIS, SUEGEE	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10413	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
58506	Fee-for-Service	1376610220	1376610220	1	1	TOLBERT, LINDA D MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	62804	07	Dermatology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
58520	Fee-for-Service	1730649146	1730649146	1	1	TRAN, GEORGE N MD	4/25/2022	207R00000X	NA	Other	026	PHYSICIANS	177621	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
58535	Fee-for-Service	1649290107	1649290107	1	1	THE SAN JOAQUIN ORTHOTICS AN	5/17/2021	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ND PROSTHETICS CORPORATI	2211 N CALIFORNIA ST	None	STOCKTON	CA	95204	5503	39	06077	37.97379136	-121.2903686	San Joaquin County
58547	Fee-for-Service	1104350370	1104350370	1	1	TUGIZOVA, MADINA S MD	10/14/2021	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	158315	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
58572	Fee-for-Service	1720474547	1720474547	1	1	TRUONG, AN T PT	7/4/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1721 TECHNOLOGY DR	None	SAN JOSE	CA	95110	1305	43	06085	37.36464282	-121.9163895	Santa Clara County
58583	Fee-for-Service	1366568750	1366568750	1	1	TAYLOR, LEILANI RN	11/3/2016	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1160 EL SOLYO HEIGHTS DR	None	FELTON	CA	95018	9307	44	06087	37.07004806	-122.092673	Santa Cruz County
58595	Fee-for-Service	1407934300	1407934300	1	1	TEJADA, FELIXBERTO C MD	8/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	67845	40	Pediatrics	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
58596	Fee-for-Service	1831129543	1831129543	1	1	THERAPEUTIC RADIOLOGY	3/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	MED ASSOCIATES, INC	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
58623	Fee-for-Service	1669768867	1669768867	1	1	TOY, ALISON L NP	11/10/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43112 N 15TH STREET W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
58646	Fee-for-Service	1578177630	1578177630	1	1	TIRTADINATA, WILBERT CRNA	6/2/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
58665	Fee-for-Service	1215969787	1215969787	1	1	TENET HOSPITALS LIMITED	7/19/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1625 MEDICAL CENTER ST	None	EL PASO	TX	79902	5044	00	None	31.778163	-106.4797289	El Paso County
58673	Fee-for-Service	1528084522	1528084522	1	1	TAYLOR, WILLIAM R MD	9/1/1993	207T00000X	NA	General Surgery	026	PHYSICIANS	72205	14	Neurological Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
58727	Fee-for-Service	1942374905	1942374905	1	1	TAI, KENNETH B MD	5/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91670	None	None	0	In state provider	None	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
58736	Fee-for-Service	1679682009	1679682009	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 6028	490 S MAIN ST	None	FORT BRAGG	CA	95437	4806	23	06045	39.43683704	-123.8060282	Mendocino County
58781	Fee-for-Service	1134792245	1134792245	1	1	TEHRAN, SAGHI NP	1/31/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
58785	Fee-for-Service	1104807239	1104807239	1	1	TIERNEY, ELIF S S MD	5/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54453	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
58817	Fee-for-Service	1023166907	1023166907	1	1	TIRIVEEDHI, PAVANA K MD	9/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87564	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
58916	Fee-for-Service	1407806086	1407806086	1	1	THIPPESWAMY, GEETHA B MD	6/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85061	40	Pediatrics	0	In state provider	None	10430 S DE ANZA BLVD	STE 130	CUPERTINO	CA	95014	3024	43	06085	37.3172651	-122.0321678	Santa Clara County
58917	Fee-for-Service	1356665905	1356665905	1	1	TRIVEDI, JANKI MD	6/10/2020	207RR0500X	NA	Other	026	PHYSICIANS	138148	83	Rheumatology	0	In state provider	None	29798 HAUN RD	SUITE 301	MENIFEE	CA	92586	6542	33	06065	33.68787713	-117.1748638	Riverside County
58919	Fee-for-Service	1710504022	1710504022	1	1	TENNI-MOC'S SHOE STORE INC	3/27/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ORTHICS	6536 E SPRING ST	None	LONG BEACH	CA	90815	1554	19	06037	33.81038548	-118.105677	Los Angeles County
58952	Fee-for-Service	1215969787	1215969787	1	1	TENET HOSPITALS LIMITED	5/1/1999	282NC2000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1625 MEDICAL CENTER ST	None	EL PASO	TX	79902	5044	00	None	31.778163	-106.4797289	El Paso County
59030	Fee-for-Service	1770638033	1770638033	1	1	TAM, THOMAS MD	11/25/1975	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	24893	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	455 N GARFIELD AVE	STE 101	MONTEREY PARK	CA	91754	1201	19	06037	34.06718186	-118.122919	Los Angeles County
59043	Fee-for-Service	1497924872	1497924872	1	1	TSE, HERMAN HO-YU MD	3/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	98848	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
59053	Fee-for-Service	1447261813	1447261813	1	1	THRIFTY DRUG STORE 5772	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	2738 E THOMPSON BLVD	None	VENTURA	CA	93003	2719	56	06111	34.270812	-119.2601745	Ventura County
59065	Fee-for-Service	1336356690	1336356690	1	1	TERRACINA MEDICAL CLINIC INC	3/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	6584	08	Family Practice	0	In state provider	None	34636 COUNTY LINE RD	STE 32	YUCAIPA	CA	92399	5393	36	06071	34.00425906	-117.0494049	San Bernardino County
59086	Fee-for-Service	1205126695	1205126695	1	1	TEMPLE, BLISS M MD	7/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126249	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
59175	Fee-for-Service	1457458606	1457458606	1	1	TWETEN, SCOTT D MD	5/31/1995	207L00000X	NA	Other	026	PHYSICIANS	51903	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
59188	Fee-for-Service	1063726297	1063726297	1	1	TUCKER, ALLISON L PT	8/22/2018	225100000X	NA	Physical Therapist	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
59195	Fee-for-Service	1619756533	1619756533	1	1	THOMPSON, LATRESE L LPCC	12/6/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
59224	Fee-for-Service	1437481942	1437481942	1	1	TOMAN, JEFFREY R, MD PC	2/15/2013	208C00000X	NA	General Surgery	026	PHYSICIANS	83995	02	General Surgery	0	In state provider	None	4060 FOURTH AVE	SUITE 510	SAN DIEGO	CA	92103	2121	37	06073	32.75053673	-117.1616539	San Diego County
59239	Fee-for-Service	1932795325	1932795325	1	1	TITUS HOSPICE INC	9/19/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14621 TITUS ST	STE 120	PANORAMA CITY	CA	91402	4904	19	06037	34.21972652	-118.451799	Los Angeles County
59257	Fee-for-Service	1891442232	1891442232	1	1	TANAKA, MARIE L PHD	11/17/2024	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
59266	Fee-for-Service	1770675043	1770675043	1	1	THAPA, MAHESH M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CHILDREN'S UNIV MED GRP	4500 SAND POINT WAY NE,	#100	SEATTLE	WA	98105	0000	00	None	47.66165594	-122.2864502	King County
59294	Fee-for-Service	1619220456	1619220456	1	1	TRUONG, ALBERT MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117538	05	Anesthesiology	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4378	43	06085	37.36893518	-122.0779448	Santa Clara County
59295	Fee-for-Service	1396893228	1396893228	1	1	THORPE, RUTH A CNM	10/21/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4650 PALM AVE	None	SAN DIEGO	CA	92154	7914	37	06073	32.5839467	-117.0337851	San Diego County
59318	Fee-for-Service	1770638033	1770638033	1	1	TAM, THOMAS MD	11/25/1975	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	24893	01	General Practice	0	In state provider	None	455 N GARFIELD AVE	STE 101	MONTEREY PARK	CA	91754	1201	19	06037	34.06718186	-118.122919	Los Angeles County
59351	Fee-for-Service	1750487401	1750487401	1	1	TANG, STEPHEN MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	45947	40	Pediatrics	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
59411	Fee-for-Service	1568432128	1568432128	1	1	THOMAS, RENEE MD	2/15/2024	207ZP0102X	NA	Other	026	PHYSICIANS	135193	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
59471	Fee-for-Service	1467561985	1467561985	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5817	8000 WHITE LN	None	BAKERSFIELD	CA	93309	7688	15	06029	35.31836801	-119.0909013	Kern County
59500	Fee-for-Service	1295781029	1295781029	1	1	TRAN, ANDY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3805 E BELL RD	STE 3100	PHOENIX	AZ	85032	2136	00	None	33.640038	-112.000023	Maricopa County
59515	Fee-for-Service	1669587614	1669587614	1	1	THOMAS, MARK E.	5/31/1989	207P00000X	NA	Other	026	PHYSICIANS	5977	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
59529	Fee-for-Service	1932795325	1932795325	1	1	TITUS HOSPICE INC	9/19/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14621 TITUS ST	STE 120	PANORAMA CITY	CA	91402	4904	19	06037	34.21972652	-118.451799	Los Angeles County
59532	Fee-for-Service	1336392778	1336392778	1	1	TAMAMIAN, SUSHANA R PSYD	7/4/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
59548	Fee-for-Service	1477918670	1477918670	1	1	TRUONG, PHILIP D CRNA	12/28/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
59558	Fee-for-Service	1295364545	1295364545	1	1	TALEGHANI, SOPHIA MD	9/27/2023	208M00000X	NA	Other	026	PHYSICIANS	189103	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
59592	Fee-for-Service	1174055008	1174055008	1	1	TSYGANOVSKIY, EUGENE MD	8/24/2020	390200000X	NA	Other	026	PHYSICIANS	169604	41	Internal Medicine	0	In state provider	None	15107 VANOWEN STREET	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
59594	Fee-for-Service	1992906093	1992906093	1	1	T JOSEPH RAOOF MD INC	9/1/2009	207R00000X	NA	Other	026	PHYSICIANS	42698	41	Internal Medicine	0	In state provider	None	16133 VENTURA BLVD	STE 340	ENCINO	CA	91436	2426	19	06037	34.15656164	-118.4849569	Los Angeles County
59644	Fee-for-Service	1619101862	1619101862	1	1	TADEPALLI, RAGHAV MD	10/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132784	05	Anesthesiology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
59649	Fee-for-Service	1235405150	1235405150	1	1	TATE, TYLER P MD	10/29/2024	2080H0002X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
59660	Fee-for-Service	1679936264	1679936264	1	1	TRUONG, ALAN A MD	2/4/2021	207R00000X	NA	Other	026	PHYSICIANS	161623	None	None	0	In state provider	None	2261 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	3831	31	06061	38.74434897	-121.2413247	Placer County
59714	Fee-for-Service	1285785915	1285785915	1	1	THAANUM, MICHAEL J OD	8/12/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	STE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
59719	Fee-for-Service	1386197267	1386197267	1	1	THE BEACON HOUSE ASSOCIATION	3/27/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	OF SAN PEDRO	132 W 10TH ST	None	SAN PEDRO	CA	90731	3702	19	06037	33.73515384	-118.2811376	Los Angeles County
59726	Fee-for-Service	1841550217	1841550217	1	1	TSAO, SEAN W MD	5/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128498	18	Ophthalmology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
59749	Fee-for-Service	1861807885	1861807885	1	1	TAICHI IMAMURA MD	5/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
59807	Fee-for-Service	1881005809	1881005809	1	1	THEETHA KARIYANNA, PRAMOD M	1/17/2023	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	183121	None	None	0	In state provider	D	8330 RED OAK ST	101	RANCHO CUCAMONGA	CA	91730	0602	36	06071	34.10217525	-117.5693231	San Bernardino County
59829	Fee-for-Service	1760944300	1760944300	1	1	TARIQ, FARZAD MD	5/5/2022	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	355 E. 21ST STREET	SUITE G	SAN BERNARDINO	CA	92404	4836	36	06071	34.13404548	-117.2779515	San Bernardino County
59836	Fee-for-Service	1992814438	1992814438	1	1	THRIFTY PAYLESS INC	9/8/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6049	6661 AUBURN BLVD	None	CITRUS HEIGHTS	CA	95621	4925	34	06067	38.687787	-121.309398	Sacramento County
59856	Fee-for-Service	1821165739	1821165739	1	1	THOMPSON, TRACEY L MD	4/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75559	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
59925	Fee-for-Service	1629279740	1629279740	1	1	TONG, MELISSA G MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115765	18	Ophthalmology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
59932	Fee-for-Service	1437181658	1437181658	1	1	TAKAGI, ANDY DC	2/8/2015	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1506 BROOKHOLLOW DR	STE 114	SANTA ANA	CA	92705	5405	30	06059	33.71447756	-117.8498351	Orange County
59964	Fee-for-Service	1033204011	1033204011	2	1	TRAN, DUC NGOC DO	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	6642	01	General Practice	0	In state provider	None	9091 EDINGER AVE	SUITE A	WESTMINSTER	CA	92683	7458	30	06059	33.73034951	-117.9706005	Orange County
59967	Fee-for-Service	1821583774	1821583774	1	1	THUMMA, PRIYA R DO	10/14/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18042	None	None	0	In state provider	None	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
59998	Fee-for-Service	1366777906	1366777906	1	1	TATE DE LARA, ASHLEY PHD	9/28/2010	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
60041	Fee-for-Service	1720197254	1720197254	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2819 HOPYARD RD	None	PLEASANTON	CA	94588	5241	01	06001	37.67509992	-121.8956894	Alameda County
60057	Fee-for-Service	1326495219	1326495219	1	1	TODAI, JANVI MD	1/16/2021	207R00000X	NA	Other	026	PHYSICIANS	163275	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
60069	Fee-for-Service	1447367792	1447367792	1	1	TRUNEH, WAYNEAB MD	8/31/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80858	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
60086	Fee-for-Service	1023315074	1023315074	1	1	TOWER IMAGING MEDICAL	12/19/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2302	19	06037	34.02980528	-118.4786605	Los Angeles County
60141	Fee-for-Service	1407141609	1407141609	1	1	TEGEGNE, MENBEREMEDHIN A NP	12/22/2023	364SP0808X	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
60146	Fee-for-Service	1396342887	1396342887	1	1	TRIFINITY HOSPICE INC	5/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1701 W BURBANK BLVD	STE 204	BURBANK	CA	91506	1323	19	06037	34.18152614	-118.3298732	Los Angeles County
60148	Fee-for-Service	1508337387	1508337387	1	1	TRAN, VICTORIA N CNP	8/17/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2510 EL CAMINO REAL	None	CARLSBAD	CA	92008	1273	37	06073	33.17942276	-117.3266425	San Diego County
60155	Fee-for-Service	1336625318	1336625318	1	1	THIESEN, TIMOTHY J CNP	6/21/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	54	06107	36.327888	-119.294919	Tulare County
60200	Fee-for-Service	1104216571	1104216571	1	1	THRIFTY PAYLESS INC	12/21/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13460 HIGHLANDS PLACE	None	SAN DIEGO	CA	92130	2401	37	06073	32.9611611	-117.1903828	San Diego County
60247	Fee-for-Service	1053569095	1053569095	1	1	TARRADATH, STACY T MD	2/25/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	114688	08	Family Practice	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
60254	Fee-for-Service	1851317853	1851317853	1	1	TULLY, RICHARD J MD	5/30/1990	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	23737	30	Radiology	0	In state provider	None	28115 BRADLEY RD	None	SUN CITY	CA	92586	2276	33	06065	33.71356664	-117.1905531	Riverside County
60267	Fee-for-Service	1588217095	1588217095	1	1	TRUONG ANESTHESIA INC	10/31/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
60385	Fee-for-Service	1699745489	1699745489	1	1	TANG, HANK K MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	54078	05	Anesthesiology	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
60386	Fee-for-Service	1699112482	1699112482	1	1	THOMASON, BENTLEY J M MD	12/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133000	01	General Practice	0	In state provider	None	1165 MONTGOMERY DRIVE	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
60434	Fee-for-Service	1396342887	1396342887	1	1	TRIFINITY HOSPICE INC	5/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1701 W BURBANK BLVD	STE 204	BURBANK	CA	91506	1323	19	06037	34.18152614	-118.3298732	Los Angeles County
60463	Fee-for-Service	1851337620	1851337620	1	1	THE VONS COMPANIES INC	5/9/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3520 RIVERSIDE PLAZA DR	None	RIVERSIDE	CA	92506	2723	33	06065	33.954687	-117.389529	Riverside County
60474	Fee-for-Service	1184232019	1184232019	1	1	TRABOLD, SARAH A NP	1/3/2022	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
60486	Fee-for-Service	1629460720	1629460720	1	1	TAYLOR, WALTER R LMFT	7/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 S GRAMERCY PL	STE 110	LOS ANGELES	CA	90020	4537	19	06037	34.06872035	-118.3127987	Los Angeles County
60500	Fee-for-Service	1578667069	1578667069	1	1	THOMAS, JOHN W III MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	13538	04	Otology, Laryngology, Rhinology	0	In state provider	None	1703 TERMINO AVE	STE 210	LONG BEACH	CA	90804	2128	19	06037	33.7883073	-118.1459488	Los Angeles County
60535	Fee-for-Service	1871653063	1871653063	1	1	TRAN, KHOI D MD	11/1/1995	207R00000X	NA	Other	026	PHYSICIANS	55751	41	Internal Medicine	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
60591	Fee-for-Service	1033436449	1033436449	1	1	TRINH, ANGELA M MD	6/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134834	30	Radiology	0	In state provider	None	300 PASTEUR DR	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
60627	Fee-for-Service	1407470032	1407470032	1	1	TOMA, LUCIAN CRNA	7/22/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
60675	Fee-for-Service	1114789013	1114789013	1	1	TEMECULA VALLEY ANESTHESIA P	3/1/2024	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	ARTNERS, INC	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
60682	Fee-for-Service	1770597825	1770597825	1	1	TAN, JEFFREY MD	12/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	46699	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1720 EL CAMINO REAL	STE 205	BURLINGAME	CA	94010	3226	41	06081	37.59341466	-122.381361	San Mateo County
60696	Fee-for-Service	1811300957	1811300957	1	1	TARVER, LESLIE B MD	9/17/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	169181	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
60698	Fee-for-Service	1063068930	1063068930	1	4	TAHOE FOREST HOSPITAL DISTRI	10/14/2020	207Q00000X	NA	Adult Primary Care	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CLINICS PRIMARY CARE	1960 SQUAW VALLEY ROAD	None	OLYMPIC VALLEY	CA	96146	9995	31	06061	39.1968057	-120.2357539	Placer County
60719	Fee-for-Service	1841755980	1841755980	1	1	TIGER HOME HEALTH	5/21/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14640 VICTORY BLVD	SUITE 211	VAN NUYS	CA	91411	1623	19	06037	34.18663255	-118.452402	Los Angeles County
60745	Fee-for-Service	1548227796	1548227796	1	1	TASHAKKOR, BABAT MD	7/1/1998	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	63829	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
60802	Fee-for-Service	1376570184	1376570184	1	1	TRAN, VAN T MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	52994	41	Internal Medicine	0	In state provider	None	9143 VALLEY BLVD	UNIT 203	ROSEMEAD	CA	91770	1919	19	06037	34.08096534	-118.0700742	Los Angeles County
60808	Fee-for-Service	1639367584	1639367584	1	1	TRUITT, CLAUDIA U MD	5/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77073	None	None	0	In state provider	None	401 S FAIR OAKS AVE	None	PASADENA	CA	91105	2603	19	06037	34.13887038	-118.1504485	Los Angeles County
60834	Fee-for-Service	1730227851	1730227851	1	1	TRUJILLO, KIMBERLY C MD	7/28/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	83361	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
60847	Fee-for-Service	1649262718	1649262718	1	1	TRUONG, CHI H MD	9/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	77728	None	None	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
60851	Fee-for-Service	1821292434	1821292434	1	1	TENG, JENNIFER M MD	12/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	98751	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
60923	Fee-for-Service	1811226392	1811226392	1	1	TENDER HOME HEALTH	9/28/2012	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	17031 CHATSWORTH STREET	SUITE 201	GRANADA HILLS	CA	91344	5883	19	06037	34.2648235	-118.503513	Los Angeles County
60975	Fee-for-Service	1992789804	1992789804	1	1	THOMPSON, DAVID F MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65066	66	Emergency Medicine (Urgent Care)	0	In state provider	None	180 ROWLAND WAY	None	NOVATO	CA	94945	5009	21	06041	38.09825699	-122.5598561	Marin County
60981	Fee-for-Service	1811300957	1811300957	1	1	TARVER, LESLIE B MD	9/17/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	169181	26	Psychiatry (child)	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
61038	Fee-for-Service	1194921205	1194921205	1	1	TWARD, AARON D MD	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133557	04	Otology, Laryngology, Rhinology	0	In state provider	None	1001 POTRERO AVE	RM 4M45	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
61074	Fee-for-Service	1053322909	1053322909	1	1	TRANSCULTURAL HEALTH DEV INC	3/16/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	117 E HARRY BRIDGES BLVD	None	WILMINGTON	CA	90744	5825	19	06037	33.77134876	-118.261036	Los Angeles County
61089	Fee-for-Service	1376570184	1376570184	1	1	TRAN, VAN T MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	52994	10	Gastroenterology (M.D. only)	0	In state provider	None	9143 VALLEY BLVD	UNIT 203	ROSEMEAD	CA	91770	1919	19	06037	34.08096534	-118.0700742	Los Angeles County
61096	Fee-for-Service	1417101908	1417101908	1	2	TOM YANG, M.D., INC.	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	88613	None	None	0	In state provider	None	1105 N DOUTY ST	STE A	HANFORD	CA	93230	3788	16	06031	36.33650511	-119.6460168	Kings County
61114	Fee-for-Service	1881188407	1881188407	1	1	THIBODEAU, ALEXA R MD	11/21/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	186769	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
61119	Fee-for-Service	1326484437	1326484437	1	1	TROYER, EMILY A MD	12/15/2021	2084P0804X	NA	Psychiatry	026	PHYSICIANS	149101	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
61121	Fee-for-Service	1356521900	1356521900	1	1	THAREJA, NIDHI MD	3/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100675	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
61152	Fee-for-Service	1164093464	1164093464	1	1	THERAPY-CONNECTION	2/28/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2423 CAMINO DEL RIO SOUT	101	SAN DIEGO	CA	92108	3734	37	06073	32.76791517	-117.1388261	San Diego County
61169	Fee-for-Service	1447635313	1447635313	1	1	THOMPSON, COLLEEN M	10/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	448 REDCLIFF DR	None	REDDING	CA	96002	0161	45	06089	40.57522939	-122.3630837	Shasta County
61213	Fee-for-Service	1124423553	1124423553	1	1	TETZ, RHONDA L MD	1/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71194	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
61237	Fee-for-Service	1033111026	1033111026	1	1	TRZECIAK, MARC A DO	3/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12596	20	Orthopedic Surgery	0	In state provider	None	830 SCENIC DRIVE	STE B	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
61239	Fee-for-Service	1366908840	1366908840	1	1	TANG ACUPUNCTURE CLINIC	2/21/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	21040 HOMESTEAD RD	SUITE 102	CUPERTINO	CA	95014	0238	43	06085	37.33747954	-122.043105	Santa Clara County
61341	Fee-for-Service	1053499558	1053499558	1	1	TAI, YONGHUA MD	12/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93379	25	Physical Medicine and Rehabilitation	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
61350	Fee-for-Service	1629096946	1629096946	1	1	TORPY, JANET M MD	3/10/2017	207L00000X	NA	Other	026	PHYSICIANS	54960	05	Anesthesiology	0	In state provider	None	1441 FLORIDA AVENUE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
61353	Fee-for-Service	1104990712	1104990712	1	1	TAYLOR, MYIESHA D N MD	10/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76577	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
61362	Fee-for-Service	1053322909	1053322909	1	1	TRANSCULTURAL HEALTH DEV INC	1/1/2006	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	117 E HARRY BRIDGES BLVD	None	WILMINGTON	CA	90744	5825	19	06037	33.77134876	-118.261036	Los Angeles County
61394	Fee-for-Service	1487684148	1487684148	1	1	TEZCAN, HALUK MD	10/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55373	68	Hematology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
61402	Fee-for-Service	1356521900	1356521900	1	1	THAREJA, NIDHI MD	3/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100675	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
61441	Fee-for-Service	1417086273	1417086273	1	1	TSE, TONIA	4/19/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
61501	Fee-for-Service	1427125301	1427125301	1	1	TOME, MICHAEL A MD	12/16/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	42110	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
61504	Fee-for-Service	1477393775	1477393775	1	1	THOMAS, TIANA BIRTH DOULA	6/14/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
61578	Fee-for-Service	1275011595	1275011595	1	1	TER-NSHANIAN, ANI OD	9/10/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12737 GLENOAKS BLVD	STE 3	SYLMAR	CA	91342	4724	19	06037	34.30181336	-118.4422626	Los Angeles County
61581	Fee-for-Service	1932351756	1932351756	1	1	TAYLOR, REBEKAH LCSW	9/9/2024	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
61608	Fee-for-Service	1962723296	1962723296	1	1	TURNER, AARON L MD	8/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123597	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
61620	Fee-for-Service	1083767636	1083767636	1	1	THOMAS, CYNTHIA L DO	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	6876	08	Family Practice	0	In state provider	HIGH DESERT OSTEO MED	16017 TUSCOLA RD	STE E	APPLE VALLEY	CA	92307	1317	36	06071	34.542252	-117.2692645	San Bernardino County
61633	Fee-for-Service	1841516689	1841516689	1	1	TRUONG, SAM V MD	10/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113368	07	Dermatology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
61641	Fee-for-Service	1730253105	1730253105	1	1	TORRES, MICHAEL PHD	11/26/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3551 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
61661	Fee-for-Service	1649333030	1649333030	1	1	THE RANCH RECOVERY CENTERS	12/21/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	7885 ANNANDALE AVENUE	None	DESERT HOT SPRING	CA	92240	1419	33	06065	33.99048848	-116.5242885	Riverside County
61680	Fee-for-Service	1932315702	1932315702	1	1	TRUMMER, JASON G DO	10/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9295	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
61682	Fee-for-Service	1487684148	1487684148	1	1	TEZCAN, HALUK MD	10/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55373	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
61723	Fee-for-Service	1801861190	1801861190	1	3	TRI CITY HOSPITAL	7/15/2011	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	FORENSIC UNIT	3925 WARING ROAD	# C	OCEANSIDE	CA	92056	4459	37	06073	33.18776771	-117.2893136	San Diego County
61727	Fee-for-Service	1023065992	1023065992	1	1	THEARD, LOWELL P MD	7/1/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	37108	01	General Practice	0	In state provider	None	3831 HUGHES AVE	STE 705	CULVER CITY	CA	90232	6838	19	06037	34.02243278	-118.3981492	Los Angeles County
61748	Fee-for-Service	1124223433	1124223433	1	1	TABAN, MEHRYAR MD	7/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99093	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	STE 1-340	LOS ANGELES	CA	90024	7002	19	06037	34.06482757	-118.4443441	Los Angeles County
61772	Fee-for-Service	1649236423	1649236423	1	1	TICHANSKY, DAVID S MD	9/26/2023	208600000X	NA	General Surgery	026	PHYSICIANS	190984	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
61773	Fee-for-Service	1134668304	1134668304	1	1	TENDER CARE COMMUNITY CLINIC	11/1/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	7862 FIRESTONE BLVD	None	DOWNEY	CA	90241	4221	19	06037	33.94382457	-118.1402202	Los Angeles County
61785	Fee-for-Service	1417200312	1417200312	1	2	THOMPSON, DANNA M LMFT	6/15/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17215 STUDEBAKER RD	SUITE 110	CERRITOS	CA	90703	2521	19	06037	33.874686	-118.0998595	Los Angeles County
61892	Fee-for-Service	1265054258	1265054258	1	1	TUNESI, FEDERICO PT	12/2/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	411 W. MAIN ST.	None	BRAWLEY	CA	92227	2244	13	06025	32.97866153	-115.5481515	Imperial County
61910	Fee-for-Service	1033303284	1033303284	1	1	THRIFTY PAYLESS INC	10/9/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1180 N STATE ST	None	SAN JACINTO	CA	92583	6318	33	06065	33.802533	-116.972086	Riverside County
61916	Fee-for-Service	1093874679	1093874679	1	1	TAKAMI, CAROL Y MD	4/30/1986	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	53085	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
61917	Fee-for-Service	1548705262	1548705262	1	1	TAYLOR, IAN C LMFT	2/17/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
61924	Fee-for-Service	1942886304	1942886304	1	1	TRAN, PETER MD	9/11/2024	390200000X	NA	Other	026	PHYSICIANS	181006	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
61930	Fee-for-Service	1295883106	1295883106	1	1	TUNG, DORA TESYUAN MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73642	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
61944	Fee-for-Service	1073650719	1073650719	1	1	TUTKO, MARISSA OD	9/21/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
61945	Fee-for-Service	1013128552	1013128552	1	1	TORABI, SOHEILA MD	7/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99332	None	None	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
61952	Fee-for-Service	1841292745	1841292745	1	1	TILLES, STEVEN M MD	9/1/1983	207RN0300X	NA	Nephrology	026	PHYSICIANS	40389	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2505 SAMARITAN DR	STE 405	SAN JOSE	CA	95124	4013	43	06085	37.25111447	-121.9483395	Santa Clara County
61955	Fee-for-Service	1952675134	1952675134	1	1	TRACY, MICHAEL K MD PC	6/20/2012	193400000X	NA	Other	026	PHYSICIANS	54009	18	Ophthalmology	0	In state provider	None	6183 PASEO DEL NORTE	STE 210	CARLSBAD	CA	92011	1151	37	06073	33.11659364	-117.3161634	San Diego County
61970	Fee-for-Service	1336235662	1336235662	1	1	THEIN, PATRICK K MD	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	58343	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	24692 DEL PRADO	None	DANA POINT	CA	92629	3841	30	06059	33.46545254	-117.6988455	Orange County
61978	Fee-for-Service	1508493040	1508493040	1	1	TANNOUS, DANIEL	9/6/2022	390200000X	NA	Other	026	PHYSICIANS	176847	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
62030	Fee-for-Service	1619138542	1619138542	1	1	THOMASIAN, SANDRA E MD	8/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115451	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
62052	Fee-for-Service	1649566571	1649566571	1	1	TRAN, HUYNH MD	2/9/2018	207R00000X	NA	Other	026	PHYSICIANS	137091	None	None	0	In state provider	None	9126 VALLEY BLVD STE B	None	ROSEMEAD	CA	91770	1987	19	06037	34.08089747	-118.0704869	Los Angeles County
62060	Fee-for-Service	1134668304	1134668304	1	1	TENDER CARE COMMUNITY CLINIC	11/1/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	7862 FIRESTONE BLVD	None	DOWNEY	CA	90241	4221	19	06037	33.94382457	-118.1402202	Los Angeles County
62061	Fee-for-Service	1881752913	1881752913	1	1	THURSTON, RICHARD 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	229 S 7TH ST	None	ST MARIES	ID	83861	1803	00	None	47.31509202	-116.56671	Benewah County
62114	Fee-for-Service	1083891253	1083891253	1	1	TURNER, SARAH E MD	9/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104979	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
62255	Fee-for-Service	1447207816	1447207816	1	1	TSAI, GUOCHUAN E MD	8/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51290	36	Psychiatry	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
62330	Fee-for-Service	1205217254	1205217254	1	1	THIND, GURAMRINDER S MD	9/9/2022	207RC0200X	NA	Other	026	PHYSICIANS	178563	None	None	0	In state provider	None	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	10	06019	36.74333844	-119.7831874	Fresno County
62334	Fee-for-Service	1780751321	1780751321	1	1	TORLAK, EDINA S MD	2/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	54332	41	Internal Medicine	0	In state provider	None	6555 COYLE AVE	STE 280	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
62350	Fee-for-Service	1134668304	1134668304	1	1	TENDER CARE COMMUNITY CLINIC	3/29/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INC	7862 FIRESTONE BLVD	None	DOWNEY	CA	90241	4221	19	06037	33.94382457	-118.1402202	Los Angeles County
62385	Fee-for-Service	1700865862	1700865862	1	1	TAN, ROSEMARIE C MD	3/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	52356	None	None	0	In state provider	None	2425 SAMARITAN DRIVE	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
62427	Fee-for-Service	1528423217	1528423217	1	1	TRUONG, TAI P	8/23/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	11180 WARNER AVE	SUITE 263	FOUNTAIN VALLEY	CA	92708	7516	30	06059	33.71632048	-117.9334575	Orange County
62430	Fee-for-Service	1932134632	1932134632	1	1	TRACY BARRY	10/1/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1901 1ST AVE	None	NEW YORK	NY	10029	7494	00	None	40.784778	-73.9439055	New York County
62432	Fee-for-Service	1609903020	1609903020	1	1	TA, CHRISTOPHER N MD	6/1/1999	207W00000X	NA	Ophthalmology	026	PHYSICIANS	54687	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
62440	Fee-for-Service	1518037001	1518037001	1	1	TRAN, QUYNH K MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	80794	40	Pediatrics	0	In state provider	None	2300 CAMINO RAMON	None	SAN RAMON	CA	94583	1354	07	06013	37.77580025	-121.9664884	Contra Costa County
62476	Fee-for-Service	1750517843	1750517843	1	1	TANG, CHRISTOPHER G MD	9/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113492	84	Surgery-Head and Neck	0	In state provider	None	450 6TH AVE	None	SAN FRANCISCO	CA	94118	3010	38	06075	37.7802547	-122.4642049	San Francisco County
62478	Fee-for-Service	1164808127	1164808127	1	1	THOMAS, DANIELLE MD	12/18/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	136816	None	None	0	In state provider	None	2936 DE LA VINA ST	None	SANTA BARBARA	CA	93105	3354	42	06083	34.4383104	-119.7278207	Santa Barbara County
62503	Fee-for-Service	1285097998	1285097998	1	1	TEA, AARON	7/9/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
62561	Fee-for-Service	1538136379	1538136379	1	1	TALANIAN, REYNA M MD	1/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	82864	41	Internal Medicine	0	In state provider	None	317 WEST PUEBLO ST	None	SANTA BARBARA	CA	93105	4365	42	06083	34.42967671	-119.7228362	Santa Barbara County
62589	Fee-for-Service	1659515385	1659515385	1	1	TASHJIAN, JESSICA A MD	7/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128456	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
62605	Fee-for-Service	1790759827	1790759827	1	1	TONNU, TINA N MD	12/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88767	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
62614	Fee-for-Service	1457552168	1457552168	1	1	TIMOTHY JOHN FERNSTROM, 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	2801 N GANTENBEIN	None	PORTLAND	OR	97227	1623	00	None	45.54387841	-122.6696022	Multnomah County
62638	Fee-for-Service	1366841116	1366841116	1	1	THAO, ANNIE LCSW	11/10/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	271 TURN PIKE DR	None	FOLSOM	CA	95630	8098	34	06067	38.65509	-121.170042	Sacramento County
62662	Fee-for-Service	1871867614	1871867614	1	1	THOMAS C. OLONA, PSYCHOLOGIS	3/10/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	T, PROFESSIONAL CORPORAT	100 N BRAND BLVD	SUITE 603	GLENDALE	CA	91203	2641	19	06037	34.14652066	-118.2549229	Los Angeles County
62673	Fee-for-Service	1881029213	1881029213	1	1	TYRREL, ASHLEY E MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127248	40	Pediatrics	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
62701	Fee-for-Service	1619587011	1619587011	1	1	TOGETHER HOSPICE CARE INC	5/27/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	438 E KATELLA AVE	STE 234	ORANGE	CA	92867	4839	30	06059	33.80908349	-117.849438	Orange County
62726	Fee-for-Service	1952845687	1952845687	1	1	TLC HOSPICE INC	12/17/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2323 W LINCOLN AVE	SUITE 209	ANAHEIM	CA	92801	5100	30	06059	33.83253604	-117.9642941	Orange County
62728	Fee-for-Service	1417597600	1417597600	1	1	TRAN, WINNIE NHU-QUYNH T NP	4/16/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7955 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4001	30	06059	33.75932839	-117.9902744	Orange County
62745	Fee-for-Service	1366736977	1366736977	1	1	TARASEN, ASHLEY J MD	7/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135962	22	Pathology (M.D. only)	0	In state provider	None	2625 COFFEE RD	STE S	MODESTO	CA	95355	2050	50	06099	37.67888506	-120.9759048	Stanislaus County
62835	Fee-for-Service	1245672112	1245672112	1	1	TELLEZ, ERNESTINA	10/17/2013	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1072 SIMON WAY	None	OXNARD	CA	93036	1429	56	06111	34.23722988	-119.1539498	Ventura County
62860	Fee-for-Service	1649523663	1649523663	1	1	THOMAS, NATASHA K LMFT	2/12/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15447 ANACAPA RD	STE 102 D1	VICTORVILLE	CA	92392	2481	36	06071	34.50573979	-117.3249541	San Bernardino County
62861	Fee-for-Service	1679562698	1679562698	1	1	THE HILL MEDICAL CORPORATION	1/1/1998	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	625 S FAIR OAKS AVE	STE 180	PASADENA	CA	91105	2650	19	06037	34.134894	-118.1504155	Los Angeles County
62918	Fee-for-Service	1619935251	1619935251	1	1	THE REGENTS OF THE UNIVERSIT	8/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	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
62950	Fee-for-Service	1962550855	1962550855	1	1	TOOCHINDA, CHARERNTAS MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81962	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
62968	Fee-for-Service	1326145277	1326145277	1	1	TANG-OXLEY, QING MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73765	41	Internal Medicine	0	In state provider	None	3288 BELL RD	None	AUBURN	CA	95603	9243	31	06061	38.94193048	-121.1046075	Placer County
62979	Fee-for-Service	1538225446	1538225446	1	1	TAYLOR, KATHERINE L MD	6/18/2009	2084P0800X	NA	Psychiatry	026	PHYSICIANS	84205	36	Psychiatry	0	In state provider	None	2500 GRANT ROAD	UNIT 1-SOUTH	MOUNTAIN VIEW	CA	94040	9827	43	06085	37.36893518	-122.0779448	Santa Clara County
62990	Fee-for-Service	1619587011	1619587011	1	1	TOGETHER HOSPICE CARE INC	5/27/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	438 E KATELLA AVE	STE 234	ORANGE	CA	92867	4839	30	06059	33.80908349	-117.849438	Orange County
62996	Fee-for-Service	1972612364	1972612364	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	31091 MISSION BLVD	None	HAYWARD	CA	94544	7601	01	06001	37.61930506	-122.0351544	Alameda County
63015	Fee-for-Service	1952845687	1952845687	1	1	TLC HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2323 W LINCOLN AVE	SUITE 209	ANAHEIM	CA	92801	5100	30	06059	33.83253604	-117.9642941	Orange County
63060	Fee-for-Service	1003540931	1003540931	1	1	THE FUTURE PHARMACY INC.	9/21/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	250 E CHASE AVE	108	EL CAJON	CA	92020	6305	37	06073	32.78042748	-116.9591715	San Diego County
63083	Fee-for-Service	1548846983	1548846983	1	1	TORRES, ERICK MD	1/18/2024	207P00000X	NA	Other	026	PHYSICIANS	191560	None	None	0	In state provider	None	13100 STUDEBAKER ROAD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
63122	Fee-for-Service	1245672112	1245672112	1	1	TELLEZ, ERNESTINA	10/17/2013	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1072 SIMON WAY	None	OXNARD	CA	93036	1429	56	06111	34.23722988	-119.1539498	Ventura County
63130	Fee-for-Service	1154053528	1154053528	1	1	TOWNLEY, ANDREW	3/21/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
63139	Fee-for-Service	1629261169	1629261169	1	1	TAO, YANLI MD	5/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99731	41	Internal Medicine	0	In state provider	None	1900 GARDEN ROAD	SUITE 110	MONTEREY	CA	93940	5334	27	06053	36.58681385	-121.8623548	Monterey County
63165	Fee-for-Service	1194744177	1194744177	1	1	TOVAR, SONIA Y	7/25/2009	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	NURSING	1019 E HOLT AVE	None	POMONA	CA	91767	5720	19	06037	34.06292287	-117.7302993	Los Angeles County
63169	Fee-for-Service	1326196353	1326196353	1	1	TURLA, SALLY T DO	5/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8264	22	Pathology (M.D. only)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
63199	Fee-for-Service	1619935251	1619935251	1	1	THE REGENTS OF THE UNIVERSIT	3/23/2020	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MEDICAL PLAZA	STE 550	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
63247	Fee-for-Service	1215088356	1215088356	1	1	TRAN, CLINT Q OD	6/14/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
63280	Fee-for-Service	1396751681	1396751681	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5976	2620 EL CAMINO REAL	None	SANTA CLARA	CA	95051	3041	43	06085	37.3522785	-121.9752405	Santa Clara County
63297	Fee-for-Service	1356418214	1356418214	1	1	TUSO, PHILIP J MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	44326	01	General Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
63306	Fee-for-Service	1447845201	1447845201	1	1	THE OCCUPATIONAL MEDICINE IN	6/23/2022	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	716 W 1ST ST	None	LOS ANGELES	CA	90012	2442	19	06037	34.05672818	-118.2504245	Los Angeles County
63314	Fee-for-Service	1366837734	1366837734	1	1	TERRELONGE, MARK A MD	5/29/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	146489	13	Neurology (M.D. only)	0	In state provider	None	1001 POTRERO AVE	RM 4M62	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
63341	Fee-for-Service	1306380332	1306380332	1	1	TEJEDOR VAZQUEZ, KAREN LMFT	3/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
63343	Fee-for-Service	1104848928	1104848928	1	1	THRIFTY PAYLESS INC	4/1/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	24330 EL TORO RD	None	LAGUNA HILLS	CA	92637	2775	30	06059	33.60906595	-117.7294845	Orange County
63345	Fee-for-Service	1710234331	1710234331	1	1	THE CARING CONNECTION INC.	5/6/2011	No Taxonomy Provided	NA	None	069	PROFESSIONAL CORPORATION	-	-	NOT APPLICABLE	0	In state provider	None	10727 WHITE OAK AVENUE	#206	GRANADA HILLS	CA	91344	4660	19	06037	34.265781	-118.5197785	Los Angeles County
63374	Fee-for-Service	1902873078	1902873078	1	1	TRIPURANENI, R MD	1/1/1986	207L00000X	NA	Other	026	PHYSICIANS	42431	05	Anesthesiology	0	In state provider	None	12440 FIRESTONE BLVD	None	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
63383	Fee-for-Service	1043989551	1043989551	1	2	THE COTTAGES AT ARTESIA	1/19/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	8792 CERRITOS AVENUE	None	ANAHEIM	CA	92804	5780	30	06059	33.81030638	-117.9792995	Orange County
63404	Fee-for-Service	1255499901	1255499901	1	1	TUCKER, ALEXIS OT	5/21/2021	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2300 CAMINO RAMON	None	SAN RAMON	CA	94583	1354	07	06013	37.77580025	-121.9664884	Contra Costa County
63451	Fee-for-Service	1477631166	1477631166	1	1	TAMARU, RONALD D MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	51126	18	Ophthalmology	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
63472	Fee-for-Service	1285942714	1285942714	1	1	TOTAL RENAL CARE INC	2/1/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	45 CASTRO ST	SOUTH TOWER 2ND FLOOR	SAN FRANCISCO	CA	94114	1010	38	06075	37.76829732	-122.4357056	San Francisco County
63489	Fee-for-Service	1619935251	1619935251	1	1	THE REGENTS OF THE UNIVERSIT	8/29/2019	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	200 MEDICAL PLAZA	STE 550	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
63495	Fee-for-Service	1487129714	1487129714	1	1	TLC MEDICAL SUPPLIES INC	11/23/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	3312 W. FLORENCE AVE	SUITE D	LOS ANGELES	CA	90043	4782	19	06037	33.97451047	-118.3300245	Los Angeles County
63498	Fee-for-Service	1649480120	1649480120	1	1	TORRE, SALVACION Y MD	12/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33736	40	Pediatrics	0	In state provider	None	3200 LONG BEACH BLVD	None	LONG BEACH	CA	90807	5062	19	06037	33.815637	-118.1892215	Los Angeles County
63528	Fee-for-Service	1780677054	1780677054	1	1	TUCKER, BRUCE N MD	7/31/1981	207R00000X	NA	Other	026	PHYSICIANS	44233	41	Internal Medicine	0	In state provider	None	121 SOTOYOME ST	STE 205	SANTA ROSA	CA	95405	4822	49	06097	38.44224	-122.70195	Sonoma County
63629	Fee-for-Service	1891752614	1891752614	1	1	TREPHAN, MARYANN H MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85040	None	None	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
63652	Fee-for-Service	1669488276	1669488276	1	1	TELEPAK, ROBERT MD	10/22/2007	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
63665	Fee-for-Service	1508025388	1508025388	1	1	TESSA L. MANNING	7/5/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6161 S YALE AVE	None	TULSA	OK	74136	1902	00	None	36.07272	-95.9191515	Tulsa County
63702	Fee-for-Service	1295795037	1295795037	1	1	THAPER, MOHINDERPAL S MD	6/15/2009	207R00000X	NA	Other	026	PHYSICIANS	106869	41	Internal Medicine	0	In state provider	None	530 LOMAS SANTA FE DRIVE	#M	SOLANA BEACH	CA	92075	1346	37	06073	32.99511173	-117.2659419	San Diego County
63719	Fee-for-Service	1962004218	1962004218	1	1	TAH MAY, SABINA LCSW	2/10/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
63745	Fee-for-Service	1215115522	1215115522	1	1	TRAN, CHARLENE M OD INC	7/30/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8650 SAN YSIDRO AVE	STE 104	GILROY	CA	95020	5268	43	06085	37.02656769	-121.5668796	Santa Clara County
63754	Fee-for-Service	1902994783	1902994783	1	1	TELECARE CORPORATION	6/6/1986	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LA PAZ AT PARAMOUNT	8835 VANS ST	None	PARAMOUNT	CA	90723	4656	19	06037	33.89195134	-118.1440256	Los Angeles County
63768	Fee-for-Service	1518086404	1518086404	1	1	TATA, SATYA V	6/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98273	None	None	0	In state provider	None	15373 INNOVATION DR	STE 395	SAN DIEGO	CA	92128	3429	37	06073	32.99427342	-117.0794782	San Diego County
63772	Fee-for-Service	1609817568	1609817568	1	1	TAMMY Y KASTRE, 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	350 N WILMOT	None	TUCSON	AZ	85711	2602	00	None	32.227209	-110.8556595	Pima County
63814	Fee-for-Service	1194736082	1194736082	2	1	TSAO, JOHN M MD	10/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	23235	67	Endocrinology	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
63816	Fee-for-Service	1700875911	1700875911	1	1	TRAM, KENNETH	8/6/1995	207R00000X	NA	Other	026	PHYSICIANS	7475	41	Internal Medicine	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
64007	Fee-for-Service	1104152511	1104152511	1	1	TSAO, KENYON MD	3/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125059	66	Emergency Medicine (Urgent Care)	0	In state provider	None	345 SOUTH HALCYON RD	None	ARROYO GRANDE	CA	93420	3817	40	06079	35.113419	-120.5915945	San Luis Obispo County
64015	Fee-for-Service	1922114693	1922114693	1	1	THOMAS, LINDA D NP	7/29/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	45	06089	40.57278686	-122.3958519	Shasta County
64042	Fee-for-Service	1487671087	1487671087	1	1	TONINI, TIMOTHY D DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1107 HIGHWAY 395	None	GARDNERVILLE	NV	89410	5304	00	None	38.76078609	-119.576046	Douglas County
64072	Fee-for-Service	1245322189	1245322189	1	1	TSENG, JEFFREY MD	6/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80934	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
64078	Fee-for-Service	1629028329	1629028329	1	1	THOMAS FRERICHS M.D.	10/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4801 W 81ST ST	STE 108	MINNEAPOLIS	MN	55437	1111	00	None	44.85623947	-93.34035	Hennepin County
64080	Fee-for-Service	1952391450	1952391450	1	1	TARRAN, WILLIAM ALAN	7/24/1989	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	901 CAMPUS DR	STE 311	DALY CITY	CA	94015	4930	41	06081	37.66535778	-122.4763793	San Mateo County
64111	Fee-for-Service	1083766208	1083766208	1	1	TEPLICK, ALEXIS F MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	90427	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
64170	Fee-for-Service	1417496985	1417496985	1	1	TRAN, THERESA T MD	8/1/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	155060	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
64172	Fee-for-Service	1760541320	1760541320	1	1	TSESIN, VADIM MD	1/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	60664	41	Internal Medicine	0	In state provider	None	5525 W SLAUSON AVE	None	LOS ANGELES	CA	90056	1047	19	06037	33.98912847	-118.3784926	Los Angeles County
64187	Fee-for-Service	1891755419	1891755419	1	1	TUESTA, ENRIQUE MD	10/12/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76790	05	Anesthesiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
64219	Fee-for-Service	1275231730	1275231730	1	1	TUTTLE, RUBY H DOULA	3/20/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	12	06023	0	0	None
64225	Fee-for-Service	1588625917	1588625917	1	1	TOTAL RENAL CARE, INC	8/31/1981	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DOWNEY DIALYSIS CTR	8630 FLORENCE AVE	SUITE 100	DOWNEY	CA	90240	4017	19	06037	33.9482724	-118.1187522	Los Angeles County
64272	Fee-for-Service	1942387188	1942387188	1	1	TRI-CITY HEALTH CENTER	1/1/2000	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	LIBERTY	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
64285	Fee-for-Service	1508194788	1508194788	1	1	TREAT, JESSICA R LMFT	12/19/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	555 1ST ST	SUITE 2000	BENICIA	CA	94510	3280	48	06095	38.04877526	-122.1593437	Solano County
64296	Fee-for-Service	1134161078	1134161078	1	1	TRAN, LOAN T MD	11/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	60907	18	Ophthalmology	0	In state provider	LOAN TRAN MD, CORP	11832 ROSECRANS AVE	STE 206	NORWALK	CA	90650	4107	19	06037	33.90211977	-118.0813129	Los Angeles County
64318	Fee-for-Service	1689853012	1689853012	1	2	TORRES, AIDA ALICIA	3/22/2007	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	669 E ALLUVIAL AVE	None	FRESNO	CA	93720	2513	10	06019	36.84449702	-119.7733424	Fresno County
64361	Fee-for-Service	1245322189	1245322189	1	1	TSENG, JEFFREY MD	6/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80934	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
64402	Fee-for-Service	1578571626	1578571626	1	1	TOKUNAGA, KOSUKE MD	5/31/1992	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	77185	41	Internal Medicine	0	In state provider	None	800 3RD ST	None	MARYSVILLE	CA	95901	5831	58	06115	39.13757487	-121.5949642	Yuba County
64414	Fee-for-Service	1134145014	1134145014	1	1	TAI, SHEILA H MD	11/28/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	63967	41	Internal Medicine	0	In state provider	None	1400 S GRAND AVE	None	LOS ANGELES	CA	90015	3048	19	06037	34.03692236	-118.2655238	Los Angeles County
64417	Fee-for-Service	1972718096	1972718096	1	1	TAYAMA, TRICIA M MD	6/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99574	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
64419	Fee-for-Service	1720649940	1720649940	1	1	TRAVIS LOIDOLT D.O. INC	10/11/2019	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	584 N. SUNRISE AVE.	SUITE 100	ROSEVILLE	CA	95661	2862	31	06061	38.75842021	-121.2528302	Placer County
64421	Fee-for-Service	1114464922	1114464922	1	1	TIB PHARMACY LLC	4/23/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5886 MOWRY SCHOOL ROAD	None	NEWARK	CA	94560	5367	01	06001	37.51964517	-121.9932794	Alameda County
64446	Fee-for-Service	1346680568	1346680568	1	1	TENG, VALERIE T C MD	7/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133593	01	General Practice	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
64471	Fee-for-Service	1770947343	1770947343	1	1	TRIVEDI, NIKUNJ N MD	12/12/2022	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	170619	None	None	0	In state provider	None	905 MAPLE ST	None	REDWOOD CITY	CA	94063	0000	41	06081	37.48767797	-122.223049	San Mateo County
64553	Fee-for-Service	1336548700	1336548700	1	1	TSANG, WAYNE K MD INC	12/27/2017	207RN0300X	NA	Nephrology	026	PHYSICIANS	70393	41	Internal Medicine	0	In state provider	None	2841 LOMITA BLVD	# 300	TORRANCE	CA	90505	5112	19	06037	33.80997064	-118.3374754	Los Angeles County
64559	Fee-for-Service	1902915242	1902915242	1	1	THRIFTY PAYLESS INC	11/2/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1350 N VASCO RD	None	LIVERMORE	CA	94551	9212	01	06001	37.71756244	-121.7243455	Alameda County
64561	Fee-for-Service	1942387188	1942387188	1	1	TRI-CITY HEALTH CENTER	1/1/2000	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	LIBERTY	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
64613	Fee-for-Service	1487939989	1487939989	1	1	TERAN, RAFAEL NP	4/16/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	801 E CHAPEL ST	STE 1	SANTA MARIA	CA	93454	4607	42	06083	34.9542915	-120.424455	Santa Barbara County
64651	Fee-for-Service	1730483058	1730483058	1	1	TAG-2 MEDICAL INVESTMENT	10/15/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	GROUP LLC	1428 S MARENGO AVE	None	ALHAMBRA	CA	91803	3096	19	06037	34.07604533	-118.1418277	Los Angeles County
64662	Fee-for-Service	1043395742	1043395742	1	3	THC-ORANGE COUNTY LLC	4/6/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	550 N MONTEREY AVE	None	ONTARIO	CA	91764	3318	36	06071	34.069239	-117.642987	San Bernardino County
64668	Fee-for-Service	1790961860	1790961860	1	1	THOMAS, ROSA	9/9/2024	103TC0700X	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
64738	Fee-for-Service	1528242542	1528242542	1	1	TOTAL RENAL CARE, INC	12/1/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	PALMDALE REGIONAL	1643 E PALMDALE BLVD	None	PALMDALE	CA	93550	4847	19	06037	34.57968418	-118.0995472	Los Angeles County
64740	Fee-for-Service	1174528350	1174528350	1	1	TRAN, JOHN T	4/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	88474	36	Psychiatry	0	In state provider	None	2210 E ILLINOIS AVE	STE 401	FRESN0	CA	93701	0000	10	06019	36.74500687	-119.7846885	Fresno
64746	Fee-for-Service	1801108733	1801108733	1	1	TORRES, JUDITH W LMFT	11/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	19	06037	34.24628267	-118.5232668	Los Angeles County
64796	Fee-for-Service	1396311833	1396311833	1	1	TRIGGS, CONNOR J DO	10/24/2024	208M00000X	NA	Other	026	PHYSICIANS	22873	41	Internal Medicine	0	In state provider	None	317 WEST PUEBLO ST	None	SANTA BARBARA	CA	93105	4365	42	06083	34.42967671	-119.7228362	Santa Barbara County
64810	Fee-for-Service	1821771718	1821771718	1	1	TEJUCO, BRIANA	11/10/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	41	06081	0	0	None
64815	Fee-for-Service	1609984889	1609984889	1	1	THE WASHINGTON HOSPITAL	6/14/2016	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	155 WILSON AVENUE	None	WASHINGTON	PA	15301	3336	00	None	40.18297389	-80.24677018	Washington County
64840	Fee-for-Service	1336548700	1336548700	1	1	TSANG, WAYNE K MD INC	12/27/2017	207RN0300X	NA	Nephrology	026	PHYSICIANS	70393	45	Nephrology (Renal-Kidney)	0	In state provider	None	2841 LOMITA BLVD	# 300	TORRANCE	CA	90505	5112	19	06037	33.80997064	-118.3374754	Los Angeles County
64842	Fee-for-Service	1770141004	1770141004	1	1	THOMPSON, TYLER J DO	2/24/2023	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	20365	None	None	0	In state provider	None	2101 GEER ROAD	STE 111	TURLOCK	CA	95382	2454	50	06099	37.512324	-120.8489985	Stanislaus County
64888	Fee-for-Service	1336602507	1336602507	1	1	TYGART, MELISSA K MD	7/1/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	178923	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
64900	Fee-for-Service	1487939989	1487939989	1	1	TERAN, RAFAEL NP	4/16/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	20891	-	NOT APPLICABLE	0	In state provider	None	801 E CHAPEL ST	STE 1	SANTA MARIA	CA	93454	4607	42	06083	34.9542915	-120.424455	Santa Barbara County
64917	Fee-for-Service	1689944639	1689944639	1	1	TABIGO ON, ROY EUGENE G MD	7/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120169	41	Internal Medicine	0	In state provider	None	2185 W GRANT LINE RD	None	TRACY	CA	95377	7309	39	06077	37.75425686	-121.4567805	San Joaquin County
64925	Fee-for-Service	1659725190	1659725190	1	1	TEIXEIRA, STEPHANIE MD	9/4/2020	390200000X	NA	Other	026	PHYSICIANS	159997	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
64938	Fee-for-Service	1326379298	1326379298	1	1	THERAPY AT PLAY INC	5/23/2019	193200000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2208 CAMINO RAMON	None	SAN RAMON	CA	94583	1328	07	06013	37.77746122	-121.9677166	Contra Costa County
64974	Fee-for-Service	1205906310	1205906310	1	1	TOPSAKALYAN, ARUTYUN MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	64251	01	General Practice	0	In state provider	None	702 E COLORADO ST	STE C	GLENDALE	CA	91205	1712	19	06037	34.14264352	-118.246554	Los Angeles County
65025	Fee-for-Service	1417380643	1417380643	1	1	THAO, SANDY ANN	2/1/2017	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6186 E LIBERTY AVENUE	None	FRESNO	CA	93727	5647	10	06019	36.73138772	-119.6786213	Fresno County
65054	Fee-for-Service	1245790922	1245790922	1	1	TAUBMAN, DANIELLE S MD	6/20/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	176714	None	None	0	In state provider	None	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
65073	Fee-for-Service	1578880027	1578880027	1	1	TUAN, TERESA J MD	5/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120815	40	Pediatrics	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
65084	Fee-for-Service	1073546081	1073546081	1	1	TRACY L HARRIS	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3914 MURPHY CANYON RD	None	SAN DIEGO	CA	92123	4491	37	06073	32.81569938	-117.1166115	San Diego County
65092	Fee-for-Service	1518076900	1518076900	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05883	160 COUNTRY CLUB GATE CT	None	PACIFIC GROVE	CA	93950	5022	27	06053	36.6082561	-121.9244731	Monterey County
65103	Fee-for-Service	1841831062	1841831062	1	1	TSAI, LILLIAN OD	8/17/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	STE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
65107	Fee-for-Service	1255416459	1255416459	1	1	THAYER, STONE R MD	3/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137085	None	None	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
65169	Fee-for-Service	1366810988	1366810988	1	1	T & T CARE INC	12/22/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4566 E. FLORENCE AVE	9	CUDAHY	CA	90201	4347	19	06037	33.97001847	-118.1859258	Los Angeles County
65226	Fee-for-Service	1326379298	1326379298	1	1	THERAPY AT PLAY INC	3/14/2024	193200000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2208 CAMINO RAMON	None	SAN RAMON	CA	94583	1328	07	06013	37.77746122	-121.9677166	Contra Costa County
65231	Fee-for-Service	1497833172	1497833172	1	1	TAN, CHRISTINA A MD	1/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	54213	45	Nephrology (Renal-Kidney)	0	In state provider	None	20044 CEDAR RD N	None	SONORA	CA	95370	5900	55	06109	37.9872161	-120.3662945	Tuolumne County
65251	Fee-for-Service	1215081757	1215081757	1	1	THOMAS, NICHOLE S LMFT	5/29/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
65266	Fee-for-Service	1841428984	1841428984	1	1	TRAN, LEVINA A MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114086	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
65298	Fee-for-Service	1235843624	1235843624	1	1	TRINIDAD, NISHEA	1/18/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	10	06019	0	0	None
65312	Fee-for-Service	1417380643	1417380643	1	1	THAO, SANDY ANN	2/1/2017	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6186 E LIBERTY AVENUE	None	FRESNO	CA	93727	5647	10	06019	36.73138772	-119.6786213	Fresno County
65334	Fee-for-Service	1346842093	1346842093	1	2	TARZANA TREATMENT CENTERS, I	3/1/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC.	44421 10TH ST W	None	LANCASTER	CA	93534	3335	19	06037	34.690095	-118.148058	Los Angeles County
65371	Fee-for-Service	1306990577	1306990577	1	1	THE WILSHIRE COUNSELING CENT	7/16/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ER	16250 VENTURA BLVD	SUITE 465	ENCINO	CA	91436	4620	19	06037	34.15682212	-118.4871886	Los Angeles County
65373	Fee-for-Service	1073546081	1073546081	1	1	TRACY L HARRIS	4/3/2006	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3914 MURPHY CANYON RD	None	SAN DIEGO	CA	92123	4491	37	06073	32.81569938	-117.1166115	San Diego County
65432	Fee-for-Service	1366079188	1366079188	1	1	TOOR, RAVEENA DC	8/2/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	19693	36	Psychiatry	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
65483	Fee-for-Service	1093015786	1093015786	1	1	TILLEY-BARKER, CARLA LMFT	4/22/2024	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
65512	Fee-for-Service	1023096765	1023096765	1	1	TRUONG, PHUOC M MD	1/1/2001	207RE0101X	NA	Endocrinology	026	PHYSICIANS	58851	41	Internal Medicine	0	In state provider	None	24411 HEALTH CENTER DR	STE 550	LAGUNA HILLS	CA	92653	3687	30	06059	33.6087201	-117.7076948	Orange County
65542	Fee-for-Service	1497758569	1497758569	1	1	TUAI, BRIAN C MD	1/7/2010	174400000X	NA	Other	026	PHYSICIANS	66661	02	General Surgery	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2889	56	06111	34.2746295	-119.2573399	Ventura County
65567	Fee-for-Service	1356929483	1356929483	1	1	THOMAS, ALEXANDRIA M MD	4/25/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	192124	08	Family Practice	0	In state provider	None	15503 VENTURA BLVD	240, 340, 350	ENCINO	CA	91436	3115	19	06037	34.15483303	-118.4722163	Los Angeles County
65592	Fee-for-Service	1558449389	1558449389	1	1	TABILON,SHEILA M MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75776	41	Internal Medicine	0	In state provider	None	7551 MADISON AVE	None	CITRUS HEIGHTS	CA	95610	7449	34	06067	38.664333	-121.2879735	Sacramento County
65606	Fee-for-Service	1497950836	1497950836	1	1	TAN, ORKUN MD	10/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124810	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2300 CAMINO RAMON	None	SAN RAMON	CA	94583	1354	07	06013	37.77580025	-121.9664884	Contra Costa County
65614	Fee-for-Service	1821250762	1821250762	2	2	TARZANA MEDICAL CENTER LLC	4/18/2022	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	5411 ETIWANDA AVE	STE 100	TARZANA	CA	91356	3648	19	06037	34.169112	-118.530837	Los Angeles County
65620	Fee-for-Service	1487603668	1487603668	1	1	TANEJA, TARESH MD	4/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	54535	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
65636	Fee-for-Service	1366530321	1366530321	1	1	TOMLIN, JEFFREY M MD	4/1/2019	207T00000X	NA	General Surgery	026	PHYSICIANS	None	14	Neurological Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
65660	Fee-for-Service	1306990577	1306990577	1	1	THE WILSHIRE COUNSELING CENT	5/2/2023	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ER	16250 VENTURA BLVD	SUITE 465	ENCINO	CA	91436	4620	19	06037	34.15682212	-118.4871886	Los Angeles County
65679	Fee-for-Service	1508817271	1508817271	1	1	TRUJILLO, LLOYD L MD	12/3/2010	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	88719	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
65796	Fee-for-Service	1023096765	1023096765	1	1	TRUONG, PHUOC M MD	1/1/2001	207RE0101X	NA	Endocrinology	026	PHYSICIANS	58851	67	Endocrinology	0	In state provider	None	24411 HEALTH CENTER DR	STE 550	LAGUNA HILLS	CA	92653	3687	30	06059	33.6087201	-117.7076948	Orange County
65803	Fee-for-Service	1104067420	1104067420	1	1	TOM, DEEPA MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106732	None	None	0	In state provider	None	1801 W ROMNEYA DRIVE	STE 409	ANAHEIM	CA	92801	1827	30	06059	33.8506615	-117.946413	Orange County
65809	Fee-for-Service	1083350805	1083350805	1	1	TORRES, NAHIELY PT	11/4/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
65826	Fee-for-Service	1598758112	1598758112	1	1	THIRUVENGADAM, RAVI MD	3/14/1988	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	44566	10	Gastroenterology (M.D. only)	0	In state provider	None	6950 BROCKTON AVE	STE 3	RIVERSIDE	CA	92506	3831	33	06065	33.9474392	-117.3967287	Riverside County
65861	Fee-for-Service	1508379017	1508379017	1	7	TRI-STATE COMMUNITY	4/15/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1532 SAN BERNARDINO AVE	STE B-7	POMONA	CA	91767	3559	19	06037	34.0758525	-117.7200855	Los Angeles County
65866	Fee-for-Service	1497843742	1497843742	1	1	TAZUKE, SALLI I MD	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	79171	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
65887	Fee-for-Service	1043697071	1043697071	1	1	THIARA, DIANA K MD	8/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146827	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
65941	Fee-for-Service	1639404353	1639404353	1	1	TRIEU, HUY T MD	7/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	95029	02	General Surgery	0	In state provider	None	2321 HARRISON AVE	None	EUREKA	CA	95501	3216	12	06023	40.786857	-124.1396125	Humboldt County
65946	Fee-for-Service	1306990577	1306990577	1	1	THE WILSHIRE COUNSELING CENT	12/12/2023	103TC0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ER	16250 VENTURA BLVD	SUITE 465	ENCINO	CA	91436	4620	19	06037	34.15682212	-118.4871886	Los Angeles County
65959	Fee-for-Service	1104465046	1104465046	1	1	TOGETHERNESS HOSPICE CARE	3/24/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1254 S WATERMAN AVE	SUITE 56	SAN BERNARDINO	CA	92408	2859	36	06071	34.07886	-117.278817	San Bernardino County
65981	Fee-for-Service	1811486038	1811486038	1	1	TRAN, PAULINA T MD	7/22/2021	207R00000X	NA	Other	026	PHYSICIANS	17873	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
65985	Fee-for-Service	1801093083	1801093083	1	1	TULGAR, BIANKA M	10/19/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
66029	Fee-for-Service	1235237645	1235237645	1	1	TAKAGI, TIMOTHY R	11/13/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63349	08	Family Practice	0	In state provider	None	7601 HOSPITAL DR	STE 103	SACRAMENTO	CA	95823	5408	34	06067	38.464794	-121.415571	Sacramento County
66047	Fee-for-Service	1619906963	1619906963	1	1	TARGAN, STEPHEN R MD	7/6/1989	174400000X	NA	Other	026	PHYSICIANS	22752	01	General Practice	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
66072	Fee-for-Service	1811075393	1811075393	1	1	TZENG, BRIAN P MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72876	05	Anesthesiology	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
66102	Fee-for-Service	1407042955	1407042955	1	1	THOMPSON, KATHY J MD	7/17/2019	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	85785	77	Infectious Disease	0	In state provider	None	375 LAGUNA HONDA BLVD	None	SAN FRANCISCO	CA	94116	1411	38	06075	37.74791027	-122.4587116	San Francisco County
66113	Fee-for-Service	1598758112	1598758112	1	1	THIRUVENGADAM, RAVI MD	3/14/1988	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	44566	41	Internal Medicine	0	In state provider	None	6950 BROCKTON AVE	STE 3	RIVERSIDE	CA	92506	3831	33	06065	33.9474392	-117.3967287	Riverside County
66149	Fee-for-Service	1508379017	1508379017	1	7	TRI-STATE COMMUNITY	4/15/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1532 SAN BERNARDINO AVE	STE B-7	POMONA	CA	91767	3559	19	06037	34.0758525	-117.7200855	Los Angeles County
66156	Fee-for-Service	1881123347	1881123347	1	1	TRAN, DUY V MD	9/8/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	172541	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
66166	Fee-for-Service	1538879978	1538879978	1	1	THE RIGHT CHOICE HOME INC	1/19/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7747 VAN NOORD AVE	None	NORTH HOLLYWOOD	CA	91605	1934	19	06037	34.21155459	-118.4157833	Los Angeles County
66170	Fee-for-Service	1568477180	1568477180	2	1	T & G HEALTHCARE INC	3/27/2008	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	EL MONTE PHARMACY	3948 N PECK RD	SUITE #A1-A2	EL MONTE	CA	91732	2255	19	06037	34.07745077	-118.0210415	Los Angeles County
66178	Fee-for-Service	1770677700	1770677700	1	1	TREVISANO, MARNE A PHD	8/1/2000	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7730 MORRO RD	STE 101	ATASCADERO	CA	93422	4414	40	06079	35.47532022	-120.6680067	San Luis Obispo County
66181	Fee-for-Service	1144274614	1144274614	1	1	TISCHLER, HOWARD A MD	10/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	STE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
66190	Fee-for-Service	1669676540	1669676540	1	1	TANNA, RENUKA A PSYD	5/10/2024	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
66236	Fee-for-Service	1306990577	1306990577	1	1	THE WILSHIRE COUNSELING CENT	10/2/2024	103TC0700X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	ER	16250 VENTURA BLVD	SUITE 465	ENCINO	CA	91436	4620	19	06037	34.15682212	-118.4871886	Los Angeles County
66246	Fee-for-Service	1104465046	1104465046	1	1	TOGETHERNESS HOSPICE CARE	3/24/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1254 S WATERMAN AVE	SUITE 56	SAN BERNARDINO	CA	92408	2859	36	06071	34.07886	-117.278817	San Bernardino County
66302	Fee-for-Service	1265541791	1265541791	1	1	THRIFTY PAYLESS INC	8/1/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6089	720 SUTTON WAY	None	GRASS VALLEY	CA	95945	5393	29	06057	39.23301144	-121.0361436	Nevada County
66317	Fee-for-Service	1881710887	1881710887	1	1	TARZANA TREATMENT CENTER	4/15/1993	No Taxonomy Provided	NA	None	073	AIDS WAIVER SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	18646 OXNARD ST	None	TARZANA	CA	91356	1486	19	06037	34.17993229	-118.5397265	Los Angeles County
66408	Fee-for-Service	1851498935	1851498935	1	1	TOOMER, PAUL H MD	4/18/1994	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	35879	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	227 W JANSS RD	STE 320	THOUSAND OAKS	CA	91360	1870	56	06111	34.20611691	-118.883861	Ventura County
66473	Fee-for-Service	1154633527	1154633527	1	1	TIWANA, JASBIR S MD INC	9/1/2011	207R00000X	NA	Other	026	PHYSICIANS	105298	41	Internal Medicine	0	In state provider	None	2975 N SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
66483	Fee-for-Service	1376803940	1376803940	1	1	TRAN, HOA N MD	10/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128010	01	General Practice	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
66492	Fee-for-Service	1235369679	1235369679	1	1	TINSON, LESLYE M LMFT	6/24/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3500 GRANADA AVE	SUITE 342	SANTA CLARA	CA	95051	3300	43	06085	37.34890758	-121.9950537	Santa Clara County
66504	Fee-for-Service	1467110841	1467110841	1	1	THOMPSON, MEGHAN K PT	1/11/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	350 JOHN MUIR PKWY	250	BRENTWOOD	CA	94513	5183	07	06013	37.91980577	-121.734715	Contra Costa County
66537	Fee-for-Service	1639227200	1639227200	1	1	TURNER, GEORGE M DO	7/12/2005	207L00000X	NA	Other	026	PHYSICIANS	4918	05	Anesthesiology	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
66545	Fee-for-Service	1386749141	1386749141	1	1	TSURUDA, JAY S MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	48306	30	Radiology	0	In state provider	None	100 CONGRESS ST	None	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
66616	Fee-for-Service	1699080085	1699080085	1	1	TSANG, JENNIFER F MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113369	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
66629	Fee-for-Service	1235539784	1235539784	1	1	TULLY, LISA M PHD	6/16/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	101 THE CITY DRIVE S	BLDG 29	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
66641	Fee-for-Service	1003900366	1003900366	1	1	TRAM, HIEU N MD	2/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	80793	41	Internal Medicine	0	In state provider	None	15355 BROOKHURST ST	STE 102	WESTMINSTER	CA	92683	7071	30	06059	33.73998831	-117.9548789	Orange County
66663	Fee-for-Service	1598183121	1598183121	1	1	TOPP, POOJA A MD	6/15/2020	207R00000X	NA	Other	026	PHYSICIANS	167891	41	Internal Medicine	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
66669	Fee-for-Service	1891456190	1891456190	1	2	TERNER HOME	3/30/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	13921 CANTLAY ST	None	VAN NUYS	CA	91405	2513	19	06037	34.20223854	-118.4364315	Los Angeles County
66676	Fee-for-Service	1467473926	1467473926	1	1	TITCHER, RANDALL H MD	8/1/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	63208	-	NOT APPLICABLE	0	In state provider	None	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
66749	Fee-for-Service	1124137575	1124137575	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11750 WILMINGTON AVE	None	LOS ANGELES	CA	90059	2553	19	06037	33.92658	-118.2390545	Los Angeles County
66754	Fee-for-Service	1609038793	1609038793	1	1	TOBIN, KATHERINE P MD	6/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106161	05	Anesthesiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
66756	Fee-for-Service	1316097751	1316097751	1	1	TECHENTIN, ANNA L MD	7/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	53943	08	Family Practice	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
66766	Fee-for-Service	1750745329	1750745329	1	1	TRUONG, SANDY R MD	2/9/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168672	None	None	0	In state provider	None	5525 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
66783	Fee-for-Service	1679974885	1679974885	1	1	TATEISHI, AYA LCSW	3/14/2022	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
66831	Fee-for-Service	1942288709	1942288709	1	1	TAMMELIN, BRUCE R MD	5/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30439	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	27871 MEDICAL CENTER RD	STE 200	MISSION VIEJO	CA	92691	6406	30	06059	33.558534	-117.6641255	Orange County
66852	Fee-for-Service	1013151570	1013151570	1	2	TOP CHOICE HOME HEALTHCARE	5/27/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	539 N GLENOAKS BLVD	SUITE 201	BURBANK	CA	91502	3208	19	06037	34.18652984	-118.310858	Los Angeles County
66854	Fee-for-Service	1295175040	1295175040	1	1	TORRES, CHRISTINA LMFT	8/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1085 I ST	203	ARCATA	CA	95521	5588	12	06023	40.8707065	-124.0873395	Humboldt County
66879	Fee-for-Service	1780219550	1780219550	1	1	TOGETHER WE GROW INC	9/23/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	42389 WINCHESTER RD	SUITE B	TEMECULA	CA	92590	1807	33	06065	33.50945666	-117.1805532	Riverside County
66888	Fee-for-Service	1659456499	1659456499	1	1	THESTA ADVANCED IMAGING	10/30/1985	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	CENTER	6191 N THESTA ST	None	FRESNO	CA	93710	5266	10	06019	36.826362	-119.7831265	Fresno County
66893	Fee-for-Service	1932425782	1932425782	1	1	TEJASWI, SOORAJ MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111161	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
66900	Fee-for-Service	1568542470	1568542470	1	1	THORBUS, RUBEN S MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	13459	08	Family Practice	0	In state provider	None	812 E D ST	None	LEMOORE	CA	93245	9545	16	06031	36.30054441	-119.7692973	Kings County
66969	Fee-for-Service	1770567919	1770567919	1	1	TILLMAN, CAROL J OD	6/5/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
66972	Fee-for-Service	1043971526	1043971526	1	1	TIETSWORTH, RENEE A LCSW	1/18/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
66974	Fee-for-Service	1811006158	1811006158	1	1	THRIFTY PAYLESS INC	3/8/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	820 N LEMOORE AVE	None	LEMOORE	CA	93245	2333	16	06031	36.30753	-119.780784	Kings County
66981	Fee-for-Service	1134546039	1134546039	1	1	THOMAS, BENJAMIN A MD	10/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141863	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
66985	Fee-for-Service	1720405491	1720405491	1	1	TIBURCIO VASQUEZ HEALTH	11/13/2014	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	16110 E 14TH ST	None	SAN LEANDRO	CA	94578	3002	01	06001	37.6977026	-122.1176484	Alameda County
66993	Fee-for-Service	1619902954	1619902954	1	1	TU, QUOC D OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	907 6TH AVE	None	SAN DIEGO	CA	92101	6205	37	06073	32.7147817	-117.1591734	San Diego County
67013	Fee-for-Service	1548529787	1548529787	1	1	TARJAN, SARA MD	7/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134613	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVENUE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
67029	Fee-for-Service	1336545599	1336545599	1	1	TATREAU, AMY LMFT	3/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5320 VIRGINIA WAY	None	SACRAMENTO	CA	95822	2875	34	06067	38.526597	-121.4914185	Sacramento County
67104	Fee-for-Service	1336245828	1336245828	1	1	THE CHILDREN'S HOSPITAL	1/3/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	13123 EAST 16TH AVENUE	None	AURORA	CO	80045	7106	00	None	39.742164	-104.8350375	Adams County
67109	Fee-for-Service	1891305520	1891305520	1	1	THE MINDVIEW INC.	1/22/2021	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	169 PIER AVE	SUITE 2	SANTA MONICA	CA	90405	5311	19	06037	33.99824642	-118.4806396	Los Angeles County
67153	Fee-for-Service	1194130229	1194130229	1	1	TULLOS, HURTIS J MD	9/17/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	174323	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
67181	Fee-for-Service	1932425782	1932425782	1	1	TEJASWI, SOORAJ MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111161	10	Gastroenterology (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
67194	Fee-for-Service	1629025861	1629025861	1	1	THANGATHURAV, DURAIYAH	6/21/2000	207L00000X	NA	Other	026	PHYSICIANS	39606	05	Anesthesiology	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
67233	Fee-for-Service	1588999718	1588999718	1	1	THIJSSEN, ANTHONY M MD INC	12/7/2009	208800000X	NA	Other	026	PHYSICIANS	87191	34	Urology and Urological Surgery	0	In state provider	None	2510 AIRPARK DR	STE 103	REDDING	CA	96001	2461	45	06089	40.57119566	-122.4016582	Shasta County
67241	Fee-for-Service	1497868251	1497868251	2	1	TAMHANE, SHRIKANT K DO	6/12/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7213	08	Family Practice	0	In state provider	None	23517 MAIN STREET	SUITE 103	CARSON	CA	90745	5234	19	06037	33.81129174	-118.2756933	Los Angeles County
67264	Fee-for-Service	1821250762	1821250762	2	1	TARZANA MEDICAL CENTER LLC	12/2/2019	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	18321 CLARK STREET	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
67268	Fee-for-Service	1295064905	1295064905	1	1	TOTAL RENAL CARE INC	4/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	375 ROLLING OAKS DRIVE	STE 100	THOUSAND OAKS	CA	91361	1023	56	06111	34.17433197	-118.8706258	Ventura County
67274	Fee-for-Service	1720405491	1720405491	1	1	TIBURCIO VASQUEZ HEALTH	10/12/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	16110 E 14TH ST	None	SAN LEANDRO	CA	94578	3002	01	06001	37.6977026	-122.1176484	Alameda County
67285	Fee-for-Service	1629637285	1629637285	1	1	TSUCHIYA, KIMIKO DO	12/30/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	1100 N PALM CANYON DR	STE 109	PALM SPRINGS	CA	92262	4418	33	06065	33.838182	-116.546744	Riverside County
67321	Fee-for-Service	1497323935	1497323935	1	1	TRANSPORT4US LLC	12/7/2021	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	14393 PARK AVE	100	VICTORVILLE	CA	92392	0000	36	06071	34.5123	-117.3248825	San Bernardino County
67342	Fee-for-Service	1265699904	1265699904	1	1	THAKKAR, SNEHA I MD	12/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118380	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
67350	Fee-for-Service	1851317788	1851317788	1	1	TAM, FELIX K MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	47808	10	Gastroenterology (M.D. only)	0	In state provider	None	200 JOSE FIGUERES AVE	STE 480	SAN JOSE	CA	95116	1595	43	06085	37.36122014	-121.8505998	Santa Clara County
67380	Fee-for-Service	1821557729	1821557729	1	1	TRAN, CHLOE DO	9/9/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20039	None	None	0	In state provider	None	17762 BEACH BLVD.	220	HUNTINGTON BEACH	CA	92647	6860	30	06059	33.70404013	-117.9890603	Orange County
67392	Fee-for-Service	1336245828	1336245828	1	1	THE CHILDREN'S HOSPITAL	1/3/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	13123 EAST 16TH AVENUE	None	AURORA	CO	80045	7106	00	None	39.742164	-104.8350375	Adams County
67424	Fee-for-Service	1861070427	1861070427	1	1	TZE, EMILY DO	8/26/2024	208M00000X	NA	Other	026	PHYSICIANS	22197	70	Clinic (mixed specialty)	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
67475	Fee-for-Service	1205037561	1205037561	1	1	TAYLOR, MEHUL M MD	12/12/2010	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	102466	20	Orthopedic Surgery	0	In state provider	None	44105 N 15TH ST W	STE 207	LANCASTER	CA	93534	4088	19	06037	34.684218	-118.1568465	Los Angeles County
67519	Fee-for-Service	1083758817	1083758817	1	1	TAGHAVI ZARGAR, SOHEIL MD	1/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142542	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
67525	Fee-for-Service	1952154460	1952154460	1	1	TRANQUIL TRANSPORT SOLUTIONS	7/19/2024	347C00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	73305 ROYAL PALM DR	APT B	PALM DESERT	CA	92260	2880	33	06065	33.72463948	-116.3861415	Riverside County
67533	Fee-for-Service	1013927110	1013927110	1	1	TRAN, MICHAEL L MD	3/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	85353	05	Anesthesiology	0	In state provider	None	4704 HOEN AVE	None	SANTA ROSA	CA	95405	7824	49	06097	38.441187	-122.664645	Sonoma County
67549	Fee-for-Service	1003370354	1003370354	1	1	TRAN, TIM LAC	7/19/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1 HALLIDIE PLZ	309	SAN FRANCISCO	CA	94102	2818	38	06075	37.7837027	-122.4085843	San Francisco County
67552	Fee-for-Service	1821250762	1821250762	2	1	TARZANA MEDICAL CENTER LLC	12/2/2019	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	18321 CLARK STREET	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
67564	Fee-for-Service	1720405491	1720405491	1	1	TIBURCIO VASQUEZ HEALTH	3/3/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	16110 E 14TH ST	None	SAN LEANDRO	CA	94578	3002	01	06001	37.6977026	-122.1176484	Alameda County
67585	Fee-for-Service	1700097540	1700097540	1	6	THE NORTHEAST COMMUNITY CLNC	5/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	200 E ANAHEIM STREET	None	WILMINGTON	CA	90744	4516	19	06037	33.78003976	-118.2608958	Los Angeles County
67603	Fee-for-Service	1417485889	1417485889	1	8	TRANSIT PHYSICAL THERAPY PC	8/3/2023	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25915 BARTON RD	206	LOMA LINDA	CA	92354	3813	36	06071	34.0482545	-117.2388465	San Bernardino County
67625	Fee-for-Service	1720027436	1720027436	1	1	TROTTER, MARVIN G MD	9/20/2007	207P00000X	NA	Other	026	PHYSICIANS	42597	41	Internal Medicine	0	In state provider	None	890 N BUSH ST	None	UKIAH	CA	95482	3919	23	06045	39.15870782	-123.2140277	Mendocino County
67639	Fee-for-Service	1851317788	1851317788	1	1	TAM, FELIX K MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	47808	41	Internal Medicine	0	In state provider	None	200 JOSE FIGUERES AVE	STE 480	SAN JOSE	CA	95116	1595	43	06085	37.36122014	-121.8505998	Santa Clara County
67710	Fee-for-Service	1548252786	1548252786	1	1	TRAN, QUYNH CHI THUY MD	5/26/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90008	41	Internal Medicine	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
67757	Fee-for-Service	1568556827	1568556827	1	1	TEHRANZADEH, JAMSHID MD	2/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	40403	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
67826	Fee-for-Service	1245302660	1245302660	1	1	TEGULAPALLE, SIVAREDDY MD	11/15/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	157742	10	Gastroenterology (M.D. only)	0	In state provider	None	266 S HARVARD BLVD	STE 250	LOS ANGELES	CA	90004	4884	19	06037	34.069221	-118.3041245	Los Angeles County
67832	Fee-for-Service	1497847305	1497847305	1	1	TRI VALLEY NEONATAL	8/21/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL GROUP	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
67850	Fee-for-Service	1720405491	1720405491	1	1	TIBURCIO VASQUEZ HEALTH	11/13/2014	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	16110 E 14TH ST	None	SAN LEANDRO	CA	94578	3002	01	06001	37.6977026	-122.1176484	Alameda County
67873	Fee-for-Service	1700097540	1700097540	1	6	THE NORTHEAST COMMUNITY CLNC	5/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	200 E ANAHEIM STREET	None	WILMINGTON	CA	90744	4516	19	06037	33.78003976	-118.2608958	Los Angeles County
67888	Fee-for-Service	1417485889	1417485889	1	8	TRANSIT PHYSICAL THERAPY PC	1/31/2024	261QP2000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	25915 BARTON RD	206	LOMA LINDA	CA	92354	3813	36	06071	34.0482545	-117.2388465	San Bernardino County
67913	Fee-for-Service	1720027436	1720027436	1	1	TROTTER, MARVIN G MD	9/20/2007	207P00000X	NA	Other	026	PHYSICIANS	42597	66	Emergency Medicine (Urgent Care)	0	In state provider	None	890 N BUSH ST	None	UKIAH	CA	95482	3919	23	06045	39.15870782	-123.2140277	Mendocino County
67934	Fee-for-Service	1588816086	1588816086	1	1	TITH, TEVY MD	6/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103521	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
67946	Fee-for-Service	1265453708	1265453708	1	1	TRAN, THANH K MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74665	40	Pediatrics	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
67958	Fee-for-Service	1033421805	1033421805	1	1	TENENBLATT, KAREN J MD	12/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140300	40	Pediatrics	0	In state provider	None	1650 RESPONSE RD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
68028	Fee-for-Service	1881614345	1881614345	1	1	THOMPSON, KEVIN S MD	12/1/1992	207ZP0105X	NA	Other	026	PHYSICIANS	64070	None	None	0	In state provider	None	25333 BARTON RD	None	LOMA LINDA	CA	92354	3123	36	06071	34.04801656	-117.251334	San Bernardino County
68073	Fee-for-Service	1871602243	1871602243	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	531 N GLENDALE AVE	None	GLENDALE	CA	91206	3307	19	06037	34.15425741	-118.2432398	Los Angeles County
68082	Fee-for-Service	1437226248	1437226248	1	1	TADWALKAR, VISHWAS D MD	12/31/1987	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	40950	04	Otology, Laryngology, Rhinology	0	In state provider	None	805 S GAREY AVE	None	POMONA	CA	91766	3326	19	06037	34.05218103	-117.7499799	Los Angeles County
68092	Fee-for-Service	1003806076	1003806076	2	1	TAYLOR, WILLIAM H MD	8/21/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
68093	Fee-for-Service	1740341296	1740341296	1	1	TOMAS A MURILLO, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 7TH AVE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
68102	Fee-for-Service	1932143104	1932143104	1	1	TRAN, THUAN T MD	10/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76066	30	Radiology	0	In state provider	None	301 NEWPORT BEACH BLVD	None	NEWPORT BEACH	CA	92663	0000	30	06059	33.6242782	-117.9284249	Orange County
68120	Fee-for-Service	1497847305	1497847305	1	1	TRI VALLEY NEONATAL	8/21/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GROUP	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
68153	Fee-for-Service	1003251901	1003251901	1	1	THORNE, CHRISTINE A MD	4/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119170	01	General Practice	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
68155	Fee-for-Service	1265609010	1265609010	1	1	TSANG, MING K MD	9/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107173	05	Anesthesiology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
68163	Fee-for-Service	1497940357	1497940357	1	1	THOMAS, EVAN J MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91877	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2801 L ST	None	SACRAMENTO	CA	95816	5615	34	06067	38.57202	-121.4692695	Sacramento County
68171	Fee-for-Service	1679562698	1679562698	1	2	THE HILL MEDICAL CORPORATION	12/2/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	751 CORDOVA ST.	None	PASADENA	CA	91101	2617	19	06037	34.1425735	-118.134927	Los Angeles County
68176	Fee-for-Service	1477034122	1477034122	1	1	TAHMASIAN, TADEH RCP	11/20/2018	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
68201	Fee-for-Service	1679035208	1679035208	1	1	TRAN, DUY C MD	8/20/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	186792	None	None	0	In state provider	None	401 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6387	43	06085	37.36777579	-122.0276404	Santa Clara County
68204	Fee-for-Service	1598715252	1598715252	1	1	TSAO, ALICE M MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80269	05	Anesthesiology	0	In state provider	None	725 E SANTA CLARA ST	STE 101	SAN JOSE	CA	95112	1936	43	06085	37.34328626	-121.8756374	Santa Clara County
68239	Fee-for-Service	1962580738	1962580738	1	1	TOY, HERBERT MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	47933	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
68251	Fee-for-Service	1467005710	1467005710	1	1	TIN RX CASTRO SAN FRANCISCO	5/5/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2175 MARKET ST.	UNIT 122	SAN FRANCISCO	CA	94114	1474	38	06075	37.76645454	-122.4301026	San Francisco County
68280	Fee-for-Service	1225393747	1225393747	1	1	TRIMBA, ROMAN MD	7/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155716	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
68288	Fee-for-Service	1972099182	1972099182	1	1	TENG, KIANA S MD	6/17/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	164697	None	None	0	In state provider	None	2601 ALAMEDA AVE	412	BURBANK	CA	91505	4800	19	06037	34.15783817	-118.3293969	Los Angeles County
68340	Fee-for-Service	1861579534	1861579534	1	1	TAJLIL, ALI MD	12/12/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	37847	02	General Surgery	0	In state provider	None	3941 J ST	STE 370	SACRAMENTO	CA	95819	3633	34	06067	38.570652	-121.4535465	Sacramento County
68388	Fee-for-Service	1154479723	1154479723	1	1	THE REGENTS OF THE UNIVERSIT	2/14/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	M	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
68391	Fee-for-Service	1902069438	1902069438	1	1	TEJAL, THAKKAR MD	7/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95652	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
68397	Fee-for-Service	1962459479	1962459479	1	1	THE VALLEY CLINICA MEDICA GE	8/6/2021	261QP2300X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MEDICA GENERAL, MED CNTR	6511 VAN NUYS BLVD	None	VAN NUYS	CA	91401	1425	19	06037	34.18912197	-118.4487608	Los Angeles County
68426	Fee-for-Service	1699726182	1699726182	1	1	TURNER, ROBERT M MD	5/17/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40449	None	None	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 103	GARDEN GROVE	CA	92843	1915	30	06059	33.77450141	-117.9123364	Orange County
68464	Fee-for-Service	1346654985	1346654985	1	1	TAYLOR, DANIEL M DO	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16172	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95111	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
68527	Fee-for-Service	1962580738	1962580738	1	1	TOY, HERBERT MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	47933	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
68570	Fee-for-Service	1588853840	1588853840	1	1	TRUONG, PRISCILLA OD	3/24/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W VALLEY BLVD	STE 115	SAN GABRIEL	CA	91776	3784	19	06037	34.07958215	-118.1021957	Los Angeles County
68627	Fee-for-Service	1255426144	1255426144	1	1	TABOADA, DAVE S	5/2/2011	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
68639	Fee-for-Service	1801922570	1801922570	1	1	TOBE, BRIAN T MD	5/16/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	104068	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
68661	Fee-for-Service	1982096186	1982096186	1	1	TRINH, THUY PHUONG B	12/13/2022	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
68683	Fee-for-Service	1962459479	1962459479	1	1	THE VALLEY CLINICA MEDICA GE	5/4/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICA GENERAL, MED CNTR	6511 VAN NUYS BLVD	None	VAN NUYS	CA	91401	1425	19	06037	34.18912197	-118.4487608	Los Angeles County
68720	Fee-for-Service	1194017855	1194017855	1	1	TASHMAN, RAAD F MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147269	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
68725	Fee-for-Service	1144855107	1144855107	1	1	TAWFILIS, AMY C NP	1/15/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7625 MESA COLLEGE DR	250A	SAN DIEGO	CA	92111	5343	37	06073	32.80089797	-117.1572727	San Diego County
68735	Fee-for-Service	1669580064	1669580064	1	1	TRAN, THUC B T MD	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139269	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	13031 KERRY STREET	None	GARDEN GROVE	CA	92844	1638	30	06059	33.773265	-117.958877	Orange County
68738	Fee-for-Service	1518181494	1518181494	1	1	TORRICELLI, GLENDA R	4/30/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	61075	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
68755	Fee-for-Service	1184764011	1184764011	1	1	TAVASSOLI, SARA OD	12/10/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
68803	Fee-for-Service	1710040936	1710040936	1	1	TANIOS, MAGED A INC	3/2/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3605 LONG BEACH BLVD	STE 405	LONG BEACH	CA	90807	4026	19	06037	33.822693	-118.1893765	Los Angeles County
68816	Fee-for-Service	1962580738	1962580738	1	1	TOY, HERBERT MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	47933	03	Allergy	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
68847	Fee-for-Service	1528583531	1528583531	1	1	TURNER, KELLI A OT	1/10/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
68851	Fee-for-Service	1912154642	1912154642	1	1	THIES, MARY E	2/23/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
68920	Fee-for-Service	1235213604	1235213604	1	1	TAHAN, CARLA N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	76934	40	Pediatrics	0	In state provider	None	358 KANAN RD	None	OAK PARK	CA	91377	1111	56	06111	34.17620875	-118.7595979	Ventura County
68951	Fee-for-Service	1336824085	1336824085	1	1	THE CIRCLE FAMILY CENTER	8/6/2024	261Q00000X	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	44	06087	0	0	None
68971	Fee-for-Service	1962459479	1962459479	1	1	THE VALLEY CLINICA MEDICA GE	3/5/1996	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICA GENERAL, MED CNTR	6511 VAN NUYS BLVD	None	VAN NUYS	CA	91401	1425	19	06037	34.18912197	-118.4487608	Los Angeles County
68995	Fee-for-Service	1558896407	1558896407	1	1	TEAM MAKENA LLC	6/24/2019	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	6801 PARK TERRACE DRIVE	SUITE 110	LOS ANGELES	CA	90045	1544	19	06037	33.97777821	-118.3928444	Los Angeles County
69026	Fee-for-Service	1083033179	1083033179	1	1	TAM, TIFFANIE MD	10/25/2023	207VF0040X	NA	Obstetrics & Gynecology	026	PHYSICIANS	188241	None	None	0	In state provider	None	2801 K STREET	SUITE 200	SACRAMENTO	CA	95816	9582	34	06067	38.572947	-121.46904	Sacramento County
69030	Fee-for-Service	1568843019	1568843019	1	1	THRIFTY PAYLESS INC	11/24/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1710 N FARMERSVILLE BLVD	None	FARMERSVILLE	CA	93223	2306	54	06107	36.312732	-119.2070045	Tulare County
69036	Fee-for-Service	1124138912	1124138912	1	1	THRIFTY PAYLESS INC	3/4/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6243	2500 N 10TH AVE	None	HANFORD	CA	93230	2391	16	06031	36.35784	-119.6371195	Kings County
69078	Fee-for-Service	1346276540	1346276540	1	1	TSENG, JUSTINA J MD	9/1/2020	207RR0500X	NA	Other	026	PHYSICIANS	54040	41	Internal Medicine	0	In state provider	None	19929 GREENLEY RD	None	SONORA	CA	95370	5996	55	06109	37.9837971	-120.366851	Tuolumne County
69090	Fee-for-Service	1851810105	1851810105	1	1	TABIB, SHIRIN M LMFT	5/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
69094	Fee-for-Service	1114957628	1114957628	1	1	TAM, TONY	12/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	71710	02	General Surgery	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
69119	Fee-for-Service	1760603161	1760603161	1	1	THOMAS, CHARLES H MD	8/1/2000	2084P0800X	NA	Psychiatry	026	PHYSICIANS	63126	36	Psychiatry	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
69120	Fee-for-Service	1922258078	1922258078	1	1	TRAN, DORA LCSW	12/7/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
69181	Fee-for-Service	1982792065	1982792065	2	1	TRAUT, JOEL MD	3/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	51079	None	None	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
69191	Fee-for-Service	1336464718	1336464718	1	1	THAM, STEVEN F MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120022	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
69249	Fee-for-Service	1033173844	1033173844	1	1	TANG, GEXIN MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69406	05	Anesthesiology	0	In state provider	None	9920 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.7016655	-117.955521	Orange County
69250	Fee-for-Service	1457383929	1457383929	1	1	TANNER, WILLIAM S	5/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63125	None	None	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
69260	Fee-for-Service	1962459479	1962459479	1	1	THE VALLEY CLINICA MEDICA GE	11/24/2020	261QP2300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICA GENERAL, MED CNTR	6511 VAN NUYS BLVD	None	VAN NUYS	CA	91401	1425	19	06037	34.18912197	-118.4487608	Los Angeles County
69262	Fee-for-Service	1265485783	1265485783	1	1	TOWERY, OWEN B MD	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	42234	36	Psychiatry	0	In state provider	None	2700 GRANT ST	STE 202	CONCORD	CA	94520	2266	07	06013	37.98417931	-122.0361585	Contra Costa County
69280	Fee-for-Service	1841368925	1841368925	1	4	TRIANGLE EYE INSTITUTE	3/9/1990	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	MEDICAL CENTER, INC.	5201 CALIFORNIA AVE	STE 410	BAKERSFIELD	CA	93309	1673	15	06029	35.35945895	-119.0607332	Kern County
69347	Fee-for-Service	1003904350	1003904350	1	1	TAN, WINONA M MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80084	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
69379	Fee-for-Service	1073612545	1073612545	1	1	TYAGI, VIVAIK MD	12/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78333	41	Internal Medicine	0	In state provider	None	1331 W AVENUE J	STE 102	LANCASTER	CA	93534	2946	19	06037	34.68946152	-118.155699	Los Angeles County
69388	Fee-for-Service	1720160336	1720160336	2	1	TRAN, TOAN Q MD	2/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	39066	41	Internal Medicine	0	In state provider	None	7631 WYOMING ST	STE 102	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
69396	Fee-for-Service	1487940995	1487940995	1	1	TUN, AYE M MD	8/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127864	41	Internal Medicine	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
69400	Fee-for-Service	1548251895	1548251895	1	1	TAGLE, BRUCE MD	3/31/1986	207R00000X	NA	Other	026	PHYSICIANS	57211	None	None	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
69426	Fee-for-Service	1437313582	1437313582	1	1	TZUNG, BRIAN S MD	4/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	95890	30	Radiology	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
69447	Fee-for-Service	1669066924	1669066924	1	1	TAYLOR, RYAN MD	11/2/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	171222	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
69459	Fee-for-Service	1194054585	1194054585	1	1	TAKARA, TADASHI MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109982	20	Orthopedic Surgery	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
69467	Fee-for-Service	1407948474	1407948474	1	1	TO, BRYAN H MD	6/4/2019	207R00000X	NA	Other	026	PHYSICIANS	84344	41	Internal Medicine	0	In state provider	None	24910 LAS BRISAS RD	SUITE #120	MURRIETA	CA	92562	4035	33	06065	33.57522424	-117.1828078	Riverside County
69511	Fee-for-Service	1821353723	1821353723	1	1	TRUONG, JANE N MD	8/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115388	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
69540	Fee-for-Service	1972526812	1972526812	1	1	TOWNSEND, RICHARD E PHD	2/18/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1908 SWEETWATER RD	None	NATIONAL CITY	CA	91950	7628	37	06073	32.66119079	-117.0786584	San Diego County
69607	Fee-for-Service	1912971763	1912971763	1	1	TURNER, TODD R MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71641	41	Internal Medicine	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
69608	Fee-for-Service	1164059655	1164059655	1	1	TRAC, BRANDON MD	4/26/2022	390200000X	NA	Other	026	PHYSICIANS	176889	None	None	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
69613	Fee-for-Service	1487848651	1487848651	1	1	TEJURA, KRUPALI K MD	1/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99732	78	Neoplastic Diseases/Oncology	0	In state provider	None	1280 CORONA POINTE CT	None	CORONA	CA	92879	1770	33	06065	33.87039079	-117.5408442	Riverside County
69666	Fee-for-Service	1073612545	1073612545	1	1	TYAGI, VIVAIK MD	12/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78333	10	Gastroenterology (M.D. only)	0	In state provider	None	1331 W AVENUE J	STE 102	LANCASTER	CA	93534	2946	19	06037	34.68946152	-118.155699	Los Angeles County
69767	Fee-for-Service	1689762817	1689762817	1	1	TRAN, DUC NGOC DO INC	2/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	6642	01	General Practice	0	In state provider	None	9091 EDINGER AVE	STE A	WESTMINSTER	CA	92683	5986	30	06059	33.73034951	-117.9706005	Orange County
69781	Fee-for-Service	1114668647	1114668647	1	1	THE LOS ANGELES FREE CLINIC	6/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	6043 HOLLYWOOD BLVD	None	LOS ANGELES	CA	90028	5411	19	06037	34.1016835	-118.321569	Los Angeles County
69784	Fee-for-Service	1467428326	1467428326	1	1	TSAI, CHAI YUNG J MD	9/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81441	08	Family Practice	0	In state provider	None	2601 VIA CAMPO	None	MONTEBELLO	CA	90640	1807	19	06037	34.03278164	-118.1237597	Los Angeles County
69815	Fee-for-Service	1851851836	1851851836	1	1	TORRES-SOLANO, MARIO MD	8/26/2024	208M00000X	NA	Other	026	PHYSICIANS	None	77	Infectious Disease	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
69902	Fee-for-Service	1487848651	1487848651	1	1	TEJURA, KRUPALI K MD	1/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99732	30	Radiology	0	In state provider	None	1280 CORONA POINTE CT	None	CORONA	CA	92879	1770	33	06065	33.87039079	-117.5408442	Riverside County
69957	Fee-for-Service	1578977914	1578977914	1	1	TSENG, HOWARD J MD	9/27/2020	207P00000X	NA	Other	026	PHYSICIANS	161643	08	Family Practice	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
69959	Fee-for-Service	1255977955	1255977955	1	1	TLC HOMECARE INC	3/10/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3017 DOUGLAS BLVD	SUITE 300 #61	ROSEVILLE	CA	95661	3850	31	06061	38.74412077	-121.232331	Placer County
70050	Fee-for-Service	1154785004	1154785004	1	1	THOUSAND OAKS HOSPICE INC	1/16/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	22222 SHERMAN WAY	STE 104	CANOGA PARK	CA	91303	4323	19	06037	34.20099052	-118.611162	Los Angeles County
70056	Fee-for-Service	1326545500	1326545500	1	1	TURNER, JASON T MD	8/1/2023	2086S0129X	NA	General Surgery	026	PHYSICIANS	183554	None	None	0	In state provider	None	77 CASA ST	STE 103	SAN LUIS OBISPO	CA	93405	5804	40	06079	35.29306786	-120.6650709	San Luis Obispo County
70057	Fee-for-Service	1215249164	1215249164	1	1	TANAKA, MIA S S DO	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12054	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
70070	Fee-for-Service	1235624123	1235624123	1	1	TIET, NANCY Q DO	1/17/2022	207R00000X	NA	Other	026	PHYSICIANS	19112	None	None	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
70074	Fee-for-Service	1114668647	1114668647	1	1	THE LOS ANGELES FREE CLINIC	6/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	6043 HOLLYWOOD BLVD	None	LOS ANGELES	CA	90028	5411	19	06037	34.1016835	-118.321569	Los Angeles County
70097	Fee-for-Service	1780693382	1780693382	1	1	TOWFIGH, ABBASSEH DPM	9/20/2007	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	9375 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1418	19	06037	34.2395322	-118.3939944	Los Angeles County
70120	Fee-for-Service	1326026832	1326026832	1	1	THAKRAN, ALKA MD	4/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74301	30	Radiology	0	In state provider	None	945 SHASTA ST	None	YUBA CITY	CA	95991	4114	51	06101	39.14392271	-121.6160328	Sutter County
70133	Fee-for-Service	1699872366	1699872366	1	1	THOMAS, BERT J MD	10/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	43282	01	General Practice	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
70135	Fee-for-Service	1588360127	1588360127	1	1	TAN, MARILETH NP	5/29/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1100 MAGELLAN DR	None	TEHACHAPI	CA	93561	1380	15	06029	35.14690796	-118.4506925	Kern County
70158	Fee-for-Service	1205003670	1205003670	1	1	TABBIT, LISA A DO	11/16/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	12172	01	General Practice	0	In state provider	None	3605 HOSPITAL ROAD	None	ATWATER	CA	95301	5173	24	06047	37.36678073	-120.576731	Merced County
70167	Fee-for-Service	1508379017	1508379017	1	2	TRI-STATE COMMUNITY	3/20/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4137 VERDUGO RD	None	LOS ANGELES	CA	90065	3820	19	06037	34.1261475	-118.2319835	Los Angeles County
70200	Fee-for-Service	1508813379	1508813379	2	1	TRI STATE CARE FLIGHT LLC	1/25/2016	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	2	Out of state provider	None	2000 HIGHWAY 95	STE 210	BULLHEAD CITY	AZ	86442	6057	00	None	35.11494	-114.5975085	Mohave County
70231	Fee-for-Service	1851695175	1851695175	1	1	TAUBMAN, JEREMY M LCSW	12/8/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	800 SERENO DR	None	VALLEJO	CA	94589	2411	48	06095	38.12792924	-122.2506587	Solano County
70282	Fee-for-Service	1114107844	1114107844	1	1	TIAN, ASHLEY G MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	100807	14	Neurological Surgery	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
70283	Fee-for-Service	1639466535	1639466535	1	1	TONG, JUSTIN Y MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135784	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	SUITE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
70338	Fee-for-Service	1154785004	1154785004	1	1	THOUSAND OAKS HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	22222 SHERMAN WAY	STE 104	CANOGA PARK	CA	91303	4323	19	06037	34.20099052	-118.611162	Los Angeles County
70362	Fee-for-Service	1508028846	1508028846	1	1	THOMSON, EMILY J DO	5/16/2023	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	15493	None	None	0	In state provider	None	28780 SINGLE OAK DRIVE	SUITE 160	TEMECULA	CA	92590	5528	33	06065	33.49890392	-117.1612965	Riverside County
70380	Fee-for-Service	1497798847	1497798847	1	1	TENENBERG	10/21/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1850 STATE ST	None	NEW ALBANY	IN	47150	4990	00	None	38.3008159	-85.83535883	Floyd County
70412	Fee-for-Service	1275608895	1275608895	1	1	TAKLA, ROGER Y MD	7/1/1986	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	1040 ELM AVE	STE 301	LONG BEACH	CA	90813	3267	19	06037	33.779799	-118.1879535	Los Angeles County
70421	Fee-for-Service	1295288272	1295288272	1	1	THAI, PEARL T B OD	7/19/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
70448	Fee-for-Service	1700801909	1700801909	1	1	TENET HOSPITALS LTD	5/5/2000	282NC2000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	PROVIDENCE MEMORIAL HOSP	2001 N OREGON ST	None	EL PASO	TX	79902	3320	00	None	31.77138005	-106.4995755	El Paso County
70456	Fee-for-Service	1508379017	1508379017	1	2	TRI-STATE COMMUNITY	3/20/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4137 VERDUGO RD	None	LOS ANGELES	CA	90065	3820	19	06037	34.1261475	-118.2319835	Los Angeles County
70520	Fee-for-Service	1902692544	1902692544	1	1	TAYLOR, SKYE BIRTH DOULA	4/28/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	09	06017	0	0	None
70521	Fee-for-Service	1851695175	1851695175	1	2	TAUBMAN, JEREMY M LCSW	10/22/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	26837	-	NOT APPLICABLE	0	In state provider	None	1820 SCENIC AVENUE	None	BERKELEY	CA	94709	1324	01	06001	37.87536985	-122.2622489	Alameda County
70531	Fee-for-Service	1265858146	1265858146	1	1	TROCHANOVA, NADIA NP	8/29/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95000484	-	NOT APPLICABLE	0	In state provider	None	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
70552	Fee-for-Service	1972685196	1972685196	1	1	THE CAMP RECOVERY CENTER, LL	6/21/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	C	3600 GLEN CANYON RD	2	SCOTTS VALLEY	CA	95066	4916	44	06087	37.04102106	-122.0230491	Santa Cruz County
70626	Fee-for-Service	1477041127	1477041127	1	1	TRAN, LILLIAN T MD	6/29/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	176246	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
70652	Fee-for-Service	1144426750	1144426750	1	1	THACKER, TARA N MD	6/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99654	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
70660	Fee-for-Service	1750668349	1750668349	1	1	TEBBEN, MEGAN LCSW	12/3/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
70718	Fee-for-Service	1447254347	1447254347	1	2	TOUCHETTE, DEBORAH A AU	4/5/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
70729	Fee-for-Service	1548416167	1548416167	1	1	TRAN, THU	12/25/2023	207ZP0102X	NA	Other	026	PHYSICIANS	109742	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
70737	Fee-for-Service	1700801909	1700801909	1	1	TENET HOSPITALS LTD	5/5/2000	261QA1903X	NA	Other	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	PROVIDENCE MEMORIAL HOSP	2001 N OREGON ST	None	EL PASO	TX	79902	3320	00	None	31.77138005	-106.4995755	El Paso County
70785	Fee-for-Service	1578962742	1578962742	1	1	TRUMBULL, JOSHUA R LMFT	11/29/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
70826	Fee-for-Service	1619294048	1619294048	1	1	TSAI, ALBERT G MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118638	22	Pathology (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
70872	Fee-for-Service	1356577258	1356577258	1	1	TUCKER, RAELYNN M MD	8/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	77146	22	Pathology (M.D. only)	0	In state provider	None	31872 COAST HWY	None	LAGUNA BEACH	CA	92651	6773	30	06059	33.49961197	-117.7420867	Orange County
70878	Fee-for-Service	1366828766	1366828766	1	1	TWILIGHT HOMES, INC.	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	3033 E. LOS ALTOS AVE	None	FRESNO	CA	93710	4968	10	06019	36.83257056	-119.7355115	Fresno County
70916	Fee-for-Service	1518537414	1518537414	1	1	TRIBUTE HOME HEALTH CARE INC	9/29/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	520 E WILSON AVE	SUITE 200	BURBANK	CA	91206	4374	19	06037	34.14812361	-118.2491324	Los Angeles County
70928	Fee-for-Service	1225764459	1225764459	1	1	TRAN, HAYLIE	3/12/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9940 TALBERT AVE	204	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166347	-117.955494	Orange County
70985	Fee-for-Service	1467297804	1467297804	1	1	TRINITY HEALTHCARE INC	12/3/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	28015 SECO CANYON RD	None	SANTA CLARITA	CA	91390	4204	19	06037	34.46079165	-118.5343665	Los Angeles County
71002	Fee-for-Service	1558466342	1558466342	1	1	TOFLER, IAN R MD	9/1/1998	2084P0804X	NA	Psychiatry	026	PHYSICIANS	50160	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
71013	Fee-for-Service	1922285188	1922285188	1	1	TAN, TOM X MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111670	41	Internal Medicine	0	In state provider	None	43830 10TH ST W	None	LANCASTER	CA	93534	4826	19	06037	34.67913961	-118.1478725	Los Angeles County
71034	Fee-for-Service	1477008035	1477008035	1	1	TROLL, RYAN V	9/9/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5061 SHASTA DAM BLVD	None	SHASTA LAKE	CA	96019	9405	45	06089	40.68027851	-122.3557875	Shasta County
71053	Fee-for-Service	1871540369	1871540369	1	1	TARLOW, GARDNER D MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71363	08	Family Practice	0	In state provider	None	215 N STATE COLLEGE BLVD	STE B	ANAHEIM	CA	92806	2937	30	06059	33.84270255	-117.8893257	Orange County
71108	Fee-for-Service	1326047309	1326047309	1	1	TIWARI, BHOODEV MD	1/3/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	27830 BRADLEY RD	None	SUN CITY	CA	92586	2201	33	06065	33.71615891	-117.1906431	Riverside County
71110	Fee-for-Service	1518351733	1518351733	1	1	THOMASSIAN, RAZMIK MD	8/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152242	41	Internal Medicine	0	In state provider	None	1880 N ORANGE GROVE AVE	None	POMONA	CA	91767	3006	19	06037	34.07803211	-117.74833	Los Angeles County
71129	Fee-for-Service	1689624983	1689624983	1	1	TAJIRI, KATHLEEN S MD	11/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	65082	43	Pediatric Allergy	0	In state provider	None	1100 PEAR TREE LANE	None	NAPA	CA	94558	6446	28	06055	38.32087983	-122.2946228	Napa County
71154	Fee-for-Service	1417391558	1417391558	1	1	TOOMARIAN, MOJDEH MD	6/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143035	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
71172	Fee-for-Service	1689732687	1689732687	1	1	TRAN, ANDREW Q MD	7/9/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	150320	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
71215	Fee-for-Service	1265410351	1265410351	1	1	TOGNACCI, EDWARD J DO	4/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3269 STOCKTON HILL RD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
71236	Fee-for-Service	1972616860	1972616860	1	1	TUDTUD-HANS, LEAH A MD	6/1/1995	207R00000X	NA	Other	026	PHYSICIANS	53471	41	Internal Medicine	0	In state provider	None	9851 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.918192	-117.4547295	Riverside County
71266	Fee-for-Service	1124074166	1124074166	1	1	TOURSARKISSIAN, KARIM MD	8/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87408	None	None	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
71269	Fee-for-Service	1568830123	1568830123	1	1	TERAO, RYAN PSYD	1/20/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
71338	Fee-for-Service	1528152584	1528152584	1	1	TAMURA, CALYTON T MD	1/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63944	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
71360	Fee-for-Service	1447284591	1447284591	1	1	THOMAS, EVAN D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	650 ADDISON AVE W	None	TWIN FALLS	ID	83301	5444	00	None	42.56415243	-114.4940357	Twin Falls County
71370	Fee-for-Service	1417485889	1417485889	1	7	TRANSIT PHYSICAL THERAPY PC	8/2/2023	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	17051 SIERRA LAKES PKWY	SUITE 204	FONTANA	CA	92336	1274	36	06071	34.13797332	-117.4324372	San Bernardino County
71405	Fee-for-Service	1184702714	1184702714	1	1	TRAN,HIEN L DC	8/1/2000	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	5114 EL CAJON BLVD	APT 1	SAN DIEGO	CA	92115	4723	37	06073	32.75717297	-117.0842565	San Diego County
71406	Fee-for-Service	1174693493	1174693493	1	5	THE WECARE GROUP	2/6/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	100 HORSESHOE LN	None	WEAVERVILLE	CA	96093	0000	53	06105	40.73568628	-122.9304765	Trinity County
71407	Fee-for-Service	1639201999	1639201999	1	1	TOBIAS-CIPOLLA, NGINA E	8/10/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	5479 E ABBEYFIELD ST	STE 3	LONG BEACH	CA	90815	3050	19	06037	33.79388819	-118.1261825	Los Angeles County
71481	Fee-for-Service	1265792360	1265792360	1	1	TING, JARRIET A MD	1/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	117859	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LN	STE 450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
71483	Fee-for-Service	1326337544	1326337544	1	1	TENG, JAMES MD	7/12/2018	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	148235	04	Otology, Laryngology, Rhinology	0	In state provider	None	1595 SOQUEL DR	STE 230	SANTA CRUZ	CA	95065	1721	44	06087	36.98879599	-121.9826354	Santa Cruz County
71486	Fee-for-Service	1255792784	1255792784	1	1	TANG, PHILIP DO	9/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16368	41	Internal Medicine	0	In state provider	None	1020 29TH STREET	STE 120	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
71515	Fee-for-Service	1033485016	1033485016	1	1	TRUDEAU, JACQUELINE D MD	5/25/2020	163WG0000X	NA	Other	026	PHYSICIANS	131135	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
71545	Fee-for-Service	1366601999	1366601999	1	1	THAM, TRANG M MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112301	66	Emergency Medicine (Urgent Care)	0	In state provider	None	28400 MCCALL BLVD	None	SUN CITY	CA	92585	9658	33	06065	33.71805454	-117.1672547	Riverside County
71547	Fee-for-Service	1750522983	1750522983	1	1	TSU, NICHOLAS MD	6/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110244	05	Anesthesiology	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
71585	Fee-for-Service	1346885134	1346885134	1	1	TRANQUILITY CARE HOSPICE INC	6/11/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3704 FOOTHILL BLVD	None	GLENDALE	CA	91214	1740	19	06037	34.23635732	-118.2596444	Los Angeles County
71629	Fee-for-Service	1962577924	1962577924	1	1	TAYLOR, CLIFFORD D PHD	7/8/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
71658	Fee-for-Service	1417485889	1417485889	1	7	TRANSIT PHYSICAL THERAPY PC	1/31/2024	261QP2000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	17051 SIERRA LAKES PKWY	SUITE 204	FONTANA	CA	92336	1274	36	06071	34.13797332	-117.4324372	San Bernardino County
71691	Fee-for-Service	1083001234	1083001234	1	1	TIRTAPUTRA, EVAN	7/3/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9324 GARVEY AVE	UNIT J	SOUTH EL MONTE	CA	91733	1090	19	06037	34.06269254	-118.065933	Los Angeles County
71697	Fee-for-Service	1174693493	1174693493	1	5	THE WECARE GROUP	2/6/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	100 HORSESHOE LN	None	WEAVERVILLE	CA	96093	0000	53	06105	40.73568628	-122.9304765	Trinity County
71715	Fee-for-Service	1235372640	1235372640	1	1	TAGORE, SIMRANJEET K NP	11/21/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
71740	Fee-for-Service	1972599652	1972599652	1	1	TOROSOFF, MIKHAIL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	47 NEW SCOTLAND AVE	None	ALBANY	NY	12208	3412	00	None	42.65281106	-73.77466567	Albany County
71772	Fee-for-Service	1639390339	1639390339	1	1	TARZANA TREATMENT CENTERS, I	12/1/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	907 W LANCASTER BLVD	None	LANCASTER	CA	93534	2305	19	06037	34.69735779	-118.1471724	Los Angeles County
71776	Fee-for-Service	1124160155	1124160155	1	1	TAN,JANE C MD	11/9/2000	207RN0300X	NA	Nephrology	026	PHYSICIANS	85943	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
71807	Fee-for-Service	1417485889	1417485889	1	2	TRANSIT PHYSICAL THERAPY PC	2/19/2025	261QP2000X	NA	Physical Therapist	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LN	103	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
71828	Fee-for-Service	1891049128	1891049128	1	1	TRIEU, JESSIE K MD	12/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123561	41	Internal Medicine	0	In state provider	None	375 HUNTINGTON DR	SUITE G	SAN MARINO	CA	91108	2357	19	06037	34.1067704	-118.1349621	Los Angeles County
71831	Fee-for-Service	1831570951	1831570951	1	1	TORRES, JULIANNE S DO	5/27/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
71832	Fee-for-Service	1508814336	1508814336	1	1	THOMAS,RUHLEN F MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10401 W THUNDERBIRD BLVD	None	SUN CITY	AZ	85351	0000	00	None	33.603885	-112.2831765	Maricopa County
71842	Fee-for-Service	1326133042	1326133042	1	1	TANG, EDWARD MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69085	None	None	0	In state provider	None	FRESNO & R STREET	None	FRESNO	CA	93715	0000	10	06019	36.741663	-119.7841005	Fresno County
71861	Fee-for-Service	1205945631	1205945631	1	1	THRIFTY PAYLESS INC	4/1/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID # 6267	6512 COMSTOCK AVE	None	WHITTIER	CA	90601	4103	19	06037	33.982272	-118.0385405	Los Angeles County
71865	Fee-for-Service	1063770097	1063770097	1	1	TIMOTHY WILLIAM THOMSEN M.D.	10/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
71867	Fee-for-Service	1417526757	1417526757	1	1	TURNBULL, DENNIS L DO	7/26/2024	208M00000X	NA	Other	026	PHYSICIANS	20425	41	Internal Medicine	0	In state provider	None	1100 MAGELLAN DR	None	TEHACHAPI	CA	93561	1380	15	06029	35.14690796	-118.4506925	Kern County
71870	Fee-for-Service	1346885134	1346885134	1	1	TRANQUILITY CARE HOSPICE INC	6/11/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3704 FOOTHILL BLVD	None	GLENDALE	CA	91214	1740	19	06037	34.23635732	-118.2596444	Los Angeles County
71882	Fee-for-Service	1235372376	1235372376	1	1	TANTAWI, DIYA H M MD	9/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	126218	02	General Surgery	0	In state provider	None	39000 BOB HOPE DRIVE	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
71898	Fee-for-Service	1215968953	1215968953	1	1	THERESA M. TARCHA	1/9/2012	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	5112 W. 190TH STREET	None	TORRANCE	CA	90503	1005	19	06037	33.85823955	-118.366902	Los Angeles County
71932	Fee-for-Service	1881604742	1881604742	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3745 E FOOTHILL BLVD	None	PASADENA	CA	91107	2202	19	06037	34.15026686	-118.0725845	Los Angeles County
71959	Fee-for-Service	1144562737	1144562737	1	1	TRAN, DAVID MD	8/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131973	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
71983	Fee-for-Service	1518975242	1518975242	1	1	TAUGHER, KAREN C OD	8/19/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
71989	Fee-for-Service	1144545773	1144545773	1	1	TOBIAS KULIK	3/12/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2719	00	None	35.08771808	-106.6192188	Bernalillo County
72015	Fee-for-Service	1518968098	1518968098	1	1	TALBERT MEDICAL GROUP	11/1/2001	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	INC	13152 NEWPORT AVE	None	TUSTIN	CA	92780	3416	30	06059	33.74737358	-117.812672	Orange County
72024	Fee-for-Service	1598067613	1598067613	1	1	THE CENTER FOR COMPREHENSIVE	2/23/2012	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ISORDERS (CIBD) PHARMACY	701 S PARKER ST	SUITE 1400	ORANGE	CA	92868	4720	30	06059	33.77647082	-117.8595932	Orange County
72097	Fee-for-Service	1417485889	1417485889	1	2	TRANSIT PHYSICAL THERAPY PC	9/25/2019	261QP2000X	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
72111	Fee-for-Service	1649466327	1649466327	1	2	TRACY, BRIDGET CRNA	2/4/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
72124	Fee-for-Service	1639602154	1639602154	1	3	TRU VISION LLC	4/15/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1013 WHITE LANE	None	BAKERSFIELD	CA	93307	4727	15	06029	35.31758353	-119.014101	Kern County
72165	Fee-for-Service	1467466243	1467466243	1	1	TRAN, TU A MD	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	53389	18	Ophthalmology	0	In state provider	None	9611 GARVEY AVE	STE 118	SOUTH EL MONTE	CA	91733	1087	19	06037	34.06276646	-118.0594125	Los Angeles County
72184	Fee-for-Service	1811764061	1811764061	1	1	TIEN QUOC NGUYEN DPM, INC	7/1/2024	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	14360 BROOKHURST ST	None	GARDEN GROVE	CA	92843	4608	30	06059	33.753825	-117.954801	Orange County
72204	Fee-for-Service	1174585376	1174585376	1	1	TAN, ZALDY S MD	3/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	69001	None	None	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90045	1047	19	06037	34.06527974	-118.4462792	Los Angeles County
72218	Fee-for-Service	1033407572	1033407572	1	1	TALAYEH, MAKAN MD	10/22/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	117094	36	Psychiatry	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
72225	Fee-for-Service	1679597009	1679597009	1	1	THAN, LINA N OD INC	8/14/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9842 BOLSA AVE	STE 104	WESTMINSTER	CA	92683	6686	30	06059	33.7447947	-117.9570555	Orange County
72231	Fee-for-Service	1528127255	1528127255	1	1	TSAI, KRISTI CRNA	6/24/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
72249	Fee-for-Service	1174586960	1174586960	1	1	THOMSEN, LISA MD	1/31/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63943	08	Family Practice	0	In state provider	None	210 S GRAND AVE,	SUITE 400	GLENDORA	CA	91741	4279	19	06037	34.133859	-117.872523	Los Angeles County
72307	Fee-for-Service	1790894244	1790894244	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3650 ADAMS AVE	None	SAN DIEGO	CA	92116	2212	37	06073	32.76331123	-117.1131236	San Diego County
72316	Fee-for-Service	1437678794	1437678794	1	1	TAYLOR, MICHAEL W PT	3/8/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3191 B MISSION INN AVE	None	RIVERSIDE	CA	92507	4138	33	06065	33.98015514	-117.3677324	Riverside County
72332	Fee-for-Service	1659553410	1659553410	1	1	TAM, KARBO A MD	7/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101595	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
72349	Fee-for-Service	1366590168	1366590168	1	1	TRAN, LISA M MD	9/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87427	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
72360	Fee-for-Service	1841785037	1841785037	1	1	TSUI, NANCY OD	2/11/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
72373	Fee-for-Service	1487759858	1487759858	1	1	TRINITY REGIONAL MEDICAL CEN	1/2/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	802 KENYON RD	None	FORT DODGE	IA	50501	5740	00	None	42.491862	-94.1930955	Webster County
72375	Fee-for-Service	1083883664	1083883664	1	1	TOTAL RENAL CARE INC	8/28/2008	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4400 STEVENS CREEK BLVD	STE 50	SAN JOSE	CA	95129	1104	43	06085	37.32310412	-121.9790789	Santa Clara County
72382	Fee-for-Service	1417485889	1417485889	1	2	TRANSIT PHYSICAL THERAPY PC	5/7/2020	261QP2000X	NA	Physical Therapist	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LN	103	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
72384	Fee-for-Service	1669773156	1669773156	2	1	TAPIA, DIANA C	2/24/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	26945 CAMPUS POINT DR	None	MORENO VALLEY	CA	92555	3706	33	06065	33.92509957	-117.1926633	Riverside County
72408	Fee-for-Service	1609903749	1609903749	1	1	TOLAND, LORA C OT	12/10/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 WEST 6TH ST	SUITE 111	LOS ANGELES	CA	90017	1823	19	06037	34.05416748	-118.2622848	Los Angeles County
72428	Fee-for-Service	1942214887	1942214887	1	1	TAVAKOLI, JAHAN MD	9/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116715	78	Neoplastic Diseases/Oncology	0	In state provider	None	2238 GEARY RD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
72445	Fee-for-Service	1356908370	1356908370	1	1	TAKIAR, PUJA G MD	4/10/2024	390200000X	NA	Other	026	PHYSICIANS	190111	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
72453	Fee-for-Service	1235227489	1235227489	1	1	TAYLOR, LESLIE M MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67224	08	Family Practice	0	In state provider	None	2790 S ELM AVE	None	FRESNO	CA	93706	5435	10	06019	36.700533	-119.7908665	Fresno County
72454	Fee-for-Service	1366175812	1366175812	1	1	THIELEN, SCOTT	1/20/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	317 S CARRILLO RD	None	OJAI	CA	93023	3604	56	06111	34.43910034	-119.2643768	Ventura County
72525	Fee-for-Service	1154803286	1154803286	1	1	TRUONG-ONG TA, ANN LMFT	5/19/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
72551	Fee-for-Service	1700230133	1700230133	1	1	THOMPSON, SUSAN D NP	6/7/2017	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
72632	Fee-for-Service	1043278369	1043278369	1	1	TANG, JULIN F MD	12/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	48474	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
72667	Fee-for-Service	1194913327	1194913327	1	1	THOMAS, COURTNEY PSYD	7/29/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
72672	Fee-for-Service	1417485889	1417485889	1	2	TRANSIT PHYSICAL THERAPY PC	9/25/2019	261QP2000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LN	103	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
72684	Fee-for-Service	1720008246	1720008246	1	1	TERHYUNE, MARGARET 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	9816 MAYLAND DR	None	RICHMOND	VA	23233	1457	00	None	37.63854603	-77.56531112	Henrico County
72691	Fee-for-Service	1720165301	1720165301	1	1	TAKEMURA, ROY K OD	10/7/1977	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	21018 GOLDEN SPRINGS DR	None	DIAMOND BAR	CA	91789	3831	19	06037	33.99933667	-117.8455253	Los Angeles County
72701	Fee-for-Service	1104053180	1104053180	1	1	TUTERA, DOMINIC F MD	1/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118952	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2700 DOLBEER STREET	None	EUREKA	CA	95501	4799	12	06023	40.78355148	-124.1420294	Humboldt County
72732	Fee-for-Service	1588040794	1588040794	1	1	TARRAB HERZLICH, AVIV MD	10/11/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	171982	None	None	0	In state provider	None	824 E CARSON ST	SUITE 203	CARSON	CA	90745	2262	19	06037	33.83159904	-118.2605506	Los Angeles County
72745	Fee-for-Service	1457364333	1457364333	1	1	TEITELBAUM, BENJAMIN J MD	8/25/2009	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	88530	04	Otology, Laryngology, Rhinology	0	In state provider	None	1351 E SPRUCE	None	FRESNO	CA	93720	3342	10	06019	36.84136088	-119.7588077	Fresno County
72846	Fee-for-Service	1467562249	1467562249	1	1	TAKHAR, DALJINDER S DO	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7322	08	Family Practice	0	In state provider	None	9089 BASELINE RD	STE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
72883	Fee-for-Service	1336259167	1336259167	1	1	THRIFTY PAYLESS INC	5/6/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1801 EUREKA WAY	None	REDDING	CA	96001	0434	45	06089	40.58633549	-122.3975498	Shasta County
72905	Fee-for-Service	1518220896	1518220896	1	1	TOURAY, SUNKARU MD	9/1/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
72908	Fee-for-Service	1750455077	1750455077	1	1	TSAI, WESLEY MD	8/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84962	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
72970	Fee-for-Service	1265515704	1265515704	1	1	TRAN, ROBERT H MD	6/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73084	40	Pediatrics	0	In state provider	None	1760 TERMINO AVE	SUITE 300	LONG BEACH	CA	90804	2105	19	06037	33.78889871	-118.1458784	Los Angeles County
72997	Fee-for-Service	1184048886	1184048886	1	1	TIU, LALAINE MD INC	8/6/2014	261Q00000X	NA	Other	026	PHYSICIANS	63191	01	General Practice	0	In state provider	None	3069 TULARE STREET	None	FRESNO	CA	93721	1434	10	06019	36.74155802	-119.7793629	Fresno County
73012	Fee-for-Service	1043577315	1043577315	1	1	TILLY, MONICA K MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122926	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
73047	Fee-for-Service	1700934619	1700934619	1	1	TALAMO, ANA V MD	10/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81452	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
73068	Fee-for-Service	1699206359	1699206359	1	1	TUCCIARONE, JASON M MD	8/4/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	158020	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
73078	Fee-for-Service	1992873723	1992873723	1	1	TSANG, NANG-LOK E MD	10/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	53928	41	Internal Medicine	0	In state provider	None	225 SPRUCE AVE	None	S SAN FRANCISCO	CA	94080	3631	41	06081	37.6561785	-122.4161514	San Mateo County
73100	Fee-for-Service	1356704605	1356704605	1	1	THONGKHAM, DEAN W MD	7/1/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172745	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
73220	Fee-for-Service	1215246186	1215246186	1	1	TSANG, DIANA	1/11/2013	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
73224	Fee-for-Service	1114941341	1114941341	1	1	TSAO, PRISCILLA MD	10/9/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	68777	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
73236	Fee-for-Service	1518259084	1518259084	1	1	TARLOW, GARDNER D MD INC	3/19/2013	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	71363	08	Family Practice	0	In state provider	None	215 N STATE COLLEGE	SUITE B	ANAHEIM	CA	92806	2937	30	06059	33.84270255	-117.8893257	Orange County
73281	Fee-for-Service	1184919474	1184919474	1	1	TREISTER, JOSEPH E MD	7/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123699	40	Pediatrics	0	In state provider	None	6235 N FRESNO ST	SUITE 103	FRESNO	CA	93721	5269	10	06019	36.82733123	-119.7814229	Fresno County
73319	Fee-for-Service	1376573006	1376573006	1	1	TODD P TRITCH, 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 RIVERBEND DR	None	SPRINGFIELD	OR	97477	8800	00	None	44.08199228	-123.0283538	Lane County
73323	Fee-for-Service	1013235969	1013235969	1	1	TSAI, RICHARD Y C MD INC	12/22/2011	261QM2500X	NA	Other	026	PHYSICIANS	52190	20	Orthopedic Surgery	0	In state provider	None	420 N GARFIELD AVENUE	STE 201	MONTEREY PARK	CA	91754	1206	19	06037	34.0670077	-118.1228585	Los Angeles County
73360	Fee-for-Service	1275795122	1275795122	1	1	TWIN RIVERS UNIFIED	2/6/2008	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOL DISTRICT	5115 DUDLEY BLVD	None	MCCLELLAN	CA	95652	1024	34	06067	38.660238	-121.388706	Sacramento County
73394	Fee-for-Service	1114075108	1114075108	1	1	TOWNE, DANIELLE A MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	58234	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
73444	Fee-for-Service	1063441640	1063441640	1	1	THE MEMORIAL HOSPITAL	11/7/2006	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	111 BREWSTER ST	None	PAWTUCKET	RI	02860	4400	00	None	41.87044183	-71.37478519	Providence County
73445	Fee-for-Service	1275823635	1275823635	1	1	TADI, RAVIKANTH R MD	5/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147160	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LN	SUITE 450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
73504	Fee-for-Service	1093905556	1093905556	1	1	TAYLOR, SIMONE PSYD	7/23/2021	103TF0000X	NA	Mental Health Outpatient Services	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
73531	Fee-for-Service	1952895864	1952895864	1	1	TASTENHOYE, CAMILLE MD	9/3/2024	2084F0202X	NA	Psychiatry	026	PHYSICIANS	185263	36	Psychiatry	0	In state provider	None	2248 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1474	34	06067	38.554983	-121.458555	Sacramento County
73543	Fee-for-Service	1174037451	1174037451	1	1	TROITSKAYA, EKATERINA A NP	5/10/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
73597	Fee-for-Service	1750837993	1750837993	1	1	TONELLI, ALYSSA DO	11/1/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15216	08	Family Practice	0	In state provider	None	18210 YORBA LINDA BLVD	SUITE 404	YORBA LINDA	CA	92886	4060	30	06059	33.8883981	-117.8154098	Orange County
73606	Fee-for-Service	1164741070	1164741070	1	1	THE FRESNO CENTER	8/4/2020	251S00000X	NA	Other	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	4855 E KINGS CANYON RD	STE 1	FRESNO	CA	93727	3811	10	06019	36.73603005	-119.7335333	Fresno County
73645	Fee-for-Service	1205328028	1205328028	1	1	TRAN, ELIZABETH N OD	4/27/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
73667	Fee-for-Service	1548782139	1548782139	1	1	TSE, ELIZABETH M NP	3/21/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
73675	Fee-for-Service	1427043389	1427043389	1	1	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	FAMILY MEDICAL CLINIC	8330 RESEDA BLVD	None	NORTHRIDGE	CA	91324	4619	19	06037	34.221609	-118.5360405	Los Angeles County
73682	Fee-for-Service	1114075108	1114075108	1	1	TOWNE, DANIELLE A MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	58234	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
73725	Fee-for-Service	1427111418	1427111418	1	1	THOMPSON, NATHAN	6/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
73731	Fee-for-Service	1063441640	1063441640	1	1	THE MEMORIAL HOSPITAL	11/7/2006	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	111 BREWSTER ST	None	PAWTUCKET	RI	02860	4400	00	None	41.87044183	-71.37478519	Providence County
73781	Fee-for-Service	1093853012	1093853012	1	1	TRAN, BILLY L OD	5/23/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PARK PLACE OPTOMETRY INC	9896 KATELLA AVE	STE B	ANAHEIM	CA	92804	6418	30	06059	33.80304606	-117.9614659	Orange County
73848	Fee-for-Service	1730914458	1730914458	1	1	THACKER, ELOISE CMF	10/27/2024	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	355 E 21ST STREET	SUITE J	SAN BERNARDINO	CA	92404	4851	36	06071	34.13404548	-117.2779515	San Bernardino County
73863	Fee-for-Service	1619408556	1619408556	1	1	THORPE, JOSEPH M MD	9/28/2021	207N00000X	NA	Dermatology	026	PHYSICIANS	161145	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
73870	Fee-for-Service	1235748872	1235748872	1	1	TURLOCK FAMILY COUNSELING	2/2/2024	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1351 GEER RD	#107	TURLOCK	CA	95380	3269	50	06099	37.50571084	-120.8489913	Stanislaus County
73873	Fee-for-Service	1215015813	1215015813	1	1	TZENG, YINN S MD	12/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	60257	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
73891	Fee-for-Service	1760440499	1760440499	1	1	TORRIANI, FRANCESCA MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62647	77	Infectious Disease	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
73922	Fee-for-Service	1790737559	1790737559	1	1	TRAN, PHUONG M MD	7/1/1998	207R00000X	NA	Other	026	PHYSICIANS	62125	41	Internal Medicine	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
73955	Fee-for-Service	1083810832	1083810832	1	1	TRANG, VINH Q MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120900	34	Urology and Urological Surgery	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
73963	Fee-for-Service	1427043389	1427043389	1	1	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	FAMILY MEDICAL CLINIC	8330 RESEDA BLVD	None	NORTHRIDGE	CA	91324	4619	19	06037	34.221609	-118.5360405	Los Angeles County
73970	Fee-for-Service	1184791048	1184791048	1	1	TAKHAR, PARAMJIT S MD	2/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	34676	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
74013	Fee-for-Service	1366162943	1366162943	1	1	TAYLOR, NATALIE E NP	10/17/2022	207PP0204X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	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
74016	Fee-for-Service	1174693493	1174693493	1	1	THE WECARE GROUP	12/15/2006	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	321 VAN DUZEN ROAD	None	MAD RIVER	CA	95552	0004	53	06105	40.46004463	-123.5301743	Trinity County
74051	Fee-for-Service	1487763900	1487763900	1	1	THRIFTY PAYLESS INC	9/30/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6021	1793 MARLOW RD	None	SANTA ROSA	CA	95401	4474	49	06097	38.451591	-122.7528495	Sonoma County
74057	Fee-for-Service	1275112484	1275112484	1	1	TAYLOR, MICHAEL K MD	9/1/2024	207P00000X	NA	Other	026	PHYSICIANS	184653	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
74083	Fee-for-Service	1457354110	1457354110	1	1	TONG, WILLIAM F MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43285	01	General Practice	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
74086	Fee-for-Service	1497759948	1497759948	1	1	TATE, JAMES D MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	27149	14	Neurological Surgery	0	In state provider	None	2888 EUREKA WAY	STE 200	REDDING	CA	96001	0210	45	06089	40.58556034	-122.4159705	Shasta County
74102	Fee-for-Service	1750527735	1750527735	1	1	TANG, BRIAN G MD	9/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97260	01	General Practice	0	In state provider	None	725 WELCH RD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
74187	Fee-for-Service	1598952517	1598952517	1	1	TROCKEL, MICKEY T MD	7/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	96743	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
74214	Fee-for-Service	1801103015	1801103015	1	1	TRUONG, LINH N MD	9/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	117861	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
74221	Fee-for-Service	1902916711	1902916711	1	1	TAWANSY, KHALED A MD INC	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76762	18	Ophthalmology	0	In state provider	CHILDRENS RETINA INST	7447 N FIGUEROA ST	STE 200	LOS ANGELES	CA	90041	1716	19	06037	34.13946007	-118.187311	Los Angeles County
74234	Fee-for-Service	1669472916	1669472916	1	1	TAN, CHARITY L NP	7/1/2015	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
74239	Fee-for-Service	1952751596	1952751596	1	1	TONTHAT, CHRISTOPHER C DO	9/16/2019	207R00000X	NA	Other	026	PHYSICIANS	17233	41	Internal Medicine	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
74251	Fee-for-Service	1427043389	1427043389	1	1	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	FAMILY MEDICAL CLINIC	8330 RESEDA BLVD	None	NORTHRIDGE	CA	91324	4619	19	06037	34.221609	-118.5360405	Los Angeles County
74286	Fee-for-Service	1659735959	1659735959	1	1	TRIPLETT, KATHERINE DO	1/30/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17703	12	Manipulative Therapy (D.O. only)	0	In state provider	None	12746 W JEFFERSON BLVD	FL 2-4	LOS ANGELES	CA	90094	2885	19	06037	33.97751255	-118.417598	Los Angeles County
74293	Fee-for-Service	1073968244	1073968244	1	1	TAYLOR, TRACEY L DO	6/15/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17010	None	None	0	In state provider	None	3100 SAN PABLO AVE	STE 300, 310	BERKELEY	CA	94702	2498	01	06001	37.85066636	-122.286288	Alameda County
74307	Fee-for-Service	1174693493	1174693493	1	1	THE WECARE GROUP	6/2/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	321 VAN DUZEN ROAD	None	MAD RIVER	CA	95552	0004	53	06105	40.46004463	-123.5301743	Trinity County
74344	Fee-for-Service	1205919339	1205919339	1	1	TZIPPY CARE, INC	1/1/1979	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2190 W ADAMS BLVD	None	LOS ANGELES	CA	90018	2039	19	06037	34.03262713	-118.3146769	Los Angeles County
74351	Fee-for-Service	1447369988	1447369988	1	1	THRIFTY DRUG STORE 5425	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	334 S VERMONT AVE	None	LOS ANGELES	CA	90020	1899	19	06037	34.067943	-118.2916425	Los Angeles County
74358	Fee-for-Service	1740711324	1740711324	1	1	THE INSTITUTE OF TRAUMA AND	10/27/2017	2086S0127X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ACUTE CARE	160 E. ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
74372	Fee-for-Service	1114280450	1114280450	1	1	TRAN, BRIAN D MD	9/28/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	126800	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
74393	Fee-for-Service	1750527735	1750527735	1	1	TANG, BRIAN G MD	9/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97260	40	Pediatrics	0	In state provider	None	725 WELCH RD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
74411	Fee-for-Service	1881710887	1881710887	1	2	TARZANA TREATMENT CENTERS, I	8/30/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	7101 BAIRD AVENUE	None	RESEDA	CA	91335	4150	19	06037	34.1995012	-118.5373824	Los Angeles County
74421	Fee-for-Service	1982729786	1982729786	1	1	TSENG, HELEN C MD	7/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104030	18	Ophthalmology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
74445	Fee-for-Service	1760420913	1760420913	1	1	TORRADO-RIDLEY, BEATRIZ	10/31/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	6750	08	Family Practice	0	In state provider	None	11411 BROOKSHIRE AVE	STE 204	DOWNEY	CA	90241	5004	19	06037	33.93667091	-118.1309273	Los Angeles County
74475	Fee-for-Service	1700274800	1700274800	1	1	THI, WIN M MD	9/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133519	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
74495	Fee-for-Service	1093874752	1093874752	1	1	TSENG, WILLIAM T MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68201	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
74540	Fee-for-Service	1427043389	1427043389	1	1	TARZANA TREATMENT CENTERS, I	12/1/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	FAMILY MEDICAL CLINIC	8330 RESEDA BLVD	None	NORTHRIDGE	CA	91324	4619	19	06037	34.221609	-118.5360405	Los Angeles County
74547	Fee-for-Service	1679562698	1679562698	1	3	THE HILL MEDICAL CORPORATION	12/14/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	R	301 W. HUNTINGTON DR.	SUITE 617	ARCADIA	CA	91007	1519	19	06037	34.13481053	-118.0425638	Los Angeles County
74560	Fee-for-Service	1447550884	1447550884	1	1	TAKEUCHI, TETSUYA MD	5/7/2020	2086S0127X	NA	General Surgery	026	PHYSICIANS	146019	89	Surgery-Traumatic	0	In state provider	None	24411 HEALTH CENTER DR	SUITE 350	LAGUNA HILLS	CA	92653	3687	30	06059	33.6087201	-117.7076948	Orange County
74594	Fee-for-Service	1174693493	1174693493	1	1	THE WECARE GROUP	12/15/2006	207Q00000X	NA	Adult Primary Care	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	321 VAN DUZEN ROAD	None	MAD RIVER	CA	95552	0004	53	06105	40.46004463	-123.5301743	Trinity County
74602	Fee-for-Service	1982010443	1982010443	1	1	THORNHILL, PETER B MD	5/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149703	05	Anesthesiology	0	In state provider	None	1165 MONTGOMERY DRIVE	None	SANTA ROSA	CA	94505	4801	49	06097	38.443806	-122.701374	Sonoma County
74668	Fee-for-Service	1558858423	1558858423	1	1	TRAVNITZ, CHRISTINA LCSW	11/27/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
74698	Fee-for-Service	1881710887	1881710887	1	2	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	7101 BAIRD AVENUE	None	RESEDA	CA	91335	4150	19	06037	34.1995012	-118.5373824	Los Angeles County
74705	Fee-for-Service	1225070949	1225070949	1	1	TCHELEPI, HISHAM A MD	6/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89392	30	Radiology	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
74709	Fee-for-Service	1881649184	1881649184	1	1	TROY CHRISTIAN ROCK, 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	1500 JAMES SIMPSON JR WA	None	COVINGTON	KY	41011	0801	00	None	39.0715176	-84.51775131	Kenton County
74745	Fee-for-Service	1851708465	1851708465	1	1	THERAPEUTIC TIME INC	10/25/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	43713 20TH ST WEST	STE 5	LANCASTER	CA	93534	4628	19	06037	34.67701317	-118.1657538	Los Angeles County
74764	Fee-for-Service	1073796058	1073796058	1	1	TANGEN, KIMBERLY A PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4785 N FIRST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
74827	Fee-for-Service	1477662831	1477662831	1	1	THRIFTY PAYLES INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 6083	7860 GERBER RD	None	SACRAMENTO	CA	95828	4302	34	06067	38.480868	-121.411548	Sacramento County
74860	Fee-for-Service	1093976938	1093976938	1	1	TAN, ANN Z MD	7/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95082	22	Pathology (M.D. only)	0	In state provider	None	1509 WILSON TERRACE	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
74879	Fee-for-Service	1932121928	1932121928	5	1	THE SCOOTER STORE SAC LLC	6/28/2017	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1170 NATIONAL DR	STE 30	SACRAMENTO	CA	95834	2957	34	06067	38.643831	-121.4857035	Sacramento County
74910	Fee-for-Service	1366524019	1366524019	1	1	THE MEDICINE CABINET INC	6/26/2006	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5906 ATLANTIC BLVD	None	MAYWOOD	CA	90270	3101	19	06037	33.98649753	-118.1856581	Los Angeles County
74927	Fee-for-Service	1548263205	1548263205	1	1	TOPOROFF, BRUCE M MD	12/5/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86325	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1700 N ROSE AVE	STE 420	OXNARD	CA	93030	7656	56	06111	34.21746	-119.155545	Ventura County
74939	Fee-for-Service	1841833894	1841833894	1	1	TARASEN, ERICA R CRNA	5/14/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
74941	Fee-for-Service	1255816864	1255816864	1	1	TSATURYAN, ASHOT RCP	11/30/2018	2279C0205X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
74986	Fee-for-Service	1881710887	1881710887	1	2	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	7101 BAIRD AVENUE	None	RESEDA	CA	91335	4150	19	06037	34.1995012	-118.5373824	Los Angeles County
75012	Fee-for-Service	1467575233	1467575233	1	1	THOMA, MARK S MD	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91601	05	Anesthesiology	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
75041	Fee-for-Service	1134158686	1134158686	1	1	TAN, MARINA G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56388	40	Pediatrics	0	In state provider	None	795 WILLOW RD	BLDG 334	MENLO PARK	CA	94025	2539	41	06081	37.466676	-122.160384	San Mateo County
75047	Fee-for-Service	1801835475	1801835475	1	1	TETON COUNTY HOSPITAL DIST	3/1/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	625 E BROADWAY AVE	None	JACKSON	WY	83001	8642	00	None	43.47974099	-110.749734	Teton County
75051	Fee-for-Service	1598360455	1598360455	1	1	TOMA, KEELY N OD	2/8/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	82227 US HWY 111	STE B2	INDIO	CA	92201	5668	33	06065	33.71471443	-116.2312195	Riverside County
75075	Fee-for-Service	1104909027	1104909027	1	1	THORNTON, LORNA M MD	11/21/2008	174400000X	NA	Other	026	PHYSICIANS	75201	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
75198	Fee-for-Service	1013105246	1013105246	1	1	THE ALLIANCE FOR COMMUNITY W	7/5/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	COMITE FOR RAZA MENTAL	3315 INTERNATIONAL BLVD	None	OAKLAND	CA	94601	3005	01	06001	37.77682647	-122.22429	Alameda County
75218	Fee-for-Service	1548263205	1548263205	1	1	TOPOROFF, BRUCE M MD	12/5/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86325	33	Thoracic Surgery	0	In state provider	None	1700 N ROSE AVE	STE 420	OXNARD	CA	93030	7656	56	06111	34.21746	-119.155545	Ventura County
75262	Fee-for-Service	1043470354	1043470354	1	1	TABARES, BLANCA LCSW	3/12/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
75273	Fee-for-Service	1881710887	1881710887	1	2	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	7101 BAIRD AVENUE	None	RESEDA	CA	91335	4150	19	06037	34.1995012	-118.5373824	Los Angeles County
75368	Fee-for-Service	1467528695	1467528695	1	1	TANKHILEVICH, OLGA CRNA	7/19/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
75406	Fee-for-Service	1942953781	1942953781	1	1	TIWARI, BINITA OT	5/17/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
75407	Fee-for-Service	1952813479	1952813479	1	1	THOMAS, BRIANA LMFT	9/20/2024	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
75418	Fee-for-Service	1316045388	1316045388	1	1	THE OLIVE LEAF	12/21/2004	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	19133 INGOMAR STREET	None	RESEDA	CA	91335	1720	19	06037	34.21202868	-118.5503672	Los Angeles County
75428	Fee-for-Service	1548200561	1548200561	1	1	TAYLOR, GREGORY M MD	10/31/1991	207P00000X	NA	Other	026	PHYSICIANS	64832	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
75492	Fee-for-Service	1447290515	1447290515	1	1	TROTTER, WILLIAM L MD	4/23/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	68199	18	Ophthalmology	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
75554	Fee-for-Service	1841229168	1841229168	1	1	TERRY, RICHARD W MD	10/8/1976	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	24143	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3300 WEBSTER ST	STE 710	OAKLAND	CA	94609	3122	01	06001	37.82132826	-122.2621843	Alameda County
75588	Fee-for-Service	1346480175	1346480175	1	1	TRAN, UYEN P MD	12/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106870	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	1778	19	06037	34.06373445	-118.443537	Los Angeles County
75643	Fee-for-Service	1467960690	1467960690	1	1	TAVAKOLI, JONATHAN DPM	12/12/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	12520 MAGNOLIA BLVD	#304	VALLEY VILLAGE	CA	91607	2355	19	06037	34.16485451	-118.406106	Los Angeles County
75689	Fee-for-Service	1205810017	1205810017	1	1	THOMAS F BREEN M.D.	8/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	281 LINCOLN ST	None	WORCESTER	MA	01605	2138	00	None	42.285402	-71.7903855	Worcester County
75735	Fee-for-Service	1891051496	1891051496	1	1	TRUJILLO GARCIA, ALEJANDRA	9/5/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11145 TAMPA AVE	SUITE 15 A	NORTHRIDGE	CA	91326	2265	19	06037	34.27373836	-118.5564202	Los Angeles County
75757	Fee-for-Service	1427084607	1427084607	1	1	TANG, BOAWEI MD	12/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	89305	83	Rheumatology	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
75777	Fee-for-Service	1306032792	1306032792	1	1	TABILA, BRIAN T MD	12/28/2007	207R00000X	NA	Other	026	PHYSICIANS	96984	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
75793	Fee-for-Service	1023141165	1023141165	1	1	THRIFTY PAYLESS INC	5/10/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #6492	15890 SOQUEL CANYON PKWY	None	CHINO HILLS	CA	91709	7927	36	06071	33.96302125	-117.6935089	San Bernardino County
75833	Fee-for-Service	1124053517	1124053517	1	1	TANAKA, JUNE MD	8/27/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77266	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
75868	Fee-for-Service	1346796422	1346796422	1	2	TT HEALTHCARE INC	11/29/2017	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8054 GARVEY AVE	SUITE 101	ROSEMEAD	CA	91770	2449	19	06037	34.06262455	-118.092753	Los Angeles County
75941	Fee-for-Service	1144479700	1144479700	1	1	THE VONS COMPANIES INC	12/11/2008	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11800 DE PALMA RD	None	CORONA	CA	92883	8498	33	06065	33.74635292	-117.4536847	Riverside County
75953	Fee-for-Service	1114799970	1114799970	1	2	TILLMAN, CONNAITRE S DOULA	10/31/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	56	06111	0	0	None
75991	Fee-for-Service	1639607047	1639607047	1	1	TSACOUMANGOS, ALEXIS A PHD	3/13/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
75997	Fee-for-Service	1598755175	1598755175	1	1	TAKAHASHI, GUY H MD	5/22/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	104734	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
76006	Fee-for-Service	1538236559	1538236559	1	1	TRAN, DIEM LINH MD	11/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83554	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
76008	Fee-for-Service	1346320249	1346320249	1	1	TANG, HWAI-EN J OD	12/12/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1102 IRVINE BLVD	None	TUSTIN	CA	92780	3529	30	06059	33.74822099	-117.8105618	Orange County
76024	Fee-for-Service	1295963627	1295963627	1	1	TUNSTILL, GEORGIA L MD	3/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122668	22	Pathology (M.D. only)	0	In state provider	None	2374 EAST PACIFICA PLACE	None	RANCHO DOMINGUEZ	CA	90220	6214	19	06037	33.84864797	-118.2240829	Los Angeles County
76083	Fee-for-Service	1447761838	1447761838	1	1	TIME EASY TRANSPORTATION, LL	5/24/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	C	24630 WASHINGTON AVE.	STE. 202	MURRIETA	CA	92562	6177	33	06065	33.55565675	-117.2163131	Riverside County
76100	Fee-for-Service	1841378650	1841378650	1	1	TAN, XIAOHUI MD	10/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82264	41	Internal Medicine	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
76101	Fee-for-Service	1144203423	1144203423	1	1	TAYLOR-WIEDEMAN, JEAN MD	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	43137	40	Pediatrics	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
76110	Fee-for-Service	1003452517	1003452517	1	1	TIGLAO, KRISKA A NP	9/1/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
76138	Fee-for-Service	1508118977	1508118977	1	1	TOTAL RENAL CARE INC	12/1/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	7880 VALLEY VIEW ST	None	BUENA PARK	CA	90620	2353	30	06059	33.847983	-118.028434	Orange County
76155	Fee-for-Service	1588689806	1588689806	1	1	TAYLOR, DONALD M MD	11/30/1995	207L00000X	NA	Other	026	PHYSICIANS	54364	05	Anesthesiology	0	In state provider	None	1600 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3010	38	06075	37.78475261	-122.43973	San Francisco County
76191	Fee-for-Service	1245322213	1245322213	1	1	TIANGCO, IRINEO D MD	5/28/2015	207R00000X	NA	Other	026	PHYSICIANS	52655	41	Internal Medicine	0	In state provider	None	2720 E PLAZA BLVD	STE R	NATIONAL CITY	CA	91950	4004	37	06073	32.68056516	-117.0777703	San Diego County
76220	Fee-for-Service	1144752833	1144752833	1	1	TANNAZ EBRAHIMI ADIB, MD APC	8/18/2017	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2067 W VISTA WAY STE 160	None	VISTA	CA	92083	6032	37	06073	33.18505594	-117.285958	San Diego County
76236	Fee-for-Service	1770998940	1770998940	1	1	TRINITY HEALTH SERVICES	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1419 N SAN FERNANDO BLVD	SUITE 230	BURBANK	CA	91504	1739	19	06037	34.19071688	-118.322281	Los Angeles County
76287	Fee-for-Service	1861998957	1861998957	1	1	TYLER, MELISSA LMFT	12/13/2024	171M00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
76306	Fee-for-Service	1720377484	1720377484	1	1	TAYLOR, BRANDON C MD	11/17/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175640	None	None	0	In state provider	None	8750 WILSHIRE BLVD	STE 100	BEVERLY HILLS	CA	90211	2713	19	06037	34.06685846	-118.3829408	Los Angeles County
76365	Fee-for-Service	1760186423	1760186423	1	1	THOMAS, JESSICA M LCSW	4/24/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17777 CENTER COURT DR N	SUITE 600 OFFICE 604	CERRITOS	CA	90703	8575	19	06037	33.8693357	-118.0609689	Los Angeles County
76382	Fee-for-Service	1962863993	1962863993	1	1	TRAN, NANCY A DO	7/3/2019	207R00000X	NA	Other	026	PHYSICIANS	16027	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
76391	Fee-for-Service	1144203423	1144203423	1	1	TAYLOR-WIEDEMAN, JEAN MD	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	43137	77	Infectious Disease	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
76449	Fee-for-Service	1942358742	1942358742	1	1	TSAY, TI JO MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70065	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
76497	Fee-for-Service	1942513734	1942513734	1	1	THOMPSON, DARREN R DO	4/30/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	13605	66	Emergency Medicine (Urgent Care)	0	In state provider	None	191 E ALESSANDRO BLVD	9A	RIVERSIDE	CA	92508	5095	33	06065	33.91628074	-117.3284633	Riverside County
76520	Fee-for-Service	1376961151	1376961151	1	1	TAKEMOTO, ANDREA S MD	1/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139877	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
76521	Fee-for-Service	1770998940	1770998940	1	1	TRINITY HEALTH SERVICES	12/28/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1419 N SAN FERNANDO BLVD	SUITE 230	BURBANK	CA	91504	1739	19	06037	34.19071688	-118.322281	Los Angeles County
76553	Fee-for-Service	1134182561	1134182561	1	1	TOTAL RENAL CARE, INC	4/1/1997	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	MANZANITA DIALYSIS CTR	4005 MANZANITA AVE	STE 17	CARMICHAEL	CA	95608	1779	34	06067	38.637936	-121.330494	Sacramento County
76653	Fee-for-Service	1447267380	1447267380	1	1	THRIFTY DRUG STORE 5614	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	740 OTAY LAKES RD	# 907	CHULA VISTA	CA	91910	6915	37	06073	32.64616845	-117.0017488	San Diego County
76713	Fee-for-Service	1750511846	1750511846	1	1	TURLOCK EMG & NEUROLOGY INC	10/15/2009	261QM2500X	NA	Other	026	PHYSICIANS	54426	13	Neurology (M.D. only)	0	In state provider	None	1051 E TUOLUMNE RD	STE 107	TURLOCK	CA	95382	1546	50	06099	37.51464553	-120.837501	Stanislaus County
76730	Fee-for-Service	1447208210	1447208210	1	1	TIMOTHY C GREINER MD	2/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
76749	Fee-for-Service	1922641588	1922641588	1	1	TALLANDIER, CHELLSEE LCSW	2/22/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
76790	Fee-for-Service	1003250044	1003250044	1	1	TRAYNIS, ILANA MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136206	18	Ophthalmology	0	In state provider	None	710 LAWRENCE EXPRESSWAY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
76819	Fee-for-Service	1861092868	1861092868	1	1	TRI RIVER MEDICINE	12/30/2020	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	7260 E SOUTHGATE DR	STE D	SACRAMENTO	CA	95823	2609	34	06067	38.493999	-121.438395	Sacramento County
76838	Fee-for-Service	1821484130	1821484130	1	1	TAMMANY, ALISON J	8/29/2022	208600000X	NA	General Surgery	026	PHYSICIANS	177258	None	None	0	In state provider	None	236 SAN JOSE	None	SALINAS	CA	93901	3901	27	06053	36.6582359	-121.6463252	Monterey County
76849	Fee-for-Service	1245447580	1245447580	1	1	TROCHANOWSKI, ROMAN MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	97489	05	Anesthesiology	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
76857	Fee-for-Service	1326364068	1326364068	1	1	TSANG, PANSY MD	2/1/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	148473	41	Internal Medicine	0	In state provider	None	215 PESETAS LANE	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
76899	Fee-for-Service	1134190457	1134190457	1	1	TAGLIATI, MICHELE MD	9/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54321	13	Neurology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
76918	Fee-for-Service	1699121905	1699121905	1	1	TAMURA, LYNDLY J MD	5/13/2021	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	151149	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
76943	Fee-for-Service	1922334671	1922334671	1	1	TRUMP, MARK E MD	5/20/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	122454	20	Orthopedic Surgery	0	In state provider	None	1345 PAUL BUNYAN DRIVE	SUITE A	SUSANVILLE	CA	96130	3159	18	06035	40.43531297	-120.6557201	Lassen County
76957	Fee-for-Service	1578672952	1578672952	2	1	THRIFTY PAYLESS INC	2/21/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	42021 E FLORIDA AVE	None	HEMET	CA	92544	5016	33	06065	33.7476747	-116.9144971	Riverside County
77003	Fee-for-Service	1508986704	1508986704	1	1	TIEDEMAN, DANIEL S OD	3/27/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
77052	Fee-for-Service	1225527153	1225527153	1	1	TAUTGES, BENJAMIN L OD	7/26/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	207 S SANTA ANITA ST	SUITE P-25	SAN GABRIEL	CA	91776	1145	19	06037	34.10072807	-118.1066296	Los Angeles County
77105	Fee-for-Service	1245387752	1245387752	1	1	TEKLE, ALEMNESH M MD	1/2/2019	208M00000X	NA	Other	026	PHYSICIANS	151325	41	Internal Medicine	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
77109	Fee-for-Service	1609924620	1609924620	1	1	TATOSYAN, LYNNETTE DO	12/11/2007	207R00000X	NA	Other	026	PHYSICIANS	8913	41	Internal Medicine	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
77117	Fee-for-Service	1619936192	1619936192	1	1	TOSICK, MARIANNE MD	1/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	50146	40	Pediatrics	0	In state provider	None	5201 NORRIS CANYON RD	STE 240	SAN RAMON	CA	94583	5405	07	06013	37.77779028	-121.9600626	Contra Costa County
77136	Fee-for-Service	1639532179	1639532179	1	1	TETREAULT, TYLER A MD	7/15/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	171255	None	None	0	In state provider	None	1417 S CENTRAL AVE	None	COMPTON	CA	90220	4102	19	06037	33.88307087	-118.2489369	Los Angeles County
77146	Fee-for-Service	1225166788	1225166788	1	1	TOTALLY KIDS SPECIALTY	9/1/1997	3140N1450X	NA	Skilled Nursing Facility	065	PEDIATRIC SUBACUTE CARE/LTC	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE	1720 MOUNTAIN VIEW AVE	None	LOMA LINDA	CA	92354	1727	36	06071	34.06969354	-117.2437096	San Bernardino County
77172	Fee-for-Service	1144227380	1144227380	1	1	TAPLIN, GERALDINE C MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	25673	77	Infectious Disease	0	In state provider	None	335 EL DORADO ST	STE 9	MONTEREY	CA	93940	4624	27	06053	36.59168391	-121.892381	Monterey County
77222	Fee-for-Service	1619155900	1619155900	1	1	TURK, RAMI J MD	11/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91879	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3536 MENDOCINO AVE	STE 200	SANTA ROSA	CA	95403	3634	49	06097	38.473326	-122.725935	Sonoma County
77238	Fee-for-Service	1245493766	1245493766	1	1	TRAVIS JONES MD	1/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
77296	Fee-for-Service	1033357033	1033357033	1	1	THWE, YIN M MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	106837	08	Family Practice	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
77300	Fee-for-Service	1811075468	1811075468	1	1	THIERER, DOUGLAS MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	6998	01	General Practice	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
77346	Fee-for-Service	1144703935	1144703935	1	1	TIMOTHY GALAN, M.D., INC	9/20/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	400 OLD RIVER RD	None	BAKERSFIELD	CA	93311	9781	15	06029	35.351487	-119.1143025	Kern County
77371	Fee-for-Service	1730534488	1730534488	1	1	TERLE, MEGAN R MD	8/1/2021	390200000X	NA	Other	026	PHYSICIANS	172744	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
77382	Fee-for-Service	1689601536	1689601536	1	1	THE UROLOGY CNTR OF S CA	8/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MED GRP	1820 FULLERTON AVE	STE 260	CORONA	CA	92881	3101	33	06065	33.858756	-117.5503465	Riverside County
77426	Fee-for-Service	1639532179	1639532179	1	1	TETREAULT, TYLER A MD	8/1/2023	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	1417 S CENTRAL AVE	None	COMPTON	CA	90220	4102	19	06037	33.88307087	-118.2489369	Los Angeles County
77484	Fee-for-Service	1679069637	1679069637	1	1	THWE, SU M MD	9/15/2021	390200000X	NA	Other	026	PHYSICIANS	174319	None	None	0	In state provider	None	17577 ARROW BLVD	None	FONTANA	CA	92335	4011	36	06071	34.09938951	-117.421272	San Bernardino County
77489	Fee-for-Service	1265812259	1265812259	1	1	TAWFIK, KYROLLOS Y MD	7/1/2021	390200000X	NA	Other	026	PHYSICIANS	147907	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
77578	Fee-for-Service	1841566577	1841566577	1	1	TADLOCK, STERLING J MD	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126921	36	Psychiatry	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
77627	Fee-for-Service	1114900438	1114900438	1	1	TRACI CLAUTICE ENGLE MD	10/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1460 NE MEDICAL DR	None	BEND	OR	97701	0000	00	None	44.064765	-121.2666635	Deschutes County
77746	Fee-for-Service	1326344938	1326344938	1	1	THE BERKELEY CLINIC INC	9/9/2023	261QU0200X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	6430 SELMA AVE.	None	LOS ANGELES	CA	90028	9998	19	06037	34.09973993	-118.3305661	Los Angeles County
77780	Fee-for-Service	1891741310	1891741310	1	1	TRIOLO, PETER J MD	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	32939	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
77788	Fee-for-Service	1134340334	1134340334	1	1	TRUONG, VICTOR	2/20/2025	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1902 ROYALTY DRIVE	SUITE 170	POMONA	CA	91767	3030	19	06037	34.07791925	-117.746146	Los Angeles County
77796	Fee-for-Service	1730724642	1730724642	1	1	T STREET LLC	7/28/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6254 66TH AVENUE	None	SACRAMENTO	CA	95823	2733	34	06067	38.491506	-121.4310285	Sacramento County
77797	Fee-for-Service	1932276953	1932276953	1	1	TAYYARH, MAJID MD	11/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91672	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
77807	Fee-for-Service	1265498349	1265498349	1	1	TRAN, THANH Q MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67914	67	Endocrinology	0	In state provider	None	15651 BROOKHURST ST	None	WESTMINSTER	CA	92683	7556	30	06059	33.735213	-117.9547979	Orange County
77845	Fee-for-Service	1346308798	1346308798	1	1	TOMSKY, JANA MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	84411	01	General Practice	0	In state provider	None	1220 ROSSMOOR PARKWAY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
77851	Fee-for-Service	1699729855	1699729855	1	1	THURBER, SAMUEL JOHN MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65610	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
77859	Fee-for-Service	1487702213	1487702213	1	1	TURNER, LORNA D MD	9/30/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	62278	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
77882	Fee-for-Service	1295956324	1295956324	1	1	TEPPERMAN, MARGOT E LCSW	5/16/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	171 N VAN NESS AVE	None	FRESNO	CA	93701	1671	10	06019	36.74538092	-119.798923	Fresno County
77942	Fee-for-Service	1720199797	1720199797	1	2	THE CENTER FOR INTERVENTION	5/27/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CARDIOLOGY AND NEPHROLOG	8635 W 3RD STREET	SUITE 695 W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
77953	Fee-for-Service	1821302571	1821302571	1	1	TAIWO, ADETOKUNBO A MD	8/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126379	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
78040	Fee-for-Service	1720671704	1720671704	1	1	TRAN, KARINS CNP	12/7/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8260 MIRA MESA BLVD	None	SAN DIEGO	CA	92126	2662	37	06073	32.91277002	-117.1459433	San Diego County
78068	Fee-for-Service	1841378445	1841378445	1	1	TEMPESTA, RONALD R MD	5/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70274	01	General Practice	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
78078	Fee-for-Service	1487120291	1487120291	1	1	THONG, OLIVIA C PT	11/13/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1085 W EL CAMINO REAL	None	SUNNYVALE	CA	94087	1030	43	06085	37.37270741	-122.0517412	Santa Clara County
78095	Fee-for-Service	1881789493	1881789493	1	1	TIET, QUYEN PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	25 N 14TH ST	STE 660	SAN JOSE	CA	95112	6214	43	06085	37.34293357	-121.8775187	Santa Clara County
78129	Fee-for-Service	1346308798	1346308798	1	1	TOMSKY, JANA MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	84411	41	Internal Medicine	0	In state provider	None	1220 ROSSMOOR PARKWAY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
78134	Fee-for-Service	1124214754	1124214754	1	1	TOSHKOV, FANY S LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVENUE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
78135	Fee-for-Service	1821284779	1821284779	1	1	TASHKIN, KIMBERLY I PT	4/2/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2200 E. MAPLE AVE	None	EL SEGUNDO	CA	90245	6507	19	06037	33.92690475	-118.3857342	Los Angeles County
78165	Fee-for-Service	1760689715	1760689715	1	4	TOTALCARE WALK-IN CLINIC INC	8/24/2021	207R00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4784 PECK RD	STE A	EL MONTE	CA	91732	1360	19	06037	34.09071973	-118.0144474	Los Angeles County
78181	Fee-for-Service	1093187676	1093187676	1	1	TRAN, YEN LMFT	1/21/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
78187	Fee-for-Service	1659639540	1659639540	1	1	TOY, BRIAN C MD	6/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126637	18	Ophthalmology	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
78212	Fee-for-Service	1013929231	1013929231	1	1	TOM, DARCI J	3/31/1991	207L00000X	NA	Other	026	PHYSICIANS	66613	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
78230	Fee-for-Service	1275970576	1275970576	1	1	TYAN, SHERRY S PT	2/3/2015	No Taxonomy Provided	NA	None	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
78237	Fee-for-Service	1346690682	1346690682	1	1	TAUSIF, HASSAN MD	10/14/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	179336	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
78241	Fee-for-Service	1821302571	1821302571	1	1	TAIWO, ADETOKUNBO A MD	8/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126379	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
78245	Fee-for-Service	1427762632	1427762632	1	1	TAPIA, MICHELLE	3/28/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9065 HAVEN AVE	STE 110	RANCHO CUCAMONGA	CA	91730	5429	36	06071	34.089012	-117.5756625	San Bernardino County
78254	Fee-for-Service	1073584520	1073584520	1	1	TEPER, IRENE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	84912	41	Internal Medicine	0	In state provider	None	165 ROWLAND WAY	STE 201	NOVATO	CA	94945	5055	21	06041	38.09824386	-122.559872	Marin County
78261	Fee-for-Service	1750656880	1750656880	1	1	TIBBETTS, RACHELLE J MD	5/7/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	143428	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
78264	Fee-for-Service	1750716270	1750716270	1	1	TAKHMAZYAN, HERBERT LMFT	10/20/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2331 HONOLULU AVE.	SUITE G	MONTROSE	CA	91020	1844	19	06037	34.20604709	-118.2293958	Los Angeles County
78278	Fee-for-Service	1275615239	1275615239	1	1	TOBIN, NICOLE H MD	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91277	77	Infectious Disease	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
78296	Fee-for-Service	1104242767	1104242767	1	1	THOMPSON, JANTINA LCSW	9/20/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1135 PINE ST	21	REDDING	CA	96001	0750	45	06089	40.58859278	-122.3911662	Shasta County
78298	Fee-for-Service	1144221763	1144221763	1	1	TOLBA, KAMEI B MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72066	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
78299	Fee-for-Service	1164532834	1164532834	1	1	THRIFTY PAYLESS INC	1/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5435	1637 N VERMONT AVE	None	LOS ANGELES	CA	90027	5312	19	06037	34.101018	-118.2917995	Los Angeles County
78344	Fee-for-Service	1023696473	1023696473	1	1	TUNG, TZE YU OD	1/10/2023	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
78346	Fee-for-Service	1871987578	1871987578	1	1	THERAPIZE ME	12/1/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	4100 W ALAMEDA AVE FL 3	STE 365	BURBANK	CA	91505	4191	19	06037	34.1526111	-118.3447742	Los Angeles County
78463	Fee-for-Service	1639761273	1639761273	1	1	TRINITAS HOSPICE CARE LLC	12/23/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5230 CLARK AVENUE	SUITE 1	LAKEWOOD	CA	90712	2653	19	06037	33.853032	-118.1337615	Los Angeles County
78497	Fee-for-Service	1992739338	1992739338	1	1	TAKAMURA, MICHAEL M MD	12/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81208	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
78522	Fee-for-Service	1033444120	1033444120	1	1	TOOGOOD, PAUL A MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115067	20	Orthopedic Surgery	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
78551	Fee-for-Service	1376907741	1376907741	1	1	TRAN, KENNETH MD	7/7/2023	390200000X	NA	Other	026	PHYSICIANS	152332	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
78562	Fee-for-Service	1700299906	1700299906	1	1	THOMPSON, CORTNEY D NP	8/24/2018	No Taxonomy Provided	NA	None	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
78564	Fee-for-Service	1275615239	1275615239	1	1	TOBIN, NICOLE H MD	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91277	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
78568	Fee-for-Service	1841368925	1841368925	1	1	TRIANGLE EYE INSTITUTE	3/9/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	1519 GARCES HWY	STE 101	DELANO	CA	93215	3694	15	06029	35.76146003	-119.2367778	Kern County
78575	Fee-for-Service	1104217751	1104217751	1	1	TRUNG V TRAN OD OPTOMETRIC	3/19/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	3824 LA SIERRA AVE	None	RIVERSIDE	CA	92505	3528	33	06065	33.90447335	-117.4771776	Riverside County
78579	Fee-for-Service	1932196888	1932196888	1	1	TUTTLE'S HOEN PHARMACY	3/30/1995	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4731 HOEN AVE	None	SANTA ROSA	CA	95405	7862	49	06097	38.442825	-122.6636235	Sonoma County
78583	Fee-for-Service	1144221763	1144221763	1	1	TOLBA, KAMEI B MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72066	41	Internal Medicine	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
78606	Fee-for-Service	1881405835	1881405835	1	1	TORREGROSSA, LENIE PHD	2/27/2025	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
78610	Fee-for-Service	1194253856	1194253856	1	1	TABAKA, MEG E MD	6/22/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	156919	08	Family Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
78613	Fee-for-Service	1063843506	1063843506	1	1	TRUONG, ALEX W MD	7/6/2018	208M00000X	NA	Other	026	PHYSICIANS	147828	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
78730	Fee-for-Service	1457913972	1457913972	1	1	THI, WAI PHYO MD	1/14/2025	207RE0101X	NA	Endocrinology	026	PHYSICIANS	None	67	Endocrinology	0	In state provider	None	3883 AIRWAY DR	202	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
78731	Fee-for-Service	1932169182	1932169182	1	1	TUTHILL,HEIDI L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	915 HIGHLAND BLVD	None	BOZEMAN	MT	59715	0000	00	None	45.669708	-111.020157	Gallatin County
78746	Fee-for-Service	1255342044	1255342044	1	1	THEAKER, ROBERT M O D AN	5/29/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CORPORATION	365 6TH ST	None	HOLLISTER	CA	95023	3834	35	06069	36.85040612	-121.4032566	San Benito County
78751	Fee-for-Service	1639761273	1639761273	1	1	TRINITAS HOSPICE CARE LLC	12/23/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5230 CLARK AVENUE	SUITE 1	LAKEWOOD	CA	90712	2653	19	06037	33.853032	-118.1337615	Los Angeles County
78757	Fee-for-Service	1013100874	1013100874	1	1	TRUONG, LAN T MD	4/11/2011	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	116188	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1201 N CHERRY ST	None	TULARE	CA	93274	2233	54	06107	36.2249133	-119.336993	Tulare County
78764	Fee-for-Service	1174101976	1174101976	1	1	TAN, DOROTHY HUI-JIA MD	9/2/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	9411	38	06075	37.78610439	-122.421569	San Francisco County
78834	Fee-for-Service	1851384044	1851384044	1	1	TAN, DE MD	4/8/2011	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	90989	10	Gastroenterology (M.D. only)	0	In state provider	None	7600 HOSPITAL DR	STE C	SACRAMENTO	CA	95823	5406	34	06067	38.463876	-121.414698	Sacramento County
78836	Fee-for-Service	1952472961	1952472961	1	1	TANNER, JOAN D LMFT	6/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2201 F STREET	None	BAKERSFIELD	CA	93301	3850	15	06029	35.379342	-119.023506	Kern County
78864	Fee-for-Service	1447259965	1447259965	1	1	TESKE, THOMAS E MD	3/31/1992	2084N0400X	NA	Neurology	026	PHYSICIANS	65518	13	Neurology (M.D. only)	0	In state provider	None	1745 S IMPERIAL AVE	STE 101	EL CENTRO	CA	92243	4243	13	06025	32.77792365	-115.569499	Imperial County
78869	Fee-for-Service	1114902202	1114902202	1	1	TORTOSA, RICHARD D MD	7/1/1981	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	31524	02	General Surgery	0	In state provider	None	370 DEL NORTE AVE	STE 201	YUBA CITY	CA	95991	4142	51	06101	39.14466521	-121.6166961	Sutter County
78880	Fee-for-Service	1245341445	1245341445	1	1	THAO, LONG	2/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	66867	None	None	0	In state provider	None	700 W OLIVE AVE	STE A	MERCED	CA	95348	2435	24	06047	37.31918006	-120.480202	Merced County
78903	Fee-for-Service	1811917073	1811917073	1	1	TOBIS, JONATHAN M MD	2/8/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	29150	None	None	0	In state provider	UCI MED GRP MEDICINE	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
78911	Fee-for-Service	1831141027	1831141027	1	1	TOM,JAMIE 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	1301 PUNCHBOWL STREET	None	HONOLULU	HI	96813	0000	00	None	21.30800017	-157.8550765	Honolulu County
78912	Fee-for-Service	1962152512	1962152512	1	1	TOTAL HEALTHCARE SERVICES IN	11/11/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	10117 SEPULVEDA BLVD	SUITE 203B	MISSION HILLS	CA	91345	2600	19	06037	34.254252	-118.467507	Los Angeles County
78929	Fee-for-Service	1174832026	1174832026	1	1	TUAN, KE H MD INC	10/23/2003	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	85944	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	929 CLAY ST	STE 305	SAN FRANCISCO	CA	94108	1570	38	06075	37.79398652	-122.4083496	San Francisco County
78994	Fee-for-Service	1356310957	1356310957	1	1	THIO, ANDREW H MD	4/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	75296	05	Anesthesiology	0	In state provider	None	41011 CALIFORNIA OAKS RD	STE 103	MURRIETA	CA	92562	5751	33	06065	33.56684933	-117.2064118	Riverside County
78997	Fee-for-Service	1326104233	1326104233	1	1	TERRA BELLA UNION SD	12/11/2000	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9121 ROAD 240	None	TERRA BELLA	CA	93270	9423	54	06107	35.95543091	-119.0361235	Tulare County
79052	Fee-for-Service	1295918977	1295918977	1	1	TAYANI, RAMIN MD	7/27/2018	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	653 CAMINO DE LOS MARES	SUITE 101	SAN CLEMENTE	CA	92673	2808	30	06059	33.45767098	-117.6495718	Orange County
79085	Fee-for-Service	1417472226	1417472226	1	1	TAKEDA, GLORIA E LMFT	12/19/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	120273	-	NOT APPLICABLE	0	In state provider	None	4990 WILLIAMS AVENUE	None	LA MESA	CA	91942	7409	37	06073	32.76933362	-117.0371085	San Diego County
79086	Fee-for-Service	1821181199	1821181199	1	1	TEAFORD, ANDREW MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3400 LUTHERAN PKWY	None	WHEAT RIDGE	CO	80033	6035	00	None	39.76545461	-105.0886954	Jefferson County
79125	Fee-for-Service	1053708149	1053708149	1	1	TOMENO, KAITLYN CRNA	12/9/2021	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
79136	Fee-for-Service	1215602297	1215602297	1	1	TAMPICO HEALTHCARE CENTER	8/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	130 TAMPICO STREET	None	WALNUT CREEK	CA	94598	2948	07	06013	37.9105477	-122.0454604	Contra Costa County
79138	Fee-for-Service	1942319314	1942319314	1	1	THRIFTY DRUG STORE 5741	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	13822 BROOKHURST ST	None	GARDEN GROVE	CA	92843	3121	30	06059	33.761034	-117.954832	Orange County
79157	Fee-for-Service	1487790143	1487790143	1	2	TOMPKINS, DAVID A MD	3/18/2021	2084A0401X	NA	Psychiatry	026	PHYSICIANS	149238	None	None	0	In state provider	None	1001 POTRERO AVE RM 5H22	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
79202	Fee-for-Service	1578777835	1578777835	1	1	TEMPLE CITY UNIFIED SD	8/6/2002	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9700 LAS TUNAS DR	None	TEMPLE CITY	CA	91780	2242	19	06037	34.10704578	-118.0579785	Los Angeles County
79245	Fee-for-Service	1497897367	1497897367	1	1	THE VILLAGE HEALTH	5/13/2015	261QC1500X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	FOUNDATION INC	4073-75 W PICO BLVD	None	LOS ANGELES	CA	90019	4308	19	06037	34.04764232	-118.3243937	Los Angeles County
79283	Fee-for-Service	1356310957	1356310957	1	1	THIO, ANDREW H MD	4/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	75296	01	General Practice	0	In state provider	None	41011 CALIFORNIA OAKS RD	STE 103	MURRIETA	CA	92562	5751	33	06065	33.56684933	-117.2064118	Riverside County
79297	Fee-for-Service	1871987578	1871987578	1	2	THERAPIZE ME	3/18/2025	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	PSYCHOLOGICAL CORPORATI	879 W 190TH ST	400	GARDENA	CA	90248	4223	19	06037	33.85927671	-118.2896516	Los Angeles County
79298	Fee-for-Service	1932185220	1932185220	1	1	THOMAS LEE BOSTWICK, 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	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
79303	Fee-for-Service	1013949049	1013949049	1	1	TEASDALE, ROBERT D JR MD	6/30/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	33292	20	Orthopedic Surgery	0	In state provider	None	1375 S ELISEO DR	STE D	GREENBRAE	CA	94904	2013	21	06041	37.94506413	-122.5373483	Marin County
79304	Fee-for-Service	1235167305	1235167305	1	1	TREISTER, NEIL W MD	1/1/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	45103	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
79338	Fee-for-Service	1619355708	1619355708	1	1	TAMBE, BEVERLY MD	8/16/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	143722	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
79371	Fee-for-Service	1649845215	1649845215	1	1	TRANG, JANICE OD	8/12/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
79391	Fee-for-Service	1083616197	1083616197	1	1	TECUANHUEY, LEOPOLDO A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	718 CUPPLES RD	STE 102	SAN ANTONIO	TX	78237	4354	00	None	29.40555688	-98.54815099	Bexar County
79438	Fee-for-Service	1396752887	1396752887	1	1	TRAN, BANG K OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1982 TULLY RD	None	SAN JOSE	CA	95122	1889	43	06085	37.323999	-121.8201705	Santa Clara County
79520	Fee-for-Service	1508916651	1508916651	1	1	THE FAMILY-CENTERED EAR NOSE	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	40654	03	Allergy	0	In state provider	THROAT GROUP, A MED CORP	9360 N NAME UNO	STE 120	GILROY	CA	95020	3535	43	06085	37.035801	-121.569858	Santa Clara County
79601	Fee-for-Service	1326181165	1326181165	1	1	TEJEDA, ISABEL C MD	3/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88853	08	Family Practice	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
79618	Fee-for-Service	1851722540	1851722540	1	1	TURNER, SHEYVON F LPCC	10/3/2021	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	G SERVICES	2627 W FLORIDA AVE	STE 203	HEMET	CA	92545	4618	33	06065	33.74731552	-116.999784	Riverside County
79781	Fee-for-Service	1558740852	1558740852	1	1	THE LOS ANGELES FREE CLINIC	11/14/2018	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5205 MELROSE AVENUE	None	LOS ANGELES	CA	90038	3144	19	06037	34.08354051	-118.314009	Los Angeles County
79788	Fee-for-Service	1922019447	1922019447	1	1	THEODORE V. AREVALO, M.D.	7/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4402	00	None	29.508012	-98.578683	Bexar County
79805	Fee-for-Service	1508916651	1508916651	1	1	THE FAMILY-CENTERED EAR NOSE	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	40654	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	THROAT GROUP, A MED CORP	9360 N NAME UNO	STE 120	GILROY	CA	95020	3535	43	06085	37.035801	-121.569858	Santa Clara County
79833	Fee-for-Service	1619668498	1619668498	1	1	THE INDI WOMENS CLUB LLC	5/15/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
79834	Fee-for-Service	1174743165	1174743165	1	1	TOOR, HARPREET MD	11/10/2009	390200000X	NA	Other	026	PHYSICIANS	105232	08	Family Practice	0	In state provider	None	969 PLUMAS STREET	SUITE 205	YUBA CITY	CA	95991	4011	51	06101	39.14263634	-121.6176593	Sutter County
79848	Fee-for-Service	1417485889	1417485889	1	3	TRANSIT PHYSICAL THERAPY PC	5/20/2020	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2280 MARKET ST	SUITE 230	RIVERSIDE	CA	92501	2117	33	06065	33.99828881	-117.3720693	Riverside County
79869	Fee-for-Service	1619910346	1619910346	1	1	TRAVERS, MCLOUGHLIN J MD	7/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92339	30	Radiology	0	In state provider	None	311 HAM LN	None	LODI	CA	95242	3512	39	06077	38.1388078	-121.2884813	San Joaquin County
79883	Fee-for-Service	1871602235	1871602235	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7900 W SUNSET BLVD	None	LOS ANGELES	CA	90046	3304	19	06037	34.09802449	-118.361997	Los Angeles County
79890	Fee-for-Service	1700900032	1700900032	1	2	TONNOS, FREDERICK E DO	6/4/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	11113	20	Orthopedic Surgery	0	In state provider	None	6620 COYLE AVE	STE 212	CARMICHAEL	CA	95608	6337	34	06067	38.66751	-121.310028	Sacramento County
79893	Fee-for-Service	1003811746	1003811746	1	1	TSENG, HENNESSEY MD	1/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	86069	None	None	0	In state provider	None	1450 TREAT BLVD	STE 220B	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
79937	Fee-for-Service	1639190887	1639190887	1	1	TCHARFAS, OLGA MD	6/25/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69191	05	Anesthesiology	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
79942	Fee-for-Service	1992065825	1992065825	1	1	TSAI, ANDERSON H DO	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12996	41	Internal Medicine	0	In state provider	None	500 SAN PABLO AVE	None	ALBANY	CA	94706	1127	01	06001	37.89781848	-122.3014067	Alameda County
79989	Fee-for-Service	1730621905	1730621905	1	1	TIECHE, JESSICA J CRNA	9/9/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
80003	Fee-for-Service	1629552427	1629552427	1	1	THOMAS, AMY M RCP	11/16/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
80037	Fee-for-Service	1902493232	1902493232	1	1	TWO PALMS SKILLED CARE, LLC	1/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2637 E WASHINGTON BLVD	None	PASADENA	CA	91107	1412	19	06037	34.16917311	-118.0959996	Los Angeles County
80038	Fee-for-Service	1184716185	1184716185	1	1	TREJO, ERICA LMFT	1/21/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
80039	Fee-for-Service	1720405491	1720405491	1	3	TIBURCIO VASQUEZ HEALTH	2/17/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	750 FARGO AVE	None	SAN LEANDRO	CA	94579	2104	01	06001	37.6879428	-122.1424773	Alameda County
80058	Fee-for-Service	1285618207	1285618207	1	1	TRENTO, ALFREDO MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44773	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
80066	Fee-for-Service	1235489709	1235489709	1	1	TAKHER, JASPRIT S MD	10/27/2020	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
80090	Fee-for-Service	1023583580	1023583580	1	1	TEIXEIRA, ZACHARY S RN CPNP	11/13/2019	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
80098	Fee-for-Service	1346017126	1346017126	1	1	THRIVE RX PHARMACY INC	2/21/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2945 HONOLULU AVE	None	LA CRESCENTA	CA	91214	3912	19	06037	34.21373621	-118.2436083	Los Angeles County
80120	Fee-for-Service	1962516591	1962516591	1	2	TIMBERLAKE FAMILY PRACTICE	1/7/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	A MEDICAL CORPORATION	9381 E STOCKTON BLVD	STE 216	ELK GROVE	CA	95624	5070	34	06067	38.416689	-121.3915185	Sacramento County
80135	Fee-for-Service	1417485889	1417485889	1	3	TRANSIT PHYSICAL THERAPY PC	11/11/2021	261QP2000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2280 MARKET ST	SUITE 230	RIVERSIDE	CA	92501	2117	33	06065	33.99828881	-117.3720693	Riverside County
80160	Fee-for-Service	1619910346	1619910346	1	1	TRAVERS, MCLOUGHLIN J MD	7/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92339	78	Neoplastic Diseases/Oncology	0	In state provider	None	311 HAM LN	None	LODI	CA	95242	3512	39	06077	38.1388078	-121.2884813	San Joaquin County
80213	Fee-for-Service	1255005666	1255005666	1	1	TREMBLAY, LOUIS P MD	9/21/2021	208G00000X	NA	General Surgery	026	PHYSICIANS	174283	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
80226	Fee-for-Service	1104926112	1104926112	1	1	TAYLOR, ALICIA MD	2/8/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	182388	None	None	0	In state provider	None	1665 ESPLANADE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
80245	Fee-for-Service	1417485889	1417485889	1	4	TRANSIT PHYSICAL THERAPY PC	9/17/2021	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1850 N RIVERSIDE AVE	240	RIALTO	CA	92376	8071	36	06071	34.132905	-117.3704675	San Bernardino County
80299	Fee-for-Service	1568777266	1568777266	1	1	TRAN, TONY M	4/4/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
80302	Fee-for-Service	1083009286	1083009286	1	1	TSOU, SHIHHUI S NP	4/15/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15272 SUMMIT AVE	None	FONTANA	CA	92336	0231	36	06071	34.152624	-117.4724415	San Bernardino County
80327	Fee-for-Service	1720405491	1720405491	1	3	TIBURCIO VASQUEZ HEALTH	2/17/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	750 FARGO AVE	None	SAN LEANDRO	CA	94579	2104	01	06001	37.6879428	-122.1424773	Alameda County
80348	Fee-for-Service	1285618207	1285618207	1	1	TRENTO, ALFREDO MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44773	33	Thoracic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
80355	Fee-for-Service	1376710335	1376710335	2	1	TERRA BELLA COMMUNITITES	10/18/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	797 LAWRENCE DRIVE	None	GILROY	CA	95020	4005	43	06085	37.02056631	-121.589127	Santa Clara County
80473	Fee-for-Service	1205098696	1205098696	1	1	TRAN, MARK M MD	11/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121821	07	Dermatology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
80474	Fee-for-Service	1548713266	1548713266	1	1	TOWN CENTER HOSPICE CARE	11/5/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	11260 WILBUR AVE	STE 306	PORTER RANCH	CA	91326	2450	19	06037	34.2746575	-118.5470435	Los Angeles County
80486	Fee-for-Service	1174650691	1174650691	1	1	THOMAS, JEFFREY S MD	10/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	85278	41	Internal Medicine	0	In state provider	None	225 SPRUCE ST	None	GRIDLEY	CA	95948	2215	04	06007	39.36695351	-121.68954	Butte County
80491	Fee-for-Service	1609825082	1609825082	1	1	TSAI, CHARLES C MD	1/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	84045	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
80535	Fee-for-Service	1417485889	1417485889	1	4	TRANSIT PHYSICAL THERAPY PC	10/18/2022	261QP2000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1850 N RIVERSIDE AVE	240	RIALTO	CA	92376	8071	36	06071	34.132905	-117.3704675	San Bernardino County
80557	Fee-for-Service	1851652572	1851652572	1	1	THOMAS, VIRGINIA W MD	11/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121349	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
80570	Fee-for-Service	1689601536	1689601536	1	2	THE UROLOGY CNTR OF S CA	12/12/2017	208800000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	MED GRP	801 S MAIN ST	STE 201	CORONA	CA	92882	3410	33	06065	33.87299458	-117.566728	Riverside County
80571	Fee-for-Service	1871936534	1871936534	1	1	THOMAS, REENA MD	9/15/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	171530	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
80572	Fee-for-Service	1609026574	1609026574	1	1	TAYLOR, KIMBERLY LMFT	9/19/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	9705 S HOLMES AVE	None	LOS ANGELES	CA	90002	3031	19	06037	33.94797442	-118.2408345	Los Angeles County
80586	Fee-for-Service	1265736052	1265736052	1	1	TIMMERMAN, MOLLY A DO	4/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11468	25	Physical Medicine and Rehabilitation	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
80587	Fee-for-Service	1205400769	1205400769	1	1	THE JAZZY DOC, PC	11/9/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	None	None	0	In state provider	None	2216 N CALIFORNIA ST	STE A	STOCKTON	CA	95204	5533	39	06077	37.97386974	-121.2903465	San Joaquin County
80589	Fee-for-Service	1073040937	1073040937	1	1	TUCKER, JALIA MD	5/15/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169992	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
80602	Fee-for-Service	1033608922	1033608922	1	1	TAYLOR, LORNE MD	2/7/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	186018	None	None	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
80616	Fee-for-Service	1285712836	1285712836	1	1	TORRES, MICHELLE MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71967	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
80632	Fee-for-Service	1043535255	1043535255	1	1	TSENG, TERESA MD	10/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125725	40	Pediatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
80650	Fee-for-Service	1568473015	1568473015	1	1	TARPON SPRINGS HOSPITAL	2/9/2013	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FOUNDATION INC	1395 S PINELLAS AVE	None	TARPON SPRINGS	FL	34689	3790	00	None	28.13276692	-82.7586001	Pinellas County
80694	Fee-for-Service	1710282421	1710282421	1	1	TAKEUCHI WANLASS, ISAAC A	9/6/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	15477 VENTURA BLVD	SUITE 200	SHERMAN OAKS	CA	91403	3013	19	06037	34.15468022	-118.4712272	Los Angeles County
80701	Fee-for-Service	1902168792	1902168792	1	1	TIMBERS, WILLIAM D MD	9/29/2015	207P00000X	NA	Other	026	PHYSICIANS	136911	66	Emergency Medicine (Urgent Care)	0	In state provider	None	150 PIONEER LN	None	BISHOP	CA	93514	2517	14	06027	37.36193834	-118.4073304	Inyo County
80713	Fee-for-Service	1558793810	1558793810	1	1	THERAPEUTIC DESIGNS INC	5/23/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	355 W LAS PALMAS AVE	None	PATTERSON	CA	95363	2551	50	06099	37.47078866	-121.131867	Stanislaus County
80737	Fee-for-Service	1710972997	1710972997	1	1	TRAN, THOMAS T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	85242	41	Internal Medicine	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
80742	Fee-for-Service	1174887947	1174887947	1	1	TUMBER, KIRANJEET K DO	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12326	None	None	0	In state provider	None	9330 STOCKDALE HWY	SUITE 400	BAKERSFIELD	CA	93311	3615	15	06029	35.35452946	-119.106351	Kern County
80758	Fee-for-Service	1659042893	1659042893	1	2	TOWNS HEALTH SERVICES, INC.	10/19/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	400 S. FAIRMONT AVE	None	LODI	CA	95240	3802	39	06077	38.12841607	-121.2858821	San Joaquin County
80762	Fee-for-Service	1548713266	1548713266	1	1	TOWN CENTER HOSPICE CARE	11/5/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	11260 WILBUR AVE	STE 306	PORTER RANCH	CA	91326	2450	19	06037	34.2746575	-118.5470435	Los Angeles County
80780	Fee-for-Service	1760560312	1760560312	1	1	TABAK, CAROL A MD	12/29/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	35466	33	Thoracic Surgery	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
80818	Fee-for-Service	1346063377	1346063377	1	1	TOVAR MARTIN, ALMA L	11/18/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	5100 N SIXTH ST	STE 120	FRESNO	CA	93710	7506	10	06019	36.810666	-119.763204	Fresno County
80830	Fee-for-Service	1053998989	1053998989	1	1	TRUONG, KEVIN LE MD	8/21/2024	207R00000X	NA	Other	026	PHYSICIANS	191553	41	Internal Medicine	0	In state provider	None	27235 TOURNEY	2500	VALENCIA	CA	91355	5908	19	06037	34.41755702	-118.5772646	Los Angeles County
80853	Fee-for-Service	1003463993	1003463993	1	1	TRINITY ADHC INC	7/21/2020	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	6200 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91606	4005	19	06037	34.18317458	-118.3856468	Los Angeles County
80865	Fee-for-Service	1447923693	1447923693	1	1	TAGHDIMI, MARYAM PSYD	5/23/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
80869	Fee-for-Service	1073622510	1073622510	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05782	2480 VICTORIA AVE	None	PORT HUENEME	CA	93041	2141	56	06111	34.177095	-119.2212915	Ventura County
80892	Fee-for-Service	1831523836	1831523836	1	1	TOBLER, DIANA MD	7/10/2019	208M00000X	NA	Other	026	PHYSICIANS	154056	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
80927	Fee-for-Service	1861860306	1861860306	1	1	TIBURCIO VASQUEZ HEALTH	3/30/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	28300 HUNTWOOD AVE	None	HAYWARD	CA	94544	5470	01	06001	37.63265296	-122.0643095	Alameda County
80940	Fee-for-Service	1568473015	1568473015	1	1	TARPON SPRINGS HOSPITAL	2/9/2013	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FOUNDATION INC	1395 S PINELLAS AVE	None	TARPON SPRINGS	FL	34689	3790	00	None	28.13276692	-82.7586001	Pinellas County
80943	Fee-for-Service	1265827190	1265827190	1	1	TAIT, AIDAN MD	10/11/2021	207L00000X	NA	Other	026	PHYSICIANS	144059	None	None	0	In state provider	None	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
80950	Fee-for-Service	1902244676	1902244676	1	1	THIHA, THAW Z MD	11/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138548	01	General Practice	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
80987	Fee-for-Service	1871655480	1871655480	1	1	TAMBOLI, KAUSHAL R MD	7/1/1994	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	38408	06	Cardiovascular Disease (M.D. only)	0	In state provider	SUITE 403	11411 BROOKSHIRE AVE	None	DOWNEY	CA	90241	5003	19	06037	33.93667091	-118.1309273	Los Angeles County
81010	Fee-for-Service	1174646509	1174646509	1	1	TAM, YOLANDA Q MD	6/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97773	05	Anesthesiology	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
81037	Fee-for-Service	1952453318	1952453318	1	1	TORABZADEH, SAEED MD	7/20/1994	207R00000X	NA	Other	026	PHYSICIANS	53306	01	General Practice	0	In state provider	None	5458 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4113	19	06037	34.01923526	-118.1519003	Los Angeles County
81083	Fee-for-Service	1306955711	1306955711	1	1	THRIFTY PAYLESS INC	4/19/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5718	8015 LIMONITE AVE	None	RIVERSIDE	CA	92509	6108	33	06065	33.97832183	-117.4591281	Riverside County
81095	Fee-for-Service	1699965798	1699965798	1	1	TRACY R EDIGER M.D.	7/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
81110	Fee-for-Service	1346680774	1346680774	1	1	TORRES, ANA MARIE	10/29/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
81123	Fee-for-Service	1023159860	1023159860	1	1	THOUSAND OAKS SURGICAL CTR	4/26/2011	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	415 ROLLING OAKS DR	STE 115	THOUSAND OAKS	CA	91361	1036	56	06111	34.17439717	-118.8691161	Ventura County
81132	Fee-for-Service	1669570008	1669570008	1	1	TERRAZZINO, JOSEPH MD	2/27/2009	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	75356	41	Internal Medicine	0	In state provider	INC	26357 MCBEAN PKWY	STE 210	VALENCIA	CA	91355	4497	19	06037	34.41257644	-118.5597683	Los Angeles County
81141	Fee-for-Service	1437260825	1437260825	1	1	TAKEMOTO, FERN S MD	6/30/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	71709	40	Pediatrics	0	In state provider	None	8421 AUBURN BLVD	None	CITRUS HEIGHTS	CA	95610	0359	34	06067	38.719026	-121.291335	Sacramento County
81147	Fee-for-Service	1528627106	1528627106	1	1	TOPANGA HOSPICE CARE INC	2/20/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8374 TOPANGA CANYON BLVD	SUITE 212	CANOGA PARK	CA	91304	2344	19	06037	34.222113	-118.605974	Los Angeles County
81148	Fee-for-Service	1386744357	1386744357	1	1	TORPOCO, JESUS A MD	5/8/2013	207RA0201X	NA	Other	026	PHYSICIANS	25606	03	Allergy	0	In state provider	None	19231 VICTORY BLVD	None	RESEDA	CA	91335	6308	19	06037	34.18659852	-118.552221	Los Angeles County
81149	Fee-for-Service	1770519233	1770519233	1	1	TUREK, PAUL J MD	7/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	79369	34	Urology and Urological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
81180	Fee-for-Service	1275037103	1275037103	1	1	TAM, ERIC MD	10/19/2021	208M00000X	NA	Other	026	PHYSICIANS	164896	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
81213	Fee-for-Service	1861860306	1861860306	1	1	TIBURCIO VASQUEZ HEALTH	3/30/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	28300 HUNTWOOD AVE	None	HAYWARD	CA	94544	5470	01	06001	37.63265296	-122.0643095	Alameda County
81240	Fee-for-Service	1609070051	1609070051	1	1	TSAI, EUNICE Y MD	12/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	76239	07	Dermatology	0	In state provider	None	3555 WHIPPLE ROAD	None	OAKLAND	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
81254	Fee-for-Service	1417933177	1417933177	1	1	TERRY, CHERIE A MD	10/1/2022	207P00000X	NA	Other	026	PHYSICIANS	167970	None	None	0	In state provider	None	1720 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
81309	Fee-for-Service	1295817989	1295817989	1	1	TORRES-WATSON, TAMARA S MD	1/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	96445	40	Pediatrics	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
81364	Fee-for-Service	1942631759	1942631759	1	1	TRAN, ALINE T	2/18/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
81381	Fee-for-Service	1235166471	1235166471	1	1	TOUNG, JACK C MD	3/4/2008	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	99818	30	Radiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
81415	Fee-for-Service	1770830325	1770830325	1	5	TWO TREES PHYSICAL THERAPY &	9/12/2019	225100000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2100 SOLAR DRIVE	204	OXNARD	CA	93036	2602	56	06111	34.22156515	-119.14488	Ventura County
81420	Fee-for-Service	1417156811	1417156811	1	1	TAN, JESSICA C MD	5/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103757	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
81430	Fee-for-Service	1184269128	1184269128	1	1	TONG, CHRISTOPHER C OD	10/23/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	899 WASHINGTON ST	6	SAN FRANCISCO	CA	94108	1214	38	06075	37.79495957	-122.4078614	San Francisco County
81437	Fee-for-Service	1528627106	1528627106	1	1	TOPANGA HOSPICE CARE INC	2/20/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8374 TOPANGA CANYON BLVD	SUITE 212	CANOGA PARK	CA	91304	2344	19	06037	34.222113	-118.605974	Los Angeles County
81446	Fee-for-Service	1649248709	1649248709	1	1	TODD A LEFKOWITZ MD	12/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1101 E MISSOURI AVE	None	PHOENIX	AZ	85014	2709	00	None	33.516099	-112.0582575	Maricopa County
81477	Fee-for-Service	1518185305	1518185305	1	2	TRAN, DAN QUANG MD	11/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80816	41	Internal Medicine	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
81482	Fee-for-Service	1780640524	1780640524	1	1	TISCARENO, MARIA E MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68064	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
81484	Fee-for-Service	1639625635	1639625635	1	1	THRIFTY PAYLESS INC	12/9/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	707 N PACIFIC AVE	None	GLENDALE	CA	91203	1025	19	06037	34.15691856	-118.264279	Los Angeles County
81487	Fee-for-Service	1649664673	1649664673	1	1	TELISCHAK, KATHERINE MD	12/2/2020	207L00000X	NA	Other	026	PHYSICIANS	147829	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
81494	Fee-for-Service	1013226802	1013226802	1	1	THACKER, RUPA MD	8/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125535	None	None	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
81505	Fee-for-Service	1861860306	1861860306	1	1	TIBURCIO VASQUEZ HEALTH	3/30/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	28300 HUNTWOOD AVE	None	HAYWARD	CA	94544	5470	01	06001	37.63265296	-122.0643095	Alameda County
81526	Fee-for-Service	1629008610	1629008610	1	1	TAKAHASHI, PATRICK H MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	54838	10	Gastroenterology (M.D. only)	0	In state provider	HI-BRIDGE GASTRO MED GRP	420 E 3RD ST	STE 606	LOS ANGELES	CA	90013	1645	19	06037	34.04702011	-118.241912	Los Angeles County
81537	Fee-for-Service	1730481755	1730481755	1	1	TRAN, BRUCE M MD	5/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114006	40	Pediatrics	0	In state provider	None	6235 N FRESNO ST	STE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
81543	Fee-for-Service	1780683193	1780683193	1	1	TUCKER, KANT MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	35483	41	Internal Medicine	0	In state provider	None	2950 SYCAMORE DR	STE 100	SIMI VALLEY	CA	93065	1210	56	06111	34.28932056	-118.7438673	Ventura County
81561	Fee-for-Service	1356542955	1356542955	1	1	TOWNSEND, CHERI LMFT	10/9/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4001 W ALAMEDA AVE	STE 207	BURBANK	CA	91505	4338	19	06037	34.15302397	-118.3436924	Los Angeles County
81572	Fee-for-Service	1689831919	1689831919	1	1	TITRE-HAYFRON, DEBORAH D	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103863	05	Anesthesiology	0	In state provider	MD	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
81626	Fee-for-Service	1316992951	1316992951	1	1	THOMPSON, KIRK L	4/4/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
81655	Fee-for-Service	1275625360	1275625360	1	1	THRIFTY PAYLESS INC	12/29/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	211 W BIRCH ST	None	CALEXICO	CA	92231	2348	13	06025	32.67916454	-115.501569	Imperial County
81672	Fee-for-Service	1972685196	1972685196	1	2	THE CAMP RECOVERY CENTER, LL	11/20/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	3192 GLEN CANYON RD	None	SCOTTS VALLEY	CA	95066	4916	44	06087	37.036674	-122.01498	Santa Cruz County
81692	Fee-for-Service	1689288003	1689288003	1	1	THOMASON, TORI CCC-SLP	10/21/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
81704	Fee-for-Service	1770830325	1770830325	1	5	TWO TREES PHYSICAL THERAPY &	8/13/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2100 SOLAR DRIVE	204	OXNARD	CA	93036	2602	56	06111	34.22156515	-119.14488	Ventura County
81736	Fee-for-Service	1639697758	1639697758	1	1	TRAN, LENI PSYD	10/11/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
81739	Fee-for-Service	1568404812	1568404812	1	1	TOPHAM, STEVEN L MD	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	STE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
81741	Fee-for-Service	1497895197	1497895197	1	1	TIZNADO, MONICA M LMFT	8/27/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST 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
81742	Fee-for-Service	1679038061	1679038061	1	1	TIMBER ZWICKILTON, CLINICAL	5/2/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYCHOLOGIST INC	11440 W BERNARDO CT	256	SAN DIEGO	CA	92127	1653	37	06073	33.02287444	-117.0821057	San Diego County
81779	Fee-for-Service	1871725895	1871725895	1	1	TIWANA, JASPREET K MD	8/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119171	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
81780	Fee-for-Service	1205925112	1205925112	1	1	TORRES,MARCELA DIANA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	COOK CHILDRENS PHYSICIAN	NETWORK	801 SEVENTH AVENUE	FORT WORTH	TX	76104	0000	00	None	0	0	None
81807	Fee-for-Service	1629008610	1629008610	1	1	TAKAHASHI, PATRICK H MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	54838	41	Internal Medicine	0	In state provider	HI-BRIDGE GASTRO MED GRP	420 E 3RD ST	STE 606	LOS ANGELES	CA	90013	1645	19	06037	34.04702011	-118.241912	Los Angeles County
81816	Fee-for-Service	1609822493	1609822493	1	1	TESTA, NICHOLAS E MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83023	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
81821	Fee-for-Service	1033717194	1033717194	1	1	TREJO, ANA C NP	11/3/2020	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
81829	Fee-for-Service	1780683193	1780683193	1	1	TUCKER, KANT MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	35483	45	Nephrology (Renal-Kidney)	0	In state provider	None	2950 SYCAMORE DR	STE 100	SIMI VALLEY	CA	93065	1210	56	06111	34.28932056	-118.7438673	Ventura County
81891	Fee-for-Service	1285868786	1285868786	1	1	THOMAS, REENA P MD	9/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117262	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
81902	Fee-for-Service	1841309275	1841309275	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE 5670	82154 US HIGHWAY 111	None	INDIO	CA	92201	5654	33	06065	33.71489944	-116.231722	Riverside County
81931	Fee-for-Service	1265451058	1265451058	1	1	TAMMELA, JONATHAN E MD	11/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153584	None	None	0	In state provider	None	6501 TRUXTUN AVE	None	BAKERSFIELD	CA	93309	0633	15	06029	35.36196445	-119.0749413	Kern County
81934	Fee-for-Service	1548283914	1548283914	1	1	TEO, BENA MD	4/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80908	08	Family Practice	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
81950	Fee-for-Service	1609013762	1609013762	1	1	TRANG, DONG C DO	10/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	10804	41	Internal Medicine	0	In state provider	None	8041 NEWMAN AVE	None	HUNTINGTON BEACH	CA	92647	7034	30	06059	33.70481104	-117.9882948	Orange County
81991	Fee-for-Service	1770830325	1770830325	1	5	TWO TREES PHYSICAL THERAPY &	4/18/2024	225100000X	NA	Physical Therapist	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2100 SOLAR DRIVE	204	OXNARD	CA	93036	2602	56	06111	34.22156515	-119.14488	Ventura County
81993	Fee-for-Service	1427136332	1427136332	1	1	TABRIZIANI, HOSSEIN MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78291	41	Internal Medicine	0	In state provider	None	11370 ANDERSON STREET	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
82024	Fee-for-Service	1609888411	1609888411	1	1	THAI, MINH Q MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	75250	08	Family Practice	0	In state provider	None	60 N 13TH ST	STE B	SAN JOSE	CA	95112	3525	43	06085	37.34297359	-121.8787654	Santa Clara County
82030	Fee-for-Service	1871518217	1871518217	1	1	TRAN, DUNG M MD	11/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82188	41	Internal Medicine	0	In state provider	None	481 PLUMAS BLVD	STE 202	YUBA CITY	CA	95991	5075	51	06101	39.13306148	-121.6140103	Sutter County
82204	Fee-for-Service	1437611456	1437611456	1	1	TIRAIE, MEHRAFARID MD	9/19/2022	207R00000X	NA	Other	026	PHYSICIANS	176362	None	None	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
82228	Fee-for-Service	1043572076	1043572076	1	1	TOTAL BODY HEALTHCARE INC	10/10/2014	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	81865	01	General Practice	0	In state provider	None	26700 TOWNE CENTRE DR	SUITE 170	FOOTHILL RANCH	CA	92610	2850	30	06059	33.67455886	-117.6639195	Orange County
82235	Fee-for-Service	1225763865	1225763865	1	1	TRAN, SUE CNP	9/30/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	576 E EL CAMINO REAL	None	SUNNYVALE	CA	94087	1940	43	06085	37.36249974	-122.0260401	Santa Clara County
82239	Fee-for-Service	1922231620	1922231620	1	1	TEYMOORIAN, NADIA LMFT	7/15/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	105869	-	NOT APPLICABLE	0	In state provider	None	350 VINTON AVE	STE 102	POMONA	CA	91767	3000	19	06037	34.07937061	-117.746663	Los Angeles County
82244	Fee-for-Service	1386718971	1386718971	1	1	THINN, WIN M MD	11/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96627	83	Rheumatology	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
82297	Fee-for-Service	1467823831	1467823831	1	1	TRISTAN, JANA	11/22/2024	363L00000X	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
82298	Fee-for-Service	1023089562	1023089562	1	1	TATYANA PETROSOVA	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3009 N BALLAS RD	BLDG A #142	SAINT LOUIS	MO	63131	2322	00	None	38.635317	-90.448749	St. Louis County
82304	Fee-for-Service	1326676826	1326676826	1	1	TAKHAR, JASMINE K DO	9/15/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19641	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
82370	Fee-for-Service	1366472813	1366472813	1	1	TAFAZOLI, MANSOUR MD	10/10/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	46577	30	Radiology	0	In state provider	None	9080 COLIMA RD	None	WHITTIER	CA	90605	1600	19	06037	33.95062799	-118.0051627	Los Angeles County
82446	Fee-for-Service	1619054558	1619054558	1	1	TAO, HONG MD	6/27/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75456	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
82468	Fee-for-Service	1104489152	1104489152	1	1	TA, QUYNHVY N DO	10/27/2022	207P00000X	NA	Other	026	PHYSICIANS	19759	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
82477	Fee-for-Service	1154960334	1154960334	1	1	TAM, ALAN K CNP	3/20/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
82481	Fee-for-Service	1245691559	1245691559	1	1	TEDESCO, MADALYN M LMFT	8/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1200 AVIATION BLVD	SUITE 102	REDONDO BEACH	CA	90278	4063	19	06037	33.86558294	-118.386439	Los Angeles County
82497	Fee-for-Service	1578657847	1578657847	1	1	TRAN, HUY THAI MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	6274	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
82526	Fee-for-Service	1639469802	1639469802	1	1	TATE, DEBORAH K LCSW	6/4/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
82579	Fee-for-Service	1023475274	1023475274	1	1	THE SALVATION ARMY	5/19/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	5600 RICKENBACKER RD	2A-B	BELL	CA	90201	6425	19	06037	33.98966197	-118.1648431	Los Angeles County
82603	Fee-for-Service	1306229265	1306229265	1	1	TALNA HOSPICE CARE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	26323 JEFFERSON AVE	SUITE D	MURRIETA	CA	92562	9514	33	06065	33.53455308	-117.1789876	Riverside County
82631	Fee-for-Service	1952054876	1952054876	1	1	TAYLOR-CEBALLOS, CANDY LCSW	2/20/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
82640	Fee-for-Service	1689120586	1689120586	1	1	TONEKABONI, MARYAM S MD INC	6/26/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	118665	01	General Practice	0	In state provider	None	18350 ROSCOE BLVD	STE 307	NORTHRIDGE	CA	91325	4159	19	06037	34.22071855	-118.5341175	Los Angeles County
82655	Fee-for-Service	1427169366	1427169366	1	1	TARIN MEDICAL CORP	3/1/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	900 S MAIN ST	STE 108	CORONA	CA	92882	3401	33	06065	33.87190191	-117.5669613	Riverside County
82674	Fee-for-Service	1164531513	1164531513	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05830	740 QUINTANA RD	None	MORRO BAY	CA	93442	1940	40	06079	35.36772476	-120.8425949	San Luis Obispo County
82686	Fee-for-Service	1750365656	1750365656	1	1	TURAJ TOM SHAFA	9/25/2017	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8733 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1827	19	06037	34.07688048	-118.3815765	Los Angeles County
82689	Fee-for-Service	1801009188	1801009188	1	1	TUSTIN UNIFIED SD	11/8/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	300 SOUTH C ST	None	TUSTIN	CA	92780	3633	30	06059	33.74318295	-117.8249377	Orange County
82717	Fee-for-Service	1669991642	1669991642	1	1	TALAVERA, XIMENA A CCC-SLP	12/14/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
82768	Fee-for-Service	1316957640	1316957640	1	1	TORRENTE, MICHAEL J DO	11/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9080	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
82834	Fee-for-Service	1841451465	1841451465	1	1	TYSON, MAUREEN A MD	10/23/2008	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	89337	25	Physical Medicine and Rehabilitation	0	In state provider	None	2693 E WASHINGTON BLVD	None	PASADENA	CA	91107	1412	19	06037	34.16895749	-118.0951839	Los Angeles County
82851	Fee-for-Service	1023029584	1023029584	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8400 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	3610	19	06037	34.22349	-118.4487305	Los Angeles County
82852	Fee-for-Service	1902452857	1902452857	1	1	TRANSPORTATION PABLO TRANSIT	12/23/2021	344600000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	28810 POSEY AVE	None	MADERA	CA	93638	5865	20	06039	36.94579483	-120.021327	Madera County
82859	Fee-for-Service	1376862821	1376862821	1	1	TAN, MIRANDA DO	9/22/2022	207RS0012X	NA	Other	026	PHYSICIANS	20250	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
82860	Fee-for-Service	1265466940	1265466940	1	1	TRULL, DAVID W OD	4/4/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	991 E MONTE VISTA AVE	None	TURLOCK	CA	95382	0403	50	06099	37.52188647	-120.83769	Stanislaus County
82885	Fee-for-Service	1588040802	1588040802	1	1	TAYLOR, JAMULA E LMFT	1/19/2022	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
82890	Fee-for-Service	1306229265	1306229265	1	1	TALNA HOSPICE CARE	4/24/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	26323 JEFFERSON AVE	SUITE D	MURRIETA	CA	92562	9514	33	06065	33.53455308	-117.1789876	Riverside County
82892	Fee-for-Service	1306967955	1306967955	1	1	TEHACHAPI UNIFIED SD	1/22/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	300 S ROBINSON	None	TEHACHAPI	CA	93561	1727	15	06029	35.12937454	-118.4464281	Kern County
82907	Fee-for-Service	1942371588	1942371588	1	2	TURNS, JOHN E MD	1/12/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	44402	-	NOT APPLICABLE	0	In state provider	None	682 BRIERGATE WAY	None	HAYWARD	CA	94544	7245	01	06001	37.62610365	-122.038863	Alameda County
82944	Fee-for-Service	1366104960	1366104960	1	1	TRAN, CHRIS OD	10/19/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	718 DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	1038	19	06037	34.03167081	-117.8089198	Los Angeles County
83041	Fee-for-Service	1518499318	1518499318	1	1	TALEB, SHAYANDOKHT MD	9/15/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	172412	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
83043	Fee-for-Service	1760606925	1760606925	1	1	TRI-CITY HEALTH CENTER-	10/2/2006	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	STATE STREET	39184 STATE ST	None	FREMONT	CA	94538	1436	01	06001	37.54945968	-121.9834643	Alameda County
83058	Fee-for-Service	1316957640	1316957640	1	1	TORRENTE, MICHAEL J DO	11/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9080	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
83132	Fee-for-Service	1982150546	1982150546	1	1	TORRES, CHRISTINE C ICBD	3/5/2025	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	38	06075	0	0	None
83168	Fee-for-Service	1033136791	1033136791	1	1	TRAMBLEY, JOEL F MD	3/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87204	None	None	0	In state provider	None	2430 CLAY ST	None	SAN FRANCISCO	CA	94115	1809	38	06075	37.79088567	-122.4331058	San Francisco County
83191	Fee-for-Service	1346561305	1346561305	1	1	TONG, WAI KAI K LMFT	2/4/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
83212	Fee-for-Service	1972748507	1972748507	2	1	TMC PHARMACY INC	10/22/2019	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3500 W 6TH ST	SUITE 120	LOS ANGELES	CA	90020	5801	19	06037	34.06358251	-118.2985785	Los Angeles County
83221	Fee-for-Service	1881987063	1881987063	2	1	TULSHIAN, PRIYANKA B	10/21/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	130930	None	None	0	In state provider	None	331 ILENE ST	None	MARTINEZ	CA	94553	2631	07	06013	38.00820807	-122.1335048	Contra Costa County
83272	Fee-for-Service	1629807870	1629807870	1	1	THE VINE FAMILY COUNSELING,	10/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATI	1765 GOODYEAR AVE	STE 206-207	VENTURA	CA	93003	0128	56	06111	34.25673859	-119.2325449	Ventura County
83330	Fee-for-Service	1396199808	1396199808	1	1	TASHJIAN, VARTAN MD	9/10/2019	390200000X	NA	Other	026	PHYSICIANS	154855	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
83349	Fee-for-Service	1467500363	1467500363	1	1	TRAN, CAM-LY P MD	3/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74948	02	General Surgery	0	In state provider	None	101 CITY DR S	STE B10	ORANGE	CA	92868	0000	30	06059	33.78674051	-117.8888713	Orange County
83363	Fee-for-Service	1295356905	1295356905	1	1	TOP FLIGHT REGISTRY INC	9/7/2023	251E00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	4208 N FREEWAY BLVD	STE 7A	SACRAMENTO	CA	95834	1241	34	06067	38.645559	-121.477383	Sacramento County
83420	Fee-for-Service	1902001597	1902001597	1	1	TSAI, HUGH V MD	11/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93665	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVENUE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
83422	Fee-for-Service	1952506446	1952506446	1	1	TROTT, SUZANNE A MD INC	11/20/2008	174400000X	NA	Other	026	PHYSICIANS	86387	24	Plastic Surgery	0	In state provider	None	462 N LINDEN DR	STE 240	BEVERLY HILLS	CA	90212	2107	19	06037	34.06760415	-118.4080892	Los Angeles County
83439	Fee-for-Service	1912511734	1912511734	1	1	TRAN, RICHARD PT	3/4/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
83460	Fee-for-Service	1285636209	1285636209	1	1	TRAN, KIET T MD	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	43094	41	Internal Medicine	0	In state provider	None	815 W CESAR E CHAVEZ AVE	STE 201	LOS ANGELES	CA	90012	6601	19	06037	34.06156387	-118.2449673	Los Angeles County
83464	Fee-for-Service	1205035250	1205035250	1	1	TOCZEK, MARIA T MD	3/8/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80792	13	Neurology (M.D. only)	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	94304	1117	19	06037	34.09817553	-118.293237	Los Angeles County
83505	Fee-for-Service	1396151593	1396151593	1	1	TIMANE, RIZI LCSW	9/15/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
83561	Fee-for-Service	1568297133	1568297133	1	1	THOMAS, YOLANDA BIRTH DOULA	3/27/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
83596	Fee-for-Service	1336258797	1336258797	1	1	THRIFTY PAYLESS INC	3/3/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6293	1605 S SAN JACINTO AVE	None	SAN JACINTO	CA	92583	5181	33	06065	33.77060288	-116.9587638	Riverside County
83633	Fee-for-Service	1457422487	1457422487	1	1	TAN, ANTHONY S MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76428	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
83651	Fee-for-Service	1295356905	1295356905	1	1	TOP FLIGHT REGISTRY INC	7/10/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4208 N FREEWAY BLVD	STE 7A	SACRAMENTO	CA	95834	1241	34	06067	38.645559	-121.477383	Sacramento County
83655	Fee-for-Service	1568514990	1568514990	1	1	TODD, BARBARA M PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
83669	Fee-for-Service	1437562188	1437562188	1	1	TRESTLER, LAUREN M LCSW	1/14/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	675 18TH STREET	None	SAN FRANCISCO	CA	94143	0984	38	06075	37.76085391	-122.4356007	San Francisco County
83700	Fee-for-Service	1992816094	1992816094	1	1	THRIFTY PAYLESS INC	9/19/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1411 KETTNER BLVD	None	SAN DIEGO	CA	92101	2420	37	06073	32.719905	-117.1691805	San Diego County
83772	Fee-for-Service	1205927258	1205927258	1	1	THOMPSON, STEPHEN C MD	6/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
83800	Fee-for-Service	1053637959	1053637959	1	1	TAN, JOANNA A MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	109279	41	Internal Medicine	0	In state provider	None	1045 ATLANTIC AVENUE	STE 708	LONG BEACH	CA	90813	3410	19	06037	33.780267	-118.1850795	Los Angeles County
83807	Fee-for-Service	1083703508	1083703508	1	1	TSUTSUI, LARRY M DC	5/1/1999	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	4678 N 1ST ST	None	FRESNO	CA	93726	0903	10	06019	36.802791	-119.7722135	Fresno County
83819	Fee-for-Service	1114313988	1114313988	1	1	TANG, ERIC	6/3/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	451 CLARKSON AVENUE	None	BROOKLYN	NY	11203	2054	00	None	40.656258	-73.9446165	Kings County
83820	Fee-for-Service	1861461709	1861461709	1	1	TEERMANN, GABRIELE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3100 CHANNING WAY	None	IDAHO FALLS	ID	83404	7533	00	None	43.470198	-111.9901955	Bonneville County
83821	Fee-for-Service	1336778877	1336778877	1	1	TURNER, MAURICE J MD	10/23/2024	207QH0002X	NA	Adult Primary Care	026	PHYSICIANS	184793	38	Geriatrics	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
83833	Fee-for-Service	1215341862	1215341862	1	1	TREVIAS, BENJAMIN J MD	3/5/2018	207P00000X	NA	Other	026	PHYSICIANS	148129	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
83857	Fee-for-Service	1740224468	1740224468	1	1	TUSCHKA, THEODORE MD	1/1/1995	207L00000X	NA	Other	026	PHYSICIANS	55807	05	Anesthesiology	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
83884	Fee-for-Service	1659446011	1659446011	1	1	TUFAIL, FEHMA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	91778	41	Internal Medicine	0	In state provider	None	1611 1ST ST	None	BAKERSFIELD	CA	93304	2901	15	06029	35.35506651	-119.020518	Kern County
83903	Fee-for-Service	1962525006	1962525006	1	1	TON-THAT, CHAU DO INC	1/1/1998	2084P0800X	NA	Psychiatry	026	PHYSICIANS	7177	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	9533 BOLSA AVE	None	WESTMINSTER	CA	92683	5904	30	06059	33.74500145	-117.9629235	Orange County
84009	Fee-for-Service	1992983688	1992983688	1	1	TROSMAN, STELLA V MD	7/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	100062	None	None	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5073	19	06037	33.81253631	-118.3435557	Los Angeles County
84018	Fee-for-Service	1699734319	1699734319	1	1	TRITES, DAFNA DO	4/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	6852	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18460 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22071454	-118.5357375	Los Angeles County
84031	Fee-for-Service	1194067256	1194067256	1	1	TRINH, AUSTIN T MD	11/5/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	135439	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
84049	Fee-for-Service	1962896654	1962896654	1	1	TOBIAS-GATEWOOD, DEBORAH L	10/26/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47442	-	NOT APPLICABLE	0	In state provider	LMFT	2934 N FRESNO ST	None	FRESNO	CA	93703	1123	10	06019	36.777735	-119.7815105	Fresno County
84084	Fee-for-Service	1295733855	1295733855	1	1	TSENG, HENRY R DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	15909 GALE AVE	STE A	HACIENDA HEIGHTS	CA	91745	1644	19	06037	34.01012734	-117.9605259	Los Angeles County
84106	Fee-for-Service	1942355037	1942355037	1	1	TRAN, LYNN D MD	4/22/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	106028	08	Family Practice	0	In state provider	None	10110 ADAMS AVE	None	HUNTINGTON BEACH	CA	92646	4907	30	06059	33.670539	-117.9521865	Orange County
84153	Fee-for-Service	1750581203	1750581203	1	1	TSIPERFAL, ANGELA NP	10/24/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
84165	Fee-for-Service	1811076961	1811076961	1	1	TUSHLA, MICHAEL C MD	7/3/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	54473	08	Family Practice	0	In state provider	None	242 E HARVARD BLVD	# C	SANTA PAULA	CA	93060	3372	56	06111	34.34728904	-119.068761	Ventura County
84169	Fee-for-Service	1710453295	1710453295	1	1	TOTO, JAMIE OT	5/3/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
84172	Fee-for-Service	1932671526	1932671526	1	1	TEJIDOR, ROY V PT	12/30/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3142 VISTA WAY	STE 101	OCEANSIDE	CA	92056	3627	37	06073	33.18253858	-117.3252818	San Diego County
84177	Fee-for-Service	1376676403	1376676403	1	2	THE KIDS DOC APMC	1/3/2011	193400000X	NA	Other	026	PHYSICIANS	44860	40	Pediatrics	0	In state provider	None	933 S SUNSET AVE	STE 101	WEST COVINA	CA	91790	3410	19	06037	34.06428275	-117.9432037	Los Angeles County
84192	Fee-for-Service	1962525006	1962525006	1	1	TON-THAT, CHAU DO INC	1/1/1998	2084P0800X	NA	Psychiatry	026	PHYSICIANS	7177	36	Psychiatry	0	In state provider	None	9533 BOLSA AVE	None	WESTMINSTER	CA	92683	5904	30	06059	33.74500145	-117.9629235	Orange County
84203	Fee-for-Service	1518559533	1518559533	1	1	TYRONE HOSPICE CARE, INC	2/14/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1207 W IMPERIAL HWY	SUITE 101	BREA	CA	92821	3737	30	06059	33.9174843	-117.9167335	Orange County
84234	Fee-for-Service	1013114420	1013114420	1	1	TSAI, WILBERT T MD	2/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	107727	08	Family Practice	0	In state provider	None	1770 N ORANGE GROVE AVE	SUITE 101	POMONA	CA	91767	3027	19	06037	34.07637624	-117.7492622	Los Angeles County
84322	Fee-for-Service	1619789542	1619789542	1	1	THE BRIGHT SIDE, SPEECH THER	1/28/2025	261QH0700X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	APY, INC.	1916 ORANGE TREE LANE	SUITE 406	REDLANDS	CA	92374	4542	36	06071	34.06785848	-117.2189386	San Bernardino County
84328	Fee-for-Service	1881755759	1881755759	1	1	TEXAS COUNTY MEMORIAL	6/25/2018	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	1333 S SAM HOUSTON BLVD	None	HOUSTON	MO	65483	2046	00	None	37.3158798	-91.95950676	Texas County
84342	Fee-for-Service	1780625863	1780625863	1	1	TAN, DESMOND MD	7/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53075	08	Family Practice	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
84398	Fee-for-Service	1245248376	1245248376	1	1	THE RECTOR WARDENS & VESTRY	12/9/1999	261QC1500X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CHURCH OF OUR SAVIOUR	4368 SANTA ANITA AVE	None	EL MONTE	CA	91731	1606	19	06037	34.08572956	-118.0293405	Los Angeles County
84421	Fee-for-Service	1760689715	1760689715	1	6	TOTALCARE WALK-IN CLINIC INC	8/23/2022	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	14775 JEFFREY RD	C	IRVINE	CA	92618	0400	30	06059	33.68803177	-117.7704565	Orange County
84450	Fee-for-Service	1467649111	1467649111	1	1	TOTAL RENAL CARE INC	11/26/2008	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2005 NAGLEE AVE	None	SAN JOSE	CA	95128	4801	43	06085	37.32770925	-121.9323009	Santa Clara County
84494	Fee-for-Service	1518559533	1518559533	1	1	TYRONE HOSPICE CARE, INC	2/14/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1207 W IMPERIAL HWY	SUITE 101	BREA	CA	92821	3737	30	06059	33.9174843	-117.9167335	Orange County
84503	Fee-for-Service	1386966588	1386966588	1	1	THE REHABILITATION CENTER OF	10/8/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	OAKLAND LLC	210 40TH STREET WAY	None	OAKLAND	CA	94611	5612	01	06001	37.82697949	-122.2550806	Alameda County
84535	Fee-for-Service	1629019468	1629019468	1	1	TRICHTER, ROBERT M MD	2/28/1993	2084P0800X	NA	Psychiatry	026	PHYSICIANS	36041	36	Psychiatry	0	In state provider	None	9730 WASHINGTON BLVD	None	CULVER CITY	CA	90232	2722	19	06037	34.02225898	-118.3963922	Los Angeles County
84542	Fee-for-Service	1487967055	1487967055	1	1	THOMAS, MARIA B DO	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13316	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
84549	Fee-for-Service	1942377759	1942377759	1	1	TAKABAYASHI, ALTONM MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	32122	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
84595	Fee-for-Service	1619086154	1619086154	1	1	THRIFTY PAYLESS INC	3/15/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5595	1480 FOOTHILL BLVD	None	LA VERNE	CA	91750	3450	19	06037	34.11653239	-117.7751412	Los Angeles County
84599	Fee-for-Service	1154610947	1154610947	1	1	THAKUR, AKANKSHA MD	7/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122110	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
84601	Fee-for-Service	1104904960	1104904960	1	1	TANAKA, MARK M MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83467	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
84620	Fee-for-Service	1194354878	1194354878	1	1	TIGER, ZACHARY MD	8/27/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
84655	Fee-for-Service	1225195415	1225195415	1	1	TIEU, NHU-CYNTHIA M DO	3/12/2008	207R00000X	NA	Other	026	PHYSICIANS	9373	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
84660	Fee-for-Service	1922498435	1922498435	1	1	TOMES, ADRIAN MD	11/16/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	170069	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
84668	Fee-for-Service	1053371559	1053371559	1	1	TSENG, ROBERT R MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66496	None	None	0	In state provider	None	2825 J ST	None	SACRAMENTO	CA	95816	4300	34	06067	38.573757	-121.468248	Sacramento County
84700	Fee-for-Service	1306026281	1306026281	1	1	TEYMOORIAN, SAVAK MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116058	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
84701	Fee-for-Service	1225814098	1225814098	1	1	TLT CARE ENDEAVOR LLC	10/11/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	14402 HELWIG AVE	None	NORWALK	CA	90650	5022	19	06037	33.90062023	-118.0691004	Los Angeles County
84722	Fee-for-Service	1245456672	1245456672	1	1	TRAN, PHI L DO	2/22/2019	208M00000X	NA	Other	026	PHYSICIANS	16597	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
84738	Fee-for-Service	1184612624	1184612624	1	1	TANNER, GARTH B MD	12/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	64407	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1429 COLLEGE AVENUE	STE K	MODESTO	CA	95350	4057	50	06099	37.6654086	-121.0076479	Stanislaus County
84766	Fee-for-Service	1396279436	1396279436	1	1	TARAS, JOHN P MD	7/1/2019	390200000X	NA	Other	026	PHYSICIANS	159678	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
84769	Fee-for-Service	1841787520	1841787520	1	1	TOY, JAKE DO	10/1/2020	390200000X	NA	Other	026	PHYSICIANS	17725	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
84833	Fee-for-Service	1396018537	1396018537	1	1	TATE, SAMUEL J MD	6/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133545	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
84848	Fee-for-Service	1528831898	1528831898	1	1	TURNER, KIANA R	4/4/2024	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	34	06067	0	0	None
84870	Fee-for-Service	1518978006	1518978006	1	1	TAI ON PHARMACY, INC	11/29/1988	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	818 N HILL ST	STE A	LOS ANGELES	CA	90012	2395	19	06037	34.06327796	-118.2392731	Los Angeles County
84871	Fee-for-Service	1780634717	1780634717	1	1	TRINH, SON H MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	45184	41	Internal Medicine	0	In state provider	None	1135 S SUNSET AVE	None	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
84911	Fee-for-Service	1407965866	1407965866	1	1	THRIFTY PAYLESS INC	5/5/2000	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10989 VENTURA BLVD	None	STUDIO CITY	CA	91604	3341	19	06037	34.14001304	-118.3690063	Los Angeles County
84936	Fee-for-Service	1235365610	1235365610	1	1	TSAI, KENNETH MD	7/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97195	05	Anesthesiology	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
84961	Fee-for-Service	1366478638	1366478638	1	1	TACY, THERESA A MD	1/1/2002	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	50143	35	Pediatric Cardiology (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
85005	Fee-for-Service	1851513139	1851513139	1	1	TRAN, KHOI Q MD	12/29/2009	208600000X	NA	General Surgery	026	PHYSICIANS	104069	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
85024	Fee-for-Service	1184612624	1184612624	1	1	TANNER, GARTH B MD	12/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	64407	41	Internal Medicine	0	In state provider	None	1429 COLLEGE AVENUE	STE K	MODESTO	CA	95350	4057	50	06099	37.6654086	-121.0076479	Stanislaus County
85058	Fee-for-Service	1801619580	1801619580	1	1	THE VULNERABLE WOLF FAMILY T	11/6/2024	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	HERAPY A PROFESSIONAL CO	4645 NORTH AVE	None	SAN DIEGO	CA	92116	2621	37	06073	32.76184735	-117.1475046	San Diego County
85067	Fee-for-Service	1033753249	1033753249	1	1	TEPPONE, VICTORIA V CNP	1/16/2020	207Q00000X	NA	Adult Primary Care	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
85104	Fee-for-Service	1538394044	1538394044	1	1	TU, CHRISTINE S H MD	3/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119254	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
85137	Fee-for-Service	1952895187	1952895187	1	1	TEVIS, GINA P LMFT	3/15/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	831 ALAMO DRIVE	SUITE 6C	VACAVILLE	CA	95688	5343	48	06095	38.34840279	-121.9987874	Solano County
85155	Fee-for-Service	1255482949	1255482949	1	1	TEODORO, ANNA	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
85190	Fee-for-Service	1437119906	1437119906	1	1	TAYLOR, PETER J MD	6/1/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	61889	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10175 LEVONE AVE	None	TRUCKEE	CA	96161	4821	29	06057	39.32413811	-120.2000473	Nevada County
85194	Fee-for-Service	1720222565	1720222565	2	1	THAKER, ASHESH A MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
85216	Fee-for-Service	1528074770	1528074770	1	1	TAYLOR, SHANNAN N LMFT	11/3/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
85220	Fee-for-Service	1457533507	1457533507	1	1	TONG, YEE W. MD INC	4/15/2013	207LP2900X	NA	Other	026	PHYSICIANS	29698	None	None	0	In state provider	None	18 ENDEAVOR	STE 304	IRVINE	CA	92618	3177	30	06059	33.6675519	-117.7622659	Orange County
85232	Fee-for-Service	1720271323	1720271323	1	1	TU, MARIAKRISTINA C LMFT	6/13/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
85257	Fee-for-Service	1528462819	1528462819	1	1	THE ENDOSCOPY CENTER	1/1/2015	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	870 SHASTA STREET	SUITE 100	YUBA CITY	CA	95991	4117	51	06101	39.14204	-121.6161711	Sutter County
85288	Fee-for-Service	1548298607	1548298607	1	1	TOURO UNIVERSITY	12/24/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	160 GLEN COVE MARINA RD	STE 103	VALLEJO	CA	94591	7290	48	06095	38.07062486	-122.2124251	Solano County
85309	Fee-for-Service	1053474379	1053474379	1	1	TUNG, THOMAS C MD	11/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68618	33	Thoracic Surgery	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
85329	Fee-for-Service	1578767992	1578767992	1	1	TRAN, VYTHAO T MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106361	30	Radiology	0	In state provider	None	2801 K STREET	STE 502	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
85363	Fee-for-Service	1972130193	1972130193	1	1	TEDESCO, KATHLEEN MD	7/23/2024	390200000X	NA	Other	026	PHYSICIANS	186303	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
85391	Fee-for-Service	1013947738	1013947738	1	1	THANOS, JERALD J MD	4/30/1991	193400000X	NA	Other	026	PHYSICIANS	46502	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2262 N STATE COLLEGE BLV	None	FULLERTON	CA	92831	1361	30	06059	33.89665015	-117.8917953	Orange County
85444	Fee-for-Service	1912071515	1912071515	1	1	TIPTON, ANN C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43110	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
85448	Fee-for-Service	1720166218	1720166218	1	1	TORELLO, ELENA E MD	6/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92688	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
85503	Fee-for-Service	1124020839	1124020839	1	1	TILSON, SCOTT T	10/23/2008	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	609 L ST	None	SACRAMENTO	CA	95814	2326	34	06067	38.579544	-121.499118	Sacramento County
85526	Fee-for-Service	1619133659	1619133659	1	1	TRAN, HANG T DO	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11793	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
85554	Fee-for-Service	1528271418	1528271418	1	1	TRUONG, CHI Q DO	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9027	66	Emergency Medicine (Urgent Care)	0	In state provider	None	PUEBLE AT BATH	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
85565	Fee-for-Service	1881614493	1881614493	1	1	TILLISCH, KIRSTEN MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67398	10	Gastroenterology (M.D. only)	0	In state provider	None	1801 WILSHIRE BLVD	STE 100	SANTA MONICA	CA	90403	5609	19	06037	34.03012232	-118.4848095	Los Angeles County
85580	Fee-for-Service	1548298607	1548298607	1	1	TOURO UNIVERSITY	12/24/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	160 GLEN COVE MARINA RD	STE 103	VALLEJO	CA	94591	7290	48	06095	38.07062486	-122.2124251	Solano County
85592	Fee-for-Service	1588862858	1588862858	1	1	THAYER, LISA M DO	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10841	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
85596	Fee-for-Service	1417485889	1417485889	1	5	TRANSIT PHYSICAL THERAPY PC	9/17/2021	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	100 BARRANCA ST.	SUITE 920	WEST COVINA	CA	91791	1637	19	06037	34.073073	-117.8812535	Los Angeles County
85597	Fee-for-Service	1053474379	1053474379	1	1	TUNG, THOMAS C MD	11/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68618	02	General Surgery	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
85657	Fee-for-Service	1831592732	1831592732	1	1	TOROK, JULI F LMFT	7/6/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	99228	-	NOT APPLICABLE	0	In state provider	None	4645 PACHECO AVE	None	MARTINEZ	CA	94553	3625	07	06013	38.00367595	-122.0848185	Contra Costa County
85753	Fee-for-Service	1477605699	1477605699	1	1	TAN, KWONG Y MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75685	01	General Practice	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
85783	Fee-for-Service	1821340100	1821340100	1	1	TESTA, TERESA A	4/12/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
85802	Fee-for-Service	1548698269	1548698269	1	1	THE VONS COMPANIES INC	1/9/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16550 W SOLEDAD CANYON	None	SANTA CLARITA	CA	91387	3215	19	06037	34.42676803	-118.425457	Los Angeles County
85812	Fee-for-Service	1124053152	1124053152	2	1	TURCIOS, ROBERT A JR OD	1/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	395 CIVIC DR	STE G	PLEASANT HILL	CA	94523	1950	07	06013	37.96218807	-122.0728145	Contra Costa County
85821	Fee-for-Service	1588958805	1588958805	1	1	TIEN, DUC A MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141172	04	Otology, Laryngology, Rhinology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
85839	Fee-for-Service	1962553099	1962553099	1	1	TANG, HELEN OD	6/18/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1481 E PLAZA BLVD	None	NATIONAL CITY	CA	91950	3613	37	06073	32.6768163	-117.0909096	San Diego County
85849	Fee-for-Service	1710098363	1710098363	1	1	TORNATORE, CHARLES W OD	3/1/1996	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
85861	Fee-for-Service	1548298607	1548298607	1	1	TOURO UNIVERSITY	12/24/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	160 GLEN COVE MARINA RD	STE 103	VALLEJO	CA	94591	7290	48	06095	38.07062486	-122.2124251	Solano County
85875	Fee-for-Service	1619338720	1619338720	1	1	TRUONG, JENNIFER L DO	5/8/2020	207R00000X	NA	Other	026	PHYSICIANS	16348	41	Internal Medicine	0	In state provider	None	1180 N INDIAN CANYON DR	STE E421	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
85883	Fee-for-Service	1417485889	1417485889	1	5	TRANSIT PHYSICAL THERAPY PC	10/18/2022	261QP2000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 BARRANCA ST.	SUITE 920	WEST COVINA	CA	91791	1637	19	06037	34.073073	-117.8812535	Los Angeles County
85907	Fee-for-Service	1306172424	1306172424	1	1	TRAN, GINA D MD	10/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129307	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
85909	Fee-for-Service	1003913690	1003913690	1	1	TANAKA, TARA L MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74834	40	Pediatrics	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
85953	Fee-for-Service	1669418505	1669418505	1	1	TEMPCARE LLC	4/22/2005	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	31080 UNION CITY BLVD	STE 203	UNION CITY	CA	94587	4217	01	06001	37.59578558	-122.0807871	Alameda County
85957	Fee-for-Service	1316184617	1316184617	1	1	TABRIZI, RANNA	6/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108152	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
85993	Fee-for-Service	1144274804	1144274804	1	1	THEURER, WILLIAM MD	6/30/1993	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	67611	30	Radiology	0	In state provider	None	1150 N VENTURA RD	None	OXNARD	CA	93030	3837	56	06111	34.21334043	-119.1944	Ventura County
86021	Fee-for-Service	1326320094	1326320094	1	1	TUTTLE, DEBBIE J NP	10/24/2016	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
86026	Fee-for-Service	1427724368	1427724368	1	1	TOTAL RENAL CARE INC	4/22/2022	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	8333 IOWA ST	STE 200	DOWNEY	CA	90241	4994	19	06037	33.93744359	-118.1339382	Los Angeles County
86028	Fee-for-Service	1871642157	1871642157	1	1	TRAN, TIN HUU MD	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70018	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
86045	Fee-for-Service	1740257179	1740257179	2	1	THIBEAULT, CLAUDE R MD	12/10/2019	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
86062	Fee-for-Service	1881082683	1881082683	1	1	TAN, RICARDO A MD INC	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	52236	03	Allergy	0	In state provider	None	44726 CERISA ST	None	LANCASTER	CA	93535	1705	19	06037	34.696017	-118.0842535	Los Angeles County
86079	Fee-for-Service	1396889051	1396889051	1	1	TROLAN, WILLIAM H MD	5/2/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	60676	01	General Practice	0	In state provider	None	192 BEACON ST	None	S SAN FRANCISCO	CA	94080	6913	41	06081	37.63966055	-122.4022905	San Mateo County
86108	Fee-for-Service	1467561084	1467561084	2	1	TAN, TIENG M OD	9/3/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5531 E STEARNS ST	STE A	LONG BEACH	CA	90815	3125	19	06037	33.7961005	-118.123911	Los Angeles County
86118	Fee-for-Service	1659791101	1659791101	1	1	TALLEUR, BRIAN N MD	9/14/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	154190	-	NOT APPLICABLE	0	In state provider	None	1947 N CALIFORNIA ST	STE B & C	STOCKTON	CA	95204	6029	39	06077	37.97199174	-121.2896956	San Joaquin County
86189	Fee-for-Service	1598356602	1598356602	1	1	TORRANCE INTENSIVIST GROUP I	1/4/2021	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NC.	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
86216	Fee-for-Service	1942477203	1942477203	1	1	TARGONSKA, BOGNA I MD	2/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
86249	Fee-for-Service	1770830325	1770830325	1	6	TWO TREES PHYSICAL THERAPY &	9/8/2020	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4960 VERDUGO	None	CAMARILLO	CA	93012	8632	56	06111	34.21547303	-119.0040356	Ventura County
86315	Fee-for-Service	1104066026	1104066026	1	1	TAYLOR, NORA PSYD	12/15/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1820 S CATALINA AVE	105	REDONDO BEACH	CA	90277	5511	19	06037	33.81689639	-118.3873877	Los Angeles County
86334	Fee-for-Service	1245867829	1245867829	1	1	TRAN, LOC T DO	7/18/2023	207R00000X	NA	Other	026	PHYSICIANS	21230	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
86351	Fee-for-Service	1881082683	1881082683	1	1	TAN, RICARDO A MD INC	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	52236	41	Internal Medicine	0	In state provider	None	44726 CERISA ST	None	LANCASTER	CA	93535	1705	19	06037	34.696017	-118.0842535	Los Angeles County
86356	Fee-for-Service	1154481950	1154481950	1	1	TRAN, AMBER N PHD	10/16/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
86368	Fee-for-Service	1871641738	1871641738	1	1	TEJURA, NATWARLAL B MD	6/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	31525	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
86398	Fee-for-Service	1144424888	1144424888	1	1	TOVSKY, STAN MD	2/4/2022	207L00000X	NA	Other	026	PHYSICIANS	160302	None	None	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
86430	Fee-for-Service	1902804230	1902804230	1	1	TRAN, DAVID D DPM	8/23/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	901 CAMPUS DR	SUITE 311	DALY CITY	CA	94015	4900	41	06081	37.66535778	-122.4763793	San Mateo County
86434	Fee-for-Service	1972939783	1972939783	1	1	THOMAS, RESHALE L	5/18/2018	No Taxonomy Provided	NA	None	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
86436	Fee-for-Service	1457307282	1457307282	1	1	TODD DAVIS, D.O.	5/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	475 S DOBSON RD	None	CHANDLER	AZ	85224	5605	00	None	33.29768043	-111.8761089	Maricopa County
86474	Fee-for-Service	1457379851	1457379851	1	1	TSE, WILLIAM MD	10/31/2019	207LP2900X	NA	Other	026	PHYSICIANS	75793	05	Anesthesiology	0	In state provider	None	525 W ACACIA ST	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
86501	Fee-for-Service	1669785069	1669785069	1	1	TRAN, MAILAN D OD	10/3/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	947 S ANAHEIM BLVD	STE 120	ANAHEIM	CA	92805	8502	30	06059	33.82164135	-117.909385	Orange County
86537	Fee-for-Service	1598147050	1598147050	1	1	THOMPSON, KYLE M MD	8/30/2024	2086S0120X	NA	General Surgery	026	PHYSICIANS	145817	85	Surgery-Pediatric	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
86539	Fee-for-Service	1770830325	1770830325	1	6	TWO TREES PHYSICAL THERAPY &	2/3/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4960 VERDUGO	None	CAMARILLO	CA	93012	8632	56	06111	34.21547303	-119.0040356	Ventura County
86544	Fee-for-Service	1861954604	1861954604	1	1	TRANG, KAREN MD	3/10/2023	208600000X	NA	General Surgery	026	PHYSICIANS	177294	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
86556	Fee-for-Service	1730233511	1730233511	1	1	TORNABENE, FELICIA I MD	9/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91878	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
86559	Fee-for-Service	1881723344	1881723344	1	1	THE TWELFTH STEP HOUSE OF	12/27/2017	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO	5855 & 5860 STEAMVIEW DR	APT 2 & 3	SAN DIEGO	CA	92105	3910	37	06073	32.74442781	-117.0700954	San Diego County
86612	Fee-for-Service	1922031632	1922031632	1	1	TEMECULA VLY CARDIOLOGY	9/21/1992	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	25405 HANCOCK AVE	STE 216	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
86623	Fee-for-Service	1356430375	1356430375	1	1	TONSEKAR, KISHORE S MD	6/1/1998	174400000X	NA	Other	026	PHYSICIANS	54184	02	General Surgery	0	In state provider	None	3625 MARTIN LUTHER KING	STE 10	LYNWOOD	CA	90262	3509	19	06037	33.93044131	-118.2021564	Los Angeles County
86659	Fee-for-Service	1679662357	1679662357	2	1	THE WILTON PHARMACY, INC	5/2/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3511 W OLYMPIC BLVD	STE 102	LOS ANGELES	CA	90019	3563	19	06037	34.0525695	-118.3152015	Los Angeles County
86663	Fee-for-Service	1982675666	1982675666	1	1	THOMPSON, ROBERT E MD	2/8/2015	207RP1001X	NA	Pulmonology	026	PHYSICIANS	30548	29	Pulmonary Diseases (M.D. only)	0	In state provider	A PROF CORP	13851 FOOTHILL BLVD	None	SYLMAR	CA	91342	3019	19	06037	34.31119451	-118.4351004	Los Angeles County
86728	Fee-for-Service	1730349739	1730349739	1	1	TEDD E DAWSON MD INC	3/29/2020	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	1196 S MAIN ST	None	WILLITS	CA	95490	4304	23	06045	39.3999805	-123.3497005	Mendocino County
86731	Fee-for-Service	1962538181	1962538181	1	1	TABILA, RODOLFO T MD	7/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	38544	08	Family Practice	0	In state provider	None	1339 WILLOW STREET	None	LONG BEACH	CA	90810	3116	19	06037	33.80441648	-118.2098295	Los Angeles County
86735	Fee-for-Service	1609938877	1609938877	1	1	TRAN, SHANNON PHD	2/6/2015	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
86828	Fee-for-Service	1770830325	1770830325	1	6	TWO TREES PHYSICAL THERAPY &	4/18/2024	225X00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4960 VERDUGO	None	CAMARILLO	CA	93012	8632	56	06111	34.21547303	-119.0040356	Ventura County
86834	Fee-for-Service	1184145708	1184145708	1	1	TORCEDO, ABIGAIL	6/24/2024	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
86854	Fee-for-Service	1801281084	1801281084	1	1	TAMRAZ, RANA A MD	8/2/2021	207L00000X	NA	Other	026	PHYSICIANS	172855	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
86869	Fee-for-Service	1407691470	1407691470	1	1	TENGRA, NANCY	11/19/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
86870	Fee-for-Service	1992852990	1992852990	1	1	TERRY, ERIC S PSYD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	101 S KRAEMER BLVD	STE 125	PLACENTIA	CA	92870	6105	30	06059	33.87035522	-117.8630104	Orange County
86901	Fee-for-Service	1497141832	1497141832	1	1	TANG, EMILY NP	4/15/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	359 LAKEPORT BLVD	None	LAKEPORT	CA	95453	9754	17	06033	39.03457855	-122.9181731	Lake County
86915	Fee-for-Service	1356430375	1356430375	1	1	TONSEKAR, KISHORE S MD	6/1/1998	174400000X	NA	Other	026	PHYSICIANS	54184	34	Urology and Urological Surgery	0	In state provider	None	3625 MARTIN LUTHER KING	STE 10	LYNWOOD	CA	90262	3509	19	06037	33.93044131	-118.2021564	Los Angeles County
87019	Fee-for-Service	1962538181	1962538181	1	1	TABILA, RODOLFO T MD	7/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	38544	01	General Practice	0	In state provider	None	1339 WILLOW STREET	None	LONG BEACH	CA	90810	3116	19	06037	33.80441648	-118.2098295	Los Angeles County
87074	Fee-for-Service	1659430049	1659430049	1	1	TSAI, PATRIKA M MD	12/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96242	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
87095	Fee-for-Service	1124002688	1124002688	1	1	TRUONG, JELIN Y MD	11/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84692	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
87111	Fee-for-Service	1124691944	1124691944	1	1	TRANSFORMATIONS CARE INC	7/27/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	18726 S WESTERN AVE	209	GARDENA	CA	90248	3813	19	06037	33.860511	-118.309141	Los Angeles County
87162	Fee-for-Service	1407261282	1407261282	1	1	TU, BRIAN MD	5/1/2020	207P00000X	NA	Other	026	PHYSICIANS	163954	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2303	19	06037	34.02980528	-118.4786605	Los Angeles County
87192	Fee-for-Service	1730568163	1730568163	1	1	TELMO, MARIEL L DPM	1/26/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	847 W CHILDS AVE	None	MERCED	CA	95341	6805	24	06047	37.28825369	-120.4963159	Merced County
87194	Fee-for-Service	1821283813	1821283813	1	1	TOLMAJIAN, JASMINE H LMFT	4/25/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
87201	Fee-for-Service	1356430375	1356430375	1	1	TONSEKAR, KISHORE S MD	6/1/1998	174400000X	NA	Other	026	PHYSICIANS	54184	24	Plastic Surgery	0	In state provider	None	3625 MARTIN LUTHER KING	STE 10	LYNWOOD	CA	90262	3509	19	06037	33.93044131	-118.2021564	Los Angeles County
87287	Fee-for-Service	1982768925	1982768925	1	1	TRUONG, CUONG Q OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	326 LOS CERRITOS CENTER	None	CERRITOS	CA	90703	5425	19	06037	33.86249756	-118.0927951	Los Angeles County
87289	Fee-for-Service	1801527817	1801527817	1	1	THONE, TONYA A LPCC	6/29/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	31045 TEMECULA PARKWAY	204	TEMECULA	CA	92592	3085	33	06065	33.47594383	-117.1218244	Riverside County
87325	Fee-for-Service	1679792287	1679792287	1	1	TORREY, MELISSA L MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88472	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
87327	Fee-for-Service	1427043389	1427043389	1	3	TARZANA TREATMENT CENTERS, I	3/21/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC.	8330 RESEDA BLVD	None	NORTHRIDGE	CA	91324	4619	19	06037	34.221609	-118.5360405	Los Angeles County
87355	Fee-for-Service	1801388426	1801388426	1	1	TAN, QIUXUE T MD	9/1/2021	207R00000X	NA	Other	026	PHYSICIANS	174546	None	None	0	In state provider	None	2336 SANTA MONICA BLVD	301, 304	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
87370	Fee-for-Service	1639263999	1639263999	1	1	TYNAN, MARTIN C MD	7/1/1994	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	53822	20	Orthopedic Surgery	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
87375	Fee-for-Service	1598497570	1598497570	1	1	TRAN, BREANNA M OD	10/16/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2195 CLUB CENTER DR	STE L	SAN BERNARDINO	CA	92408	4162	36	06071	34.06055692	-117.2814193	San Bernardino County
87379	Fee-for-Service	1295881175	1295881175	1	1	TORRES, KIRK A MD	4/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	96695	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
87385	Fee-for-Service	1124002688	1124002688	1	1	TRUONG, JELIN Y MD	11/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84692	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
87456	Fee-for-Service	1316076474	1316076474	1	1	THEIMER, SVETLANA A LMFT	3/3/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39 QUAIL COURT	305	WALNUT CREEK	CA	94596	5570	07	06013	37.88807869	-122.0553886	Contra Costa County
87461	Fee-for-Service	1447578992	1447578992	1	1	TONG, THEN E DO	11/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	12974	01	General Practice	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
87516	Fee-for-Service	1316132319	1316132319	1	1	TEEPLE, DAVID 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	2450 E RIVER RD	None	TUCSON	AZ	85718	6526	00	None	32.285088	-110.934765	Pima County
87529	Fee-for-Service	1831608884	1831608884	1	1	TORRES, JENAE P LMFT	8/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1030 NEVADA ST.	SUITE 103	REDLANDS	CA	92374	2957	36	06071	34.064172	-117.217431	San Bernardino County
87556	Fee-for-Service	1962502815	1962502815	1	1	TOWNSEND, REBECCA A MD	9/24/2018	207R00000X	NA	Other	026	PHYSICIANS	64637	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
87586	Fee-for-Service	1427269398	1427269398	1	1	TRIVEDI, DHAVAL P MD	5/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146432	33	Thoracic Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
87645	Fee-for-Service	1639597313	1639597313	1	1	TOYOSHIMA, TAKEO MD	6/13/2017	2084P0800X	NA	Psychiatry	026	PHYSICIANS	138476	27	Psychiatry Neurology (D.O. 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
87694	Fee-for-Service	1154343952	1154343952	1	1	THOMPSON, TERESA	8/5/1995	207L00000X	NA	Other	026	PHYSICIANS	79040	05	Anesthesiology	0	In state provider	None	9851 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.918192	-117.4547295	Riverside County
87787	Fee-for-Service	1790861201	1790861201	1	1	THAI, VAN B MD	9/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	73140	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
87809	Fee-for-Service	1184120412	1184120412	1	1	THOMPSON, DANA L MD	7/1/2022	207P00000X	NA	Other	026	PHYSICIANS	179427	None	None	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	54	06107	36.327888	-119.294919	Tulare County
87819	Fee-for-Service	1083704902	1083704902	1	1	TITCHER, ROBERT MD	3/31/1984	207R00000X	NA	Other	026	PHYSICIANS	35435	01	General Practice	0	In state provider	None	11311 INGLEWOOD AVENUE	None	INGLEWOOD	CA	90304	0000	19	06037	33.91461005	-118.3612905	Los Angeles County
87827	Fee-for-Service	1366488140	1366488140	1	1	TOLA, FRANCES E CRNA	8/1/2002	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
87846	Fee-for-Service	1154610939	1154610939	1	1	TRAN, VIET Q MD	6/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125099	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
87860	Fee-for-Service	1740440148	1740440148	1	1	TYAGI, AVISHKAR MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123065	30	Radiology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
87862	Fee-for-Service	1326357773	1326357773	1	1	TOTAL RENAL CARE INC	12/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1310 LAS TABLAS RD	SUITE 101	TEMPLETON	CA	93465	9746	40	06079	35.55442349	-120.722643	San Luis Obispo County
87900	Fee-for-Service	1710020433	1710020433	1	1	TRIEU, LINH M OD	8/1/2013	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
87910	Fee-for-Service	1699942425	1699942425	1	1	TAN, IRENE S MD	1/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104564	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1147 RED TAIL WAY	None	SIMI VALLEY	CA	93065	7232	56	06111	34.25942227	-118.7951311	Ventura County
87924	Fee-for-Service	1851410930	1851410930	1	1	TAKAGI, SANDRA M MD	5/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	61146	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
87954	Fee-for-Service	1265468201	1265468201	1	1	TARNG, TUNG-HUAN J INC	3/15/2004	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	JOYFUL CHIROPRACTIC INC	17524 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	1750	19	06037	33.99031902	-117.9236252	Los Angeles County
87959	Fee-for-Service	1053392761	1053392761	1	1	TALWAR, GURMEET K MD	7/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84997	08	Family Practice	0	In state provider	None	3581 PALMER DR	STE 602	CAMERON PARK	CA	95682	8238	09	06017	38.66109103	-120.9649544	El Dorado County
87997	Fee-for-Service	1386136620	1386136620	1	1	TUTTLE, MICHAEL C LPT	11/9/2018	208100000X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3418 LOMA VISTA RD	A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
88004	Fee-for-Service	1386600799	1386600799	1	1	TAYLOR, JOHN M MD	9/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79254	05	Anesthesiology	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
88017	Fee-for-Service	1689770489	1689770489	1	2	TASSINARI, JOHN D OD FAAO	2/6/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E SECOND ST	STE 2	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
88042	Fee-for-Service	1043302540	1043302540	1	1	TRUEBLOOD, HENRY W MD	5/13/1991	208600000X	NA	General Surgery	026	PHYSICIANS	44655	02	General Surgery	0	In state provider	A MEDICAL CORP	2204 GRANT RD	STE 203	MOUNTAIN VIEW	CA	94040	3877	43	06085	37.37193085	-122.0779465	Santa Clara County
88046	Fee-for-Service	1144295171	1144295171	1	1	TORRES, LYDIA M OD	10/16/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3939 3RD AVE	None	SAN DIEGO	CA	92103	3002	37	06073	32.74905668	-117.16268	San Diego County
88051	Fee-for-Service	1568715928	1568715928	1	1	TAN, CHRISTINA MD	10/22/2020	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	123695	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
88056	Fee-for-Service	1396778197	1396778197	1	1	TWIN CITIES COMMUNITY	6/1/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL INC	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
88070	Fee-for-Service	1336382019	1336382019	1	1	TA, JENNIFER H MD	12/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113181	04	Otology, Laryngology, Rhinology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
88077	Fee-for-Service	1164443768	1164443768	1	1	TRUONG, MONG-HOA T MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	46227	40	Pediatrics	0	In state provider	None	1695 ALUM ROCK AVE	STE 7A	SAN JOSE	CA	95116	2445	43	06085	37.35259805	-121.8559999	Santa Clara County
88083	Fee-for-Service	1780366161	1780366161	1	1	TURNER, JOANNA	9/6/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	38	06075	0	0	None
88108	Fee-for-Service	1992168108	1992168108	1	1	TOBONI, JENNIFER M PT	11/17/2023	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1650 LOS GAMOS DR	None	SAN RAFAEL	CA	94903	1850	21	06041	38.02105246	-122.5420674	Marin County
88128	Fee-for-Service	1780670976	1780670976	1	1	TAW, LIM L MEDICAL	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30992	41	Internal Medicine	0	In state provider	CORPORATION	1500 S CENTRAL AVE	STE 314	GLENDALE	CA	91204	2852	19	06037	34.12736888	-118.257777	Los Angeles County
88171	Fee-for-Service	1447945647	1447945647	1	1	TORRES PEDIATRICS CORP	6/19/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	E	47647 CALEO BAY DR	230	LA QUINTA	CA	92253	8859	33	06065	33.70305235	-116.2936509	Riverside County
88196	Fee-for-Service	1467496448	1467496448	1	1	TARIN, THIEN T MD	11/1/2001	207L00000X	NA	Other	026	PHYSICIANS	31855	05	Anesthesiology	0	In state provider	SANTA ANA HOSP MED CTR	12900A GARDEN GROVE BLVD	STE 122	GARDEN GROVE	CA	92843	2016	30	06059	33.77433148	-117.9075735	Orange County
88206	Fee-for-Service	1619028669	1619028669	1	1	TWU, CONSTANCE C OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
88247	Fee-for-Service	1023637055	1023637055	1	1	TRAN, KRISTI	9/13/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
88257	Fee-for-Service	1659497824	1659497824	1	1	TORKIAN, BEHROOZ MD	4/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78758	04	Otology, Laryngology, Rhinology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
88265	Fee-for-Service	1518730845	1518730845	1	1	THUO, ELIZABETH NJERI	1/10/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	7271 BLUE CRAB CT	None	EASTVALE	CA	92880	3449	33	06065	33.95620749	-117.5646523	Riverside County
88287	Fee-for-Service	1578522462	1578522462	1	2	TAN, DORIS T DO	12/22/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	7928	-	NOT APPLICABLE	0	In state provider	None	676 LOUGHBOROUGH DRIVE	None	MERCED	CA	95348	2601	24	06047	37.32268062	-120.4793547	Merced County
88291	Fee-for-Service	1386600799	1386600799	1	1	TAYLOR, JOHN M MD	9/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79254	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
88307	Fee-for-Service	1427088194	1427088194	1	1	THANOS, NICHOLAS J MD	9/30/1990	193400000X	NA	Other	026	PHYSICIANS	35873	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2262 N STATE COLLEGE BLV	None	FULLERTON	CA	92831	1361	30	06059	33.89665015	-117.8917953	Orange County
88316	Fee-for-Service	1851467609	1851467609	1	1	TUNKEL, RICHARD S	7/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71309	25	Physical Medicine and Rehabilitation	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
88334	Fee-for-Service	1558544817	1558544817	1	1	TECHNICAL RESOURCE	2/2/2018	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	MANAGEMENT LLC	1760 E ROUTE 66	SUITE 1	FLAGSTAFF	AZ	86004	5119	00	None	35.196912	-111.626055	Coconino County
88344	Fee-for-Service	1396778197	1396778197	1	1	TWIN CITIES COMMUNITY	6/1/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL INC	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
88395	Fee-for-Service	1790215663	1790215663	1	1	TASSE, LINDSAY LMFT	8/9/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1140 MANGROVE AVE	STE D	CHICO	CA	95926	3500	04	06007	39.74217522	-121.8384743	Butte County
88417	Fee-for-Service	1538522412	1538522412	1	1	TENET HOSPITALS LIMITED	3/14/2018	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	TRANSMOUNTAIN CAMPUS	2000 TRANSMOUNTAIN RD	None	EL PASO	TX	79911	3601	00	None	31.904676	-106.5644685	El Paso County
88450	Fee-for-Service	1134238595	1134238595	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05683	366 S PALM CANYON DR	None	PALM SPRINGS	CA	92262	7302	33	06065	33.817896	-116.5467625	Riverside County
88465	Fee-for-Service	1992326060	1992326060	1	1	TRAN, HAN NI NP	10/30/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
88466	Fee-for-Service	1679880421	1679880421	1	1	TAKAYAMA, JARRETT R PHD	10/26/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
88468	Fee-for-Service	1114003621	1114003621	1	1	TU, RAYMOND H MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69961	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
88470	Fee-for-Service	1144515149	1144515149	1	5	THE SAN FRANCISCO AIDS	11/6/2020	No Taxonomy Provided	NA	None	040	FREE CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1035 MARKET ST	STE 400	SAN FRANCISCO	CA	94103	1665	38	06075	37.78152549	-122.4111668	San Francisco County
88481	Fee-for-Service	1346726254	1346726254	1	1	TUNG, JACK K	7/11/2022	207ZC0006X	NA	Other	026	PHYSICIANS	165148	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
88517	Fee-for-Service	1346311230	1346311230	1	1	TERRY, ORRIN MD	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	45099	04	Otology, Laryngology, Rhinology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
88539	Fee-for-Service	1063991115	1063991115	1	1	THOMAS, TIJU PT	11/26/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3460 E LA PALMA AVE	None	ANAHEIM	CA	92806	9999	30	06059	33.85429451	-117.8446551	Orange County
88552	Fee-for-Service	1518730845	1518730845	1	1	THUO, ELIZABETH NJERI	1/10/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	7271 BLUE CRAB CT	None	EASTVALE	CA	92880	3449	33	06065	33.95620749	-117.5646523	Riverside County
88560	Fee-for-Service	1821115064	1821115064	1	1	TEHRANCHI, ELAHEH N MD	7/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6490 S MCCARRAN BLVD	B13	RENO	NV	89509	6102	00	None	39.47672552	-119.796471	Washoe County
88561	Fee-for-Service	1275951196	1275951196	1	1	TEMECULA CA UNITED SURGERY	9/29/2020	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER LP	31469 RANCHO PUEBLO RD	STE 100	TEMECULA	CA	92592	4834	33	06065	33.47811895	-117.1118871	Riverside County
88582	Fee-for-Service	1659471746	1659471746	1	1	TRI VALLEY UROLOGY MEDICAL G	6/27/2019	208800000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	ROUP	25495 MEDICAL CENTER DR	204	MURRIETA	CA	92562	4903	33	06065	33.55804188	-117.1834064	Riverside County
88619	Fee-for-Service	1184269128	1184269128	1	2	TONG, CHRISTOPHER C OD	10/23/2021	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	899 WASHINGTON ST	6	SAN FRANCISCO	CA	94108	1214	38	06075	37.79495957	-122.4078614	San Francisco County
88624	Fee-for-Service	1508283250	1508283250	1	1	TSENG, JEAN Y DO	11/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15765	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
88630	Fee-for-Service	1447404439	1447404439	1	1	TSO, AMY R MD	4/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111770	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	#365	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
88641	Fee-for-Service	1487763843	1487763843	1	1	THRIFTY PAYLESS INC	2/21/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1201 S COAST HWY	None	OCEANSIDE	CA	92054	5119	37	06073	33.18351423	-117.369269	San Diego County
88658	Fee-for-Service	1679928378	1679928378	1	1	THOMAS, SAMUEL C MD	9/16/2019	207R00000X	NA	Other	026	PHYSICIANS	165045	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
88673	Fee-for-Service	1457537672	1457537672	1	1	THRIFTY PAYLESS INC	4/8/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6509	16491 LAKESHORE DRV	None	LAKE ELSINORE	CA	92530	6723	33	06065	33.68835776	-117.3727845	Riverside County
88684	Fee-for-Service	1780922468	1780922468	1	1	TADROUS, CHRISTINA T MD	8/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122728	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
88707	Fee-for-Service	1538522412	1538522412	1	1	TENET HOSPITALS LIMITED	3/14/2018	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	TRANSMOUNTAIN CAMPUS	2000 TRANSMOUNTAIN RD	None	EL PASO	TX	79911	3601	00	None	31.904676	-106.5644685	El Paso County
88721	Fee-for-Service	1366948093	1366948093	1	1	TRANNGUYEN, MINH T DO	7/8/2021	207R00000X	NA	Other	026	PHYSICIANS	17936	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
88722	Fee-for-Service	1538549373	1538549373	1	1	TAVERNETTI, JENNIFER R MD	8/29/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	144905	None	None	0	In state provider	None	401 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6387	43	06085	37.36777579	-122.0276404	Santa Clara County
88745	Fee-for-Service	1053420406	1053420406	1	1	THRIFTY PAYLESS INC	2/2/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	602 WILLIAMS RD	None	SALINAS	CA	93905	1927	27	06053	36.67990238	-121.6065357	Monterey County
88754	Fee-for-Service	1558552513	1558552513	1	1	THOMAS, BETTY A LCSW	6/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
88757	Fee-for-Service	1114003621	1114003621	1	1	TU, RAYMOND H MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69961	10	Gastroenterology (M.D. only)	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
88773	Fee-for-Service	1730321787	1730321787	1	1	TELEN MEDICAL, AMC	5/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	86147	89	Surgery-Traumatic	0	In state provider	None	6501 COYLE AVENUE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
88789	Fee-for-Service	1265653356	1265653356	1	1	TALLURI, JAYANTH MD	2/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132343	01	General Practice	0	In state provider	None	444 PLUMAS BLVD	None	YUBA CITY	CA	95991	5071	51	06101	39.13178911	-121.6141048	Sutter County
88801	Fee-for-Service	1225692726	1225692726	1	1	TRENT, TIFFANY LMFT	5/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	964 5TH AVENUE	SUITE 535	SAN DIEGO	CA	92101	6102	37	06073	32.71539477	-117.1601872	San Diego County
88802	Fee-for-Service	1346311230	1346311230	1	1	TERRY, ORRIN MD	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	45099	84	Surgery-Head and Neck	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
88804	Fee-for-Service	1972709970	1972709970	1	1	TENET HOSPITALS LIMITED	6/29/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3280 JOSE BATTLE BLVD	None	EL PASO	TX	79938	2622	00	None	31.790412	-106.2643545	El Paso County
88850	Fee-for-Service	1700905908	1700905908	1	1	TOBIN, SCOTT L LMFT	12/5/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11600 WASHINGTON PL	STE 216C	LOS ANGELES	CA	90066	5083	19	06037	34.00465708	-118.4208535	Los Angeles County
88861	Fee-for-Service	1528389269	1528389269	1	1	TENISSON, ADRIA PT	11/1/2018	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
88877	Fee-for-Service	1922061944	1922061944	1	1	TOTAL RENAL CARE, INC	1/26/2000	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	516-522 E WASHINGTON BLV	None	LOS ANGELES	CA	90015	3723	19	06037	34.02866849	-118.2597481	Los Angeles County
88884	Fee-for-Service	1811929151	1811929151	1	1	TENET HEALTHSYSTEM	10/27/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2986 KATE BOND RD	None	BARLETT	TN	38133	4003	00	None	35.20710098	-89.80232323	Shelby County
88949	Fee-for-Service	1730251562	1730251562	1	1	TRESELER, CATHERINE B MD	12/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	54301	01	General Practice	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
88962	Fee-for-Service	1598792210	1598792210	1	1	TSAI, FAYEEN V OD	8/28/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W VALLEY BLVD	STE 115	SAN GABRIEL	CA	91776	3784	19	06037	34.07958215	-118.1021957	Los Angeles County
88964	Fee-for-Service	1235594656	1235594656	1	1	TOTAL RENAL CARE INC	4/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2263 S DEPOT STREET	None	SANTA MARIA	CA	93455	1216	42	06083	34.91729112	-120.4435221	Santa Barbara County
88973	Fee-for-Service	1033407549	1033407549	1	1	TAN, JEFFREY J MD	7/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135284	18	Ophthalmology	0	In state provider	None	1450 SAN PABLO STREET	SUITE 4000	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
88984	Fee-for-Service	1396955266	1396955266	1	1	TRUONG, BAN G DO	9/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9831	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 HOSPITAL ROAD	None	STOCKTON	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
88988	Fee-for-Service	1184820995	1184820995	1	1	THIAGARAJAN, RAMU MD PC	7/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95502	41	Internal Medicine	0	In state provider	None	382 PEARSON DR	None	PORTERVILLE	CA	93257	3368	54	06107	36.07245184	-119.0275806	Tulare County
89011	Fee-for-Service	1538230412	1538230412	1	1	TOWNER, WILLIAM J MD	10/1/1995	207R00000X	NA	Other	026	PHYSICIANS	80011	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
89026	Fee-for-Service	1841203783	1841203783	1	1	THIAGARAJAN, RAMU MD	5/14/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	95502	13	Neurology (M.D. only)	0	In state provider	None	202 W WILLOW AVE	SUITE 502	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
89031	Fee-for-Service	1225410293	1225410293	1	1	TONG, KEVIN K S OD	12/28/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
89078	Fee-for-Service	1407923428	1407923428	1	1	TAMJIDI, SEYED A MD	12/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	49563	None	None	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
89089	Fee-for-Service	1972709970	1972709970	1	1	TENET HOSPITALS LIMITED	6/29/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3280 JOSE BATTLE BLVD	None	EL PASO	TX	79938	2622	00	None	31.790412	-106.2643545	El Paso County
89090	Fee-for-Service	1194012245	1194012245	1	1	TURKSON, NICOLE Y MD	4/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133005	01	General Practice	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
89097	Fee-for-Service	1962606798	1962606798	1	1	TUSCANO, DAYMEN S MD	12/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	842 E MAIN ST	None	MEDFORD	OR	97504	7134	00	None	42.32787853	-122.863311	Jackson County
89155	Fee-for-Service	1174514962	1174514962	1	1	TOM, JAMES A MD	4/21/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	173300	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
89168	Fee-for-Service	1811929151	1811929151	1	1	TENET HEALTHSYSTEM	10/27/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2986 KATE BOND RD	None	BARLETT	TN	38133	4003	00	None	35.20710098	-89.80232323	Shelby County
89189	Fee-for-Service	1417979642	1417979642	1	1	TRAN, SOPHIA T MD	4/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76541	41	Internal Medicine	0	In state provider	None	1725 W 17TH ST	STE 101E	SANTA ANA	CA	90706	2316	30	06059	33.75999552	-117.892593	Orange County
89198	Fee-for-Service	1710393913	1710393913	1	1	TUCKER, KASSANDRA C DO	8/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15660	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
89216	Fee-for-Service	1801185467	1801185467	1	1	TANG, HENG K MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129533	None	None	0	In state provider	None	6001 NORRIS CANYON RD	None	SAN RAMON	CA	94583	5400	07	06013	37.7755858	-121.958923	Contra Costa County
89222	Fee-for-Service	1205819471	1205819471	1	1	TANAKA, MICHAEL S	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	50495	68	Hematology	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
89229	Fee-for-Service	1962942961	1962942961	1	1	THOMAS, MINDY A NP	6/9/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
89231	Fee-for-Service	1396059556	1396059556	1	1	TWU, STEPHANIE LCSW	11/12/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
89247	Fee-for-Service	1437848603	1437848603	1	1	TIP OF THE SPEAR CLINICAL TH	10/23/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	PY GROUP	41880 KALMIA STREET	UNIT 115	MURRIETA	CA	92562	1297	33	06065	33.55740114	-117.2157733	Riverside County
89275	Fee-for-Service	1184820995	1184820995	1	1	THIAGARAJAN, RAMU MD PC	7/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95502	13	Neurology (M.D. only)	0	In state provider	None	382 PEARSON DR	None	PORTERVILLE	CA	93257	3368	54	06107	36.07245184	-119.0275806	Tulare County
89278	Fee-for-Service	1134158215	1134158215	1	1	TE, FRANCIS	9/5/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	53388	41	Internal Medicine	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
89386	Fee-for-Service	1407932908	1407932908	1	1	THURSTON, WILLIAM B MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	25753	01	General Practice	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
89395	Fee-for-Service	1982782827	1982782827	1	1	TIMOTHY D KNUDSEN MD	5/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MEDICAL	None	OMAHA	NE	68198	7400	00	None	0	0	None
89402	Fee-for-Service	1629248109	1629248109	1	1	TEODORO P. NISSEN M.D., INC	4/6/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	100 HOSPITAL DRIVE	SUITE 303	VALLEJO	CA	94589	2583	48	06095	38.13100118	-122.2403008	Solano County
89447	Fee-for-Service	1831351253	1831351253	1	1	TALUKDAR, DAVID G MD	10/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111213	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
89455	Fee-for-Service	1134699218	1134699218	1	1	THEY, MICHAEL NP	4/3/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3751 E SHIELDS AVE	None	FRESNO	CA	93726	0000	10	06019	36.7796958	-119.7618088	Fresno County
89470	Fee-for-Service	1538265780	1538265780	1	11	TAHOE FOREST HOSP DIST	6/4/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10978 DONNER PASS RD	None	TRUCKEE	CA	96161	0433	29	06057	39.32616692	-120.2026317	Nevada County
89514	Fee-for-Service	1205819471	1205819471	1	1	TANAKA, MICHAEL S	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	50495	78	Neoplastic Diseases/Oncology	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
89548	Fee-for-Service	1376999680	1376999680	1	1	THERIAULT, RAMINTA V MD	8/3/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	173862	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
89576	Fee-for-Service	1427530187	1427530187	1	1	TORRES, GENEVIEVE D RCP	2/21/2024	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
89601	Fee-for-Service	1316053085	1316053085	2	1	TRAN PHARMACY INC	3/20/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	TRAN PHARMACY	14291 EUCLID ST	#D104	GARDEN GROVE	CA	92843	4980	30	06059	33.755166	-117.937627	Orange County
89629	Fee-for-Service	1255446100	1255446100	1	1	TAGGE,EDWARD P MD	9/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88002	85	Surgery-Pediatric	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
89684	Fee-for-Service	1639332687	1639332687	1	1	TRAKUL, NICHOLAS MD	6/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110066	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
89692	Fee-for-Service	1205133204	1205133204	1	1	TRAN, TONY T DO	3/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14095	01	General Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
89818	Fee-for-Service	1366447369	1366447369	1	1	TAN, HENRY H MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111285	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2450 ASHBY AVENUE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
89894	Fee-for-Service	1427111046	1427111046	1	1	TOUCHETTE REGIONAL HOSPITAL	9/30/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	5900 BOND AVE	None	CENTREVILLE	IL	62207	2326	00	None	38.57087738	-90.10722226	St. Clair County
89942	Fee-for-Service	1932436821	1932436821	1	1	THARA, EDDIE DO	1/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	10972	78	Neoplastic Diseases/Oncology	0	In state provider	None	11480 BROOKSHIRE AVENUE	SUITE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
89980	Fee-for-Service	1942817721	1942817721	1	1	TOP QUALITY HOSPICE &	10/28/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	5315 LAUREL CANYON BLVD	STE 106	VALLEY VILLAGE	CA	91607	4926	19	06037	34.16713798	-118.3965446	Los Angeles County
89987	Fee-for-Service	1790280279	1790280279	1	1	TIAO, JOSHUA R MD	5/12/2022	207P00000X	NA	Other	026	PHYSICIANS	177808	None	None	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
90025	Fee-for-Service	1134689383	1134689383	1	1	TRUONG, NATALIE T MD	7/1/2022	207P00000X	NA	Other	026	PHYSICIANS	176261	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
90038	Fee-for-Service	1861733727	1861733727	1	1	THURSTON, ANGELA B DO	12/7/2020	208M00000X	NA	Other	026	PHYSICIANS	18300	None	None	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
90047	Fee-for-Service	1477993723	1477993723	1	2	TUONG, CATHERINE OD	10/29/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	951 N MILLIKEN AVE	None	ONTARIO	CA	91764	5008	36	06071	34.073883	-117.5602365	San Bernardino County
90079	Fee-for-Service	1578820734	1578820734	1	1	TEASDALE, SARA R MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127945	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
90082	Fee-for-Service	1033177399	1033177399	1	1	TAKASUMI, YUKI MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62456	22	Pathology (M.D. only)	0	In state provider	None	1328 22ND ST	None	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
90099	Fee-for-Service	1891870564	1891870564	1	1	THOMAS, ELIZABETH F MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	44906	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
90110	Fee-for-Service	1720145683	1720145683	1	1	TRAYLOR, LAURA A LCSW	3/23/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5755 COTTLE RD	BLDG 4	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
90137	Fee-for-Service	1235450305	1235450305	1	1	TCHEKMEDYIAN, NISHAN MD	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137047	78	Neoplastic Diseases/Oncology	0	In state provider	None	19582 BEACH BLVD	212	HUNTINGTON BEACH	CA	92648	5923	30	06059	33.67831649	-117.9885198	Orange County
90166	Fee-for-Service	1447388806	1447388806	1	1	TRIVEDI, ABHI H OD	2/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9384 PHOENIX PL	None	ARLETA	CA	91331	1055	19	06037	34.2400608	-118.4100919	Los Angeles County
90184	Fee-for-Service	1427111046	1427111046	1	1	TOUCHETTE REGIONAL HOSPITAL	9/30/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	5900 BOND AVE	None	CENTREVILLE	IL	62207	2326	00	None	38.57087738	-90.10722226	St. Clair County
90197	Fee-for-Service	1144375791	1144375791	1	1	TEEPLE, KATHERINE A MD	11/1/2018	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	84177	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	FLOOR 2	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
90200	Fee-for-Service	1073950432	1073950432	1	1	TSAU, CINDY W NP	5/18/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
90221	Fee-for-Service	1912913203	1912913203	1	1	THRIFTY PAYLESS INC	2/6/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	411 HARRIS ST	None	EUREKA	CA	95503	4416	12	06023	40.78046595	-124.164194	Humboldt County
90229	Fee-for-Service	1932436821	1932436821	1	1	THARA, EDDIE DO	1/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	10972	68	Hematology	0	In state provider	None	11480 BROOKSHIRE AVENUE	SUITE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
90231	Fee-for-Service	1821091083	1821091083	1	1	THOMSON, JAMES F. MD	10/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1202 E LOCUST ST	None	EMMETT	ID	83617	2715	00	None	43.87907751	-116.4848985	Gem County
90262	Fee-for-Service	1912584814	1912584814	1	1	TOTAL RENAL CARE, INC	4/27/2022	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1520 N BROADWAY	None	SANTA MARIA	CA	93454	2251	42	06083	34.967295	-120.4356325	Santa Barbara County
90269	Fee-for-Service	1942817721	1942817721	1	1	TOP QUALITY HOSPICE &	10/28/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	5315 LAUREL CANYON BLVD	STE 106	VALLEY VILLAGE	CA	91607	4926	19	06037	34.16713798	-118.3965446	Los Angeles County
90270	Fee-for-Service	1760509137	1760509137	1	1	TIMM, LORI J CRNA	1/20/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
90327	Fee-for-Service	1548485832	1548485832	1	1	TYM, BRADLEY D MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73970	05	Anesthesiology	0	In state provider	None	1531 THE ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
90341	Fee-for-Service	1528521788	1528521788	1	1	THOMPSON, CAPRICE DO	9/19/2023	207R00000X	NA	Other	026	PHYSICIANS	21343	None	None	0	In state provider	None	8851 CENTER DR	STE 305	LA MESA	CA	91942	3048	37	06073	32.78189749	-117.0075062	San Diego County
90352	Fee-for-Service	1982227088	1982227088	1	1	TLC HOSPICE CARE INC	4/13/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4605 LANKERSHIM BLVD	SUITE 305A	NORTH HOLLYWOOD	CA	91602	1875	19	06037	34.15389329	-118.3679999	Los Angeles County
90362	Fee-for-Service	1932383924	1932383924	1	1	TRAN, TOAN H MD INC	1/27/2012	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	37620	01	General Practice	0	In state provider	None	4545 GEORGETOWN PLACE	STE C16	STOCKTON	CA	95207	6230	39	06077	37.98906659	-121.3134248	San Joaquin County
90368	Fee-for-Service	1669607511	1669607511	1	1	TORSNEY-WEIR, MAIREAD J MD	5/20/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	124813	08	Family Practice	0	In state provider	None	4323 W RIVERSIDE DRIVE	None	BURBANK	CA	91505	4044	19	06037	34.15223748	-118.347426	Los Angeles County
90386	Fee-for-Service	1205223161	1205223161	1	1	TRAN, NHI T MD MPH	8/5/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	166262	None	None	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
90398	Fee-for-Service	1629470489	1629470489	1	1	TWEEDY URGENT CARE INC APC	11/17/2015	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2809 TWEEDY BLVD	None	SOUTH GATE	CA	90280	5538	19	06037	33.94599284	-118.2211199	Los Angeles County
90399	Fee-for-Service	1598842544	1598842544	1	1	THOMPSON, MICHELE M MD	9/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97038	22	Pathology (M.D. only)	0	In state provider	None	1701 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3011	38	06075	37.78553106	-122.4399475	San Francisco County
90425	Fee-for-Service	1235450305	1235450305	1	1	TCHEKMEDYIAN, NISHAN MD	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137047	68	Hematology	0	In state provider	None	19582 BEACH BLVD	212	HUNTINGTON BEACH	CA	92648	5923	30	06059	33.67831649	-117.9885198	Orange County
90455	Fee-for-Service	1215513890	1215513890	1	1	TANG, WILLIE MD	8/20/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	23 REED BLVD	STE 120	MILL VALLEY	CA	94941	2334	21	06041	37.9011569	-122.5149215	Marin County
90469	Fee-for-Service	1548379076	1548379076	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #6005	1245 W YOSEMITE AVE	None	MANTECA	CA	95337	5125	39	06077	37.7974563	-121.2356948	San Joaquin County
90475	Fee-for-Service	1003158585	1003158585	1	1	TRIPAHI, MUKTI MD	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143810	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
90523	Fee-for-Service	1053411884	1053411884	1	1	TODD POPP	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
90617	Fee-for-Service	1538265780	1538265780	1	7	TAHOE FOREST HOSP DIST	6/4/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10710 DONNER PASS RD	None	TRUCKEE	CA	96161	4812	29	06057	39.32660448	-120.1966779	Nevada County
90639	Fee-for-Service	1639271935	1639271935	1	1	TUOLUMNE CO HEALTH DEPT	3/3/1980	251K00000X	NA	Other	048	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	20111 CEDAR RD N	None	SONORA	CA	95370	5939	55	06109	37.98813587	-120.3664247	Tuolumne County
90640	Fee-for-Service	1184878167	1184878167	1	1	TADROS, REDA M MD INC	11/10/2008	193200000X	NA	Other	026	PHYSICIANS	84889	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	15248 11TH ST	None	VICTORVILLE	CA	92392	3704	36	06071	34.52825401	-117.2925587	San Bernardino County
90641	Fee-for-Service	1982227088	1982227088	1	1	TLC HOSPICE CARE INC	4/13/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4605 LANKERSHIM BLVD	SUITE 305A	NORTH HOLLYWOOD	CA	91602	1875	19	06037	34.15389329	-118.3679999	Los Angeles County
90687	Fee-for-Service	1629470489	1629470489	1	1	TWEEDY URGENT CARE INC APC	11/17/2015	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2809 TWEEDY BLVD	None	SOUTH GATE	CA	90280	5538	19	06037	33.94599284	-118.2211199	Los Angeles County
90689	Fee-for-Service	1598842544	1598842544	1	1	THOMPSON, MICHELE M MD	9/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97038	07	Dermatology	0	In state provider	None	1701 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3011	38	06075	37.78553106	-122.4399475	San Francisco County
90718	Fee-for-Service	1215410964	1215410964	1	1	TREJO, NELDA LMFT	7/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
90737	Fee-for-Service	1124106760	1124106760	1	1	TSENG, WENDY W MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61376	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
90754	Fee-for-Service	1053359430	1053359430	1	1	TRI-STATE ANESTHESIA	10/19/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	1	Border provider	ASSOCIATES, PLC	2735 SILVER CREEK RD	None	BULLHEAD CITY	AZ	86442	7924	00	None	35.110926	-114.5552445	Mohave County
90766	Fee-for-Service	1295781896	1295781896	1	1	TEMPLE PARK CONV HOSP	3/11/1979	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2411 W TEMPLE ST	None	LOS ANGELES	CA	90026	4817	19	06037	34.07185655	-118.272759	Los Angeles County
90812	Fee-for-Service	1528254281	1528254281	1	1	TOWERY, JACOB B MD	5/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100853	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
90817	Fee-for-Service	1346260502	1346260502	1	1	TU, BILL YUEN MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77859	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90095	0001	19	06037	34.03781261	-118.3755101	Los Angeles County
90835	Fee-for-Service	1043387806	1043387806	1	1	TRAN, TAMMY M OD	4/4/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2531 CHESTER AVE	None	BAKERSFIELD	CA	93301	2012	15	06029	35.382582	-119.0188955	Kern County
90842	Fee-for-Service	1720133705	1720133705	1	1	TRINH, FRANK D MD	2/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82867	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
90952	Fee-for-Service	1578689733	1578689733	1	1	TABRIZ, KATAYOUN E OD	12/24/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	780 SHADOWRIDGE DR	None	VISTA	CA	92083	7986	37	06073	33.16632768	-117.2212175	San Diego County
91017	Fee-for-Service	1679733646	1679733646	1	1	TANBE, GEORGES MD	10/8/2020	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	169584	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4955 VAN NUYS BLVD	SUITE 308	SHERMAN OAKS	CA	91403	1811	19	06037	34.160805	-118.4487295	Los Angeles County
91025	Fee-for-Service	1013123280	1013123280	1	1	TAQI, MUHAMMAD A MD	4/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118331	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
91045	Fee-for-Service	1457061152	1457061152	1	1	TA, BEN	10/22/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	16169 HESPERIAN BLVD	None	SAN LORENZO	CA	94580	2451	01	06001	37.67713903	-122.1254449	Alameda County
91052	Fee-for-Service	1245426881	1245426881	1	1	THE CARING CONNECTION	8/1/2013	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	None	10727 WHITE OAK AVE	SUITE 206	GRANADA HILLS	CA	91344	4660	19	06037	34.265781	-118.5197785	Los Angeles County
91068	Fee-for-Service	1487267233	1487267233	1	1	THEPMONTRY-NHEP, CHANCE C NP	2/3/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
91104	Fee-for-Service	1548276843	1548276843	1	1	THRIFTY PAYLESS INC	11/28/2001	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5454	1744 W 6TH ST	None	LOS ANGELES	CA	90017	1004	19	06037	34.05732961	-118.2699777	Los Angeles County
91109	Fee-for-Service	1023850864	1023850864	1	1	TORANZO, KAYE NP	11/12/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	30	06059	33.62609529	-117.7293191	Orange County
91153	Fee-for-Service	1467139287	1467139287	1	1	TRINH, RACHELLE OD	9/12/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1481 E PLAZA BLVD	None	NATIONAL CITY	CA	91950	3613	37	06073	32.6768163	-117.0909096	San Diego County
91164	Fee-for-Service	1568521144	1568521144	1	1	TRUONG, JAMES H MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	61327	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
91216	Fee-for-Service	1982713434	1982713434	1	1	THRIFTY PAYLESS INC	5/30/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6016	855 MONO WAY	None	SONORA	CA	95370	5202	55	06109	37.97538151	-120.3681994	Tuolumne County
91252	Fee-for-Service	1730664111	1730664111	1	1	TILSON, EMILIE A PT	9/27/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1901 W LUGONIA AVE	SUITE 320	REDLANDS	CA	92374	9703	36	06071	34.07027851	-117.218421	San Bernardino County
91260	Fee-for-Service	1992287874	1992287874	1	1	TERRILL, JOSEPH PT	2/16/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1150 MORTON	B	PORTERVILLE	CA	93257	1940	54	06107	36.07332205	-119.0428201	Tulare County
91274	Fee-for-Service	1417200312	1417200312	1	1	THOMPSON, DANNA M LMFT	6/15/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	594 NORTH GLASSELL	None	ORANGE	CA	92867	6748	30	06059	33.796782	-117.853129	Orange County
91301	Fee-for-Service	1306838438	1306838438	1	1	THE REUTLINGER COMMUNITY	3/1/1966	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	4000 CAMINO TASSAJARA	None	DANVILLE	CA	94506	4711	07	06013	37.79912115	-121.9064568	Contra Costa County
91304	Fee-for-Service	1669825675	1669825675	1	1	TSANG, ICARUS PSYD	4/21/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	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
91340	Fee-for-Service	1245426881	1245426881	1	1	THE CARING CONNECTION	6/26/2012	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	10727 WHITE OAK AVE	SUITE 206	GRANADA HILLS	CA	91344	4660	19	06037	34.265781	-118.5197785	Los Angeles County
91367	Fee-for-Service	1356329494	1356329494	1	1	TSAI, JAMES M MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80854	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 N GARFIELD AVE	STE 310	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
91382	Fee-for-Service	1477958965	1477958965	1	1	TRAN, TAMMY LCSW	12/30/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
91403	Fee-for-Service	1437646759	1437646759	1	1	THAI, BENSEN T MD	7/31/2020	1835P1300X	NA	Other	026	PHYSICIANS	164624	36	Psychiatry	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
91545	Fee-for-Service	1073556296	1073556296	1	1	TAN, MARLENE V MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	43019	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
91593	Fee-for-Service	1952987661	1952987661	1	1	TIMMER, DAVID	12/23/2024	208M00000X	NA	Other	026	PHYSICIANS	191660	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
91620	Fee-for-Service	1841343514	1841343514	1	1	THOMAS WIXTED, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9927 MICKELBERRY RD NW	STE 121	SILVERDALE	WA	98383	9195	00	None	47.65210996	-122.6823206	Kitsap County
91635	Fee-for-Service	1437226354	1437226354	1	1	TRANTHAM, PATRICIA C MD	11/2/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	44173	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
91663	Fee-for-Service	1346388071	1346388071	1	1	THOMAS, KATHERINE LMFT	4/10/2025	No Taxonomy Provided	NA	None	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
91677	Fee-for-Service	1699953539	1699953539	1	1	THE GIFT OF SPEECH	3/17/2006	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3031 W. MARCH LANE	STE 117 SOUTH	STOCKTON	CA	95219	6568	39	06077	37.9842796	-121.3494311	San Joaquin County
91708	Fee-for-Service	1447725445	1447725445	1	1	TWO WINGS HEALTH SERVICES	5/5/2022	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	22437 NORWALK BLVD	None	HAWAIIAN GARDENS	CA	90716	2458	30	06059	33.82421372	-118.0719083	Los Angeles County
91746	Fee-for-Service	1487132163	1487132163	1	1	TWICHELL, MATTHEW J CRNA	10/1/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	205 S WEST ST	STE B	VISALIA	CA	93291	6112	54	06107	36.329031	-119.296782	Tulare County
91794	Fee-for-Service	1750735833	1750735833	1	1	TAN, JENNIFER DO	6/5/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15782	08	Family Practice	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
91795	Fee-for-Service	1417377607	1417377607	1	2	TALAVERA, KARLA MD	6/25/2022	208M00000X	NA	Other	026	PHYSICIANS	143128	None	None	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
91802	Fee-for-Service	1639176514	1639176514	2	1	THERAPEUTIC HOME CARE	9/1/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	580 EAST 3RD STREET #F	None	OXNARD	CA	93030	0184	56	06111	34.20053352	-119.1730275	Ventura County
91803	Fee-for-Service	1548327281	1548327281	1	1	TUTTLE, CYNTHIA NP	9/6/2024	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	225 N LAURSEN ST	None	HEMET	CA	92543	4437	33	06065	33.749955	-116.9608485	Riverside County
91821	Fee-for-Service	1144515149	1144515149	1	3	THE SAN FRANCISCO AIDS	12/17/2020	No Taxonomy Provided	NA	None	040	FREE CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	117 6TH ST	None	SAN FRANCISCO	CA	94103	2814	38	06075	37.78068802	-122.4082699	San Francisco County
91835	Fee-for-Service	1467420950	1467420950	1	1	TUITE, MICHAEL J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	UW HOSPITAL & CLINIC	600 HIGHLAND AVE	None	MADISON	WI	53792	0000	00	None	43.07868393	-89.4316606	Dane County
91863	Fee-for-Service	1538168950	1538168950	1	3	THE ELIZABETH HOSPICE INC	12/12/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	27720 JEFFERSON AVE	SUITE 200	TEMECULA	CA	92590	2630	33	06065	33.51188961	-117.1586219	Riverside County
91880	Fee-for-Service	1588942759	1588942759	1	1	TROPEL, JULIENNE N DO	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13500	None	None	0	In state provider	None	24 W EL ROSE DRIVE	None	PETALUMA	CA	94952	4023	49	06097	38.22308352	-122.646555	Sonoma County
91921	Fee-for-Service	1891758538	1891758538	1	1	TOTAL RENAL CARE	1/1/1998	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	MONTEREY DIALYSIS CENTER	883 S ATLANTIC BLVD	STE H	MONTEREY PARK	CA	91754	4733	19	06037	34.0507921	-118.1381694	Los Angeles County
91923	Fee-for-Service	1437226354	1437226354	1	1	TRANTHAM, PATRICIA C MD	11/2/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	44173	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
91960	Fee-for-Service	1629146980	1629146980	1	1	TORRES, SARAH N MD	10/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95653	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
92008	Fee-for-Service	1407855596	1407855596	1	1	THOMPSON, BRUCE E MD	12/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	31211	01	General Practice	0	In state provider	NORTH OAKLAND MEDICAL CL	6105 SAN PABLO AVE	None	OAKLAND	CA	94608	2225	01	06001	37.84435433	-122.2842522	Alameda County
92031	Fee-for-Service	1154852655	1154852655	1	1	TALAVERA, DAVID C PHD	12/18/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
92049	Fee-for-Service	1568537132	1568537132	1	1	TRUONG, TU NGOC MD APC	7/1/1994	207R00000X	NA	Other	026	PHYSICIANS	50756	01	General Practice	0	In state provider	None	5069 EL CAJON BLVD	None	SAN DIEGO	CA	92115	3348	37	06073	32.75696513	-117.0854242	San Diego County
92075	Fee-for-Service	1407086069	1407086069	1	1	THAKAR, SAURABH S MD	8/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148654	41	Internal Medicine	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
92154	Fee-for-Service	1538168950	1538168950	1	3	THE ELIZABETH HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	27720 JEFFERSON AVE	SUITE 200	TEMECULA	CA	92590	2630	33	06065	33.51188961	-117.1586219	Riverside County
92210	Fee-for-Service	1760793822	1760793822	1	1	THOMPSON, RACHEL M MD	3/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146187	20	Orthopedic Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
92246	Fee-for-Service	1881792711	1881792711	1	1	TRICHE, TIMOTHY J MD	9/1/1995	2086S0120X	NA	General Surgery	026	PHYSICIANS	42435	22	Pathology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
92255	Fee-for-Service	1497927610	1497927610	1	1	TU, FUN CHI MD	6/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118249	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
92257	Fee-for-Service	1205236270	1205236270	1	1	THATTE, KAVITA S MD	8/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144453	05	Anesthesiology	0	In state provider	None	5555 W LAS POSITAS BLVD	None	PLEASANTON	CA	94588	4000	01	06001	37.69212528	-121.8803442	Alameda County
92258	Fee-for-Service	1659506673	1659506673	1	1	TAETZSCH, WILLIAM R MFT	11/17/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	77172	-	NOT APPLICABLE	0	In state provider	None	11643 GLENOAKS BLVD	None	PACOIMA	CA	91331	1050	19	06037	34.28133474	-118.4198166	Los Angeles County
92291	Fee-for-Service	1225552284	1225552284	1	1	TAMVADA, DHEERA MD	2/3/2021	207R00000X	NA	Other	026	PHYSICIANS	167228	None	None	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
92296	Fee-for-Service	1407855596	1407855596	1	1	THOMPSON, BRUCE E MD	12/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	31211	08	Family Practice	0	In state provider	NORTH OAKLAND MEDICAL CL	6105 SAN PABLO AVE	None	OAKLAND	CA	94608	2225	01	06001	37.84435433	-122.2842522	Alameda County
92318	Fee-for-Service	1184280851	1184280851	1	1	THOMAS, KALEB J MD	6/14/2023	207R00000X	NA	Other	026	PHYSICIANS	176787	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
92335	Fee-for-Service	1689813552	1689813552	1	1	TRUNO NOGUEIRA, JORDI	4/14/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
92342	Fee-for-Service	1861542326	1861542326	1	1	TAYLOR, SCOTT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3100 CHANNING WAY	None	IDAHO FALLS	ID	83404	7533	00	None	43.470198	-111.9901955	Bonneville County
92359	Fee-for-Service	1407086069	1407086069	1	1	THAKAR, SAURABH S MD	8/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148654	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
92361	Fee-for-Service	1790804466	1790804466	1	1	TAJALLIAGHDAM, BEATRIZ S	8/1/1995	363L00000X	NA	Nurse Practitioner	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
92407	Fee-for-Service	1649505744	1649505744	1	1	TUNG, JONATHAN D S MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110281	18	Ophthalmology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
92417	Fee-for-Service	1497747232	1497747232	1	1	TSAO, JUNA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	63193	08	Family Practice	0	In state provider	None	1454 E 2ND STREET	None	SAN BERNARDINO	CA	92408	0118	36	06071	34.1035953	-117.2563723	San Bernardino County
92446	Fee-for-Service	1437493558	1437493558	1	1	TIFT, KATHRYN PERKINS MD INC	11/15/2013	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	104909	None	None	0	In state provider	None	11160 WARNER AVENUE	SUITE 311	FOUNTAIN VALLEY	CA	92708	4055	30	06059	33.71630854	-117.934317	Orange County
92449	Fee-for-Service	1457612004	1457612004	1	1	TULARE COUNTY OFFICE OF EDU	3/12/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	6200 MONNEY BLVD	None	VISALIA	CA	93277	0000	54	06107	36.274401	-119.311821	Tulare County
92464	Fee-for-Service	1386796209	1386796209	2	1	TINOOSH, FARNOOSH MD	11/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	69006	18	Ophthalmology	0	In state provider	None	1503 SOUTH COAST DR	SUITE 120	COSTA MESA	CA	92926	1526	30	06059	33.69159551	-117.9203625	Orange County
92595	Fee-for-Service	1427604404	1427604404	1	1	TATYANA SARKISOVA MD, INC	8/29/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	3655 LOMITA BLVD STE 108	None	TORRANCE	CA	90505	1902	19	06037	33.81497113	-118.3489779	Los Angeles County
92597	Fee-for-Service	1043499098	1043499098	1	1	TONSTAD, SIGVE	2/28/1989	207R00000X	NA	Other	026	PHYSICIANS	62012	66	Emergency Medicine (Urgent Care)	0	In state provider	None	815 WASHBURN AVE	None	CORONA	CA	91720	0000	33	06065	33.87388995	-117.5677508	Riverside County
92606	Fee-for-Service	1629346630	1629346630	1	1	TREMAYNE, PAULA DO AMC	2/19/2013	207R00000X	NA	Other	026	PHYSICIANS	8495	None	None	0	In state provider	None	817 COFFEE RD	SUITE D	MODESTO	CA	95355	4241	50	06099	37.655235	-120.975616	Stanislaus County
92682	Fee-for-Service	1801015490	1801015490	1	1	TEJIRIAN, TALAR MD	8/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86698	02	General Surgery	0	In state provider	None	200 MEDICAL PLAZA	STE 214	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
92693	Fee-for-Service	1508181389	1508181389	1	1	THONDAPU, VIKAS S MD	4/2/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	128458	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
92695	Fee-for-Service	1336407923	1336407923	1	1	TUKAJ, JOANNA MD	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	51499	40	Pediatrics	0	In state provider	None	1433 N HOLLENBECK AVE	SUITE 104	COVINA	CA	91722	1558	19	06037	34.105518	-117.8989985	Los Angeles County
92700	Fee-for-Service	1629293030	1629293030	1	1	TSAI DO, BETTY S MD	6/3/2019	207YX0901X	NA	ENT/Otolaryngology	026	PHYSICIANS	98674	84	Surgery-Head and Neck	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
92736	Fee-for-Service	1306947924	1306947924	1	1	TROZZOLINO, LINDA A PHD	5/11/2005	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90075	0000	19	06037	34.07067	-118.4432445	Los Angeles County
92741	Fee-for-Service	1457716698	1457716698	1	1	THRIFTY PAYLESS INC	9/2/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	499 ALVARDO STREET	None	MONTEREY	CA	93940	2722	27	06053	36.59781145	-121.8949242	Monterey County
92788	Fee-for-Service	1801423769	1801423769	1	1	THORPE, JONATHAN T MD	8/25/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
92832	Fee-for-Service	1659627941	1659627941	1	1	TAYLOR, MARIBEL A LMFT	7/1/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	109068	-	NOT APPLICABLE	0	In state provider	None	1303 W WALNUT PKWY	None	COMPTON	CA	90220	5030	19	06037	33.87724562	-118.2446904	Los Angeles County
92838	Fee-for-Service	1447716535	1447716535	1	1	TAMAYO, KARINA A LMFT	5/1/2024	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
92900	Fee-for-Service	1891804225	1891804225	1	1	THRIFTY PAYLESS INC	6/12/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5799	66 W MORTON AVE	None	PORTERVILLE	CA	93257	2331	54	06107	36.07308161	-119.0175114	Tulare County
92908	Fee-for-Service	1720242712	1720242712	1	1	TORRES-COLLAZO, VICTOR A MD	6/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133556	36	Psychiatry	0	In state provider	None	2340 CLAY STREET	7TH FLOOR	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
92926	Fee-for-Service	1467485474	1467485474	1	1	TARRAR, AYMEL J MD	7/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90212	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 S OAK AVE	None	OAKDALE	CA	95361	3519	50	06099	37.75764557	-120.8600743	Stanislaus County
92976	Fee-for-Service	1780402909	1780402909	1	1	TRAN, TIFFANY OD	10/22/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1909 N WATERMAN AVE	3	SAN BERNARDINO	CA	92404	4842	36	06071	34.132626	-117.2787445	San Bernardino County
92984	Fee-for-Service	1093816613	1093816613	1	1	TSE, GRAHAM C MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62058	01	General Practice	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
92986	Fee-for-Service	1457428468	1457428468	1	1	TEGET, BRUCE R MD	2/28/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37602	41	Internal Medicine	0	In state provider	None	8540 RESEDA BLVD	None	NORTHRIDGE	CA	91324	4628	19	06037	34.22579296	-118.5360435	Los Angeles County
92989	Fee-for-Service	1609367622	1609367622	1	1	TREMOLADA, BRITTANY OT	10/15/2018	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
93028	Fee-for-Service	1043522154	1043522154	1	1	TSAI, ARNOLD MD	12/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116863	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
93035	Fee-for-Service	1811933773	1811933773	1	1	THUE, JEFFREY C MD	4/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	62084	05	Anesthesiology	0	In state provider	None	4650 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6306	19	06037	33.98160766	-118.4400667	Los Angeles County
93056	Fee-for-Service	1891804332	1891804332	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 5660	10631 TIERRASANTA BLVD	None	SAN DIEGO	CA	92124	2605	37	06073	32.82309483	-117.1015222	San Diego County
93060	Fee-for-Service	1932760964	1932760964	1	1	TRAN, NHUNG OD	2/23/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	22525 MAPLE AVE	STE 100	TORRANCE	CA	90505	2700	19	06037	33.82264238	-118.3401719	Los Angeles County
93107	Fee-for-Service	1083815955	1083815955	1	1	TEETER, GLENN T PHD	2/21/2012	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
93120	Fee-for-Service	1336376342	1336376342	1	1	TORRUELLAS, CARA L MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115279	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
93190	Fee-for-Service	1659433191	1659433191	1	5	TOIYABE INDIAN HEALTH PROJEC	7/7/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1150 S GOODWIN RD	None	LONE PINE	CA	93545	0000	14	06027	36.59508126	-118.0512076	Inyo County
93215	Fee-for-Service	1467485474	1467485474	1	1	TARRAR, AYMEL J MD	7/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90212	08	Family Practice	0	In state provider	None	350 S OAK AVE	None	OAKDALE	CA	95361	3519	50	06099	37.75764557	-120.8600743	Stanislaus County
93234	Fee-for-Service	1780926964	1780926964	1	1	TELECARE CORPORATION	6/30/2014	No Taxonomy Provided	NA	None	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2250 SOQUEL AVE	SUITE 150	SANTA CRUZ	CA	95062	1402	44	06087	36.98359419	-121.9939668	Santa Cruz County
93257	Fee-for-Service	1841486404	1841486404	1	1	THOME, CHRISTOPHER B PHD	3/15/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1660 E ROSEVILLE PKWY	BUILDING C	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
93302	Fee-for-Service	1376136903	1376136903	1	1	TRINH, KATHY NP	5/19/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
93338	Fee-for-Service	1518301431	1518301431	1	1	TYE, ANDREW MD	5/18/2020	207WX0108X	NA	Ophthalmology	026	PHYSICIANS	135499	18	Ophthalmology	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
93348	Fee-for-Service	1114574977	1114574977	1	1	TRAM HOSPICE CARE INC	2/15/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	512 E WILSON AVE	SUITE 205	GLENDALE	CA	91206	4821	19	06037	34.14813015	-118.2494202	Los Angeles County
93350	Fee-for-Service	1598773467	1598773467	1	1	TRAN, KEVIN N MD	5/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73052	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
93407	Fee-for-Service	1336376342	1336376342	1	1	TORRUELLAS, CARA L MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115279	10	Gastroenterology (M.D. only)	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
93410	Fee-for-Service	1407839681	1407839681	1	1	TONG, MYRON J MD	10/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	22458	41	Internal Medicine	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
93413	Fee-for-Service	1144339052	1144339052	1	1	THRIFTY PAYLESS INC	2/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5806	5212 W WALNUT AVE	None	VISALIA	CA	93277	3475	54	06107	36.313524	-119.348667	Tulare County
93441	Fee-for-Service	1588207583	1588207583	1	1	THE TEEN PROJECT, INC.	8/18/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	29833 SANTA MARGARITA PK	400	RANCHO SANTA MARG	CA	92688	3619	30	06059	33.63792372	-117.6108629	Orange County
93478	Fee-for-Service	1659433191	1659433191	1	5	TOIYABE INDIAN HEALTH PROJEC	7/7/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1150 S GOODWIN RD	None	LONE PINE	CA	93545	0000	14	06027	36.59508126	-118.0512076	Inyo County
93483	Fee-for-Service	1215468376	1215468376	1	1	TOPILOW, NICOLE MD	7/29/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	171573	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
93495	Fee-for-Service	1144339599	1144339599	1	1	THRIFTY PAYLESS INC	2/4/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6263	27716 MCBEAN PKWY	None	VALENCIA	CA	91354	1430	19	06037	34.44540143	-118.5532948	Los Angeles County
93570	Fee-for-Service	1285687756	1285687756	1	1	TIWARI, ANIL MD	7/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84690	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
93596	Fee-for-Service	1164696993	1164696993	1	1	TURNER, RANDALL G DO MD	8/21/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	10933	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
93597	Fee-for-Service	1134225790	1134225790	1	1	TAIMOORAZY, BENJAMIN MD	8/5/2017	208VP0014X	NA	Other	026	PHYSICIANS	132677	None	None	0	In state provider	None	436 N ROXBURY DR	115	BEVERLY HILLS	CA	90210	5016	19	06037	34.06771782	-118.4065755	Los Angeles County
93599	Fee-for-Service	1942228713	1942228713	1	1	TETRUD, JAMES W MD	5/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	28154	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
93619	Fee-for-Service	1730298266	1730298266	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06076	4980 FREEPORT BLVD	None	SACRAMENTO	CA	95822	2153	34	06067	38.529441	-121.496553	Sacramento County
93636	Fee-for-Service	1114574977	1114574977	1	1	TRAM HOSPICE CARE INC	2/15/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	512 E WILSON AVE	SUITE 205	GLENDALE	CA	91206	4821	19	06037	34.14813015	-118.2494202	Los Angeles County
93683	Fee-for-Service	1669477113	1669477113	1	1	THOMAS, THEODORE S MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	61681	45	Nephrology (Renal-Kidney)	0	In state provider	None	304 IVY ST	None	SAN DIEGO	CA	92101	2030	37	06073	32.72825552	-117.161595	San Diego County
93687	Fee-for-Service	1083078091	1083078091	1	1	TENOLD, PATRICIA M MD	2/4/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	152626	40	Pediatrics	0	In state provider	None	1840 SIERRA GARDENS	None	ROSEVILLE	CA	95678	2912	31	06061	38.74730831	-121.2613758	Placer County
93690	Fee-for-Service	1295845667	1295845667	1	1	TUCKER, CRAIG A LCSW	7/5/2006	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	333 E STUART AVE	STE F	REDLANDS	CA	92374	4440	36	06071	34.05963145	-117.178245	San Bernardino County
93697	Fee-for-Service	1598206849	1598206849	1	1	TIWARI, SUBHIKSHYA MD	7/3/2024	207R00000X	NA	Other	026	PHYSICIANS	163820	41	Internal Medicine	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
93698	Fee-for-Service	1801070156	1801070156	1	1	TRUONG, BRIAN MD	2/20/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	101325	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
93714	Fee-for-Service	1629125042	1629125042	1	1	TRZEBINSKA, DANUTA MD	11/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78916	45	Nephrology (Renal-Kidney)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
93742	Fee-for-Service	1396083705	1396083705	1	1	THAI ENTERPRISES INC	4/2/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9814 GARVEY AVE	#24-25	EL MONTE	CA	91733	1290	19	06037	34.06269253	-118.0547955	Los Angeles County
93766	Fee-for-Service	1548400435	1548400435	1	1	TLC XPRESS PHARMACY INC	6/22/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	TLC XPRESS PHARMACY	10810 WARNER AVE	# 3-4	FOUNTAIN VALLEY	CA	92708	3848	30	06059	33.71627054	-117.940176	Orange County
93813	Fee-for-Service	1174601652	1174601652	1	2	THOMAS, BRIAN E MD	12/21/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	87390	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
93830	Fee-for-Service	1962484980	1962484980	1	1	TOWNER, DENA R MD	11/30/1989	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	64636	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
93835	Fee-for-Service	1447873534	1447873534	1	1	TRAN, KIM MD	10/11/2023	390200000X	NA	Other	026	PHYSICIANS	185511	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
93853	Fee-for-Service	1144337403	1144337403	1	1	TABER, REX E MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	92350	36	Psychiatry	0	In state provider	None	4125 BANGS AVENUE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
93858	Fee-for-Service	1427320704	1427320704	1	1	TEHRANI, MICHAEL S	5/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128457	None	None	0	In state provider	None	3610 ATLANTIC AVE	None	LONG BEACH	CA	90807	3418	19	06037	33.822621	-118.185002	Los Angeles County
93864	Fee-for-Service	1003449562	1003449562	1	1	THIND, GURMANN SINGH PT	2/18/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7900 DISTRICT BLVD	C	BAKERSFIELD	CA	93313	4844	15	06029	35.31318383	-119.0908089	Kern County
93923	Fee-for-Service	1740369149	1740369149	1	1	TIFT, MAYSIE LMFT	7/27/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1206 3RD ST STE 4	None	SAN RAFAEL	CA	94901	3048	21	06041	37.97235236	-122.5298814	Marin County
93938	Fee-for-Service	1912919911	1912919911	1	1	TABIBIAZAR, RAMIN MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74833	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA STE 36	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
93940	Fee-for-Service	1720519267	1720519267	1	1	TRANG, TRI M MD	5/4/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169807	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
93941	Fee-for-Service	1811099435	1811099435	1	1	TEARSE, JAMES E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	42953	18	Ophthalmology	0	In state provider	None	801 BREWSTER AVE	STE 150	REDWOOD CITY	CA	94063	1561	41	06081	37.48853111	-122.2341386	San Mateo County
93953	Fee-for-Service	1629185194	1629185194	1	1	TRAUTWEIN, JOHNN G MD	8/26/2004	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
93969	Fee-for-Service	1669477113	1669477113	1	1	THOMAS, THEODORE S MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	61681	41	Internal Medicine	0	In state provider	None	304 IVY ST	None	SAN DIEGO	CA	92101	2030	37	06073	32.72825552	-117.161595	San Diego County
93981	Fee-for-Service	1679006498	1679006498	1	1	TAFOYA, MATTHEW J MD	8/6/2021	207P00000X	NA	Other	026	PHYSICIANS	162978	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
93987	Fee-for-Service	1043766371	1043766371	1	1	THE ROSE OF SHARON 7	12/27/2017	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	23931 WARREN ROAD	None	SAN JACINTO	CA	92582	3795	33	06065	33.773895	-117.037683	Riverside County
94000	Fee-for-Service	1669812392	1669812392	1	1	THE R.O.A.D.S FOUNDATION INC	5/8/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	4800 E LOS COYOTES DIAGO	None	LONG BEACH	CA	90815	2827	19	06037	33.79304077	-118.1378147	Los Angeles County
94010	Fee-for-Service	1457928558	1457928558	1	1	THAI, AMANDA	5/28/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4240 KEARNY MESA RD #101	None	SAN DIEGO	CA	92111	3769	37	06073	32.81857281	-117.1491983	San Diego County
94022	Fee-for-Service	1700849502	1700849502	1	1	THOMAS, COLIN M MD	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	78265	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
94034	Fee-for-Service	1952489544	1952489544	1	1	TANG, THOMAS MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	53292	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
94109	Fee-for-Service	1134619075	1134619075	1	1	TAMIE COLTHARP,APRN	9/6/2021	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	602 INDIANA AVE	None	LUBBOCK	TX	79415	3364	00	None	33.58841999	-101.8880101	Lubbock County
94116	Fee-for-Service	1477787091	1477787091	1	1	TEO, ESTHER HUAH-CHI MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131078	02	General Surgery	0	In state provider	None	3301 C STREET	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
94117	Fee-for-Service	1942348743	1942348743	1	1	TEMPLE GARDEN HOMES	3/3/1995	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5746 LOMA AVE	None	TEMPLE CITY	CA	91780	2452	19	06037	34.10437081	-118.0693595	Los Angeles County
94118	Fee-for-Service	1720258486	1720258486	1	1	TABATABAI, RAMAIN R MD	5/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102726	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
94122	Fee-for-Service	1508616913	1508616913	1	1	TRAN, CINDY L RCP	6/21/2024	2278C0205X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
94131	Fee-for-Service	1902398266	1902398266	1	1	TRIVEDI, ZARANA B DO	1/24/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	23644	30	Radiology	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
94186	Fee-for-Service	1316401151	1316401151	1	1	TRANQUIL HOSPICE, INC	7/15/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	415 E HARVARD ST	SUITE 101C	GLENDALE	CA	91205	1045	19	06037	34.14448348	-118.250604	Los Angeles County
94194	Fee-for-Service	1740227545	1740227545	1	1	TOLWIN PSYCHIATRY MED	12/31/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	3831 HUGHES AVE	STE 506	CULVER CITY	CA	90232	6860	19	06037	34.02243278	-118.3981492	Los Angeles County
94204	Fee-for-Service	1659302677	1659302677	1	1	TARIGHI-SADRIEH, NAHID	10/2/2003	208100000X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ADVANCED REHAB	1321 N HARBOR BLVD	STE 10	FULLERTON	CA	92835	4131	30	06059	33.88346929	-117.9251709	Orange County
94228	Fee-for-Service	1912919911	1912919911	1	1	TABIBIAZAR, RAMIN MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74833	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA STE 36	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
94231	Fee-for-Service	1376081158	1376081158	1	1	TORRES, MARYAN CNP	12/10/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	265 S RANDOLPH AVE	STE 120	BREA	CA	92821	5798	30	06059	33.91513051	-117.8897392	Orange County
94286	Fee-for-Service	1598710782	1598710782	1	1	THAKKAR,JITENDRA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SANFORD CLINIC HOSP	1305 W 18TH ST	None	SIOUX FALLS	SD	57117	5039	00	None	43.535484	-96.7428585	Minnehaha County
94288	Fee-for-Service	1669812392	1669812392	1	1	THE R.O.A.D.S FOUNDATION INC	5/29/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	4800 E LOS COYOTES DIAGO	None	LONG BEACH	CA	90815	2827	19	06037	33.79304077	-118.1378147	Los Angeles County
94299	Fee-for-Service	1316056765	1316056765	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3171 MERIDIAN AVE	None	SAN JOSE	CA	95124	2453	43	06085	37.26831564	-121.9048755	Santa Clara County
94309	Fee-for-Service	1700849502	1700849502	1	1	THOMAS, COLIN M MD	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	78265	38	Geriatrics	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
94318	Fee-for-Service	1891039301	1891039301	1	1	TIESZEN, ALLISON E	8/5/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2702 LOW COURT	None	FAIRFIELD	CA	94534	9771	48	06095	38.23678474	-122.0847463	Solano County
94354	Fee-for-Service	1639602154	1639602154	1	1	TRU VISION LLC	10/4/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4313 MONITOR STREET	None	BAKERSFIELD	CA	93307	4743	15	06029	35.315235	-119.0119095	Kern County
94362	Fee-for-Service	1902923451	1902923451	1	1	THAI, WARREN P MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	108762	41	Internal Medicine	0	In state provider	None	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	18	06035	40.43816059	-120.6279677	Lassen County
94417	Fee-for-Service	1023021839	1023021839	1	1	TITO, DAVID D MD	1/31/1992	207P00000X	NA	Other	026	PHYSICIANS	74773	02	General Surgery	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
94427	Fee-for-Service	1689053720	1689053720	1	1	TAYLOR, NICHOLAS D DO	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16451	41	Internal Medicine	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
94433	Fee-for-Service	1528421724	1528421724	1	1	TWAIN DIALYSIS LLC	10/22/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	38454 5TH ST W	None	PALMDALE	CA	93551	4480	19	06037	34.58067331	-118.1384698	Los Angeles County
94474	Fee-for-Service	1316401151	1316401151	1	1	TRANQUIL HOSPICE, INC	7/15/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	415 E HARVARD ST	SUITE 101C	GLENDALE	CA	91205	1045	19	06037	34.14448348	-118.250604	Los Angeles County
94508	Fee-for-Service	1437624921	1437624921	1	1	THREE RIVERS COUNSELING, A P	11/24/2020	101Y00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1103 BUTTE HOUSE RD	SUITE E	YUBA CITY	CA	95991	3109	51	06101	39.14536728	-121.6306637	Sutter County
94528	Fee-for-Service	1629248109	1629248109	1	2	TEODORO P. NISSEN M.D., INC	1/17/2022	163WX0800X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	651 1ST WEST	STE M	SONOMA	CA	95476	7046	49	06097	38.28938482	-122.4593996	Sonoma County
94532	Fee-for-Service	1679623532	1679623532	1	1	TRUONG, CHAU N OD	2/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
94540	Fee-for-Service	1154399301	1154399301	1	1	TALLMAN,GARRETT J MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	84239	20	Orthopedic Surgery	0	In state provider	None	477 N EL CAMINO REAL	STE A202	ENCINITAS	CA	92024	1350	37	06073	33.05700866	-117.262449	San Diego County
94567	Fee-for-Service	1891870572	1891870572	1	1	TANG, ALVIN MD	11/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81374	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
94572	Fee-for-Service	1962640920	1962640920	1	1	TAYLOR, LISA K MD	2/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	106188	40	Pediatrics	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
94582	Fee-for-Service	1669812392	1669812392	1	1	THE R.O.A.D.S FOUNDATION INC	5/8/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	4800 E LOS COYOTES DIAGO	None	LONG BEACH	CA	90815	2827	19	06037	33.79304077	-118.1378147	Los Angeles County
94625	Fee-for-Service	1962865006	1962865006	1	1	TAGGART, ASHLEY A MD	8/17/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	169222	15	Obstetrics (D.O. only)	0	In state provider	None	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	43	06085	37.39572142	-122.1051204	Santa Clara County
94628	Fee-for-Service	1154458370	1154458370	1	1	TAHA, ASMA A NP	5/10/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
94630	Fee-for-Service	1700081734	1700081734	1	1	TROXELL, DESIREE M LMFT	7/5/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1141 MARSH ST	A	SAN LUIS OBISPO	CA	93401	3323	40	06079	35.28165044	-120.6579807	San Luis Obispo County
94632	Fee-for-Service	1932361904	1932361904	1	1	TEJADA-JITSUYA, ROXANA MD	11/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
94645	Fee-for-Service	1750189643	1750189643	1	1	TAILORED BY TAMI LLC	3/5/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
94770	Fee-for-Service	1245238427	1245238427	1	1	TRENTON MCNEIL WRIGHT M.D.	3/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5475 S 500 E	None	OGDEN	UT	84405	6905	00	None	41.16449014	-111.9686412	Weber County
94778	Fee-for-Service	1093470577	1093470577	1	1	TOLOKNOVA, OLGA PT	1/10/2022	208100000X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	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
94783	Fee-for-Service	1164921763	1164921763	1	1	TANAKCHI, SALLY D MD	6/11/2021	390200000X	NA	Other	026	PHYSICIANS	162048	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
94797	Fee-for-Service	1417184433	1417184433	1	1	TUBBESING, VICTOR A MD	9/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115389	05	Anesthesiology	0	In state provider	None	1801 HANOVER	STE F	DAVIS	CA	95616	1066	57	06113	38.55895232	-121.7567316	Yolo County
94798	Fee-for-Service	1437624921	1437624921	1	1	THREE RIVERS COUNSELING, A P	11/24/2020	101Y00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1103 BUTTE HOUSE RD	SUITE E	YUBA CITY	CA	95991	3109	51	06101	39.14536728	-121.6306637	Sutter County
94813	Fee-for-Service	1427283605	1427283605	1	1	THOMAS R WILLIAMS	12/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
94815	Fee-for-Service	1699884593	1699884593	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	340 WOODSIDE PLZ	None	REDWOOD CITY	CA	94061	3259	41	06081	37.45601505	-122.2288322	San Mateo County
94858	Fee-for-Service	1063892891	1063892891	1	1	THABIT, CHRISTINA S MD	8/1/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	159766	40	Pediatrics	0	In state provider	None	1120 W LA VETA AVE	STE 125	ORANGE	CA	92868	4235	30	06059	33.78029455	-117.864369	Orange County
94860	Fee-for-Service	1962640920	1962640920	1	1	TAYLOR, LISA K MD	2/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	106188	67	Endocrinology	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
94864	Fee-for-Service	1669812392	1669812392	1	1	THE R.O.A.D.S FOUNDATION INC	12/30/2024	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	4800 E LOS COYOTES DIAGO	None	LONG BEACH	CA	90815	2827	19	06037	33.79304077	-118.1378147	Los Angeles County
94882	Fee-for-Service	1285029645	1285029645	1	1	THANARATNAM, PREM N MD	8/7/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	None	None	1	Border provider	None	3001 SAINT ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
94908	Fee-for-Service	1154526523	1154526523	1	1	TEXTER, KAREN 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	555 S 18TH ST	None	COLUMBUS	OH	43205	2654	00	None	39.95323846	-82.9765048	Franklin County
94914	Fee-for-Service	1962865006	1962865006	1	1	TAGGART, ASHLEY A MD	8/17/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	169222	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	43	06085	37.39572142	-122.1051204	Santa Clara County
94915	Fee-for-Service	1841298718	1841298718	1	1	THOMAS, BAHNAM DO	12/21/2023	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	8914	None	None	0	In state provider	None	25150 HANCOCK AVE	STE 206	MURRIETA	CA	92562	5989	33	06065	33.56635084	-117.1823956	Riverside County
94942	Fee-for-Service	1639602154	1639602154	1	2	TRU VISION LLC	4/11/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4825 KENNY STREET	None	BAKERSFIELD	CA	93307	4743	15	06029	35.3107764	-119.0083921	Kern County
94952	Fee-for-Service	1336169580	1336169580	1	1	TAYLOR, MELANIE M MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79630	77	Infectious Disease	0	In state provider	None	20 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.0651473	-118.4458393	Los Angeles County
94972	Fee-for-Service	1508283698	1508283698	1	1	TIP TOP ANESTHESIA GROUP INC	11/12/2020	164W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	725 S ORANGE AVE	None	WEST COVINA	CA	91790	2614	19	06037	34.07079634	-117.9445034	Los Angeles County
95001	Fee-for-Service	1477527398	1477527398	1	1	TEMECULA CA ENDOSCOPY	1/26/2005	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	ASC LP	25150 HANCOCK AVE	STE 208	MURRIETA	CA	92562	5989	33	06065	33.56635084	-117.1823956	Riverside County
95015	Fee-for-Service	1295512077	1295512077	1	1	TOWNSLEY, CYNTHIA	9/9/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	12791 NEWPORT AVENUE	SUITE 101	TUSTIN	CA	92780	2785	30	06059	33.75168784	-117.808677	Orange County
95021	Fee-for-Service	1871081901	1871081901	1	1	TARZI, DAVOOD MD	7/16/2022	390200000X	NA	Other	026	PHYSICIANS	179928	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
95026	Fee-for-Service	1770830325	1770830325	1	10	TWO TREES PHYSICAL THERAPY &	10/10/2023	225100000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	177 NORTH REINO RD	None	NEWBURY PARK	CA	91320	3710	56	06111	34.18076257	-118.9529104	Ventura County
95036	Fee-for-Service	1285712976	1285712976	1	1	TYSON, NICHOLE A MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62283	None	None	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
95038	Fee-for-Service	1144201799	1144201799	1	1	TUNG, KELLY MD	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97602	None	None	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
95050	Fee-for-Service	1912081985	1912081985	1	1	TESSLER SHEVA B MD	1/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74756	40	Pediatrics	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
95057	Fee-for-Service	1104809946	1104809946	2	1	TAN, RAYMOND C MD	4/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73252	30	Radiology	0	In state provider	None	3850 G STREET	None	MERCED	CA	95340	8787	24	06047	37.33931727	-120.4689461	Merced County
95086	Fee-for-Service	1487790143	1487790143	1	1	TOMPKINS, DAVID A MD	2/23/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	149238	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	WARD 93/95	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
95202	Fee-for-Service	1194099432	1194099432	1	1	TRUFFA, LAUREN M NP	8/5/2022	363LN0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
95203	Fee-for-Service	1962865006	1962865006	1	1	TAGGART, ASHLEY A MD	8/17/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	169222	09	Gynecology (D.O. only)	0	In state provider	None	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	43	06085	37.39572142	-122.1051204	Santa Clara County
95214	Fee-for-Service	1346579885	1346579885	1	1	TALOLE, KIRTI S MD	12/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132757	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
95229	Fee-for-Service	1457540049	1457540049	1	1	THORP, WALTER N	4/1/1995	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	382 18TH AVE	None	SAN FRANCISCO	CA	94121	2317	38	06075	37.78082212	-122.4772417	San Francisco County
95240	Fee-for-Service	1205227246	1205227246	2	1	TIN RX THE INDEPENDENT	7/10/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	NETWORK INC	1322 SOLANO ST	None	CORNING	CA	96021	3053	52	06103	39.92792846	-122.1832485	Tehama County
95256	Fee-for-Service	1922103191	1922103191	1	1	TRAM, TRACY MD	6/1/2002	207R00000X	NA	Other	026	PHYSICIANS	61549	41	Internal Medicine	0	In state provider	None	2324 MONTPELIER DR	STE 6	SAN JOSE	CA	95116	1612	43	06085	37.3648224	-121.8481115	Santa Clara County
95262	Fee-for-Service	1003379223	1003379223	1	1	TOUMA, ELIE A DPM	1/27/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1045 E. PENNSYLVANIA AVE	None	ESCONDIDO	CA	92025	4616	37	06073	33.12864423	-117.0681274	San Diego County
95266	Fee-for-Service	1821457318	1821457318	1	1	TENG, JULIE L	8/14/2017	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
95272	Fee-for-Service	1316200777	1316200777	1	1	THAKER, ADARSH M MD	1/2/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	135785	None	None	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
95280	Fee-for-Service	1275893810	1275893810	1	1	TADIARCA, DREW S MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130516	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
95300	Fee-for-Service	1245790682	1245790682	1	1	TRAN, ANH DO	10/11/2022	207R00000X	NA	Other	026	PHYSICIANS	19336	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
95317	Fee-for-Service	1770830325	1770830325	1	10	TWO TREES PHYSICAL THERAPY &	10/14/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	177 NORTH REINO RD	None	NEWBURY PARK	CA	91320	3710	56	06111	34.18076257	-118.9529104	Ventura County
95324	Fee-for-Service	1124021936	1124021936	1	1	TASTO, JAMES P MD	10/18/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	14672	None	None	0	In state provider	None	6719 ALVARADO RD	STE 200	SAN DIEGO	CA	92120	5256	37	06073	32.77684978	-117.055137	San Diego County
95328	Fee-for-Service	1326201872	1326201872	1	1	THACH, TOAN T OD	10/6/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2560 N PERRIS BLVD	None	PERRIS	CA	92571	3249	33	06065	33.819705	-117.2262155	Riverside County
95340	Fee-for-Service	1407165079	1407165079	1	1	TEJADA, RONALD C JR MD	11/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118334	41	Internal Medicine	0	In state provider	None	3300 E SOUTH STREET	SUITE 205	LONG BEACH	CA	90805	4549	19	06037	33.86018093	-118.1537163	Los Angeles County
95345	Fee-for-Service	1104809946	1104809946	2	1	TAN, RAYMOND C MD	4/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73252	78	Neoplastic Diseases/Oncology	0	In state provider	None	3850 G STREET	None	MERCED	CA	95340	8787	24	06047	37.33931727	-120.4689461	Merced County
95353	Fee-for-Service	1124152145	1124152145	1	1	TAKEMOTO, SUNISA	9/27/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
95354	Fee-for-Service	1881801561	1881801561	1	1	TINSAY, GERARD D	6/24/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8250 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5427	19	06037	34.22078654	-118.4326211	Los Angeles County
95421	Fee-for-Service	1043642440	1043642440	1	1	TARIQ, ASMA MD	1/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	202 W WILLOW AVE	STE 502	VISALIA	CA	93291	6268	54	06107	36.328536	-119.293569	Tulare County
95441	Fee-for-Service	1346580537	1346580537	1	1	TILKER, THERESA D LCSW	12/31/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	328 ENCINITAS BLVD	STE 100	ENCINITAS	CA	92024	8704	37	06073	33.04815637	-117.2842827	San Diego County
95456	Fee-for-Service	1417737735	1417737735	1	1	TAITE, NONA M LCSW	12/1/2023	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
95538	Fee-for-Service	1215246160	1215246160	1	1	TUAN MEDICAL CORPORATION	3/8/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80796	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	929 CLAY ST	STE 305	SAN FRANCISCO	CA	94108	1570	38	06075	37.79398652	-122.4083496	San Francisco County
95549	Fee-for-Service	1679964217	1679964217	1	1	TURNER, CHRISTINA OD INC	2/23/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1150 E ARTESIA BLVD	None	LONG BEACH	CA	90805	1555	19	06037	33.87450353	-118.178118	Los Angeles County
95562	Fee-for-Service	1922341841	1922341841	1	1	TALUKDER, IEHAB N MD	8/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148803	05	Anesthesiology	0	In state provider	None	1400 EAST CHURCH STREET	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
95565	Fee-for-Service	1275893810	1275893810	1	1	TADIARCA, DREW S MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130516	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
95605	Fee-for-Service	1770830325	1770830325	1	10	TWO TREES PHYSICAL THERAPY &	4/18/2024	225100000X	NA	Physical Therapist	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	177 NORTH REINO RD	None	NEWBURY PARK	CA	91320	3710	56	06111	34.18076257	-118.9529104	Ventura County
95622	Fee-for-Service	1386960565	1386960565	1	1	TOMPKINS, ROSE MD	8/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142619	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
95638	Fee-for-Service	1447374012	1447374012	1	1	TOIYABE INDIAN HLTH PROJ	8/10/1998	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DIALYSIS CENTER	44 N TU SU LN	None	BISHOP	CA	93514	8058	14	06027	37.3620435	-118.4183033	Inyo County
95640	Fee-for-Service	1225569932	1225569932	1	1	THAKUR, SAUMITRA MD	3/30/2022	208M00000X	NA	Other	026	PHYSICIANS	159488	None	None	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	9411	38	06075	37.78610439	-122.421569	San Francisco County
95649	Fee-for-Service	1417981929	1417981929	1	1	THIBAULT, WILLIAM MD	12/31/1988	174400000X	NA	Other	026	PHYSICIANS	19938	33	Thoracic Surgery	0	In state provider	None	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
95655	Fee-for-Service	1003831041	1003831041	1	1	TAPSCOTT, MARK A DO	10/17/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 RESERVOIR DR	STE 100	SAN DIEGO	CA	92120	5199	37	06073	32.77628471	-117.0563688	San Diego County
95656	Fee-for-Service	1447740824	1447740824	1	4	TRANSGENDER HEALTH AND	11/14/2023	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	340 S FARRELL DRIVE	SUITE A106	PALM SPRINGS	CA	92262	7921	33	06065	33.81788398	-116.5180079	Riverside County
95687	Fee-for-Service	1184733628	1184733628	1	1	THRIFTY DRUG STORE 5770	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	5560 E SANTA ANA CANYON	None	ANAHEIM	CA	92807	3124	30	06059	33.85126322	-117.7919611	Orange County
95708	Fee-for-Service	1013905496	1013905496	1	1	THOMPSON, STEVEN A MD	6/5/1996	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	54654	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10175 LEVONE AVE	None	TRUCKEE	CA	96161	4821	29	06057	39.32413811	-120.2000473	Nevada County
95757	Fee-for-Service	1629244850	1629244850	1	1	TELISCHAK, NICHOLAS A MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	109575	30	Radiology	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
95769	Fee-for-Service	1528262854	1528262854	1	1	TRAN, LILLY A MD	12/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65733	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
95818	Fee-for-Service	1487637260	1487637260	1	1	TROKEL, MATTHEW MD	10/17/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160123	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
95834	Fee-for-Service	1619106747	1619106747	1	1	TARZANA TREATMENT CENTERS	8/30/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	44443 N 10TH STREET WEST	SUITE A	LANCASTER	CA	93534	3346	19	06037	34.69074211	-118.1480945	Los Angeles County
95850	Fee-for-Service	1114554052	1114554052	1	1	TOOR, JASMINE K MD	5/7/2024	207R00000X	NA	Other	026	PHYSICIANS	185807	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
95864	Fee-for-Service	1811942204	1811942204	1	1	TOBIN-WILLIAMS, ALICIA	2/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92932	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3581 PALMER DR	STE 608	CAMERON PARK	CA	95682	8238	09	06017	38.66109103	-120.9649544	El Dorado County
95876	Fee-for-Service	1982771804	1982771804	1	1	TOWNE, TAMAR J MD	3/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68615	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
95910	Fee-for-Service	1386960565	1386960565	1	1	TOMPKINS, ROSE MD	8/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142619	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
95916	Fee-for-Service	1114959228	1114959228	1	1	TAM, STEVEN P MD	7/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94307	41	Internal Medicine	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
95928	Fee-for-Service	1326095431	1326095431	1	1	TAKSH, UQBAH MD	10/15/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	101085	36	Psychiatry	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
95942	Fee-for-Service	1003831041	1003831041	1	1	TAPSCOTT, MARK A DO	10/17/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	28	Proctology (colon and rectal)	0	In state provider	None	5555 RESERVOIR DR	STE 100	SAN DIEGO	CA	92120	5199	37	06073	32.77628471	-117.0563688	San Diego County
95957	Fee-for-Service	1033775192	1033775192	1	1	TOOR, AMRIT K MD	9/7/2022	207P00000X	NA	Other	026	PHYSICIANS	180064	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1450 TREAT BLVD	STE 160	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
95975	Fee-for-Service	1043304017	1043304017	1	1	TARSHIS, THOMAS P MD	4/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81257	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
95978	Fee-for-Service	1225611312	1225611312	1	1	TPIRC MEDICAL FOUNDATION INC	10/18/2022	207K00000X	NA	Other	022	PHYSICIANS GROUP	-	43	Pediatric Allergy	0	In state provider	None	701 E 28TH ST	419	LONG BEACH	CA	90806	2775	19	06037	33.80803441	-118.1847137	Los Angeles County
95985	Fee-for-Service	1528178803	1528178803	1	1	TORREY, ROBERT R JR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34160	None	None	0	In state provider	INC	345 TERRACINA BLVD	None	REDLANDS	CA	92373	4829	36	06071	34.03724677	-117.2046271	San Bernardino County
96026	Fee-for-Service	1093428708	1093428708	1	1	TORRES, ANGELINA	1/21/2025	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1742 OREGON STREET	None	REDDING	CA	96001	1717	45	06089	40.5808265	-122.3932989	Shasta County
96029	Fee-for-Service	1770830325	1770830325	1	8	TWO TREES PHYSICAL THERAPY &	10/10/2023	225100000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	24 E MAIN ST	None	VENTURA	CA	93001	2660	56	06111	34.28096357	-119.3003485	Ventura County
96030	Fee-for-Service	1760689715	1760689715	1	2	TOTALCARE WALK-IN CLINIC INC	5/30/2018	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	13334 LIMONITE AVE.	130	EASTVALE	CA	92880	7257	33	06065	33.97534752	-117.5738985	Riverside County
96031	Fee-for-Service	1063610566	1063610566	1	1	THOMPSON, TERRI L PHD	7/9/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
96038	Fee-for-Service	1629246228	1629246228	1	1	TILY, HAJRA I MD	8/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98974	41	Internal Medicine	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
96042	Fee-for-Service	1558836999	1558836999	1	1	TRINIDAD, EARL	8/14/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	41540 WINCHESTER	None	TEMECULA	CA	92590	4877	33	06065	33.52069117	-117.1653103	Riverside County
96063	Fee-for-Service	1790740363	1790740363	1	1	TEXAS COUNTY MEMORIAL HOSPIT	9/19/2006	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	AL	1333 S SAM HOUSTON BLVD	None	HOUSTON	MO	65483	2046	00	None	37.3158798	-91.95950676	Texas County
96071	Fee-for-Service	1740368521	1740368521	1	1	TANG, MING-CHIEN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33132	05	Anesthesiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
96096	Fee-for-Service	1902853187	1902853187	1	1	TODD KIHNE MD	3/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4801 W 81ST ST	STE 108	MINNEAPOLIS	MN	55437	1111	00	None	44.85623947	-93.34035	Hennepin County
96101	Fee-for-Service	1295805133	1295805133	1	1	TAHMASSIAN, HARMIK PHD	11/27/2007	103TB0200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	415 WEST ROUTE 66	SUITE 202	GLENDORA	CA	91704	4335	19	06037	34.12883848	-117.869958	Los Angeles County
96130	Fee-for-Service	1588742191	1588742191	1	1	TOM, DENNIS MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62922	40	Pediatrics	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
96136	Fee-for-Service	1063034130	1063034130	1	1	TURNING POINT COMMUNITY PROG	4/30/2024	320800000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	VIKING DRIVE	10850 GOLD CENTER DR	STE 325	RANCHO CORDOVA	CA	95670	6177	34	06067	38.590353	-121.282488	Sacramento County
96140	Fee-for-Service	1518205871	1518205871	1	1	TRI VALLEY HOSPICE CARE INC	7/31/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10120 CANOGA AVENUE	STE 100	CANOGA PARK	CA	91311	3005	19	06037	34.2541661	-118.5972507	Los Angeles County
96172	Fee-for-Service	1114121746	1114121746	1	1	TIMM, DAVID MD	4/23/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	119982	30	Radiology	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
96175	Fee-for-Service	1851932321	1851932321	1	1	TREANOR, KAYLA NP	9/14/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3160 FOLSOM BLVD.	STE 1400	SACRAMENTO	CA	91816	5219	34	06067	38.568393	-121.4658585	Sacramento County
96198	Fee-for-Service	1386960565	1386960565	1	1	TOMPKINS, ROSE MD	8/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142619	01	General Practice	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
96232	Fee-for-Service	1003831041	1003831041	1	1	TAPSCOTT, MARK A DO	10/17/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	5555 RESERVOIR DR	STE 100	SAN DIEGO	CA	92120	5199	37	06073	32.77628471	-117.0563688	San Diego County
96243	Fee-for-Service	1710450143	1710450143	1	1	TIPTON ANESTHESIA, A PROFESS	6/23/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	IONAL ANESTHESIA NURSING	825 DELBON	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
96259	Fee-for-Service	1962685966	1962685966	1	1	TWEETY FAMILY CLINIC INC	1/22/2008	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	3050 TWEETY BLVD	None	SOUTH GATE	CA	90280	5742	19	06037	33.9453691	-118.2169795	Los Angeles County
96313	Fee-for-Service	1770830325	1770830325	1	8	TWO TREES PHYSICAL THERAPY &	4/18/2024	225100000X	NA	Physical Therapist	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	24 E MAIN ST	None	VENTURA	CA	93001	2660	56	06111	34.28096357	-119.3003485	Ventura County
96325	Fee-for-Service	1629246228	1629246228	1	1	TILY, HAJRA I MD	8/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98974	83	Rheumatology	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
96351	Fee-for-Service	1790740363	1790740363	1	1	TEXAS COUNTY MEMORIAL HOSPIT	5/18/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	AL	1333 S SAM HOUSTON BLVD	None	HOUSTON	MO	65483	2046	00	None	37.3158798	-91.95950676	Texas County
96360	Fee-for-Service	1417485889	1417485889	1	6	TRANSIT PHYSICAL THERAPY PC	1/9/2024	261QP2000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LANE	100	SAN BERNARDINO	CA	92408	3238	36	06071	34.0659135	-117.289215	San Bernardino County
96372	Fee-for-Service	1427022094	1427022094	1	1	TANTOD, BHAKTI D MD	9/15/2008	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	89134	01	General Practice	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
96375	Fee-for-Service	1942358395	1942358395	1	1	TAMBORNINI, GLYNIS	2/8/2015	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	730 S DORA ST	None	UKIAH	CA	95482	5336	23	06045	39.14356221	-123.2110268	Mendocino County
96382	Fee-for-Service	1972783652	1972783652	1	1	THOMPSON, ZACHARY M MD	7/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97895	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
96430	Fee-for-Service	1518205871	1518205871	1	1	TRI VALLEY 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	10120 CANOGA AVENUE	STE 100	CANOGA PARK	CA	91311	3005	19	06037	34.2541661	-118.5972507	Los Angeles County
96486	Fee-for-Service	1346582426	1346582426	1	1	TRUONG, ANHDAO N DO	11/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13650	01	General Practice	0	In state provider	None	250 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
96515	Fee-for-Service	1891252318	1891252318	1	1	THOMPSON, STACY L NP	6/22/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2185 CITRACADO PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
96532	Fee-for-Service	1427078039	1427078039	1	1	TERRITO, MARY C MD	1/1/1995	207RH0003X	NA	Oncology	026	PHYSICIANS	34130	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	UCLA PROF SVCS OFF	10833 LE CONTE AVE	# 32220	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
96541	Fee-for-Service	1346027968	1346027968	1	1	TSUMA, REBECCA MWANDA	9/26/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	20 DIANE CT	None	OAKLEY	CA	94561	2786	07	06013	37.97541331	-121.6873265	Contra Costa County
96592	Fee-for-Service	1588984785	1588984785	1	1	TRAN, ANH THU T MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131534	13	Neurology (M.D. only)	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5315	19	06037	34.06269295	-118.2030006	Los Angeles County
96602	Fee-for-Service	1770830325	1770830325	1	8	TWO TREES PHYSICAL THERAPY &	5/17/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	24 E MAIN ST	None	VENTURA	CA	93001	2660	56	06111	34.28096357	-119.3003485	Ventura County
96651	Fee-for-Service	1417485889	1417485889	1	6	TRANSIT PHYSICAL THERAPY PC	2/19/2025	261QP2000X	NA	Physical Therapist	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LANE	100	SAN BERNARDINO	CA	92408	3238	36	06071	34.0659135	-117.289215	San Bernardino County
96685	Fee-for-Service	1750302899	1750302899	1	1	TIRPAK, JULIA M LMFT	9/17/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVENUE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
96730	Fee-for-Service	1265718555	1265718555	1	1	TSOBANOUDIS, KATHERINE T	1/29/2016	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
96747	Fee-for-Service	1124090576	1124090576	1	1	TABAK, STEVEN MD	1/1/1983	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	37598	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8635 W 3RD STREET	None	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
96752	Fee-for-Service	1548233497	1548233497	1	1	TREVE HENWOOD	9/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 E 3RD ST	None	DELTA	CO	81416	2815	00	None	38.74319827	-108.0470522	Delta County
96764	Fee-for-Service	1972528016	1972528016	2	1	TO, AN NGOC MD	7/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	36399	08	Family Practice	0	In state provider	None	87 N 6TH STREET	None	SAN JOSE	CA	95112	5423	43	06085	37.33991817	-121.8862077	Santa Clara County
96779	Fee-for-Service	1396132452	1396132452	1	1	TABOREK, ALEXANDER P MD	11/5/2019	207L00000X	NA	Other	026	PHYSICIANS	144969	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
96828	Fee-for-Service	1346027968	1346027968	1	1	TSUMA, REBECCA MWANDA	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	20 DIANE CT	None	OAKLEY	CA	94561	2786	07	06013	37.97541331	-121.6873265	Contra Costa County
96863	Fee-for-Service	1194736660	1194736660	1	1	THRIFTY PAYLESS INC	1/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5571	935 N HOLLYWOOD WAY	None	BURBANK	CA	91505	2816	19	06037	34.1675748	-118.3468966	Los Angeles County
96910	Fee-for-Service	1255886826	1255886826	1	1	TAMASHIRO, JESSICA J CCC-SLP	11/19/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
96934	Fee-for-Service	1417485889	1417485889	1	6	TRANSIT PHYSICAL THERAPY PC	3/3/2023	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	275 W HOSPITALITY LANE	100	SAN BERNARDINO	CA	92408	3238	36	06071	34.0659135	-117.289215	San Bernardino County
96941	Fee-for-Service	1215189220	1215189220	1	1	TENORIO, MELINDA M	10/23/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EGDEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
96948	Fee-for-Service	1396880498	1396880498	1	1	THOMMAN, SANJU K MD	4/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	56018	01	General Practice	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
96956	Fee-for-Service	1043538150	1043538150	1	1	TORRES, EDGAR L MD	6/19/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	173179	None	None	0	In state provider	None	47647 CALEO BAY DR	230	LA QUINTA	CA	92253	8859	33	06065	33.70305235	-116.2936509	Riverside County
97025	Fee-for-Service	1407336019	1407336019	1	1	TAHA, SARAH LCSW	1/16/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23121 VERDUGO DRIVE	SUITE 105	LAGUNA HILLS	CA	92653	1003	30	06059	33.62655523	-117.7292097	Orange County
97030	Fee-for-Service	1124408794	1124408794	1	1	TABI, MA ZARA EMILIA M MD	10/1/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	171498	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
97032	Fee-for-Service	1669454294	1669454294	1	1	THOMAS J METCALF MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	UNIVERSITY OF UTAH	50 N MEDICAL DR	None	SALT LAKE CITY	UT	84132	0100	00	None	40.77197161	-111.8352608	Salt Lake County
97040	Fee-for-Service	1467818583	1467818583	1	1	THE CHILDRENS CLINIC	8/22/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1301 WEST 12TH STREET	None	LONG BEACH	CA	90813	2720	19	06037	33.78201945	-118.2088381	Los Angeles County
97084	Fee-for-Service	1720405491	1720405491	1	2	TIBURCIO VASQUEZ HEALTH	10/19/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	16110 E 14TH ST	None	SAN LEANDRO	CA	94578	3002	01	06001	37.6977026	-122.1176484	Alameda County
97120	Fee-for-Service	1013076637	1013076637	1	1	THIO, SHELLY C MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61027	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
97136	Fee-for-Service	1275607350	1275607350	1	1	TAPADIYA, DILIP MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	36858	20	Orthopedic Surgery	0	In state provider	None	11170 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	4013	30	06059	33.71631952	-117.9332325	Orange County
97148	Fee-for-Service	1316444896	1316444896	1	1	TRAN, JOHN MD	4/29/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164866	None	None	0	In state provider	None	6000 SEPULVEDA BLVD	E10	CULVER CITY	CA	90230	6421	19	06037	33.985512	-118.393524	Los Angeles County
97161	Fee-for-Service	1801135702	1801135702	1	1	TANCHOCO CHILDREN AND	8/29/2014	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	106359	40	Pediatrics	0	In state provider	ADOLESCENT CLINIC INC	1535 W MERCED AVE	SUITE 306	WEST COVINA	CA	91790	3417	19	06037	34.06295577	-117.9482872	Los Angeles County
97233	Fee-for-Service	1629429535	1629429535	1	1	TAICH, MARLI F NP	7/6/2020	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
97296	Fee-for-Service	1528072527	1528072527	1	1	TIPTON MEDICAL CLINIC	9/30/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	565 N THOMPSON RD	None	TIPTON	CA	93272	9756	54	06107	36.06373491	-119.3121874	Tulare County
97303	Fee-for-Service	1659696128	1659696128	1	1	TESHIMA, DARREN L MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119251	41	Internal Medicine	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
97309	Fee-for-Service	1215203534	1215203534	1	1	TOPPING, KATIE L MD	7/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143601	18	Ophthalmology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
97327	Fee-for-Service	1467818583	1467818583	1	1	THE CHILDRENS CLINIC	8/22/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1301 WEST 12TH STREET	None	LONG BEACH	CA	90813	2720	19	06037	33.78201945	-118.2088381	Los Angeles County
97340	Fee-for-Service	1134484850	1134484850	1	1	TSENG, YU-TZU MD	10/28/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	137132	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
97363	Fee-for-Service	1972532042	1972532042	1	1	TOSCANO, EDGAR P MD	8/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80296	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
97383	Fee-for-Service	1962934042	1962934042	1	1	TRAN-MCCASLIN, MARIE CHANTAL	6/19/2019	363AS0400X	NA	Physician Assistant	026	PHYSICIANS	None	None	None	0	In state provider	MD	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
97400	Fee-for-Service	1598797094	1598797094	1	1	TENET HEALTHSYSTEM SL	1/3/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3635 VISTA AVE	None	ST LOUIS	MO	63110	2539	00	None	38.62249413	-90.23900688	St. Louis city
97421	Fee-for-Service	1750490132	1750490132	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	18993 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	2942	19	06037	33.98767704	-117.8912613	Los Angeles County
97424	Fee-for-Service	1275607350	1275607350	1	1	TAPADIYA, DILIP MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	36858	02	General Surgery	0	In state provider	None	11170 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	4013	30	06059	33.71631952	-117.9332325	Orange County
97451	Fee-for-Service	1699078006	1699078006	1	1	TAHVILIAN, SHAHROUZ MD	5/14/2018	No Taxonomy Provided	NA	None	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
97528	Fee-for-Service	1538247002	1538247002	1	1	TINTOC, EVELYN L MMD	3/31/1995	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	46689	None	None	0	In state provider	None	3811 VISTA AZUL	None	SAN CLEMENTE	CA	92672	4543	30	06059	33.40022161	-117.599978	Orange County
97536	Fee-for-Service	1972612463	1972612463	1	1	THRIFTY PAYLESS INC	9/13/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6037	1500 ANNA SPARKS WAY	STE D	MCKINLEYVILLE	CA	95519	4170	12	06023	40.93283053	-124.101351	Humboldt County
97562	Fee-for-Service	1104003078	1104003078	1	1	THOMAS, SHELLEY P	4/1/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23470 OLIVE WOOD PLAZA D	SUITE 110	MORENO VALLEY	CA	92553	5264	33	06065	33.94013493	-117.2532525	Riverside County
97583	Fee-for-Service	1528072527	1528072527	1	1	TIPTON MEDICAL CLINIC	9/30/2003	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	565 N THOMPSON RD	None	TIPTON	CA	93272	9756	54	06107	36.06373491	-119.3121874	Tulare County
97654	Fee-for-Service	1194882886	1194882886	1	1	THOMAS, KIELY PHD	12/12/2017	No Taxonomy Provided	NA	None	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
97664	Fee-for-Service	1245675552	1245675552	1	1	TURKEN, MICHAEL A MD	7/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133793	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
97687	Fee-for-Service	1598797094	1598797094	1	1	TENET HEALTHSYSTEM SL	1/3/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3635 VISTA AVE	None	ST LOUIS	MO	63110	2539	00	None	38.62249413	-90.23900688	St. Louis city
97690	Fee-for-Service	1467468751	1467468751	1	1	THRIFTY PAYLESS INC	5/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5893	2150 ROOSEVELT AVE	None	REDWOOD CITY	CA	94061	1304	41	06081	37.46587048	-122.2418779	San Mateo County
97706	Fee-for-Service	1578522462	1578522462	1	1	TAN, DORIS T DO	2/28/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	7928	-	NOT APPLICABLE	0	In state provider	None	2550 WEST CLINTON AVENUE	None	FRESNO	CA	93705	4201	10	06019	36.77202022	-119.8415276	Fresno County
97710	Fee-for-Service	1295821445	1295821445	1	1	TANG, JOSPHINE A MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	64984	41	Internal Medicine	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
97712	Fee-for-Service	1376639583	1376639583	1	1	TADLOCK, DEON L MD	2/4/2005	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	73693	08	Family Practice	0	In state provider	None	605 NEW YORK RANCH RD	None	JACKSON	CA	95642	9328	03	06005	38.36077733	-120.7651246	Amador County
97817	Fee-for-Service	1679626220	1679626220	1	1	TRAN, STEVEN N OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
97836	Fee-for-Service	1538265780	1538265780	1	3	TAHOE FOREST HOSP DIST	6/4/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS RD	SUITE 130	TRUCKEE	CA	96161	4871	29	06057	39.32625521	-120.2012059	Nevada County
97844	Fee-for-Service	1215301783	1215301783	1	1	TSENG, CASSIE OT	2/22/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12761 SCHABARUM AVE	None	BALDWIN PARK	CA	91706	6807	19	06037	34.08060971	-117.9958001	Los Angeles County
97857	Fee-for-Service	1528699147	1528699147	1	1	TORRES, ERIKA D CNP	4/26/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1900 19TH AVE	None	SAN FRANCISCO	CA	94116	1250	38	06075	37.75211157	-122.4762664	San Francisco County
97872	Fee-for-Service	1609029206	1609029206	1	1	TAGGART, DENAH R MD	10/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91276	78	Neoplastic Diseases/Oncology	0	In state provider	None	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
97906	Fee-for-Service	1861566820	1861566820	1	1	TLCS INC	12/11/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	650 HOWE AVE	BLDG 400	SACRAMENTO	CA	95825	4731	34	06067	38.577294	-121.4146395	Sacramento County
97910	Fee-for-Service	1669650925	1669650925	1	2	TA, JOSEPH Q MD	5/13/2013	163WX0601X	NA	Other	026	PHYSICIANS	94818	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
97924	Fee-for-Service	1578520151	1578520151	2	1	TRUONG, HIEP MD	5/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	45852	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	15975 HARBOR BOULEVARD	None	FOUNTAIN VALLEY	CA	92708	1303	30	06059	33.73140379	-117.9200162	Orange County
97969	Fee-for-Service	1891804340	1891804340	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5984	6091 MERIDIAN AVE	None	SAN JOSE	CA	95120	2765	43	06085	37.22954212	-121.8842271	Santa Clara County
97981	Fee-for-Service	1205861549	1205861549	1	1	TRINH, THANH-MAI MD INC	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60206	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10212 WESTMINSTER AVENUE	#114	GARDEN GROVE	CA	92843	4800	30	06059	33.75947657	-117.9513797	Orange County
97989	Fee-for-Service	1114038403	1114038403	1	1	TALMAGE, MARK D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	875 S COLORADO BLVD	STE 653	DENVER	CO	80246	8016	00	None	39.701043	-104.940809	Denver County
97999	Fee-for-Service	1225204928	1225204928	1	1	TRUOUNG, JACK Q DC	8/22/2008	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	8788 ELK GROVE BLDG	STE F	ELK GROVE	CA	95624	1766	34	06067	38.408382	-121.3770645	Sacramento County
98021	Fee-for-Service	1073651444	1073651444	1	1	TSAI, YUHJUNG J MD	11/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	85657	41	Internal Medicine	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
98063	Fee-for-Service	1770830325	1770830325	1	1	TWO TREES PHYSICAL THERAPY &	2/2/2017	152W00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS INC	3418 LOMA VISTA RD	A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
98068	Fee-for-Service	1184633638	1184633638	1	1	TSAI, LILY J MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109827	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3811 VALLEY CENTRE DRIVE	None	SAN DIEGO	CA	92130	3318	37	06073	32.93760492	-117.2320932	San Diego County
98110	Fee-for-Service	1134318942	1134318942	1	1	TROESTER, MATTHEW M DO	8/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	79	Neurology-Child	2	Out of state provider	None	1919 E THOMAS ROAD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
98140	Fee-for-Service	1326782608	1326782608	1	1	TAULBEE, KORTNI B LCSW	10/4/2023	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
98161	Fee-for-Service	1609029206	1609029206	1	1	TAGGART, DENAH R MD	10/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91276	68	Hematology	0	In state provider	None	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
98167	Fee-for-Service	1831267384	1831267384	1	1	TAMAYO, BULMARO LCSW	12/30/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
98176	Fee-for-Service	1497786289	1497786289	1	1	TRUONG, TRUC HUY MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63392	30	Radiology	0	In state provider	None	1250 S SUNSET AVE	STE 101	WEST COVINA	CA	91790	3900	19	06037	34.0610671	-117.9463685	Los Angeles County
98204	Fee-for-Service	1194949818	1194949818	1	1	TRAN, TONY H MD	5/18/2008	207P00000X	NA	Other	026	PHYSICIANS	101828	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10362 BOLSA AVENUE	SUITE 110	WESTMINSTER	CA	92683	6763	30	06059	33.74488248	-117.94806	Orange County
98206	Fee-for-Service	1164035572	1164035572	1	1	THE PALMDALE AEROSPACE	1/1/2021	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	ACADEMY	3300 E PALMDALE BLVD	None	PALMDALE	CA	93550	5036	19	06037	34.58017948	-118.0696455	Los Angeles County
98239	Fee-for-Service	1356529473	1356529473	1	1	TEE, SILVIA MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101139	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
98257	Fee-for-Service	1659042893	1659042893	1	1	TOWNS HEALTH SERVICES, INC.	3/22/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	330 S FAIRMONT AVE , 2	400 S FAIRMONT AVE	LODI	CA	95240	3843	39	06077	38.12892266	-121.2858458	San Joaquin County
98267	Fee-for-Service	1356313993	1356313993	1	1	TOBY FREE M.D.	8/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKRA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
98297	Fee-for-Service	1124162318	1124162318	1	1	TRAN, AN OPTOMETRIC INC	5/23/2006	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	KATELLA OPTOMETRIC CTR	9896 KATELLA AVE	STE B	ANAHEIM	CA	92804	6418	30	06059	33.80304606	-117.9614659	Orange County
98351	Fee-for-Service	1770830325	1770830325	1	1	TWO TREES PHYSICAL THERAPY &	2/2/2017	152W00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS INC	3418 LOMA VISTA RD	A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
98359	Fee-for-Service	1659613941	1659613941	1	1	TALIAFERRO, KEVIN M MD	7/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156234	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
98393	Fee-for-Service	1992999817	1992999817	1	1	TAKENISHI, GREG S MD	10/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110367	20	Orthopedic Surgery	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
98443	Fee-for-Service	1487748430	1487748430	1	1	TAMAYO, MAITHE F MD	3/29/2005	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	80504	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
98449	Fee-for-Service	1609029206	1609029206	1	1	TAGGART, DENAH R MD	10/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91276	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
98492	Fee-for-Service	1194949818	1194949818	1	1	TRAN, TONY H MD	5/18/2008	207P00000X	NA	Other	026	PHYSICIANS	101828	01	General Practice	0	In state provider	None	10362 BOLSA AVENUE	SUITE 110	WESTMINSTER	CA	92683	6763	30	06059	33.74488248	-117.94806	Orange County
98514	Fee-for-Service	1588018584	1588018584	1	1	THIESSEN, BRIANNA L DO	8/17/2023	207P00000X	NA	Other	026	PHYSICIANS	20763	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
98540	Fee-for-Service	1295819621	1295819621	1	1	THORN, TRENTEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3460 S PIONEER PRKWY	None	WEST VALLEY CITY	UT	84120	2049	00	None	40.697982	-111.9903965	Salt Lake County
98544	Fee-for-Service	1215219183	1215219183	1	1	TOWER FOOT & ANKLE SURGERY,	3/1/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	INC	2080 CENTURY PARK E	SUITE 1508	LOS ANGELES	CA	90067	2001	19	06037	34.05887194	-118.4122914	Los Angeles County
98604	Fee-for-Service	1699726190	1699726190	1	1	TOMA, MAGED A MD	7/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89472	08	Family Practice	0	In state provider	None	12370 HESPERIA RD	STE 15	VICTORVILLE	CA	92395	5808	36	06071	34.47625382	-117.2913208	San Bernardino County
98637	Fee-for-Service	1770830325	1770830325	1	1	TWO TREES PHYSICAL THERAPY &	2/2/2017	152W00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	WELLNESS INC	3418 LOMA VISTA RD	A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
98654	Fee-for-Service	1194387373	1194387373	1	1	TAYLOR, TIMOTHY M NP	10/16/2024	363L00000X	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
98681	Fee-for-Service	1013900281	1013900281	1	1	TIPPIN, DOUGLAS B MD	5/21/2020	2085R0001X	NA	Other	026	PHYSICIANS	154753	32	Radiation Therapy (D.O. only)	0	In state provider	None	959 LANE AVE	None	CHULA VISTA	CA	91914	4528	37	06073	32.6508918	-116.9614999	San Diego County
98694	Fee-for-Service	1275066243	1275066243	1	1	TIZRO, PARASTOU MD	4/29/2022	207ZP0102X	NA	Other	026	PHYSICIANS	171282	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
98732	Fee-for-Service	1518196401	1518196401	1	1	TUSZYNSKI, ANN E LCSW	10/12/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	28737	-	NOT APPLICABLE	0	In state provider	None	315 TURK STREET	None	SAN FRANCISCO	CA	94102	3709	38	06075	37.78272091	-122.4143755	San Francisco County
98735	Fee-for-Service	1528051489	1528051489	1	1	TREVINO DELACHAUMIERE, ESTHE	1/2/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19343 HIGHWAY 12	None	SONOMA	CA	95476	5445	49	06097	38.29685371	-122.4755114	Sonoma County
98782	Fee-for-Service	1235619685	1235619685	1	1	TAM, SHANNON NP	1/1/2023	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
98802	Fee-for-Service	1801996640	1801996640	1	1	THAKKAR, MEHUL A MD	2/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	55478	41	Internal Medicine	0	In state provider	None	5525 ETIWANDA AVE	SUITE 320	TARZANA	CA	91356	3647	19	06037	34.17046451	-118.5308463	Los Angeles County
98816	Fee-for-Service	1013909407	1013909407	1	1	TSAI, ISAAC K MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	39031	41	Internal Medicine	0	In state provider	None	341 MAGNOLIA AVE	STE 205	CORONA	CA	92879	3332	33	06065	33.85291987	-117.5664344	Riverside County
98822	Fee-for-Service	1124299839	1124299839	1	1	TAGUCHI, NAHO MD	5/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109251	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
98849	Fee-for-Service	1972029122	1972029122	1	1	TOWNSELL, ANIA C PSYD	8/30/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
98877	Fee-for-Service	1437440013	1437440013	1	1	TEH, JIAH SHIN MD	9/16/2019	207K00000X	NA	Other	026	PHYSICIANS	146583	03	Allergy	0	In state provider	None	27303 SLEEPY HOLLOW	None	HAYWARD	CA	94545	4203	01	06001	37.63208871	-122.0939191	Alameda County
98878	Fee-for-Service	1508222977	1508222977	1	1	TEGELER, HEATHER N LMFT	12/8/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
98907	Fee-for-Service	1467781179	1467781179	1	1	TOTAL RENAL CARE INC	4/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	970 ENCHANTED WAY	None	SIMI VALLEY	CA	93065	0953	56	06111	34.28356727	-118.7826844	Ventura County
98950	Fee-for-Service	1114504321	1114504321	1	1	TSAI, ALEX DO	7/15/2023	207P00000X	NA	Other	026	PHYSICIANS	21076	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
99075	Fee-for-Service	1811360332	1811360332	1	1	THRIFTY PAYLESS INC	11/21/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	150 W KERN AVE	None	MCFARLAND	CA	93250	1349	15	06029	35.67806651	-119.2285935	Kern County
99105	Fee-for-Service	1013909407	1013909407	1	1	TSAI, ISAAC K MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	39031	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	341 MAGNOLIA AVE	STE 205	CORONA	CA	92879	3332	33	06065	33.85291987	-117.5664344	Riverside County
99214	Fee-for-Service	1407938111	1407938111	1	1	THE MEDFORD RADIOLOGICAL	5/24/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	1	Border provider	GROUP	842 E MAIN ST	None	MEDFORD	OR	97504	7155	00	None	42.32787853	-122.863311	Jackson County
99259	Fee-for-Service	1144336090	1144336090	1	1	TRUONG, THONG VAN DPM	12/1/2000	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	670 RIO LINDO AVE	STE 1000	CHICO	CA	95926	1832	04	06007	39.75339021	-121.847691	Butte County
99264	Fee-for-Service	1841380201	1841380201	1	1	THOMAS, CHANDRA A LMFT	3/1/2024	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
99298	Fee-for-Service	1699786400	1699786400	1	1	TERTZAKIAN, GARO MD	4/4/1977	204F00000X	NA	General Surgery	026	PHYSICIANS	37346	34	Urology and Urological Surgery	0	In state provider	None	2617 E CHAPMAN AVE	STE 111	ORANGE	CA	92869	3231	30	06059	33.7878445	-117.8254845	Orange County
99303	Fee-for-Service	1447311899	1447311899	1	1	TREGER, PAUL L MD	9/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	160 E ARTESIA ST	STE 120	POMONA	CA	91767	2920	19	06037	34.07556833	-117.7507835	Los Angeles County
99311	Fee-for-Service	1043977945	1043977945	1	1	TRUE ESCAPE MARRIAGE AND FAM	12/16/2021	251K00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ILY THERAPY,	13261 SPRING VALLEY PKWY	SUITE 203	VICTORVILLE	CA	92395	5132	36	06071	34.49232827	-117.2686243	San Bernardino County
99344	Fee-for-Service	1528003779	1528003779	1	1	TSAI, JEFFREY MD	3/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97123	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1050 LINDEN AVE	None	LONG BEACH	CA	90813	3393	19	06037	33.78003775	-118.1866604	Los Angeles County
99427	Fee-for-Service	1699957688	1699957688	1	1	TURAY, DAVID MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101830	02	General Surgery	0	In state provider	None	11370 ANDERSON STREET	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
99434	Fee-for-Service	1922157452	1922157452	1	1	TANN, JOSHUA H LMFT	8/27/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
99436	Fee-for-Service	1932498136	1932498136	1	1	TAMBAR, ASHISH MD	5/14/2018	2084P0804X	NA	Psychiatry	026	PHYSICIANS	151648	26	Psychiatry (child)	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
99468	Fee-for-Service	1679197792	1679197792	1	1	TRUONG, PEGGY OT	8/3/2020	225XP0019X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
99554	Fee-for-Service	1053420414	1053420414	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	921 S BROOKHURST ST	None	ANAHEIM	CA	92804	4385	30	06059	33.819228	-117.958966	Orange County
99565	Fee-for-Service	1538168950	1538168950	1	1	THE ELIZABETH HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	500 LA TERRAZA BLVD	SUITE 130	ESCONDIDO	CA	92025	3876	37	06073	33.11238641	-117.096444	San Diego County
99574	Fee-for-Service	1952581084	1952581084	1	1	TERRILL, RUSSELL T	12/3/2007	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4677 VALLEY EAST BLVD	STE 2	ARCATA	CA	95521	4630	12	06023	40.90085428	-124.0816212	Humboldt County
99635	Fee-for-Service	1851611354	1851611354	1	1	TANG, TAYLOR H MD	7/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	111977	02	General Surgery	0	In state provider	None	1310 W STEWART DRIVE	SUITE 503	ORANGE	CA	92868	3856	30	06059	33.78236048	-117.8664975	Orange County
99650	Fee-for-Service	1083639496	1083639496	1	1	TANIHANA, JAMI H	1/22/1985	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	14427 CHASE ST	STE 103	PANORAMA CITY	CA	91402	3020	19	06037	34.22477664	-118.4478733	Los Angeles County
99651	Fee-for-Service	1992863138	1992863138	1	1	TRIANA, ANA C MD	8/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137112	01	General Practice	0	In state provider	None	1450 TREAT BLVD	SUITE 120B	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
99715	Fee-for-Service	1346291598	1346291598	1	1	TERANDO, JOHN V MD	2/8/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	96786	08	Family Practice	0	In state provider	None	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
99800	Fee-for-Service	1629187158	1629187158	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	32121 CAMINO CAPISTRANO	None	SAN JUAN CAPISTRA	CA	92675	3716	30	06059	33.49637718	-117.6626008	Orange County
99812	Fee-for-Service	1801124490	1801124490	1	1	THOMAS, JESSICA E NP	12/13/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	350 ST JOSEPHS AVE	None	SAN FRANCISCO	CA	94115	3255	38	06075	37.78245426	-122.4421849	San Francisco County
99820	Fee-for-Service	1588721864	1588721864	1	1	THIEDE-ROSE, MICHELE L LCSW	7/3/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT ROAD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
99825	Fee-for-Service	1063484061	1063484061	1	1	TIMOTHY M SULLIVAN, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 E 28TH ST STE H2100	None	MINNEAPOLIS	MN	55407	3723	00	None	44.95428	-93.2614155	Hennepin County
99852	Fee-for-Service	1538168950	1538168950	1	1	THE ELIZABETH HOSPICE INC	1/1/1988	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	500 LA TERRAZA BLVD	SUITE 130	ESCONDIDO	CA	92025	3876	37	06073	33.11238641	-117.096444	San Diego County
99861	Fee-for-Service	1609976372	1609976372	1	1	TU, CLARA AU	8/22/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	301 INDUSTRIAL RD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
99922	Fee-for-Service	1851611354	1851611354	1	1	TANG, TAYLOR H MD	7/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	111977	33	Thoracic Surgery	0	In state provider	None	1310 W STEWART DRIVE	SUITE 503	ORANGE	CA	92868	3856	30	06059	33.78236048	-117.8664975	Orange County
99954	Fee-for-Service	1588041859	1588041859	1	1	TRAN, MAI-LINH N MD	7/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144159	01	General Practice	0	In state provider	None	25455 BARTON RD	SUITE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
99997	Fee-for-Service	1215310016	1215310016	1	1	TOTAL RENAL CARE INC	1/22/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	30730 RUSSEL RANCH RD	STE A	WESTLAKE VILLAGE	CA	91362	6354	19	06037	34.14929263	-118.7946074	Los Angeles County
100027	Fee-for-Service	1003903303	1003903303	3	1	THE SOFIENE COMPANY LLC	12/15/2017	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	601 EUREKA STREET	None	BAKERSFIELD	CA	93305	5811	15	06029	35.37295168	-118.9956893	Kern County
100036	Fee-for-Service	1083703565	1083703565	1	1	TSAI, JERRY F MD	1/1/1998	207R00000X	NA	Other	026	PHYSICIANS	83006	01	General Practice	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
100040	Fee-for-Service	1598793226	1598793226	1	1	TOM D LARSON MD	11/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	415 JEFFERSON ST N	None	WADENA	MN	56482	1264	00	None	46.44658422	-95.13270643	Wadena County
100051	Fee-for-Service	1619172897	1619172897	1	1	TSENG, VICTOR W CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	206 E LAS TUNAS DR	STE 1	SAN GABRIEL	CA	91776	1411	19	06037	34.10299799	-118.0977032	Los Angeles County
100067	Fee-for-Service	1659717320	1659717320	1	1	THAN, KATHLEEN L DO MD	6/11/2018	207LP3000X	NA	Other	026	PHYSICIANS	15658	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
100093	Fee-for-Service	1346638491	1346638491	1	1	TRAN, KEVIN MD	9/22/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168027	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
100133	Fee-for-Service	1841368925	1841368925	1	2	TRIANGLE EYE INSTITUTE	1/31/1995	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	255 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3427	54	06107	36.06949736	-119.0223718	Tulare County
100156	Fee-for-Service	1033599824	1033599824	1	1	TRAN, ANDY T DO	12/20/2021	207R00000X	NA	Other	026	PHYSICIANS	19030	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
100166	Fee-for-Service	1639295868	1639295868	1	1	THOMPSON, CORY A CRNA	6/10/2007	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
100251	Fee-for-Service	1871624916	1871624916	1	1	TOOKE, TARISA M LMFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4760 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
100292	Fee-for-Service	1376610238	1376610238	1	1	TOM, THOMAS Y MD	6/30/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	52856	41	Internal Medicine	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
100333	Fee-for-Service	1306840723	1306840723	1	3	TULARE LOCAL HEALTH CARE	8/1/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1437 E PROSPERITY AVE	None	TULARE	CA	93274	8051	54	06107	36.2257887	-119.3253162	Tulare County
100339	Fee-for-Service	1619248903	1619248903	1	1	TRAN, DILLON N DO	6/8/2012	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	12056	08	Family Practice	0	In state provider	None	9191 BOLSA AVENUE	SUITE 215-216	WESTMINSTER	CA	92683	5564	30	06059	33.74494947	-117.969093	Orange County
100357	Fee-for-Service	1952862922	1952862922	1	1	TRAN, SOPHIA B DO	7/12/2022	208M00000X	NA	Other	026	PHYSICIANS	19398	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
100365	Fee-for-Service	1912105362	1912105362	1	1	TERAN, ELIZABETH L	10/18/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	444 GLENOAKS BLVD	None	GLENDALE	CA	91202	2917	19	06037	34.1598361	-118.2632528	Los Angeles County
100407	Fee-for-Service	1871119032	1871119032	1	1	TRANSITION CARE TELEMETRY	2/15/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	30320 RANCHO VIEJO ROAD	SUITE 13	SAN JUAN CAPISTRA	CA	92675	1581	30	06059	33.52176033	-117.6652056	Orange County
100420	Fee-for-Service	1578114641	1578114641	1	1	TULIP HOSPICE INC	9/21/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	9221 CORBIN AVE	SUITE 225	NORTHRIDGE	CA	91324	1684	19	06037	34.23776171	-118.5623227	Los Angeles County
100428	Fee-for-Service	1891731014	1891731014	1	1	TROTTA, FRANCOIS D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	128 E MALLARD DR	None	BOISE	ID	83706	3975	00	None	43.59584152	-116.1822465	Ada County
100503	Fee-for-Service	1528540838	1528540838	1	1	THE WEST OAKLAND HEALTH COUN	11/26/2019	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7450 INTERNATIONAL BLVD	None	OAKLAND	CA	94621	2806	01	06001	37.75854617	-122.1855749	Alameda County
100522	Fee-for-Service	1417996810	1417996810	1	1	TATE, ANJALI S MD	12/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	48690	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
100550	Fee-for-Service	1366621492	1366621492	1	1	TAYLOR, SABRINA MD	3/7/2022	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	4855 BLUE DIAMOND RD	None	LAS VEGAS	NV	89139	7602	00	None	36.03258913	-115.2074608	Clark County
100577	Fee-for-Service	1821431016	1821431016	1	1	TANEJA, SONIA L MD	10/30/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	169913	10	Gastroenterology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
100588	Fee-for-Service	1518491836	1518491836	1	1	TRAN, KIM N DO	9/27/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22930	08	Family Practice	0	In state provider	None	253 S DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	1606	19	06037	34.02108125	-117.8103432	Los Angeles County
100592	Fee-for-Service	1891969416	1891969416	1	1	TOTAL RENAL CARE	10/31/2008	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	INCORPORATED	400 N WIGET LANE	None	WALNUT CREEK	CA	94598	2408	07	06013	37.92944835	-122.0288255	Contra Costa County
100598	Fee-for-Service	1942377817	1942377817	1	1	TAN, MARVIN L	6/11/1998	2080P0006X	NA	Psychiatry	026	PHYSICIANS	74523	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
100599	Fee-for-Service	1548793557	1548793557	1	1	TRINIDAD, NORVER J MD	8/22/2023	207L00000X	NA	Other	026	PHYSICIANS	161925	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
100616	Fee-for-Service	1104368919	1104368919	1	1	TONKOVICH, DEBBIE LPCC	11/27/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
100617	Fee-for-Service	1790758068	1790758068	1	1	TRAN, RYAN N MD	4/17/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79945	08	Family Practice	0	In state provider	None	3460 KATELLA AVE	None	LOS ALAMITOS	CA	90720	2334	30	06059	33.8029707	-118.073517	Orange County
100651	Fee-for-Service	1487266169	1487266169	1	1	TRANQUILITY SANDS HOSPICE	6/3/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	74333 HWY 111	STE 204	PALM DESERT	CA	92260	4131	33	06065	33.72105174	-116.3680184	Riverside County
100684	Fee-for-Service	1487995890	1487995890	1	1	TABOR, AMBER N NP	5/18/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
100687	Fee-for-Service	1548584949	1548584949	1	1	TUSTIN HEARING INC	3/4/2020	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	12791 NEWPORT AVE	SUITE 101	TUSTIN	CA	92780	2785	30	06059	33.75168784	-117.808677	Orange County
100694	Fee-for-Service	1306298112	1306298112	1	1	TELLER-HOLT, GISELLE LMFT	10/16/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	525 E. MAIN ST	None	SANTA PAULA	CA	93060	2606	56	06111	34.35159506	-119.0675327	Ventura County
100709	Fee-for-Service	1578114641	1578114641	1	1	TULIP HOSPICE INC	9/21/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	9221 CORBIN AVE	SUITE 225	NORTHRIDGE	CA	91324	1684	19	06037	34.23776171	-118.5623227	Los Angeles County
100735	Fee-for-Service	1306080924	1306080924	1	1	TSAI, ANNIE Y MD	10/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113783	05	Anesthesiology	0	In state provider	None	2131 W THIRD STREET	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
100738	Fee-for-Service	1861805335	1861805335	1	1	TSADOK, JACOB M MD INC	10/27/2014	207R00000X	NA	Other	026	PHYSICIANS	61419	41	Internal Medicine	0	In state provider	None	9808 VENICE BLVD	SUITE 603	CULVER CITY	CA	90232	6819	19	06037	34.0236396	-118.3980847	Los Angeles County
100740	Fee-for-Service	1457599276	1457599276	1	1	TOTAL RENAL CARE INC	9/22/2010	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1580 W ROSECRANS AVE	None	COMPTON	CA	90220	1001	19	06037	33.90284866	-118.2504072	Los Angeles County
100750	Fee-for-Service	1134680002	1134680002	1	1	TORRES, EDWIN	8/23/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176211	30	Radiology	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
100783	Fee-for-Service	1104476175	1104476175	1	1	TERRE DIALYSIS LLC	5/14/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1824 E SLAUSON AVE	None	VERNON	CA	90058	3829	19	06037	33.98916779	-118.2401521	Los Angeles County
100813	Fee-for-Service	1235334061	1235334061	1	1	TAYLOR, GEORGE H DO	12/19/2019	207P00000X	NA	Other	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89119	5168	00	None	36.163269	-115.1654465	Clark County
100836	Fee-for-Service	1770271264	1770271264	1	1	TERRELL B VANAKEN MD INC	7/12/2023	207QG0300X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	1255 TRAVIS BLVD	None	FAIRFIELD	CA	94533	4801	48	06095	38.25815459	-122.0487714	Solano County
100837	Fee-for-Service	1457068744	1457068744	2	1	TRINH, DANIEL NP	11/9/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	555 WASHINGTON STREET	None	SAN DIEGO	CA	92103	2289	37	06073	32.74986289	-117.1599343	San Diego County
100843	Fee-for-Service	1265451058	1265451058	1	2	TAMMELA, JONATHAN E MD	3/1/2020	207VX0201X	NA	Obstetrics & Gynecology	026	PHYSICIANS	153584	15	Obstetrics (D.O. only)	0	In state provider	None	220 PALISADE	STE 203	SANTA MARIA	CA	93454	8903	42	06083	34.95143521	-120.412098	Santa Barbara County
100863	Fee-for-Service	1073267860	1073267860	1	1	TRINITY HEALTH CARE SERVICES	4/2/2024	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	LLC	2538 SANTA FE AVE	None	LONG BEACH	CA	90810	3243	19	06037	33.803145	-118.2153505	Los Angeles County
100906	Fee-for-Service	1093344848	1093344848	1	1	TAMBOLI, MALLIKA K MD	8/22/2024	207L00000X	NA	Other	026	PHYSICIANS	190228	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
100917	Fee-for-Service	1790168987	1790168987	1	1	TRAN, DIEM KIEU T MD	8/1/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	139908	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
100939	Fee-for-Service	1487266169	1487266169	1	1	TRANQUILITY SANDS HOSPICE	6/3/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	74333 HWY 111	STE 204	PALM DESERT	CA	92260	4131	33	06065	33.72105174	-116.3680184	Riverside County
100940	Fee-for-Service	1477642502	1477642502	1	1	TOISERKANI, MICHAEL MD	6/4/2018	208M00000X	NA	Other	026	PHYSICIANS	76707	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
100975	Fee-for-Service	1548584949	1548584949	1	1	TUSTIN HEARING INC	10/9/2012	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	12791 NEWPORT AVE	SUITE 101	TUSTIN	CA	92780	2785	30	06059	33.75168784	-117.808677	Orange County
101015	Fee-for-Service	1609361765	1609361765	1	1	THAI, JULIE N MD	7/13/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	174685	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
101042	Fee-for-Service	1407218662	1407218662	1	1	TRENCH, VICKI A LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23201 MILL CREEK DR	SUITE 220	LAGUNA HILLS	CA	92653	7906	30	06059	33.62516256	-117.7353393	Orange County
101064	Fee-for-Service	1437117074	1437117074	1	2	THE REGENTS OF THE UNIVERSIT	6/28/2019	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	E	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
101066	Fee-for-Service	1922088459	1922088459	1	1	TU, SERENA A MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68366	40	Pediatrics	0	In state provider	None	1500 S CENTRAL AVE	STE 100	GLENDALE	CA	91204	2585	19	06037	34.12736888	-118.257777	Los Angeles County
101101	Fee-for-Service	1235334061	1235334061	1	1	TAYLOR, GEORGE H DO	12/19/2019	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89119	5168	00	None	36.163269	-115.1654465	Clark County
101112	Fee-for-Service	1649389982	1649389982	1	1	THRIFTY PAYLESS INC	5/6/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6451	1107 CALLOWAY DR	None	BAKERSFIELD	CA	93312	6383	15	06029	35.36797682	-119.1111837	Kern County
101122	Fee-for-Service	1942590179	1942590179	1	1	TSIANG, DAVID T MD	7/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123846	05	Anesthesiology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
101155	Fee-for-Service	1720278518	1720278518	1	1	TSAO, KUOJEN MD	4/1/2018	208600000X	NA	General Surgery	026	PHYSICIANS	-	85	Surgery-Pediatric	2	Out of state provider	None	6410 FANNIN STREET	SUITE 1500	HOUSTON	TX	77030	5306	00	None	29.71419639	-95.39755562	Harris County
101221	Fee-for-Service	1275835688	1275835688	1	1	T MAI PHAN MD INC	11/9/2020	261Q00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	10681 BOLSA	None	GARDEN GROVE	CA	92843	5270	30	06059	33.7450695	-117.9427815	Orange County
101259	Fee-for-Service	1992048557	1992048557	1	1	TALBOT, ADRIANNE V	3/12/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
101281	Fee-for-Service	1003925520	1003925520	1	1	THRIFTY PAYLESS INC	2/25/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5631	1331 S MISSION RD	None	FALLBROOK	CA	92028	4007	37	06073	33.36892262	-117.2509113	San Diego County
101309	Fee-for-Service	1144949868	1144949868	1	1	THE HAPPIER LIFE PROJECT	4/10/2024	251S00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	506 W GRAHAM AVE	106	LAKE ELSINORE	CA	92530	3666	33	06065	33.66962801	-117.3335059	Riverside County
101314	Fee-for-Service	1396798195	1396798195	1	1	TALEISNIK, ANDRES MD	2/8/2015	2086S0122X	NA	General Surgery	026	PHYSICIANS	68244	46	Hand Surgery	0	In state provider	None	1140 W LA VETA AVE	STE 860	ORANGE	CA	92868	4218	30	06059	33.7802984	-117.8651669	Orange County
101318	Fee-for-Service	1760845465	1760845465	2	1	TORREZ ANDIA, ESTEVAN A MD	5/4/2023	207R00000X	NA	Other	026	PHYSICIANS	160194	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
101371	Fee-for-Service	1124853213	1124853213	1	1	THE PARENTING CONNECTION OF	12/13/2024	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	27	06053	0	0	None
101384	Fee-for-Service	1982789657	1982789657	1	1	TSOTSIASHVILI, MERAB MD	11/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80578	36	Psychiatry	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
101418	Fee-for-Service	1487399705	1487399705	1	1	TOMLIN-HAYNES, CARON L LMFT	12/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
101420	Fee-for-Service	1760591143	1760591143	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05481	401 N PACIFIC COAST HWY	None	REDONDO BEACH	CA	90277	2840	19	06037	33.84754484	-118.3880942	Los Angeles County
101426	Fee-for-Service	1831174523	1831174523	1	1	TIBONE, JAMES E MD	9/1/2021	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	27027	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
101444	Fee-for-Service	1538102355	1538102355	1	1	TAN,JI-REN MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69133	05	Anesthesiology	0	In state provider	None	6403 COYLE AVE	STE 450	CARMICHAEL	CA	95608	0354	34	06067	38.668347	-121.3148745	Sacramento County
101533	Fee-for-Service	1427307206	1427307206	1	1	TOTAL RENAL CARE INC	12/1/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	17150 EUCLID ST	SUITE 111	FOUNTAIN VALLEY	CA	92708	4092	30	06059	33.714171	-117.9369905	Orange County
101567	Fee-for-Service	1407401946	1407401946	1	1	TRI CITY RX PHARMACY, INC.	4/7/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15940 QUANTICO RD.	100	APPLE VALLEY	CA	92307	0803	36	06071	34.54090735	-117.2706402	San Bernardino County
101580	Fee-for-Service	1831145739	1831145739	1	1	THEODORE, SHARON M MD	6/21/2005	207W00000X	NA	Ophthalmology	026	PHYSICIANS	91327	18	Ophthalmology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
101603	Fee-for-Service	1396798195	1396798195	1	1	TALEISNIK, ANDRES MD	2/8/2015	2086S0122X	NA	General Surgery	026	PHYSICIANS	68244	24	Plastic Surgery	0	In state provider	None	1140 W LA VETA AVE	STE 860	ORANGE	CA	92868	4218	30	06059	33.7802984	-117.8651669	Orange County
101604	Fee-for-Service	1780029868	1780029868	1	1	TSIU, MARIA K O MD	9/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131919	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
101637	Fee-for-Service	1134238561	1134238561	1	1	THRIFTY PAYLESS INC	8/30/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6266	526 E BIDWELL ST	None	FOLSOM	CA	95630	3119	34	06067	38.673468	-121.16412	Sacramento County
101662	Fee-for-Service	1306106125	1306106125	1	1	THAKUR, DUSHYANT S MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140705	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
101689	Fee-for-Service	1295160208	1295160208	1	1	TORRES, TAISHA E LMFT	6/19/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
101715	Fee-for-Service	1417515248	1417515248	1	1	TRINH, VIET DO	5/31/2023	207L00000X	NA	Other	026	PHYSICIANS	20274	05	Anesthesiology	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
101732	Fee-for-Service	1053388900	1053388900	1	1	TEYMOURI, SAMAN MD	11/30/1995	193400000X	NA	Other	026	PHYSICIANS	56008	41	Internal Medicine	0	In state provider	None	500 UNIVERSITY AVE	None	SACRAMENTO	CA	95825	6504	34	06067	38.568402	-121.418019	Sacramento County
101780	Fee-for-Service	1669425245	1669425245	1	1	THORNBURG, AARON T. DO	6/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3330 N. 2ND STREET	#300	PHOENIX	AZ	85012	2369	00	None	33.486606	-112.071654	Maricopa County
101789	Fee-for-Service	1679943336	1679943336	1	1	THAKOR, AVNESH MD	10/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
101798	Fee-for-Service	1578522462	1578522462	1	3	TAN, DORIS T DO	12/5/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	7928	None	None	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
101897	Fee-for-Service	1538382726	1538382726	1	1	TRAN, DON M	1/27/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1301 E BIDWELL ST	#101	FOLSOM	CA	95630	3452	34	06067	38.66841	-121.151025	Sacramento County
101952	Fee-for-Service	1316442742	1316442742	1	1	TAMRAZIAN, ANIKA OD	8/21/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
101965	Fee-for-Service	1871911677	1871911677	1	1	TUCKER, AMBER J MD	1/12/2023	207LP3000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
102028	Fee-for-Service	1225490147	1225490147	1	1	TYE, KAREN E MD	3/1/2023	2085R0001X	NA	Other	026	PHYSICIANS	156529	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
102090	Fee-for-Service	1689148710	1689148710	1	1	TRAVIS, TYEISHA M LCSW	8/29/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	937 COFFEE RD	500	MODESTO	CA	95355	4240	50	06099	37.65636629	-120.9756356	Stanislaus County
102104	Fee-for-Service	1023453206	1023453206	1	1	TORRES, TYSON S MD	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	UNIT 1	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
102139	Fee-for-Service	1962924035	1962924035	1	1	TING, WEN-CHIEH AU	1/18/2022	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	41 N GARFIELD AVE	STE 101	ALHAMBRA	CA	91801	3556	19	06037	34.09590269	-118.1274015	Los Angeles County
102157	Fee-for-Service	1992223069	1992223069	1	1	THANNIL, AMBILI N NP	10/26/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
102257	Fee-for-Service	1093249682	1093249682	1	1	TSUKIKAWA, MAI	9/6/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	178172	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
102299	Fee-for-Service	1780614545	1780614545	1	1	TOWN CENTER OPTOMETRY INC	12/1/1994	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	TOWN CENTER OPTOMETRY	1449 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	4156	19	06037	34.01888482	-118.1142145	Los Angeles County
102329	Fee-for-Service	1154337715	1154337715	1	1	THOMAS A DECOSTER	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	UNM MEDICAL GROUP INC	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
102368	Fee-for-Service	1164748497	1164748497	1	1	TSOI, KWOKYAN W MD	1/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119492	41	Internal Medicine	0	In state provider	None	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
102396	Fee-for-Service	1174582050	1174582050	1	1	THE UNIVERSITY OF TEXAS MD	11/7/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ANDERSON CANCER CENTER	1515 HOLCOMBE BOULEVARD	None	HOUSTON	TX	77030	4009	00	None	29.70638133	-95.39706066	Harris County
102415	Fee-for-Service	1174933550	1174933550	1	1	TEPORA, NAPOLEON H	8/22/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
102462	Fee-for-Service	1326393737	1326393737	1	1	TAMA, MAHER MD	7/17/2019	207R00000X	NA	Other	026	PHYSICIANS	161762	10	Gastroenterology (M.D. only)	0	In state provider	None	790 E BONITA AVE	FL 2	POMONA	CA	91767	1906	19	06037	34.09621447	-117.737406	Los Angeles County
102541	Fee-for-Service	1740686856	1740686856	1	1	TSENG, PEGGY P P MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133151	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
102549	Fee-for-Service	1447669924	1447669924	1	1	THATCHER, JAMES T PSY	4/18/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
102593	Fee-for-Service	1609986462	1609986462	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 5682	74958 COUNTRY CLUB DR	None	PALM DESERT	CA	92260	1948	33	06065	33.760341	-116.356995	Riverside County
102595	Fee-for-Service	1821402033	1821402033	1	1	TERRIBILINI, RENO G MD	2/18/2025	207R00000X	NA	Other	026	PHYSICIANS	147723	41	Internal Medicine	0	In state provider	None	4323 W RIVERSIDE DRIVE	None	BURBANK	CA	91505	4044	19	06037	34.15223748	-118.347426	Los Angeles County
102683	Fee-for-Service	1174582050	1174582050	1	1	THE UNIVERSITY OF TEXAS MD	11/7/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ANDERSON CANCER CENTER	1515 HOLCOMBE BOULEVARD	None	HOUSTON	TX	77030	4009	00	None	29.70638133	-95.39706066	Harris County
102688	Fee-for-Service	1154315307	1154315307	1	1	TRINITY MEDICAL CENTER	12/16/2007	282NR1301X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	OF BRENHAM INC	700 MEDICAL PKWY	None	BRENHAM	TX	77833	5413	00	None	30.14559213	-96.39889986	Washington County
102773	Fee-for-Service	1407331614	1407331614	1	1	TURNER, ELLEN R CCC-SLP	10/29/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	806 W ADAMS BLVD	None	LOS ANGELES	CA	90007	2505	19	06037	34.02989008	-118.2799804	Los Angeles County
102795	Fee-for-Service	1770830325	1770830325	1	2	TWO TREES PHYSICAL THERAPY &	4/18/2024	225100000X	NA	Physical Therapist	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	957 FAULKNERROAD	105	SANTA PAULA	CA	93060	9129	56	06111	34.33481551	-119.0867489	Ventura County
102798	Fee-for-Service	1871581165	1871581165	1	1	THOMAS S DENAPOLI M.D.	11/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	333 N SANTA ROSA ST	None	SAN ANTONIO	TX	78207	3108	00	None	29.42763246	-98.49794799	Bexar County
102910	Fee-for-Service	1538265780	1538265780	1	5	TAHOE FOREST HOSP DIST	6/4/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS RD	SUITE 340	TRUCKEE	CA	96161	4885	29	06057	39.32625521	-120.2012059	Nevada County
102914	Fee-for-Service	1285755991	1285755991	1	1	TOTAL RENAL CARE INC	3/5/2008	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1116 W VISALIA RD	STE 106	EXETER	CA	93221	1482	54	06107	36.29727882	-119.155075	Tulare County
102938	Fee-for-Service	1598060436	1598060436	1	1	TAKESHI YOKOO	4/2/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
102939	Fee-for-Service	1437464328	1437464328	1	1	TSAI, WILBERT T MD INC	9/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107727	08	Family Practice	0	In state provider	None	1900 ROYALTY DR	STE 250	POMONA	CA	91767	3043	19	06037	34.07754346	-117.7463466	Los Angeles County
102955	Fee-for-Service	1245674324	1245674324	1	1	TRANSITIONS CHILDRENS	6/13/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES	1945 N HELM AVENUE	SUITE 101	FRESNO	CA	93727	1670	10	06019	36.76803257	-119.723713	Fresno County
102968	Fee-for-Service	1710072442	1710072442	1	1	TRAN, THEODORE D	12/27/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	83497	18	Ophthalmology	0	In state provider	None	1739 W ROMNEYA DR	None	ANAHEIM	CA	92801	1804	30	06059	33.85068651	-117.943254	Orange County
102977	Fee-for-Service	1154315307	1154315307	1	1	TRINITY MEDICAL CENTER	12/16/2007	282NR1301X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	OF BRENHAM INC	700 MEDICAL PKWY	None	BRENHAM	TX	77833	5413	00	None	30.14559213	-96.39889986	Washington County
103028	Fee-for-Service	1245486430	1245486430	1	1	TIEU, VANESSA C MD	9/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109741	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
103049	Fee-for-Service	1831481647	1831481647	1	1	TSAI, EMILY B MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126063	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	19	06037	37.43304542	-122.1759654	Santa Clara County
103050	Fee-for-Service	1770830325	1770830325	1	9	TWO TREES PHYSICAL THERAPY &	4/18/2024	225100000X	NA	Physical Therapist	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS INC	2260 TAPO ST	B117	SIMI VALLEY	CA	93063	3022	56	06111	34.27695447	-118.7089305	Ventura County
103053	Fee-for-Service	1376621284	1376621284	1	1	TAYE, ETSEHIWOT MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78494	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
103062	Fee-for-Service	1518945229	1518945229	1	1	TRIGUEROS, DENNIS MD	5/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99177	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
103070	Fee-for-Service	1003987991	1003987991	1	1	THEAL, ROBERT MD	11/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	55100	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
103082	Fee-for-Service	1770830325	1770830325	1	2	TWO TREES PHYSICAL THERAPY &	4/17/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	957 FAULKNERROAD	105	SANTA PAULA	CA	93060	9129	56	06111	34.33481551	-119.0867489	Ventura County
103106	Fee-for-Service	1568183341	1568183341	1	1	TRAN, THU B CNP	10/5/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
103120	Fee-for-Service	1205102902	1205102902	1	1	TAYLOR, NADIA C MD	11/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127653	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
103169	Fee-for-Service	1326312372	1326312372	1	1	TURNER, CHRISTINA M OD	7/30/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2414 FAIRVIEW STREET	SUITE 103	SANTA ANA	CA	92704	5318	30	06059	33.71437705	-117.9079237	Orange County
103198	Fee-for-Service	1215493259	1215493259	1	1	THE CHILDRENS CLINIC SERVING	3/8/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	540 E ARTESIA BOULEVARD	None	LONG BEACH	CA	90805	1476	19	06037	33.87435148	-118.186947	Los Angeles County
103213	Fee-for-Service	1841710324	1841710324	1	1	THAI LAI	12/7/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1003 WILLOW CREEK RD	None	PRESCOTT	AZ	86301	1641	00	None	34.558992	-112.481901	Yavapai County
103227	Fee-for-Service	1285779223	1285779223	1	1	TURNER, JODIE R LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46049	-	NOT APPLICABLE	0	In state provider	None	370 SOUTH CRENSHAW BLVD	SUITE E-100	TORRANCE	CA	90503	1727	19	06037	33.84549	-118.3287415	Los Angeles County
103229	Fee-for-Service	1720027436	1720027436	1	2	TROTTER, MARVIN G MD	8/30/2021	207R00000X	NA	Other	086	MEDICAL DIRECTORS	42597	-	NOT APPLICABLE	0	In state provider	None	201 BRUSH ST	BLDGS 201A, 201B, 201C	UKIAH	CA	95482	3424	23	06045	39.1592217	-123.2057318	Mendocino County
103234	Fee-for-Service	1326346065	1326346065	1	1	TERGAS, ANA I MD	9/16/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	174197	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
103238	Fee-for-Service	1437437134	1437437134	1	1	THAKKER, HITESHI S MD	8/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	127447	41	Internal Medicine	0	In state provider	None	1851 N RIVERSIDE AVE	None	RIALTO	CA	92376	8069	36	06071	34.133238	-117.3704145	San Bernardino County
103272	Fee-for-Service	1316355688	1316355688	1	1	THE RADIANCE OF HOPE	11/3/2014	251S00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	COUNSELING CENTER	9107 WILSHIRE BLVD	STE 200	BEVERLY HILLS	CA	90210	5522	19	06037	34.06708751	-118.390068	Los Angeles County
103273	Fee-for-Service	1154436988	1154436988	1	2	TODAYS WOMAN MEDICAL GROUP	2/2/2010	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	55892	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	201 S BUENA VISTA ST	STE 300	BURBANK	CA	91505	4010	19	06037	34.15978726	-118.3289164	Los Angeles County
103279	Fee-for-Service	1376987941	1376987941	1	1	TAGUIBAO, ROBERTO ALVARO A	10/1/2019	207ZP0102X	NA	Other	026	PHYSICIANS	138374	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	305 PARK CREEK DR	None	CLOVIS	CA	93611	4426	10	06019	36.84077548	-119.7076545	Fresno County
103298	Fee-for-Service	1568924611	1568924611	1	1	THISTLETHWAITE, IAN MD	11/20/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	100 PINE ST	STE 1250	SAN FRANCISCO	CA	94111	5235	38	06075	37.79237874	-122.3989278	San Francisco County
103327	Fee-for-Service	1578544516	1578544516	1	1	THIBODEAUX, SAMUEL J CRNA	10/22/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
103328	Fee-for-Service	1497347967	1497347967	1	1	TAKARA HOSPICE LLC	6/3/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	333 S JUNIPER STREET	STE 103	ESCONDIDO	CA	92025	4924	37	06073	33.12052612	-117.0770162	San Diego County
103338	Fee-for-Service	1770830325	1770830325	1	9	TWO TREES PHYSICAL THERAPY &	5/19/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	WELLNESS INC	2260 TAPO ST	B117	SIMI VALLEY	CA	93063	3022	56	06111	34.27695447	-118.7089305	Ventura County
103369	Fee-for-Service	1770830325	1770830325	1	2	TWO TREES PHYSICAL THERAPY &	4/17/2019	225100000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	957 FAULKNERROAD	105	SANTA PAULA	CA	93060	9129	56	06111	34.33481551	-119.0867489	Ventura County
103372	Fee-for-Service	1992711295	1992711295	1	1	THRIFTY DRUG STORE 5476	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11325 LONG BEACH BLVD	None	LYNWOOD	CA	90262	3300	19	06037	33.92820103	-118.21098	Los Angeles County
103465	Fee-for-Service	1336303395	1336303395	1	1	TRAN, HAVEN HAU CA	2/8/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	2305 ROSEMAD BLVD	None	SOUTH EL MONTE	CA	91733	1529	19	06037	34.054605	-118.0644285	Los Angeles County
103468	Fee-for-Service	1821389966	1821389966	2	1	THOMAS, PAULA LCSW	1/27/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	32101 BANDELIER RD	None	WINCHESTER	CA	92596	8772	33	06065	33.60230081	-117.0992769	Riverside County
103469	Fee-for-Service	1982765327	1982765327	1	1	TSOI, TIMOTHY G MD	2/28/1992	207R00000X	NA	Other	026	PHYSICIANS	63288	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2287 MOWRY AVE	STE G	FREMONT	CA	94538	1622	01	06001	37.55664244	-121.9818434	Alameda County
103483	Fee-for-Service	1215493259	1215493259	1	1	THE CHILDRENS CLINIC SERVING	3/8/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	540 E ARTESIA BOULEVARD	None	LONG BEACH	CA	90805	1476	19	06037	33.87435148	-118.186947	Los Angeles County
103519	Fee-for-Service	1871570945	1871570945	1	1	TAUNTON, PHILIP M OD	11/13/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3939 3RD AVE	None	SAN DIEGO	CA	92103	3002	37	06073	32.74905668	-117.16268	San Diego County
103535	Fee-for-Service	1578929519	1578929519	1	1	TAKETA, LYNDEE M	1/19/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5105 GOLDLEAF CIRCLE	None	LOS ANGELES	CA	90056	1269	19	06037	33.9878918	-118.3672336	Los Angeles County
103540	Fee-for-Service	1598843104	1598843104	1	1	TAY, JEANY MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76038	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
103548	Fee-for-Service	1366623332	1366623332	1	1	TAYLOR, OPAL I MD	12/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92412	66	Emergency Medicine (Urgent Care)	0	In state provider	None	301 E 13TH ST	None	MERCED	CA	95340	6211	24	06047	37.29248035	-120.4730619	Merced County
103558	Fee-for-Service	1316355688	1316355688	1	1	THE RADIANCE OF HOPE	11/3/2014	251S00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELING CENTER	9107 WILSHIRE BLVD	STE 200	BEVERLY HILLS	CA	90210	5522	19	06037	34.06708751	-118.390068	Los Angeles County
103562	Fee-for-Service	1851622435	1851622435	1	1	TAN, TERRENCE C DO	7/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	11111	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
103566	Fee-for-Service	1376070607	1376070607	1	1	TRACY, NICOLE L LMFT	6/22/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	44443 N 10TH STREET WEST	SUITE A	LANCASTER	CA	93534	3346	19	06037	34.69074211	-118.1480945	Los Angeles County
103586	Fee-for-Service	1427172568	1427172568	1	1	TORRES, KENNIA LMFT	7/21/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17011 BEACH BLVD	STE 900	HUNTINGTON BEACH	CA	92647	5998	30	06059	33.71505372	-117.9892238	Orange County
103617	Fee-for-Service	1497347967	1497347967	1	1	TAKARA HOSPICE LLC	6/3/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	333 S JUNIPER STREET	STE 103	ESCONDIDO	CA	92025	4924	37	06073	33.12052612	-117.0770162	San Diego County
103626	Fee-for-Service	1740399104	1740399104	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05575	12511 MAGNOLIA BLVD	None	NORTH HOLLYWOOD	CA	91607	2305	19	06037	34.16490548	-118.40562	Los Angeles County
103628	Fee-for-Service	1770830325	1770830325	1	9	TWO TREES PHYSICAL THERAPY &	10/10/2023	225100000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS INC	2260 TAPO ST	B117	SIMI VALLEY	CA	93063	3022	56	06111	34.27695447	-118.7089305	Ventura County
103666	Fee-for-Service	1831356732	1831356732	1	1	TABIBIAN, JAMES H MD	5/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142008	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
103676	Fee-for-Service	1164412037	1164412037	1	1	TOM, PAUL T DPM	9/30/1988	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	515 ALAMEDA AVE	STE D	SALINAS	CA	93901	4024	27	06053	36.65997494	-121.6486999	Monterey County
103711	Fee-for-Service	1447235080	1447235080	1	1	TSAI, DARYL K MD	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	67478	40	Pediatrics	0	In state provider	None	15944 LOS SERRANOS COUNT	STE 220	CHINO HILLS	CA	91709	3991	36	06071	33.9635227	-117.695881	San Bernardino County
103734	Fee-for-Service	1265062210	1265062210	1	1	TWEET, KELSEY A CRNA	6/1/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
103738	Fee-for-Service	1669658894	1669658894	1	1	THE ALLIANCE FOR COMMUNITY W	9/18/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	E	425 VERNON STREET	None	OAKLAND	CA	94610	2927	01	06001	37.81680584	-122.2534611	Alameda County
103784	Fee-for-Service	1801814231	1801814231	1	1	TARANNUM, ALAM MD	11/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81175	41	Internal Medicine	0	In state provider	None	17909 SOLEDAD CANYON RD	None	CANYON COUNTRY	CA	91387	3210	19	06037	34.41652621	-118.4458684	Los Angeles County
103785	Fee-for-Service	1922144450	1922144450	1	1	TAHERI, DANIEL P MD	1/1/1998	207N00000X	NA	Dermatology	026	PHYSICIANS	80445	07	Dermatology	0	In state provider	None	41230 11TH ST W	STE E	PALMDALE	CA	93551	1411	19	06037	34.63215221	-118.1501501	Los Angeles County
103798	Fee-for-Service	1962700799	1962700799	1	1	TAYLOR, CHARLA S MD	10/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121206	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
103815	Fee-for-Service	1306096680	1306096680	1	1	TRUITT, KATHLEEN A MD	3/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	92819	07	Dermatology	0	In state provider	None	15611 POMERADO RD	STE 400	POWAY	CA	92064	2437	37	06073	32.99706	-117.05544	San Diego County
103849	Fee-for-Service	1831350131	1831350131	1	1	TRAN, TIFFANY T MD	9/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116304	08	Family Practice	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
103873	Fee-for-Service	1508169954	1508169954	1	1	TORIO, VIVIAN C MD	6/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11469	08	Family Practice	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
103930	Fee-for-Service	1003017971	1003017971	1	1	TWEET, MATTHEW L MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111016	20	Orthopedic Surgery	0	In state provider	None	2800 L STREET	SUITE 200	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
103949	Fee-for-Service	1871800714	1871800714	1	1	TRUNECEK, JILL A NP	7/27/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
103955	Fee-for-Service	1831356732	1831356732	1	1	TABIBIAN, JAMES H MD	5/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142008	10	Gastroenterology (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
103956	Fee-for-Service	1568495703	1568495703	1	1	TIZNADO, ERNESTO G	3/31/1990	2080P0006X	NA	Psychiatry	026	PHYSICIANS	45183	40	Pediatrics	0	In state provider	None	1635 3RD AVE	# I2	CHULA VISTA	CA	91911	5882	37	06073	32.59663479	-117.064444	San Diego County
103982	Fee-for-Service	1982942645	1982942645	1	1	TRINH, VALERIE B	2/4/2013	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11105 KNOTT AVE	STE A-B	CYPRESS	CA	90630	5137	30	06059	33.80083909	-118.0111199	Orange County
104027	Fee-for-Service	1154499192	1154499192	1	1	TAYLOR, LARISA MD	4/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80736	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1661 SOQUEL DR	STE A	SANTA CRUZ	CA	95065	1709	44	06087	36.98895429	-121.9821088	Santa Cruz County
104048	Fee-for-Service	1700204575	1700204575	1	1	TRULLENDER, BRETT D MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147835	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
104060	Fee-for-Service	1487645016	1487645016	1	1	TRAN, ROBERT MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71300	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
104062	Fee-for-Service	1326404815	1326404815	1	1	TRUONG, THUAN D CRNA	3/3/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
104063	Fee-for-Service	1023452554	1023452554	1	1	TORRES, KARLA F NP	5/16/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
104073	Fee-for-Service	1366990228	1366990228	1	1	TANNER, JILLIAN A M	7/2/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	206 N JACKSON ST	SUITE 202	GLENDALE	CA	91206	4330	19	06037	34.14852285	-118.2501237	Los Angeles County
104076	Fee-for-Service	1932969425	1932969425	1	1	TRAN, MICHELLE	10/28/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
104086	Fee-for-Service	1336498179	1336498179	1	1	TAMAYO, ROSALYDIA MD	6/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129846	01	General Practice	0	In state provider	None	7520 ARROYO CIRCLE	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
104087	Fee-for-Service	1881458628	1881458628	1	1	TREG CONCORD OP CO DIR LLC	4/15/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1081 MOHR LANE	None	CONCORD	CA	94518	3757	07	06013	37.94615322	-122.0483385	Contra Costa County
104119	Fee-for-Service	1467896563	1467896563	1	1	TRAN-HARDING, CAM KHANH KARE	2/6/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161434	30	Radiology	0	In state provider	N N MD	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
104137	Fee-for-Service	1831350131	1831350131	1	1	TRAN, TIFFANY T MD	9/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116304	01	General Practice	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
104138	Fee-for-Service	1831294651	1831294651	1	1	THORBURN, DAVID E MD	4/30/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	37069	18	Ophthalmology	0	In state provider	None	2161 COLORADO AVE	None	TURLOCK	CA	95382	2011	50	06099	37.51254293	-120.8353135	Stanislaus County
104141	Fee-for-Service	1497080436	1497080436	2	1	TU, MONIQUE A DO	4/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	11279	None	None	0	In state provider	None	6655 ALVARADO ROAD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
104143	Fee-for-Service	1689942286	1689942286	1	1	THORSEN, WILLOW M LCSW	1/23/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
104156	Fee-for-Service	1013915594	1013915594	1	1	TESSIER, ADLA D MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	51666	41	Internal Medicine	0	In state provider	None	7808 EL CAJON BLVD	None	SAN DIEGO	CA	92104	0000	37	06073	32.755302	-117.1248412	San Diego County
104157	Fee-for-Service	1861578247	1861578247	1	1	TRIPPLE R NEWLIFE MED SU	12/11/2007	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TRIPPLE R NEWLIFE MED SU	1641 N GAREY AVENUE	None	POMONA	CA	91767	2911	19	06037	34.07530145	-117.7523449	Los Angeles County
104161	Fee-for-Service	1609943422	1609943422	1	1	TZAKIS, EVAN G MD	12/1/1995	2084P0800X	NA	Psychiatry	026	PHYSICIANS	75939	36	Psychiatry	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
104191	Fee-for-Service	1841568425	1841568425	1	1	THOMAS, SCOTT P DO	5/20/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	11923	None	None	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
104216	Fee-for-Service	1780212944	1780212944	1	1	THONG, JULIANA W DO	9/6/2023	207P00000X	NA	Other	026	PHYSICIANS	21686	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
104237	Fee-for-Service	1457460990	1457460990	1	1	THRIFTY PAYLESS INC	12/3/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6295	1123 FRESNO ST	None	FRESNO	CA	93706	3235	10	06019	36.72996724	-119.8008539	Fresno County
104244	Fee-for-Service	1568495703	1568495703	1	1	TIZNADO, ERNESTO G	3/31/1990	2080P0006X	NA	Psychiatry	026	PHYSICIANS	45183	13	Neurology (M.D. only)	0	In state provider	None	1635 3RD AVE	# I2	CHULA VISTA	CA	91911	5882	37	06073	32.59663479	-117.064444	San Diego County
104250	Fee-for-Service	1477073757	1477073757	1	1	TALEBAGHA, SARAH	11/13/2024	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
104268	Fee-for-Service	1831150853	1831150853	1	1	TAM, YONG-YONG MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	34363	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6001 NORRIS CANYON RD	None	SAN RAMON	CA	94583	5400	07	06013	37.7755858	-121.958923	Contra Costa County
104270	Fee-for-Service	1952410318	1952410318	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05463	3802 CULVER CTR	None	CULVER CITY	CA	90232	3303	19	06037	34.01780562	-118.4077429	Los Angeles County
104284	Fee-for-Service	1255919155	1255919155	1	1	TINERO, JASON A PSYD	4/30/2024	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
104309	Fee-for-Service	1801070750	1801070750	1	1	THOMAS, ANNA K MD	8/1/2020	2085P0229X	NA	Other	026	PHYSICIANS	86701	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
104315	Fee-for-Service	1407028236	1407028236	1	1	TANAKA, VIVIAN J MD	5/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103112	05	Anesthesiology	0	In state provider	None	6969 BROCKTON AVE	STE B	RIVERSIDE	CA	92506	3870	33	06065	33.94701	-117.396786	Riverside County
104349	Fee-for-Service	1720298458	1720298458	1	1	THOMSEN,TERI R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	STATE UNIV OF IOWA	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
104351	Fee-for-Service	1013948934	1013948934	1	1	TOBBAGI, HABIB A MD	1/1/1979	174400000X	NA	Other	026	PHYSICIANS	30126	41	Internal Medicine	0	In state provider	None	25 N 14TH ST	STE 540	SAN JOSE	CA	95112	6203	43	06085	37.34293357	-121.8775187	Santa Clara County
104437	Fee-for-Service	1538752274	1538752274	1	1	TISCARENO-GONZALEZ, MARIA A	4/29/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	CCC-SLP	1500 S HAVEN AVE	SUITE 190	ONTARIO	CA	91761	2969	36	06071	34.046307	-117.576387	San Bernardino County
104439	Fee-for-Service	1821137845	1821137845	1	1	TRACY, LORI ANN MD	6/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107171	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
104448	Fee-for-Service	1871083360	1871083360	1	1	TIMPLE, JULIE MARIE V DO	11/28/2022	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
104470	Fee-for-Service	1700543022	1700543022	1	1	TAYLOR, DAVID PT	3/24/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7033 N FRESNO ST STE 202	None	FRESNO	CA	93720	2976	10	06019	36.838044	-119.7813175	Fresno County
104524	Fee-for-Service	1760576649	1760576649	1	1	TONG, JENNIFER R MD	5/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83970	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
104546	Fee-for-Service	1497775126	1497775126	1	1	TRINITY, WILBURN J DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	WILBURN CHIROPRACTIC	1756 CONTINENTAL ST	None	REDDING	CA	96001	1240	45	06089	40.58266855	-122.3843989	Shasta County
104638	Fee-for-Service	1053994509	1053994509	1	1	TANDEM PSYCHIATRIC HEALTH, A	6/21/2021	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	DVANCED NURSING PRACTICE	260 MAPLE CT	113	VENTURA	CA	93003	3551	56	06111	34.27027545	-119.24562	Ventura County
104695	Fee-for-Service	1861078545	1861078545	1	1	THOR, NICOLAS MD	3/26/2025	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	400 PEPPER	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
104708	Fee-for-Service	1437350345	1437350345	1	1	THE TURNING POINT HOME OF	12/18/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO	1315 25TH ST	None	SAN DIEGO	CA	92102	2107	37	06073	32.71932	-117.1402715	San Diego County
104732	Fee-for-Service	1760984371	1760984371	1	1	TOM, KENNETH	3/26/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1450 SAN PABLO STREET	STE 5901	LOS ANGELES	CA	95820	1536	19	06037	34.06189518	-118.203256	Los Angeles County
104738	Fee-for-Service	1093431751	1093431751	1	1	TRAN, TONYA CNP	1/6/2023	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
104750	Fee-for-Service	1710416698	1710416698	1	1	TRAN, LAN T OT	3/23/2021	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	7090 MIRATECH DR	None	SAN DIEGO	CA	92121	3109	37	06073	32.89821825	-117.1711874	San Diego County
104751	Fee-for-Service	1255539326	1255539326	1	1	TRAN, NHA P MD	7/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106513	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
104753	Fee-for-Service	1780756825	1780756825	1	1	TBITTAR INC	5/1/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	25751 MCBEAN PKWY	SUITE 215	VALENCIA	CA	91355	3701	19	06037	34.39972502	-118.5511766	Los Angeles County
104759	Fee-for-Service	1659355824	1659355824	1	1	TEGULAPALLE, LAKSHMI C	6/17/2008	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	10297	None	None	0	In state provider	DO	100 W CALIFORNIA	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
104768	Fee-for-Service	1073505400	1073505400	2	1	TENSPEDE MEDICAL, INC	2/22/2006	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TENSPEDE MEDICAL, INC	200 LINDEN AVENUE	STE 250	AUBURN	CA	95603	5281	31	06061	38.89877906	-121.0693783	Placer County
104770	Fee-for-Service	1851400287	1851400287	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05622	7100 AVENIDA ENCINAS	# C	CARLSBAD	CA	92011	4656	37	06073	33.10140629	-117.3125175	San Diego County
104808	Fee-for-Service	1184062309	1184062309	1	1	TAITANO, JOHNATHAN R DO	10/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	102 EAST LAKE MEAD PKWY	None	HENDERSON	NV	89015	5775	00	None	36.03815706	-114.9842287	Clark County
104810	Fee-for-Service	1154818342	1154818342	1	1	TOLA, HAMZA MD	9/26/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
104852	Fee-for-Service	1942317987	1942317987	1	1	TWARDOWSKI, PRZEMYSLAW	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66171	41	Internal Medicine	0	In state provider	MD	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
104959	Fee-for-Service	1437474475	1437474475	1	1	TSAI, EUGENE Y MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142027	20	Orthopedic Surgery	0	In state provider	None	8653 W 3RD ST	SUITE 485W	LOS ANGELES	CA	90048	6101	19	06037	34.07366408	-118.3809308	Los Angeles County
104991	Fee-for-Service	1033621511	1033621511	1	1	THEODORE, ZLATENA PSYD	6/15/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 N MARKET	STE 950	SAN JOSE	CA	95113	1112	43	06085	37.33791617	-121.8939388	Santa Clara County
105036	Fee-for-Service	1225695513	1225695513	1	1	TSAI, JENNIFER W MD	10/20/2023	207P00000X	NA	Other	026	PHYSICIANS	191125	None	None	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
105046	Fee-for-Service	1659433191	1659433191	1	3	TOIYABE INDIAN HEALTH PROJEC	5/28/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	PROJECT INC	250 N SEE VEE LANE	None	BISHOP	CA	93514	8130	14	06027	37.365066	-118.410912	Inyo County
105056	Fee-for-Service	1417153933	1417153933	1	1	TANG, YUNJIA MD	11/17/2021	207ZP0102X	NA	Other	026	PHYSICIANS	174282	None	None	0	In state provider	None	7592 METROPOLITAN DR	STE 405-407	SAN DIEGO	CA	92108	4428	37	06073	32.77772014	-117.1575637	San Diego County
105060	Fee-for-Service	1659433191	1659433191	1	4	TOIYABE INDIAN HEALTH PROJEC	8/5/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	199 TWIN LAKES RD	None	BRIDGEPORT	CA	93517	0696	26	06051	38.25307495	-119.2313751	Mono County
105085	Fee-for-Service	1073622460	1073622460	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	108 W ANAHEIM ST	None	WILMINGTON	CA	90744	4417	19	06037	33.77991264	-118.2631969	Los Angeles County
105087	Fee-for-Service	1346415494	1346415494	1	1	TAYLOR, MORGAN L MD	8/1/2018	207VX0201X	NA	Obstetrics & Gynecology	026	PHYSICIANS	155308	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	23600 TELO AVE	STE 250	TORRANCE	CA	90505	4037	19	06037	33.81215054	-118.3384029	Los Angeles County
105105	Fee-for-Service	1104986629	1104986629	1	1	TIAN, SHULAN MD	4/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91079	22	Pathology (M.D. only)	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
105195	Fee-for-Service	1699187906	1699187906	1	1	THORESON, LAURA L PSYD	5/12/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
105248	Fee-for-Service	1902040819	1902040819	1	1	TOMAS, JAMES P MD	9/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120476	45	Nephrology (Renal-Kidney)	0	In state provider	None	401 E HIGHLAND AVE	SUITE 551	SAN BERNARDINO	CA	92404	3840	36	06071	34.1358627	-117.2757778	San Bernardino County
105277	Fee-for-Service	1861501256	1861501256	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5793	159 W POLK ST	None	COALINGA	CA	93210	2302	10	06019	36.13647852	-120.364965	Fresno County
105308	Fee-for-Service	1790137529	1790137529	1	1	TRAN, MICHAEL Q OD	12/7/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 NORTH BRAND BLVD	SUITE 110	GLENDALE	CA	92103	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
105315	Fee-for-Service	1376160697	1376160697	1	1	TRAN, ERICA M CNP	11/2/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2410 SAMARITAN DRIVE	SUITE 201	SAN JOSE	CA	95124	3909	43	06085	37.25107654	-121.9451342	Santa Clara County
105324	Fee-for-Service	1265621197	1265621197	1	1	TO, MY-LE DO	6/16/2009	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	10674	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1207 FAIRCHILD COURT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
105332	Fee-for-Service	1457948093	1457948093	1	1	TRILOGY HOSPICE INC	6/6/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6360 VAN NUYS BLVD	STE 10	VAN NUYS	CA	91401	2638	19	06037	34.186023	-118.448701	Los Angeles County
105333	Fee-for-Service	1710106356	1710106356	1	1	THORN-SERMENO, NICHOLAS LCS	1/7/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	700 N CENTRAL AVE STE 34	None	GLENDALE	CA	91203	4238	19	06037	34.15708991	-118.2579615	Los Angeles County
105335	Fee-for-Service	1659433191	1659433191	1	3	TOIYABE INDIAN HEALTH PROJEC	11/1/1991	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	PROJECT INC	250 N SEE VEE LANE	None	BISHOP	CA	93514	8130	14	06027	37.365066	-118.410912	Inyo County
105348	Fee-for-Service	1659433191	1659433191	1	4	TOIYABE INDIAN HEALTH PROJEC	8/5/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	199 TWIN LAKES RD	None	BRIDGEPORT	CA	93517	0696	26	06051	38.25307495	-119.2313751	Mono County
105351	Fee-for-Service	1235321357	1235321357	1	1	THOMPSON, RENE C	5/7/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
105363	Fee-for-Service	1770830325	1770830325	1	4	TWO TREES PHYSICAL THERAPY &	6/23/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS, INC.	2895 LOMA VISTA ROAD	SUITE H	VENTURA	CA	93003	1542	56	06111	34.27543868	-119.2574459	Ventura County
105404	Fee-for-Service	1205907250	1205907250	1	1	TRUONG, LUAN K MD	11/1/1997	207R00000X	NA	Other	026	PHYSICIANS	54842	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
105407	Fee-for-Service	1275604902	1275604902	1	1	TO-TANAKA, LOUISE	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
105409	Fee-for-Service	1962722918	1962722918	1	1	TULI EYE CARE CENTER INC	8/3/2011	207W00000X	NA	Ophthalmology	026	PHYSICIANS	79304	18	Ophthalmology	0	In state provider	None	2601 W ALAMEDA AVENUE	SUITE 206	BURBANK	CA	91505	4810	19	06037	34.15783817	-118.3293969	Los Angeles County
105415	Fee-for-Service	1831266691	1831266691	1	1	TEOPENGCO, LUIS T MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69192	08	Family Practice	0	In state provider	None	400 OLD RIVER RD	None	BAKERSFIELD	CA	93311	9781	15	06029	35.351487	-119.1143025	Kern County
105425	Fee-for-Service	1033557574	1033557574	1	1	THACKER, GEETHA R DO	12/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14873	01	General Practice	0	In state provider	None	3779 PIEDMONT AVE	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
105432	Fee-for-Service	1851457006	1851457006	1	1	THOMAS, NEY J DPM	1/10/2008	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	02	General Surgery	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
105459	Fee-for-Service	1770939225	1770939225	1	2	TRAYNHAM, VALERIE LPCC	3/2/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ENTER	1132 BEAUMONT	106	BEAUMONT	CA	92223	1819	33	06065	33.93806931	-116.9771724	Riverside County
105537	Fee-for-Service	1902040819	1902040819	1	1	TOMAS, JAMES P MD	9/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120476	41	Internal Medicine	0	In state provider	None	401 E HIGHLAND AVE	SUITE 551	SAN BERNARDINO	CA	92404	3840	36	06071	34.1358627	-117.2757778	San Bernardino County
105541	Fee-for-Service	1437792504	1437792504	1	1	TOP TIER HOME HEALTH CARE	5/14/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	4605 LANKERSHIM BLVD	SUITE 220	NORTH HOLLYWOOD	CA	91602	1875	19	06037	34.15389329	-118.3679999	Los Angeles County
105554	Fee-for-Service	1780939066	1780939066	1	1	THISSEN, GISELE M NP	6/2/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7355 N PALM AVE	STE 100	FRESNO	CA	93711	5770	10	06019	36.84318769	-119.8097047	Fresno County
105603	Fee-for-Service	1033491311	1033491311	1	1	TOVAR PADUA, LEIDY J MD	8/11/2017	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	130894	77	Infectious Disease	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
105620	Fee-for-Service	1457948093	1457948093	1	1	TRILOGY HOSPICE INC	6/6/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6360 VAN NUYS BLVD	STE 10	VAN NUYS	CA	91401	2638	19	06037	34.186023	-118.448701	Los Angeles County
105624	Fee-for-Service	1659433191	1659433191	1	3	TOIYABE INDIAN HEALTH PROJEC	3/1/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	PROJECT INC	250 N SEE VEE LANE	None	BISHOP	CA	93514	8130	14	06027	37.365066	-118.410912	Inyo County
105650	Fee-for-Service	1326116237	1326116237	1	1	TRONDSEN, LISA A	11/4/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
105654	Fee-for-Service	1770830325	1770830325	1	4	TWO TREES PHYSICAL THERAPY &	11/26/2019	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	WELLNESS, INC.	2895 LOMA VISTA ROAD	SUITE H	VENTURA	CA	93003	1542	56	06111	34.27543868	-119.2574459	Ventura County
105661	Fee-for-Service	1538168950	1538168950	1	2	THE ELIZABETH HOSPICE INC	1/26/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8989 RIO SAN DIEGO DR	SUITE 190	SAN DIEGO	CA	92108	1647	37	06073	32.7757964	-117.1367467	San Diego County
105670	Fee-for-Service	1639256647	1639256647	1	1	TADROS, NEVEEN N MD	10/28/1994	174400000X	NA	Other	026	PHYSICIANS	49101	40	Pediatrics	0	In state provider	None	9851 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.918192	-117.4547295	Riverside County
105700	Fee-for-Service	1558636902	1558636902	1	1	TRAN, HIEN NICOLE MD	9/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122993	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
105740	Fee-for-Service	1407871585	1407871585	1	1	TAM, PETER	5/2/2011	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
105750	Fee-for-Service	1942246715	1942246715	1	1	THE VONS COMPANY INC	5/9/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	550 E BASELINE RD	None	CLAREMONT	CA	91711	2236	19	06037	34.12158852	-117.7059825	Los Angeles County
105765	Fee-for-Service	1295980431	1295980431	1	1	TAGHAVY, AZITA MD	6/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114414	41	Internal Medicine	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
105775	Fee-for-Service	1265769806	1265769806	1	1	TIPTUR MAHADEVAIAH, GURUPRAS	1/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152729	None	None	0	In state provider	AD MD	2929 K ST	STE 200	SACRAMENTO	CA	95816	5122	34	06067	38.572245	-121.4672175	Sacramento County
105797	Fee-for-Service	1174593354	1174593354	1	1	TEW, JOHN G MD	9/30/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83206	18	Ophthalmology	0	In state provider	None	10 CONGRESS ST	STE 300	PASADENA	CA	91105	3023	19	06037	34.13396893	-118.1528162	Los Angeles County
105812	Fee-for-Service	1811336951	1811336951	1	1	TSENG, LISA A MD	5/16/2020	207L00000X	NA	Other	026	PHYSICIANS	154600	05	Anesthesiology	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
105929	Fee-for-Service	1245778620	1245778620	1	1	THEUS, SEAN M NP	2/11/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
105940	Fee-for-Service	1831385707	1831385707	1	1	TING, VICKI W MD	6/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92456	None	None	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
105942	Fee-for-Service	1770830325	1770830325	1	4	TWO TREES PHYSICAL THERAPY &	4/18/2024	225X00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS, INC.	2895 LOMA VISTA ROAD	SUITE H	VENTURA	CA	93003	1542	56	06111	34.27543868	-119.2574459	Ventura County
105950	Fee-for-Service	1538622238	1538622238	1	1	TVERETINOV, AMY P CRNA	4/30/2019	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
105951	Fee-for-Service	1538168950	1538168950	1	2	THE ELIZABETH HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8989 RIO SAN DIEGO DR	SUITE 190	SAN DIEGO	CA	92108	1647	37	06073	32.7757964	-117.1367467	San Diego County
105956	Fee-for-Service	1053774885	1053774885	1	1	TAN, HANNAH N MD	10/15/2019	390200000X	NA	Other	026	PHYSICIANS	154595	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
105975	Fee-for-Service	1700390911	1700390911	1	1	TSENG, KUO-SEN	3/10/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	9711 VILLAGE CENTER DR	STE 11	GRANITE BAY	CA	95746	6493	31	06061	38.72308891	-121.2096364	Placer County
105996	Fee-for-Service	1083980577	1083980577	1	1	TACKLIND, CHRISTINE E NP	10/24/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
106000	Fee-for-Service	1437592292	1437592292	1	1	TOTAL RENAL CARE INC	11/19/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	510 E NORTH WAY	None	DINUBA	CA	93618	1653	54	06107	36.5493536	-119.3901917	Tulare County
106005	Fee-for-Service	1669661492	1669661492	1	1	TAWADROUS, ODETTE R MD	3/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99172	41	Internal Medicine	0	In state provider	None	3625 MARTIN LUTHER KING	STE 10	LYNWOOD	CA	90262	2636	19	06037	33.93044131	-118.2021564	Los Angeles County
106014	Fee-for-Service	1871544593	1871544593	1	1	TUNG, MONICA K MD	11/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	91465	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
106021	Fee-for-Service	1194043901	1194043901	1	1	TOMICH, JENNIFER MD	9/14/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	170747	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
106126	Fee-for-Service	1659433191	1659433191	1	1	TOIYABE INDIAN HEALTH PROJEC	3/1/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	BISHOP CLINIC	52 TU SU LANE	None	BISHOP	CA	93514	8058	14	06027	37.36278369	-118.4183422	Inyo County
106158	Fee-for-Service	1548999014	1548999014	1	1	TSUN, FRECO CRNA	9/20/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
106162	Fee-for-Service	1669425245	1669425245	1	2	THORNBURG, AARON T. DO	3/30/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	16041	41	Internal Medicine	0	In state provider	None	1730 PRAIRIE CITY ROAD	SUITE 120	FOLSOM	CA	95630	9594	34	06067	38.651472	-121.167387	Sacramento County
106186	Fee-for-Service	1356813711	1356813711	1	2	TOTAL VISION, P.C.	10/19/2023	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	718 DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	1038	19	06037	34.03167081	-117.8089198	Los Angeles County
106223	Fee-for-Service	1396811493	1396811493	1	1	TWEET, RUSSELL L MD	6/23/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34918	08	Family Practice	0	In state provider	None	3288 BELL RD	None	AUBURN	CA	95603	9243	31	06061	38.94193048	-121.1046075	Placer County
106226	Fee-for-Service	1720378268	1720378268	1	1	TANKAZYAN, HAMBIK H DO	10/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	12498	41	Internal Medicine	0	In state provider	None	660 W BROADWAY	None	GLENDALE	CA	91204	1008	19	06037	34.14675547	-118.269153	Los Angeles County
106298	Fee-for-Service	1588741615	1588741615	1	1	TVETEN, JOHN E MD	5/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74666	08	Family Practice	0	In state provider	None	3300 RENNER DR	None	FORTUNA	CA	95540	3120	12	06023	40.58243651	-124.135992	Humboldt County
106314	Fee-for-Service	1336412998	1336412998	1	1	TERRY, DARREN PT	10/23/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	24551 RAYMOND WAY	SUITE 125	LAKE FOREST	CA	92630	4478	30	06059	33.62196544	-117.7016469	Orange County
106333	Fee-for-Service	1275990111	1275990111	1	1	TRAN, PHUONG T NP	8/21/2018	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
106374	Fee-for-Service	1306264791	1306264791	1	1	TALLEY, ELIZABETH MD	11/7/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	163044	08	Family Practice	0	In state provider	None	8170 LAGUNA BLVD	STE 101	ELK GROVE	CA	95758	7902	34	06067	38.421054	-121.405365	Sacramento County
106391	Fee-for-Service	1295092526	1295092526	1	1	TRAN, ANTHONY D MD	7/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142625	05	Anesthesiology	0	In state provider	None	1798 N GAREY AVENUE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
106433	Fee-for-Service	1649340076	1649340076	1	2	TRAN, DAI P	2/12/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1013 E CAPITOL EXPY	None	SAN JOSE	CA	95121	2415	43	06085	37.29895883	-121.8236374	Santa Clara County
106447	Fee-for-Service	1033365796	1033365796	1	1	TAKHAR, HERNAKE S OD	10/7/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2601 FASHION PL	None	BAKERSFIELD	CA	93306	3027	15	06029	35.3908146	-118.961799	Kern County
106460	Fee-for-Service	1558130682	1558130682	1	1	THIRDGENRX INC	2/26/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	937 E. GREEN ST	None	PASADENA	CA	91106	2906	19	06037	34.14456849	-118.1310525	Los Angeles County
106496	Fee-for-Service	1427019231	1427019231	1	1	TSAI, MON-TA MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65382	None	None	0	In state provider	None	710 N EUCLID ST	# 107	ANAHEIM	CA	92801	4115	30	06059	33.8420837	-117.9415765	Orange County
106511	Fee-for-Service	1720378268	1720378268	1	1	TANKAZYAN, HAMBIK H DO	10/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	12498	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	660 W BROADWAY	None	GLENDALE	CA	91204	1008	19	06037	34.14675547	-118.269153	Los Angeles County
106539	Fee-for-Service	1598849598	1598849598	1	1	TAYLOR, MARK R MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79457	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
106552	Fee-for-Service	1609262963	1609262963	1	1	TYAGI, ABHILASHA MD	1/19/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	144751	None	None	0	In state provider	None	655 EUCLID AVE	STE 401	NATIONAL CITY	CA	91950	2978	37	06073	32.68353398	-117.082625	San Diego County
106560	Fee-for-Service	1669425575	1669425575	1	1	TSUNEISHI, CHRIS M MD	5/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	68447	41	Internal Medicine	0	In state provider	None	4201 TORRANCE BLVD	STE 360	TORRANCE	CA	90503	4507	19	06037	33.8375955	-118.358748	Los Angeles County
106561	Fee-for-Service	1497797427	1497797427	1	1	TOLWIN, MICHAEL H. MD	10/18/1994	2084P0800X	NA	Psychiatry	026	PHYSICIANS	48816	36	Psychiatry	0	In state provider	None	9730 WASHINGTON BLVD	None	CULVER CITY	CA	90232	2722	19	06037	34.02225898	-118.3963922	Los Angeles County
106584	Fee-for-Service	1205945672	1205945672	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05457	4046 S CENTINELA AVE	None	LOS ANGELES	CA	90066	4907	19	06037	33.99846688	-118.4295646	Los Angeles County
106621	Fee-for-Service	1760777197	1760777197	1	1	TOTARO, LAURA A MD	6/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125361	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
106702	Fee-for-Service	1316289648	1316289648	1	1	TAHIR, ZUNERA MD	12/13/2018	390200000X	NA	Other	026	PHYSICIANS	132167	83	Rheumatology	0	In state provider	None	10243 GENETIC CENTER DR	None	SAN DIEGO	CA	92121	6310	37	06073	32.90618683	-117.1814064	San Diego County
106703	Fee-for-Service	1982603908	1982603908	1	1	TIWARI, BHOODEV MD	9/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	49209	None	None	0	In state provider	SUN CITY CARDIOLOGY INC	27830 BRADLEY RD	None	SUN CITY	CA	92586	2239	33	06065	33.71615891	-117.1906431	Riverside County
106720	Fee-for-Service	1861578569	1861578569	1	1	TAN, SOON-MIN MD	5/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	66493	83	Rheumatology	0	In state provider	None	488 E SANTA CLASRA ST	STE 104	ARCADIA	CA	91006	7231	19	06037	34.14235063	-118.0211625	Los Angeles County
106749	Fee-for-Service	1386022382	1386022382	1	1	TALANKI, VARUN R MD FACS	3/5/2025	208800000X	NA	Other	026	PHYSICIANS	170659	34	Urology and Urological Surgery	0	In state provider	None	25495 MEDICAL CENTER DR	204	MURRIETA	CA	92562	4903	33	06065	33.55804188	-117.1834064	Riverside County
106773	Fee-for-Service	1750855938	1750855938	1	1	TAO, JIANLING MD	7/3/2023	207RN0300X	NA	Nephrology	026	PHYSICIANS	177572	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
106843	Fee-for-Service	1225653322	1225653322	1	1	THAI, MOSES OD	7/10/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	119 S L ST	None	DINUBA	CA	93618	2324	54	06107	36.54055651	-119.3899159	Tulare County
106889	Fee-for-Service	1588773915	1588773915	1	1	THRIFTY PAYLESS INC	9/1/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3029 HARBOR BLVD	None	COSTA MESA	CA	92626	2504	30	06059	33.68151	-117.919477	Orange County
106893	Fee-for-Service	1750965885	1750965885	1	1	TAN, SHAWN PT	1/7/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
106897	Fee-for-Service	1568571990	1568571990	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11845 CARMEL MOUNTAIN RD	None	SAN DIEGO	CA	92128	4602	37	06073	32.98078581	-117.0775276	San Diego County
106921	Fee-for-Service	1457640245	1457640245	1	1	TURLOCK URGENT CARE,INC	11/2/2022	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2010 COLORADO AVE	None	TURLOCK	CA	95382	2002	50	06099	37.51108384	-120.8352603	Stanislaus County
106942	Fee-for-Service	1144753245	1144753245	1	1	TAYLOR, ROBINSON D MD	8/6/2020	207P00000X	NA	Other	026	PHYSICIANS	169423	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
107001	Fee-for-Service	1114103124	1114103124	1	1	TA, TUAN MD	1/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99653	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
107006	Fee-for-Service	1861578569	1861578569	1	1	TAN, SOON-MIN MD	5/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	66493	41	Internal Medicine	0	In state provider	None	488 E SANTA CLASRA ST	STE 104	ARCADIA	CA	91006	7231	19	06037	34.14235063	-118.0211625	Los Angeles County
107009	Fee-for-Service	1992815674	1992815674	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05760	1406 W EDINGER AVE	None	SANTA ANA	CA	92704	4307	30	06059	33.72716454	-117.8874045	Orange County
107016	Fee-for-Service	1033405105	1033405105	1	1	THELEN, BRENDAN J MD	11/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144484	05	Anesthesiology	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
107021	Fee-for-Service	1952356560	1952356560	1	1	TSAI, WILLIAM JEN MD	4/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71679	41	Internal Medicine	0	In state provider	None	19742 MACARTHUR BLVD	STE 101	IRVINE	CA	92612	2447	30	06059	33.65738766	-117.8625556	Orange County
107033	Fee-for-Service	1376840231	1376840231	1	1	TRUMAN, LAURA L NP	9/12/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
107047	Fee-for-Service	1376823948	1376823948	1	1	TAYLOR, KATHERINE A MD	7/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	157249	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11303 WASHINGTON BLVD	STE 100	LOS ANGELES	CA	90095	6003	19	06037	34.00408212	-118.4147433	Los Angeles County
107055	Fee-for-Service	1255460648	1255460648	1	1	TRINITY COUNSELING CENTER	10/12/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13847 E 14TH ST	SUITE 215	SAN LEANDRO	CA	94578	2626	01	06001	37.71457844	-122.1418551	Alameda County
107069	Fee-for-Service	1457476707	1457476707	1	1	TAHERIAN, ELHAM MD	8/14/2008	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1707 W CHARLESTON BLVD	STE 230	LAS VEGAS	NV	89102	2353	00	None	36.15879353	-115.1643015	Clark County
107077	Fee-for-Service	1093269458	1093269458	1	1	TANAKA, MISA MD	11/19/2024	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	None	38	Geriatrics	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
107082	Fee-for-Service	1891788196	1891788196	1	1	THOMAS,NICKOL E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 KOOTENAI HEALTH WAY	None	COEUR D ALENE	ID	83814	6051	00	None	47.695635	-116.792906	Kootenai County
107103	Fee-for-Service	1346867280	1346867280	1	1	TOP LINE HOSPICE CARE INC	6/8/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1100 E BROADWAY AVE	SUITE 303	GLENDALE	CA	91205	1384	19	06037	34.14622171	-118.2415193	Los Angeles County
107133	Fee-for-Service	1275885766	1275885766	1	1	TOTAL RENAL CARE INC	7/23/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1147 PHELPS AVE	None	COALINGA	CA	93210	9662	10	06019	36.15155738	-120.3414256	Fresno County
107141	Fee-for-Service	1225175029	1225175029	1	1	TORAM, SATYA S	10/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	102499	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4404	50	06099	37.66508443	-120.9962589	Stanislaus County
107163	Fee-for-Service	1518527845	1518527845	1	1	TAN, MATTHEW MD	11/18/2024	207LP2900X	NA	Other	026	PHYSICIANS	182435	05	Anesthesiology	0	In state provider	None	1828 CESAR E CHAVEZ AVE	STE 4500	LOS ANGELES	CA	90033	2577	19	06037	34.05023174	-118.2154927	Los Angeles County
107211	Fee-for-Service	1477540896	1477540896	1	1	TAYLOR, JOHN K MD	8/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	36151	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4062 FLYING C RD	STE 41	CAMERON PARK	CA	95682	9664	09	06017	38.65476716	-120.9977643	El Dorado County
107217	Fee-for-Service	1063092419	1063092419	1	1	TFAYE, NICOLE DO	7/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20776	08	Family Practice	0	In state provider	None	28780 SINGLE OAK DRIVE	SUITE 160	TEMECULA	CA	92590	5528	33	06065	33.49890392	-117.1612965	Riverside County
107296	Fee-for-Service	1710015714	1710015714	1	1	TAGHDDOS, SEYED-KARIM MD	12/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102750	30	Radiology	0	In state provider	None	2450 WASHINGTON AVE	None	SAN LEANDRO	CA	94577	5996	01	06001	37.7139863	-122.1490905	Alameda County
107303	Fee-for-Service	1780768416	1780768416	1	3	THC-ORANGE COUNTY LLC	4/6/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	KINDRED HOSPITAL BREA	875 N BREA BLVD	None	BREA	CA	92821	2606	30	06059	33.93434103	-117.8932895	Orange County
107363	Fee-for-Service	1669405007	1669405007	1	1	TUSZYNSKI, MARK H	2/28/1987	2084N0400X	NA	Neurology	026	PHYSICIANS	56665	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
107366	Fee-for-Service	1093269458	1093269458	1	1	TANAKA, MISA MD	11/19/2024	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
107394	Fee-for-Service	1346867280	1346867280	1	1	TOP LINE HOSPICE CARE INC	6/8/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1100 E BROADWAY AVE	SUITE 303	GLENDALE	CA	91205	1384	19	06037	34.14622171	-118.2415193	Los Angeles County
107400	Fee-for-Service	1639853039	1639853039	1	1	THOMPSON, ESTELA	4/9/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9065 HAVEN AVE	STE 110	RANCHO CUCAMONGA	CA	91730	5429	36	06071	34.089012	-117.5756625	San Bernardino County
107408	Fee-for-Service	1316173560	1316173560	1	1	TOTALSOLUTION PAIN & REHABIL	6/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	71882	25	Physical Medicine and Rehabilitation	0	In state provider	ITATION CENTER INC	1661 HANOVER ROAD	SUITE 227	CITY OF INDUSTRY	CA	91748	1796	19	06037	33.99109665	-117.920988	Los Angeles County
107414	Fee-for-Service	1891456190	1891456190	1	3	TERNER HOME	11/14/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7056 MATILIJA AVENUE	None	VAN NUYS	CA	91405	3331	19	06037	34.199235	-118.433433	Los Angeles County
107429	Fee-for-Service	1669581013	1669581013	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1375 ROCKING W DR	None	BISHOP	CA	93514	1995	14	06027	37.37738457	-118.4203339	Inyo County
107439	Fee-for-Service	1700089141	1700089141	1	1	TWAMLEY, ELIZABETH W PHD	9/4/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
107481	Fee-for-Service	1477365997	1477365997	1	1	TEA, JACKSON NP	2/17/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	421 N BROOKHURST ST	STE 119	ANAHEIM	CA	92801	5618	30	06059	33.83743497	-117.9590498	Orange County
107487	Fee-for-Service	1265912489	1265912489	1	1	TRAN, THANH L OD	6/22/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8120 TIMBERLAKE WAY	STE 211	SACRAMENTO	CA	95823	5414	34	06067	38.461023	-121.41414	Sacramento County
107541	Fee-for-Service	1487832234	1487832234	1	1	TRAN, TONY K MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107897	None	None	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
107568	Fee-for-Service	1144786260	1144786260	1	1	THE GRANDVIEW, LLC	3/29/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2211 W 6TH STREET	None	LOS ANGELES	CA	90057	3120	19	06037	34.06040683	-118.2767606	Los Angeles County
107644	Fee-for-Service	1356920615	1356920615	1	1	TOURIEL, ROSS B MD	7/1/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
107752	Fee-for-Service	1558528976	1558528976	1	1	TSE, KEVIN Y MD	8/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109553	03	Allergy	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
107760	Fee-for-Service	1093849507	1093849507	1	1	TUMASIAN, VERONICA LMFT	1/8/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
107870	Fee-for-Service	1851400972	1851400972	1	1	THAMPY, ANILA C MD INC	12/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	48322	66	Emergency Medicine (Urgent Care)	0	In state provider	SIERRA PEDIATRIC MED	1660 E HERNDON AVE	STE 102	FRESNO	CA	93720	3346	10	06019	36.8375615	-119.7575595	Fresno County
107909	Fee-for-Service	1447340070	1447340070	1	1	TRAN, TOAN Q MD INC	4/24/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	39066	04	Otology, Laryngology, Rhinology	0	In state provider	None	7631 WYOMING ST	STE 102	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
107970	Fee-for-Service	1720171325	1720171325	1	1	TALBERT MEDICAL	4/21/2009	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	CORPORATION	3650 E SOUTH ST	STE 303	LAKEWOOD	CA	90712	1515	19	06037	33.8601747	-118.1494013	Los Angeles County
107979	Fee-for-Service	1780635169	1780635169	1	1	TRAN, MICHAEL Q MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	80738	34	Urology and Urological Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
107980	Fee-for-Service	1366904575	1366904575	1	1	THORSON, AMANDA DO	2/16/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	21016	15	Obstetrics (D.O. only)	0	In state provider	None	1941 JOHNSON AVE	None	SAN LUIS OBISPO	CA	93401	4111	40	06079	35.27804785	-120.649711	San Luis Obispo County
107986	Fee-for-Service	1912198565	1912198565	1	1	TRUONG, KIET T MD	4/21/2023	2084P0804X	NA	Psychiatry	026	PHYSICIANS	101895	None	None	0	In state provider	None	1400 EXPO PKWY	None	SACRAMENTO	CA	95815	4230	34	06067	38.597067	-121.457286	Sacramento County
107990	Fee-for-Service	1811163215	1811163215	1	1	THORPE, STEVEN W MD	8/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142035	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
108049	Fee-for-Service	1689690042	1689690042	1	1	TAPINO, LUZ RUBYROSE L	7/16/2015	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
108054	Fee-for-Service	1235956277	1235956277	1	1	TRAN PHAM, HOANG PT	1/10/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
108126	Fee-for-Service	1275096273	1275096273	1	1	THOMPSON, TINA LMFT	10/13/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1095 STAFFORD WAY	E	YUBA CITY	CA	95991	2971	51	06101	39.14336078	-121.6277128	Sutter County
108157	Fee-for-Service	1851400972	1851400972	1	1	THAMPY, ANILA C MD INC	12/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	48322	40	Pediatrics	0	In state provider	SIERRA PEDIATRIC MED	1660 E HERNDON AVE	STE 102	FRESNO	CA	93720	3346	10	06019	36.8375615	-119.7575595	Fresno County
108244	Fee-for-Service	1013928308	1013928308	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5791	199 N FAIRVIEW AVE	None	GOLETA	CA	93117	2304	42	06083	34.442856	-119.8307085	Santa Barbara County
108245	Fee-for-Service	1720171325	1720171325	1	1	TALBERT MEDICAL	4/21/2009	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CORPORATION	3650 E SOUTH ST	STE 303	LAKEWOOD	CA	90712	1515	19	06037	33.8601747	-118.1494013	Los Angeles County
108266	Fee-for-Service	1366904575	1366904575	1	1	THORSON, AMANDA DO	2/16/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	21016	09	Gynecology (D.O. only)	0	In state provider	None	1941 JOHNSON AVE	None	SAN LUIS OBISPO	CA	93401	4111	40	06079	35.27804785	-120.649711	San Luis Obispo County
108326	Fee-for-Service	1073509469	1073509469	1	1	TAFOYA, PHILLIP MD	12/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78628	41	Internal Medicine	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
108405	Fee-for-Service	1205340072	1205340072	1	1	THIND, NAVNEET K PHD	1/22/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
108408	Fee-for-Service	1558436246	1558436246	1	1	TORRES, MARINOR I MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63740	08	Family Practice	0	In state provider	MISSION MEDICAL CORP	1300 N VENTURA RD	STE 8	OXNARD	CA	93030	3836	56	06111	34.214742	-119.1943805	Ventura County
108464	Fee-for-Service	1205653706	1205653706	1	1	THAO, BAO NP	10/21/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3393 G STREET	SUITE C	MERCED	CA	95340	0964	24	06047	37.32623794	-120.4692707	Merced County
108524	Fee-for-Service	1548370638	1548370638	1	1	THORNHILL-JOYNES, M MD	1/1/1982	207R00000X	NA	Other	026	PHYSICIANS	34067	41	Internal Medicine	0	In state provider	None	1710 BROOKLYN AVE	STE 22	LOS ANGELES	CA	90033	2439	19	06037	34.040502	-118.191954	Los Angeles County
108526	Fee-for-Service	1235709684	1235709684	1	1	TOLIVER, KARINA C CNP	9/2/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11525 BROOKSHIRE AVENUE	300	DOWNEY	CA	90241	4985	19	06037	33.93544635	-118.1318321	Los Angeles County
108536	Fee-for-Service	1689672370	1689672370	1	1	TYSON, MICHELLE A MD	8/21/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72333	08	Family Practice	0	In state provider	None	1542 E FLORENCE AVE	None	LOS ANGELES	CA	90001	2536	19	06037	33.97472354	-118.246122	Los Angeles County
108547	Fee-for-Service	1023189073	1023189073	1	1	TRACY, JEFF D MD	3/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	66551	08	Family Practice	0	In state provider	None	2445 MCCABE WAY	None	IRVINE	CA	92614	4293	30	06059	33.67952503	-117.8479012	Orange County
108555	Fee-for-Service	1730745670	1730745670	1	1	THRONE HOSPICE INC	10/8/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10545 BURBANK BLVD	STE 129	NORTH HOLLYWOOD	CA	91601	2249	19	06037	34.1721655	-118.3608315	Los Angeles County
108570	Fee-for-Service	1205861234	1205861234	1	1	TOGNAZZINI, SHERILYN C	8/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89819	08	Family Practice	0	In state provider	MD	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
108606	Fee-for-Service	1225100753	1225100753	1	1	TRAN, FELICIA K MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	63728	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
108626	Fee-for-Service	1902344237	1902344237	1	1	TAIT, DON MD	2/8/2025	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	22641	41	Internal Medicine	0	In state provider	None	3770 ELIZABETH ST	None	RIVERSIDE	CA	92506	2527	33	06065	33.95899507	-117.3917212	Riverside County
108627	Fee-for-Service	1639148828	1639148828	1	1	TEGUH, COLLIN DO	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	6332	08	Family Practice	0	In state provider	None	2045 ADAMS AVE	None	SAN DIEGO	CA	92116	1212	37	06073	32.76253025	-117.1429019	San Diego County
108630	Fee-for-Service	1427576644	1427576644	1	1	TATE, ETHAN J CRNA	12/15/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
108633	Fee-for-Service	1427284918	1427284918	1	1	TINGSTAD, LA TONYA M LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
108657	Fee-for-Service	1811940794	1811940794	1	1	TONKIN, ALLISON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8TH ANVEUE + C STREET	None	SALT LAKE CITY	UT	84143	0000	00	None	40.779063	-111.8805548	Salt Lake County
108701	Fee-for-Service	1295046464	1295046464	1	1	TALISE, PAUL C MD	10/11/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	171691	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
108703	Fee-for-Service	1992082978	1992082978	1	1	TAN, SAMANTHA M NP	5/27/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
108715	Fee-for-Service	1043965452	1043965452	1	1	TAMAYO, CASSANDRA CCC-SLP	10/12/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 S INDIAN HILL BLVD S	None	CLAREMONT	CA	91711	5461	19	06037	34.084494	-117.7191945	Los Angeles County
108745	Fee-for-Service	1083953285	1083953285	1	1	TORRICER SOUSA, FRANCINE L P	7/26/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SYD	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
108753	Fee-for-Service	1942708342	1942708342	1	1	TAFRESHI, AFSANEH	5/11/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
108843	Fee-for-Service	1730745670	1730745670	1	1	THRONE HOSPICE INC	10/8/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10545 BURBANK BLVD	STE 129	NORTH HOLLYWOOD	CA	91601	2249	19	06037	34.1721655	-118.3608315	Los Angeles County
108880	Fee-for-Service	1982963765	1982963765	1	1	THOTAPALLI, KRISHNA M	5/20/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5851 NEWMAN ST	None	CYPRESS	CA	90630	2111	30	06059	33.82804648	-118.0315215	Orange County
108891	Fee-for-Service	1891456190	1891456190	1	1	TERNER HOME	2/17/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	9946 COLUMBUS AVE	None	MISSION HILLS	CA	91345	3014	19	06037	34.2514492	-118.4651801	Los Angeles County
108902	Fee-for-Service	1952627267	1952627267	1	1	TAN, ALINA G MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129303	41	Internal Medicine	0	In state provider	None	3687 MT DIABLO BLVD	SUITE 200	LAFAYETTE	CA	94549	3746	07	06013	37.8898926	-122.1304235	Contra Costa County
108924	Fee-for-Service	1295921401	1295921401	1	1	TU, RICHARD ML DPM	10/15/2008	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	4475 UNIVERSITY AVE	None	SAN DIEGO	CA	92105	1731	37	06073	32.74958647	-117.098073	San Diego County
108941	Fee-for-Service	1649899592	1649899592	1	1	TOLOUI RAHIMABADI, TARA MD	11/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187314	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
108950	Fee-for-Service	1114295250	1114295250	1	1	TANG, JOANNA Z LCSW	4/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	73957	-	NOT APPLICABLE	0	In state provider	None	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	19	06037	34.007238	-118.2653065	Los Angeles County
109003	Fee-for-Service	1164103461	1164103461	1	1	TUMMY ROOM	7/28/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	07	06013	0	0	None
109051	Fee-for-Service	1235498361	1235498361	1	1	TRIPATHI, PRIYAM V MD	5/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137372	10	Gastroenterology (M.D. only)	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
109064	Fee-for-Service	1669599296	1669599296	1	1	TANDON, JAGJIT S MD	10/19/2021	207RH0003X	NA	Oncology	026	PHYSICIANS	172028	68	Hematology	0	In state provider	None	480 4TH AVE	STE 409	CHULA VISTA	CA	91910	4413	37	06073	32.63411298	-117.0816772	San Diego County
109065	Fee-for-Service	1861450611	1861450611	1	1	TIMM, GREGORY S MD	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141250	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
109075	Fee-for-Service	1942308614	1942308614	1	1	THORSON, THOMAS D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 N 7TH ST	None	BISMARCK	ND	58501	4439	00	None	46.808109	-100.782261	Burleigh County
109103	Fee-for-Service	1821423732	1821423732	1	1	TERHUNE, THOMAS J PT	3/29/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2200 E. MAPLE AVE	None	EL SEGUNDO	CA	90245	6507	19	06037	33.92690475	-118.3857342	Los Angeles County
109123	Fee-for-Service	1649532664	1649532664	1	1	TORRES, JENA B MD	2/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132263	01	General Practice	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
109128	Fee-for-Service	1477690220	1477690220	1	1	TRUNKO, MARY ELLEN MD	2/18/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	77144	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
109136	Fee-for-Service	1669550562	1669550562	1	1	TOM, GEOFFREY Y MD	3/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87212	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
109139	Fee-for-Service	1043316888	1043316888	1	1	TOWFIGHI, AMYTIS MD	5/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96340	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	# B200	LOS ANGELES	CA	90095	0000	19	06037	34.06473399	-118.445865	Los Angeles County
109144	Fee-for-Service	1669000220	1669000220	1	1	TAMMEWAR, GAUTAM MD	6/20/2024	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
109149	Fee-for-Service	1619164456	1619164456	1	1	TRIEU, CHUYEN L MD	8/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101391	40	Pediatrics	0	In state provider	None	505 E ROMIE LN	STE K	SALINAS	CA	93901	4031	27	06053	36.65998191	-121.6461895	Monterey County
109182	Fee-for-Service	1568572865	1568572865	1	1	TRAN, TRACY T OD INC	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	305 N MAIN ST	None	SANTA ANA	CA	92701	4852	30	06059	33.7472043	-117.8675716	Orange County
109187	Fee-for-Service	1912091273	1912091273	1	1	TRAN, BICHVAN T MD	7/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91603	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
109188	Fee-for-Service	1649289505	1649289505	1	1	TU, GENE C MD	5/2/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60067	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
109227	Fee-for-Service	1558674655	1558674655	1	1	TAHA, RAZAN MD	12/16/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	124179	08	Family Practice	0	In state provider	None	3000 LAS POSITAS	None	LIVERMORE	CA	94551	9627	01	06001	37.69960369	-121.7628917	Alameda County
109228	Fee-for-Service	1063534204	1063534204	1	2	TIEN T NGUYEN M.D. INC.	10/26/2018	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	None	18035 BROOKHURST ST	SUITE 1700	FOUNTAIN VALLEY	CA	92708	6738	30	06059	33.701184	-117.9544385	Orange County
109266	Fee-for-Service	1134142623	1134142623	1	1	THOMAS, MARK	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	IDAHO EMERGENCY PHYSICAN	1512 12TH AVE RD	None	NAMPA	ID	83686	6008	00	None	43.55346193	-116.5727785	Canyon County
109329	Fee-for-Service	1538168950	1538168950	1	4	THE ELIZABETH HOSPICE INC	4/29/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5938 PRIESTLY DRIVE	SUITE 103	CARLSBAD	CA	92008	8847	37	06073	33.13319205	-117.2723582	San Diego County
109349	Fee-for-Service	1023127479	1023127479	1	2	THRIFTY PAYLESS INC	9/16/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1317 EAST PACHECO BOULEV	None	LOS BANOS	CA	93635	4335	24	06047	37.0569205	-120.8368035	Merced County
109355	Fee-for-Service	1669599296	1669599296	1	1	TANDON, JAGJIT S MD	10/19/2021	207RH0003X	NA	Oncology	026	PHYSICIANS	172028	41	Internal Medicine	0	In state provider	None	480 4TH AVE	STE 409	CHULA VISTA	CA	91910	4413	37	06073	32.63411298	-117.0816772	San Diego County
109386	Fee-for-Service	1043638901	1043638901	1	1	TSENG, YI	4/18/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
109394	Fee-for-Service	1013361138	1013361138	1	1	TORRES, JESUS R MD	12/31/2019	207P00000X	NA	Other	026	PHYSICIANS	153898	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1038 E BROKAW ROAD	SUITE 30	SAN JOSE	CA	95131	2309	43	06085	37.3827822	-121.8982439	Santa Clara County
109411	Fee-for-Service	1366522831	1366522831	1	1	TURNER, TERRI L DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	6479	41	Internal Medicine	0	In state provider	A PROFESSIONAL CORP	698 PETALUMA AVE	None	SEBASTOPOL	CA	95472	4217	49	06097	38.3960394	-122.819749	Sonoma County
109422	Fee-for-Service	1801351788	1801351788	1	1	TO, PATRICIA H OT	1/29/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	350 JOHN MUIR PKWY	250	BRENTWOOD	CA	94513	5183	07	06013	37.91980577	-121.734715	Contra Costa County
109424	Fee-for-Service	1740217223	1740217223	1	1	THIESSEN, WESLEY D LCSW	6/13/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	624 WOODWORTH AVE	None	CLOVIS	CA	93612	1847	10	06019	36.822411	-119.7034285	Fresno County
109436	Fee-for-Service	1720166333	1720166333	1	1	TSO, ALICE C MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63393	36	Psychiatry	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
109448	Fee-for-Service	1689912552	1689912552	1	1	TASHTOUSH, NADER H MD	11/25/2019	207RC0200X	NA	Other	026	PHYSICIANS	166480	41	Internal Medicine	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	0001	39	06077	37.97026329	-121.2890849	San Joaquin County
109449	Fee-for-Service	1073518015	1073518015	2	1	TEHAMA PHARMACY AND TRADING	4/15/2014	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	COMPANY	401 WALNUT STREET	None	RED BLUFF	CA	96080	3319	52	06103	40.17779587	-122.2368802	Tehama County
109462	Fee-for-Service	1972985422	1972985422	1	1	THOMAS, KAMALA S PHD	8/10/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7700 IRVINE CENTER DR	STE 800	IRVINE	CA	92618	3047	30	06059	33.65876225	-117.7500004	Orange County
109483	Fee-for-Service	1104313287	1104313287	1	1	TRAN, HOANG YEN N DPM	7/9/2021	390200000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1701 E CESAR E CHAVEZ AV	STE 100	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
109512	Fee-for-Service	1164097440	1164097440	1	1	TABATABAI-YAZDI, NEELOUFAR	7/15/2024	390200000X	NA	Other	026	PHYSICIANS	22629	66	Emergency Medicine (Urgent Care)	0	In state provider	DO	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
109531	Fee-for-Service	1407185069	1407185069	2	1	TRUC H DAO MD INC	5/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	50341	None	None	0	In state provider	None	5771 WINDBOURNE DR	None	HUNTINGTON BEACH	CA	92647	2142	30	06059	33.75213172	-118.0282366	Orange County
109587	Fee-for-Service	1336228071	1336228071	1	1	TSENG, DANIEL S MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	83271	41	Internal Medicine	0	In state provider	None	8089 MADISON AVE	None	CITRUS HEIGHTS	CA	95610	7964	34	06067	38.665584	-121.26375	Sacramento County
109618	Fee-for-Service	1538168950	1538168950	1	4	THE ELIZABETH HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5938 PRIESTLY DRIVE	SUITE 103	CARLSBAD	CA	92008	8847	37	06073	33.13319205	-117.2723582	San Diego County
109697	Fee-for-Service	1992260053	1992260053	1	1	TORREDA, HERMIL CLAIRE M NP	8/13/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1263 E ARQUES AVENUE	None	SUNNYVALE	CA	94085	4701	43	06085	37.38060846	-121.9896672	Santa Clara County
109706	Fee-for-Service	1164483533	1164483533	1	1	TOTAL RENAL CARE, INC	10/27/1999	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CRESENT HEIGHTS DIALYSIS	8151 BEVERLY BLVD	None	LOS ANGELES	CA	90048	4514	19	06037	34.0761215	-118.3671945	Los Angeles County
109773	Fee-for-Service	1508068610	1508068610	1	1	TRAN, THY THAI DO	8/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11846	40	Pediatrics	0	In state provider	None	5301 F ST	STE 313	SACRAMENTO	CA	95819	3222	34	06067	38.571354	-121.4368695	Sacramento County
109784	Fee-for-Service	1093886988	1093886988	1	1	TAUR, ALAN S MD	5/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74754	42	Nuclear 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
109815	Fee-for-Service	1750700712	1750700712	1	1	TORBENSEN, JULIE	1/12/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	981 S RIM CREST DR	None	ANAHEIM HILLS	CA	92807	4538	30	06059	33.84335844	-117.7437001	Orange County
109823	Fee-for-Service	1053819177	1053819177	1	2	TRANSAMERICA MEDICAL GROUP I	10/19/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1581 HILLMAN ST	None	TULARE	CA	93274	1633	54	06107	36.22784162	-119.3310299	Tulare County
109862	Fee-for-Service	1952509465	1952509465	1	1	TRINITY MEDICAL CENTER LLC	10/20/2010	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4343 N JOSEY LANE	None	CARROLLTON	TX	75010	4603	00	None	33.02809675	-96.88453535	Denton County
109878	Fee-for-Service	1275591984	1275591984	1	1	TUALITY COMM HOSP	11/5/2006	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	335 SE 8TH AVE	None	HILLSBORO	OR	97123	4246	00	None	45.51948957	-122.9773135	Washington County
109885	Fee-for-Service	1578690343	1578690343	1	1	TROTTER, JOEL A MD	9/30/1988	174400000X	NA	Other	026	PHYSICIANS	65207	77	Infectious Disease	0	In state provider	None	1041 E YORBA LINDA BLVD	STE 5	PLACENTIA	CA	92870	3736	30	06059	33.88848865	-117.8451029	Orange County
109886	Fee-for-Service	1588068589	1588068589	1	1	TELECARE CORPORATION	7/1/2016	No Taxonomy Provided	NA	None	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	935-B SPRING STREET	None	PLACERVILLE	CA	95667	4523	09	06017	38.73231685	-120.8018873	El Dorado County
109931	Fee-for-Service	1659541019	1659541019	1	1	TOUHY, JOHN G DO	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10067	08	Family Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
110055	Fee-for-Service	1083668313	1083668313	1	1	TOOLE, MANDANA A DO	6/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106760	None	None	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
110086	Fee-for-Service	1770830325	1770830325	1	3	TWO TREES PHYSICAL THERAPY &	4/18/2024	225X00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2051 STATHAM BLVD	None	OXNARD	CA	93033	3901	56	06111	34.17967669	-119.1655477	Ventura County
110108	Fee-for-Service	1750700712	1750700712	1	1	TORBENSEN, JULIE	1/12/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	981 S RIM CREST DR	None	ANAHEIM HILLS	CA	92807	4538	30	06059	33.84335844	-117.7437001	Orange County
110116	Fee-for-Service	1598079717	1598079717	1	1	TAWIL, RANA N MD	10/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112547	22	Pathology (M.D. only)	0	In state provider	None	1401 GARCES HIGHWAY	None	DELANO	CA	93215	3690	15	06029	35.76144847	-119.238912	Kern County
110149	Fee-for-Service	1235183427	1235183427	1	1	THOMAS BOYER DO	1/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	751 NE BLAKELY DR	None	ISSAQUAH	WA	98029	6201	00	None	47.53652154	-122.0220045	King County
110152	Fee-for-Service	1952509465	1952509465	1	1	TRINITY MEDICAL CENTER LLC	10/20/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4343 N JOSEY LANE	None	CARROLLTON	TX	75010	4603	00	None	33.02809675	-96.88453535	Denton County
110155	Fee-for-Service	1205367174	1205367174	1	1	THAKKAR, AMRUTA MD	12/11/2023	2080P0205X	NA	Endocrinology	026	PHYSICIANS	190231	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
110163	Fee-for-Service	1700056314	1700056314	1	1	TONG. WINNIE M MD	10/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	88471	24	Plastic Surgery	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
110167	Fee-for-Service	1275591984	1275591984	1	1	TUALITY COMM HOSP	11/5/2006	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	335 SE 8TH AVE	None	HILLSBORO	OR	97123	4246	00	None	45.51948957	-122.9773135	Washington County
110170	Fee-for-Service	1194987800	1194987800	1	1	TENG, EDWARD C H MD	11/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1200 W MOHAVE STREET	None	PARKER	AZ	85344	6349	00	None	34.13580083	-114.2842352	La Paz County
110174	Fee-for-Service	1578690343	1578690343	1	1	TROTTER, JOEL A MD	9/30/1988	174400000X	NA	Other	026	PHYSICIANS	65207	41	Internal Medicine	0	In state provider	None	1041 E YORBA LINDA BLVD	STE 5	PLACENTIA	CA	92870	3736	30	06059	33.88848865	-117.8451029	Orange County
110176	Fee-for-Service	1871026526	1871026526	1	1	TINGLIN, PATRICIA RONNICA	8/9/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3567 SARDINIA ISLAND WAY	None	SACRAMENTO	CA	95834	7760	34	06067	38.646036	-121.5411885	Sacramento County
110200	Fee-for-Service	1255575221	1255575221	1	1	TOROUSSIAN, ROBERT MD	6/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114999	None	None	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
110224	Fee-for-Service	1780718742	1780718742	1	1	TOVAR, EDWARD LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
110237	Fee-for-Service	1780848325	1780848325	1	1	TIMME, REBECCA S DO	2/22/2023	2084P0804X	NA	Psychiatry	026	PHYSICIANS	12195	None	None	0	In state provider	None	5 BON AIR ROAD	STE 105	LARKSPUR	CA	94939	1137	21	06041	37.9438204	-122.5395357	Marin County
110240	Fee-for-Service	1881793420	1881793420	1	1	TUNGUYEN, DAITRANG	9/20/2007	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	7240 E SOUTHGATE DR	STE G	SACRAMENTO	CA	95823	2627	34	06067	38.494359	-121.438377	Sacramento County
110261	Fee-for-Service	1508975962	1508975962	1	1	THRIFTY PAYLESS INC	5/15/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6396	2419 E AVENUE S	None	PALMDALE	CA	93550	6202	19	06037	34.55816343	-118.0852364	Los Angeles County
110300	Fee-for-Service	1215267190	1215267190	1	1	TIU, HANNAH S MD	9/11/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	-	45	Nephrology (Renal-Kidney)	1	Border provider	None	2545 S BRUCE ST	STE 200	LAS VEGAS	NV	89169	1731	00	None	36.143271	-115.1254975	Clark County
110348	Fee-for-Service	1144507930	1144507930	1	1	TULARE ANESTHESIA	12/15/2011	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CONSULTANTS INC	869 N CHERRY ST	None	TULARE	CA	93274	2207	54	06107	36.220932	-119.337698	Tulare County
110351	Fee-for-Service	1679525349	1679525349	1	1	TAN, LUCAS GO MD	8/21/1996	207L00000X	NA	Other	026	PHYSICIANS	25847	05	Anesthesiology	0	In state provider	DOUGHERTY AVENUE	RR 2 BOX 619G	None	MORGAN HILL	CA	95037	9802	43	06085	37.128753	-121.6531193	Santa Clara County
110369	Fee-for-Service	1962089615	1962089615	1	1	THOMAS, JOSEPH J MD	6/10/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
110370	Fee-for-Service	1699156281	1699156281	1	1	TAYLOR, NICHOLAS K MD	5/25/2018	390200000X	NA	Other	026	PHYSICIANS	144643	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
110373	Fee-for-Service	1770830325	1770830325	1	3	TWO TREES PHYSICAL THERAPY &	4/25/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2051 STATHAM BLVD	None	OXNARD	CA	93033	3901	56	06111	34.17967669	-119.1655477	Ventura County
110428	Fee-for-Service	1457511628	1457511628	1	1	TENDULKAR, AMOD MD	4/22/2022	208G00000X	NA	General Surgery	026	PHYSICIANS	81369	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
110441	Fee-for-Service	1174824544	1174824544	1	1	TEPLIN, LAWRENCE A D P M	8/31/2011	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	909 SAN RAMON VALLEY BLV	STE 118	DANVILLE	CA	94526	4038	07	06013	37.80810228	-121.9921839	Contra Costa County
110443	Fee-for-Service	1467533976	1467533976	1	1	TOLL, PAMELA PSY D	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	100 N BRAND BLVD	STE 207	GLENDALE	CA	91203	2641	19	06037	34.14652066	-118.2549229	Los Angeles County
110450	Fee-for-Service	1447681325	1447681325	1	1	TRAN, THUC MD CORP	10/24/2018	193400000X	NA	Other	026	PHYSICIANS	139269	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	13031 KERRY STREET	None	GARDEN GROVE	CA	92844	1638	30	06059	33.773265	-117.958877	Orange County
110464	Fee-for-Service	1871026526	1871026526	1	1	TINGLIN, PATRICIA RONNICA	8/9/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3567 SARDINIA ISLAND WAY	None	SACRAMENTO	CA	95834	7760	34	06067	38.646036	-121.5411885	Sacramento County
110592	Fee-for-Service	1477987352	1477987352	1	1	TUTTLE, MEREDITH Q NP	4/24/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
110598	Fee-for-Service	1649858879	1649858879	1	1	TERRASSA, PATRICK J MD	7/1/2024	207P00000X	NA	Other	026	PHYSICIANS	187055	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
110619	Fee-for-Service	1487712790	1487712790	1	1	THAKUR, CHAHAT MD	4/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94354	08	Family Practice	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
110637	Fee-for-Service	1174815815	1174815815	1	1	TA, VON A MD	8/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115066	03	Allergy	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
110642	Fee-for-Service	1235248691	1235248691	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	520 W LODI AVE	None	LODI	CA	95240	3425	39	06077	38.12998351	-121.280229	San Joaquin County
110657	Fee-for-Service	1962089615	1962089615	1	1	THOMAS, JOSEPH J MD	6/10/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
110662	Fee-for-Service	1770830325	1770830325	1	3	TWO TREES PHYSICAL THERAPY &	4/25/2019	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2051 STATHAM BLVD	None	OXNARD	CA	93033	3901	56	06111	34.17967669	-119.1655477	Ventura County
110703	Fee-for-Service	1114556495	1114556495	1	1	TIEU, NINA DO	9/3/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	22696	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
110739	Fee-for-Service	1841054822	1841054822	1	1	TASKIDS SPEECH THERAPY, INC	2/26/2024	224Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2201 E 4TH ST	None	SANTA ANA	CA	92705	3804	30	06059	33.74828847	-117.8360595	Orange County
110792	Fee-for-Service	1881881357	1881881357	1	1	TRUONG, HIEU T MD	11/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96377	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
110800	Fee-for-Service	1407988389	1407988389	1	1	TSUDA, SHAWN T MD	8/14/2008	208600000X	NA	General Surgery	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	1707 W CHARLESTON BLVD	SUITE 120	LAS VEGAS	NV	89102	2352	00	None	36.15879353	-115.1643015	Clark County
110824	Fee-for-Service	1952807513	1952807513	1	1	TRZCINSKI, BRETT R MD	10/9/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	42	06083	34.42887662	-119.7237878	Santa Barbara County
110838	Fee-for-Service	1790453975	1790453975	1	1	THOMPSON, PHILLISHA CNP	2/7/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	5400 SOUTH RAINBOW BLVD.	None	LAS VEGAS	NV	89118	1859	00	None	36.090072	-115.2405585	Clark County
110847	Fee-for-Service	1235784216	1235784216	1	1	TAKHAR, LIVNEET K NP	9/25/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
110866	Fee-for-Service	1225098692	1225098692	1	1	TAN, LYDIA A OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	756 W GARVEY AVE	None	MONTEREY PARK	CA	91754	2708	19	06037	34.06236548	-118.1331225	Los Angeles County
110871	Fee-for-Service	1548329626	1548329626	1	1	TAMMINGA, JULIE A LMFT	8/27/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7293 DUMOSA AVE	STE 8	YUCCA VALLEY	CA	92284	3700	36	06071	34.12094334	-116.4177385	San Bernardino County
110888	Fee-for-Service	1437465028	1437465028	1	1	TREMMEL-HOWELL, KELLY CCC-A	9/21/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2415 HIGH SCHOOL AVE	STE 300	CONCORD	CA	94520	1815	07	06013	37.98481374	-122.0347555	Contra Costa County
110892	Fee-for-Service	1184187379	1184187379	1	1	TINGLEY, JENNIFER P MD	7/7/2023	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	186135	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
110907	Fee-for-Service	1487712790	1487712790	1	1	THAKUR, CHAHAT MD	4/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94354	01	General Practice	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
110910	Fee-for-Service	1982696944	1982696944	1	1	THIAGARAJAH, CHITTA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	33498	05	Anesthesiology	0	In state provider	None	1720 W AVENUE J	None	LANCASTER	CA	93534	2700	19	06037	34.68938955	-118.161981	Los Angeles County
110926	Fee-for-Service	1174815815	1174815815	1	1	TA, VON A MD	8/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115066	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
110945	Fee-for-Service	1962089615	1962089615	1	1	THOMAS, JOSEPH J MD	6/10/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
110965	Fee-for-Service	1619465770	1619465770	1	1	TURGISS, KRYSTAL L MD	10/28/2021	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
110996	Fee-for-Service	1851611842	1851611842	1	1	TYLER, MATTHEW D DO	12/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3269 STOCKTON HILL RD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
111031	Fee-for-Service	1841054822	1841054822	1	1	TASKIDS SPEECH THERAPY, INC	2/26/2024	224Z00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2201 E 4TH ST	None	SANTA ANA	CA	92705	3804	30	06059	33.74828847	-117.8360595	Orange County
111073	Fee-for-Service	1124560024	1124560024	1	1	TAMBOLI, KAVITA C LAC	6/8/2020	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	4086 BAY ST	A	FREMONT	CA	94538	4205	01	06001	37.53290964	-121.9612098	Alameda County
111088	Fee-for-Service	1942542592	1942542592	1	1	TSAI, JENNIFER MD	6/6/2019	2080P0207X	NA	Hematology	026	PHYSICIANS	140548	68	Hematology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
111090	Fee-for-Service	1275587461	1275587461	1	1	TEFERRA, ETHIOPIA MD	11/20/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	133779	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
111097	Fee-for-Service	1093582470	1093582470	1	1	THRIVE PRIMARY CARE	3/20/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2390 BIDWELL ST	300	FOLSOM	CA	95630	3872	34	06067	38.664882	-121.1381055	Sacramento County
111104	Fee-for-Service	1164696993	1164696993	1	2	TURNER, RANDALL G DO	7/19/2022	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	10933	-	NOT APPLICABLE	0	In state provider	None	707 E. TAHQUITZ CANYON W	14	PALM SPRINGS	CA	92262	6761	33	06065	33.8230137	-116.54049	Riverside County
111131	Fee-for-Service	1932218211	1932218211	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5657	6505 MISSION GORGE RD	None	SAN DIEGO	CA	92120	2306	37	06073	32.79204233	-117.0976478	San Diego County
111170	Fee-for-Service	1194742650	1194742650	1	1	TOBIN, GARRY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	660 S EUCLID	CAMPUS BOX 8015	ST LOUIS	MO	63110	1010	00	None	38.63518793	-90.26307576	St. Louis city
111173	Fee-for-Service	1437117074	1437117074	1	1	THE REGENTS OF THE UNIVERSIT	5/15/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	E	300 MEDICAL PLAZA # B200	None	LOS ANGELES	CA	90095	8346	19	06037	34.06473399	-118.445865	Los Angeles County
111202	Fee-for-Service	1205252103	1205252103	1	1	TERESA TALBOT	7/12/2020	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 W THOMAS RD	STE 600	PHOENIX	AZ	85013	4221	00	None	33.481485	-112.080816	Maricopa County
111213	Fee-for-Service	1275944035	1275944035	1	1	TSAI, TE-JUNG MD	11/17/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	169263	None	None	0	In state provider	None	4640 ADMIRALTY WAY	STE 102	MARINA DEL REY	CA	90292	6629	19	06037	33.98120707	-118.4409729	Los Angeles County
111232	Fee-for-Service	1518128115	1518128115	1	1	TINITIGAN, ROCHELLE J MD	11/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115985	08	Family Practice	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
111234	Fee-for-Service	1649318866	1649318866	1	1	TEPPER, ROBYN S MD	1/1/1993	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	78527	08	Family Practice	0	In state provider	None	570 PRICE AVE	# 100	REDWOOD CITY	CA	94063	1411	41	06081	37.49373911	-122.2312352	San Mateo County
111247	Fee-for-Service	1851963045	1851963045	1	1	THOMAS, KELLI LMFT	9/17/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6904 VILLAGE PARKWAY	None	DUBLIN	CA	94568	2406	01	06001	37.70726135	-121.9248393	Alameda County
111273	Fee-for-Service	1588609721	1588609721	1	1	THOMAS TAYERI MD, INC	2/15/2006	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1805 EL CAMINO REAL	STE 100	PALO ALTO	CA	94306	1162	43	06085	37.42920084	-122.1507067	Santa Clara County
111325	Fee-for-Service	1790881795	1790881795	1	1	TWARDOWSKA, KATARZYNA M	5/15/2009	207R00000X	NA	Other	026	PHYSICIANS	69481	41	Internal Medicine	0	In state provider	MD	100 W CALIFORNIA BLVD	None	PASADENA	CA	91109	7013	19	06037	34.133598	-118.1534895	Los Angeles County
111327	Fee-for-Service	1447749882	1447749882	1	1	TAKYAR, ANKIT MD	6/23/2022	207R00000X	NA	Other	026	PHYSICIANS	173410	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
111377	Fee-for-Service	1942542592	1942542592	1	1	TSAI, JENNIFER MD	6/6/2019	2080P0207X	NA	Hematology	026	PHYSICIANS	140548	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
111391	Fee-for-Service	1902804230	1902804230	1	2	TRAN, DAVID D DPM	10/28/2022	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1 SHRADER ST	SUITE 580	SAN FRANCISCO	CA	94117	1016	38	06075	37.77467326	-122.4529451	San Francisco County
111462	Fee-for-Service	1437117074	1437117074	1	1	THE REGENTS OF THE UNIVERSIT	7/20/1992	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	E	300 MEDICAL PLAZA # B200	None	LOS ANGELES	CA	90095	8346	19	06037	34.06473399	-118.445865	Los Angeles County
111470	Fee-for-Service	1326502931	1326502931	1	1	TAFOYA, ADRIAN LCSW	4/18/2023	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
111516	Fee-for-Service	1376201046	1376201046	1	1	THE VINEYARDS AT FOWLER LLC	11/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1306 E SUMNER AVE	None	FOWLER	CA	93625	2627	10	06019	36.62727693	-119.6729936	Fresno County
111524	Fee-for-Service	1033225636	1033225636	1	1	THOMAS, ANGELYN MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85229	09	Gynecology (D.O. only)	0	In state provider	None	461 34TH ST	None	OAKLAND	CA	94609	2815	01	06001	37.82196319	-122.2637023	Alameda County
111533	Fee-for-Service	1073651287	1073651287	1	1	THOMAS, GARY A	3/13/1996	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	17973 BEAR VALLEY RD	STE 1	HESPERIA	CA	92345	4904	36	06071	34.47101651	-117.271602	San Bernardino County
111542	Fee-for-Service	1134230725	1134230725	1	1	TAN, ZEHUI MD	4/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84029	41	Internal Medicine	0	In state provider	None	488 E VALLEY PKWY	STE 314	ESCONDIDO	CA	92025	3376	37	06073	33.12523814	-117.0769715	San Diego County
111544	Fee-for-Service	1255406732	1255406732	1	1	TRASK, TRACI M	9/28/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
111547	Fee-for-Service	1528769593	1528769593	1	1	THOMPSON, HOLLY C LPCC	11/13/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
111550	Fee-for-Service	1184746968	1184746968	1	1	TATEVOSSIAN, RAYMOND G	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87098	05	Anesthesiology	0	In state provider	MD	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	4809	19	06037	34.158213	-118.328112	Los Angeles County
111568	Fee-for-Service	1144703935	1144703935	1	2	TIMOTHY GALAN, M.D., INC	9/20/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
111581	Fee-for-Service	1639694011	1639694011	1	1	TIMBERLAKE, BRIANA R	10/2/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
111632	Fee-for-Service	1902553498	1902553498	1	1	TITH, JENNY K PT	2/28/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9850 GENESEE AVE	510	LA JOLLA	CA	92037	1224	37	06073	32.882913	-117.226341	San Diego County
111641	Fee-for-Service	1841827409	1841827409	1	1	TRAN, MINH TRANG T MD	12/5/2023	207R00000X	NA	Other	026	PHYSICIANS	177824	None	None	0	In state provider	None	955 W IMPERIAL HWY	SUITE 110	BREA	CA	92821	3812	30	06059	33.91745451	-117.9133065	Orange County
111672	Fee-for-Service	1619988508	1619988508	1	1	TONIA HOGGARTH MD	4/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 21ST AVE SE	None	MINOT	ND	58701	6064	00	None	48.20922151	-101.2815981	Ward County
111683	Fee-for-Service	1366491474	1366491474	1	1	TARAS, HOWARD L MD	8/31/1984	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	41696	40	Pediatrics	0	In state provider	None	225 DICKINSON ST	# H201	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
111686	Fee-for-Service	1720644602	1720644602	1	1	THE STEPHOUSE RECOVERY, INC.	5/18/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1601 BAKER ST	None	COSTA MESA	CA	92626	3701	30	06059	33.68079547	-117.923451	Orange County
111691	Fee-for-Service	1740713387	1740713387	1	1	TON-THAT, MATTHEW V MD	9/30/2022	208800000X	NA	Other	026	PHYSICIANS	177363	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
111730	Fee-for-Service	1861762593	1861762593	1	1	THAGHALLI SIDDEGOWDA, MD	6/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124069	41	Internal Medicine	0	In state provider	SUNIL K MD	1000 GREENLEY ROAD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
111752	Fee-for-Service	1215916002	1215916002	1	1	THOMAS JEFFERSON	9/30/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	UNIVERSITY HOSPITAL	111 SOUTH 11TH STREET	None	PHILADELPHIA	PA	19107	4949	00	None	39.949619	-75.15870779	Philadelphia County
111793	Fee-for-Service	1881198406	1881198406	1	1	TEE, ALEXANDRA MD	7/29/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164392	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
111807	Fee-for-Service	1033225636	1033225636	1	1	THOMAS, ANGELYN MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85229	15	Obstetrics (D.O. only)	0	In state provider	None	461 34TH ST	None	OAKLAND	CA	94609	2815	01	06001	37.82196319	-122.2637023	Alameda County
111832	Fee-for-Service	1528556180	1528556180	1	1	TAN, ZHE MD	11/23/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173411	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
111833	Fee-for-Service	1376632315	1376632315	1	1	TRAN, THOA K LCSW	12/19/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	594 NORTH GLASSELL STREE	None	ORANGE	CA	92867	6748	30	06059	33.796782	-117.853129	Orange County
111840	Fee-for-Service	1528681491	1528681491	1	1	TALACH SPEECH THERAPY, INC.	1/24/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL CORPORATI	1700 N BROADWAY	390	WALNUT CREEK	CA	94596	4115	07	06013	37.90296351	-122.0611486	Contra Costa County
111862	Fee-for-Service	1760793822	1760793822	1	2	THOMPSON, RACHEL M MD	5/1/2017	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	403 W ADAMS BLVD	None	LOS ANGELES	CA	90007	2664	19	06037	34.02741539	-118.2743622	Los Angeles County
111925	Fee-for-Service	1386283091	1386283091	1	1	TOM, JONATHAN N DO	7/1/2024	207P00000X	NA	Other	026	PHYSICIANS	20879	66	Emergency Medicine (Urgent Care)	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
111999	Fee-for-Service	1316319171	1316319171	1	1	TALAGA, JOHN	8/2/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	38	06075	37.76850146	-122.3949365	San Francisco County
112026	Fee-for-Service	1699284307	1699284307	1	1	THAKUR GARCIA, JAYVANI MD	9/8/2023	207R00000X	NA	Other	026	PHYSICIANS	188068	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
112041	Fee-for-Service	1215916002	1215916002	1	1	THOMAS JEFFERSON	9/30/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	UNIVERSITY HOSPITAL	111 SOUTH 11TH STREET	None	PHILADELPHIA	PA	19107	4949	00	None	39.949619	-75.15870779	Philadelphia County
112045	Fee-for-Service	1891150397	1891150397	1	1	TAVALLAEE, MAHKAM MD	8/27/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154555	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
112075	Fee-for-Service	1447700737	1447700737	1	1	T & T CARE, INC	11/12/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2015 WILSHIRE BLVD	None	LOS ANGELES	CA	90057	3503	19	06037	34.05752693	-118.2749902	Los Angeles County
112133	Fee-for-Service	1609455492	1609455492	1	1	TRAN, PAUL	7/15/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
112148	Fee-for-Service	1295928976	1295928976	1	1	TONG, CONNIE C CCC-SLP	2/18/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	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
112272	Fee-for-Service	1932754637	1932754637	1	1	TORRES, ALVARO F OD	8/18/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	207 S SANTA ANITA ST	SUITE P-25	SAN GABRIEL	CA	91776	1145	19	06037	34.10072807	-118.1066296	Los Angeles County
112285	Fee-for-Service	1871602292	1871602292	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	914 S FAIR OAKS AVE	None	PASADENA	CA	91105	2626	19	06037	34.13025152	-118.1502744	Los Angeles County
112335	Fee-for-Service	1891789566	1891789566	1	1	TANTAMJARIK, PUMIPAK MD	8/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71362	None	None	0	In state provider	None	12555 GARDEN GROVE BLVD	STE 504	GARDEN GROVE	CA	92843	1903	30	06059	33.77450946	-117.913041	Orange County
112361	Fee-for-Service	1750638821	1750638821	1	1	TRI-CITY EMERGENCY MEDICAL	5/2/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	GROUP	2122 S EL CAMINO REAL	STE 100	OCEANSIDE	CA	92054	6209	37	06073	33.18964194	-117.3280508	San Diego County
112370	Fee-for-Service	1275186793	1275186793	1	1	THINKNETIC MEDICAL CORPORATI	8/30/2021	2083P0901X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1950 S SUNWEST LN	108	SAN BERNARDINO	CA	92408	3263	36	06071	34.06493336	-117.2907254	San Bernardino County
112388	Fee-for-Service	1093277899	1093277899	1	1	TAYLOR, ALTELISHA L MD	8/17/2022	207QS0010X	NA	Adult Primary Care	026	PHYSICIANS	178138	None	None	0	In state provider	None	1225 15TH ST	2100	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
112408	Fee-for-Service	1144606237	1144606237	1	1	TRAN, JENNIFER OD	4/18/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	13800 SAN ANTONIO DR	None	NORWALK	CA	90650	4094	19	06037	33.9058081	-118.0785951	Los Angeles County
112418	Fee-for-Service	1609455492	1609455492	1	1	TRAN, PAUL	7/15/2024	207P00000X	NA	Other	026	PHYSICIANS	-	70	Clinic (mixed specialty)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
112425	Fee-for-Service	1487631446	1487631446	1	1	TOUSINEZHAD, AHMAD PHD	4/1/2001	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8140 N 8TH ST	None	FRESNO	CA	93720	2262	10	06019	36.85453228	-119.7641746	Fresno County
112430	Fee-for-Service	1417310962	1417310962	1	1	TEMPLE, LUISA F MD	10/5/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168868	15	Obstetrics (D.O. only)	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
112447	Fee-for-Service	1053819177	1053819177	1	1	TRANSAMERICA MEDICAL GROUP I	3/6/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	810 N CHERRY ST	None	TULARE	CA	93274	2208	54	06107	36.21963458	-119.3376383	Tulare County
112459	Fee-for-Service	1194316430	1194316430	1	1	TRAN, BETTY PT	3/26/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7525 METROPOLITAN DR	STE 306	SAN DIEGO	CA	92108	4404	37	06073	32.77677653	-117.1592911	San Diego County
112474	Fee-for-Service	1609199066	1609199066	1	1	TLC MEDICAL TRANSPORT SVCS	6/1/2015	3416L0300X	NA	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	2	Out of state provider	INC	638 BURNET AVENUE	None	SYRACUSE	NY	13203	2404	00	None	43.051968	-76.134618	Onondaga County
112488	Fee-for-Service	1972766129	1972766129	1	1	TEMELKOVSKA, VESNA A MD	9/26/2012	207L00000X	NA	Other	026	PHYSICIANS	96900	05	Anesthesiology	0	In state provider	None	21530 SOUTH PIONEER BLVD	None	HAWAIIAN GARDENS	CA	90716	2608	19	06037	33.83358457	-118.0817796	Los Angeles County
112505	Fee-for-Service	1942371588	1942371588	1	1	TURNS, JOHN E MD	6/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	44402	66	Emergency Medicine (Urgent Care)	0	In state provider	CARE POINT MEDICAL CENTE	22101 REDWOOD RD	None	CASTRO VALLEY	CA	94546	7107	01	06001	37.68666803	-122.0735922	Alameda County
112510	Fee-for-Service	1427129485	1427129485	1	1	TEPLINSKY, KERRY S MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68682	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1801 W ROMNEYA DR	STE 409	ANAHEIM	CA	92801	1827	30	06059	33.8506615	-117.946413	Orange County
112517	Fee-for-Service	1699770321	1699770321	1	1	T0RKAN, BRUCE MD	11/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40561	08	Family Practice	0	In state provider	None	1148 SO BOWAN AVE, #2	None	LOS ANGELES	CA	90023	0000	19	06037	34.019604	-118.187202	Los Angeles County
112543	Fee-for-Service	1083723514	1083723514	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05678	51101 HARRISON ST	None	COACHELLA	CA	92236	1560	33	06065	33.71023983	-116.1827622	Riverside County
112608	Fee-for-Service	1346297892	1346297892	2	1	THE CHARLOTTE-MECKLENBURG HO	2/10/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	Y	8800 N TRYON ST	None	CHARLOTTE	NC	28262	3300	00	None	35.306298	-80.7474735	Mecklenburg County
112621	Fee-for-Service	1528563186	1528563186	1	1	TSENG, PHILLIP MD	1/15/2022	207P00000X	NA	Other	026	PHYSICIANS	175190	None	None	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
112655	Fee-for-Service	1275186793	1275186793	1	1	THINKNETIC MEDICAL CORPORATI	12/6/2022	2083P0901X	NA	Adult Primary Care	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1950 S SUNWEST LN	108	SAN BERNARDINO	CA	92408	3263	36	06071	34.06493336	-117.2907254	San Bernardino County
112672	Fee-for-Service	1417311572	1417311572	1	1	TSENG, JOSEPH J MD	6/2/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	150733	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
112675	Fee-for-Service	1508536434	1508536434	1	1	TAGHAVI, SONJA	4/11/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
112684	Fee-for-Service	1841696341	1841696341	1	1	TRAN, ELAINE	12/24/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	116 E WALNUT AVE	None	MONROVIA	CA	91016	3431	19	06037	34.14367921	-118.0000903	Los Angeles County
112699	Fee-for-Service	1659678837	1659678837	1	1	TONG, YI C I	8/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135011	None	None	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
112716	Fee-for-Service	1194337626	1194337626	1	1	TRAN, LAN PHUONG CRNA	6/1/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	465 PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
112726	Fee-for-Service	1255384814	1255384814	1	1	TALAMO, MARTIN J MD	4/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85034	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
112752	Fee-for-Service	1881182491	1881182491	1	1	TRAN, TRUC T MD	6/27/2022	390200000X	NA	Other	026	PHYSICIANS	164287	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
112762	Fee-for-Service	1548467871	1548467871	1	1	TAN, LIONEL G MD	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105627	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
112797	Fee-for-Service	1255440608	1255440608	1	1	THRIFTY PAYLESS INC	4/8/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID # 6303	3225 PANAMA LN	None	BAKERSFIELD	CA	93313	3732	15	06029	35.29579448	-119.0381773	Kern County
112798	Fee-for-Service	1427129485	1427129485	1	1	TEPLINSKY, KERRY S MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68682	41	Internal Medicine	0	In state provider	None	1801 W ROMNEYA DR	STE 409	ANAHEIM	CA	92801	1827	30	06059	33.8506615	-117.946413	Orange County
112799	Fee-for-Service	1942371588	1942371588	1	1	TURNS, JOHN E MD	6/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	44402	08	Family Practice	0	In state provider	CARE POINT MEDICAL CENTE	22101 REDWOOD RD	None	CASTRO VALLEY	CA	94546	7107	01	06001	37.68666803	-122.0735922	Alameda County
112803	Fee-for-Service	1386796183	1386796183	1	1	TSE, CHUNG-HING	4/11/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	51805	01	General Practice	0	In state provider	None	1 CENTRAL AVE	None	SAN FRANCISCO	CA	94117	4114	38	06075	37.7690226	-122.443365	San Francisco County
112864	Fee-for-Service	1457332447	1457332447	1	1	TERRERI, ANTHONY MD	8/5/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	53984	None	None	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
112869	Fee-for-Service	1184706848	1184706848	1	1	THOMPSON II, JOHN F DO	2/11/2008	207R00000X	NA	Other	026	PHYSICIANS	9304	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
112885	Fee-for-Service	1104169531	1104169531	3	1	TRATT	8/3/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1135 S SAN GABRIEL BLVD	2	SAN GABRIEL	CA	91776	3114	19	06037	34.086672	-118.0908455	Los Angeles County
112897	Fee-for-Service	1346297892	1346297892	2	1	THE CHARLOTTE-MECKLENBURG HO	2/10/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	Y	8800 N TRYON ST	None	CHARLOTTE	NC	28262	3300	00	None	35.306298	-80.7474735	Mecklenburg County
112906	Fee-for-Service	1689916835	1689916835	1	1	TANAMAI, VAYA W	10/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146494	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
112930	Fee-for-Service	1801883780	1801883780	1	1	TANNER MEDICAL CENTER, INC	6/8/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	705 DIXIE ST	None	CARROLLTON	GA	30117	3818	00	None	33.56971608	-85.07253326	Carroll County
112943	Fee-for-Service	1275186793	1275186793	1	1	THINKNETIC MEDICAL CORPORATI	3/10/2022	2083P0901X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1950 S SUNWEST LN	108	SAN BERNARDINO	CA	92408	3263	36	06071	34.06493336	-117.2907254	San Bernardino County
113030	Fee-for-Service	1619986080	1619986080	1	1	TUROK, XIOMARA P NP	1/12/2011	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
113054	Fee-for-Service	1083155493	1083155493	1	1	TSE, GODWIN MD	7/1/2021	207L00000X	NA	Other	026	PHYSICIANS	157061	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
113065	Fee-for-Service	1952410326	1952410326	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5504	802 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	4213	19	06037	34.01725032	-118.1060477	Los Angeles County
113068	Fee-for-Service	1629089073	1629089073	1	1	TOOMA, GHASSAN S MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	64601	01	General Practice	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
113072	Fee-for-Service	1104573096	1104573096	1	1	TUR, MARITZA NP	3/13/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
113085	Fee-for-Service	1912913831	1912913831	1	1	TORRES, FERNANDO G MD	9/16/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	48691	None	None	0	In state provider	None	11878 AVENUE OF INDUSTRY	None	SAN DIEGO	CA	92128	3423	37	06073	32.99058739	-117.0752486	San Diego County
113160	Fee-for-Service	1871838516	1871838516	1	1	THOMAS SPECHT ALPERT AND	3/7/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SAAREMETS	10121 PINE AVENUE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
113165	Fee-for-Service	1255622296	1255622296	1	1	TINLOY, BRADFORD T MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134822	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
113181	Fee-for-Service	1982035119	1982035119	1	1	TAYLOR, SARAH LMFT	10/24/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12522 MOORPARK ST	106	STUDIO CITY	CA	91604	1355	19	06037	34.15033253	-118.406061	Los Angeles County
113199	Fee-for-Service	1124177530	1124177530	1	1	TRAN, CUONG V MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32093	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
113218	Fee-for-Service	1275757700	1275757700	1	1	TAYLOR, ZACKARY W MD	5/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88577	77	Infectious Disease	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
113229	Fee-for-Service	1093119257	1093119257	1	1	TAUREK, DAVIDA LPCC	10/11/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21 TAMAL VISTA BLVD	205	CORTE MADERA	CA	94925	1130	21	06041	37.93173997	-122.5179353	Marin County
113241	Fee-for-Service	1962608539	1962608539	1	1	TAN, SABRINA G MD	5/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151878	41	Internal Medicine	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
113334	Fee-for-Service	1740341023	1740341023	1	1	TROLIO, TERI L PT	4/26/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2016 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
113355	Fee-for-Service	1376501619	1376501619	1	1	TRANISI, CARL F MD	11/24/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175491	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
113430	Fee-for-Service	1154369320	1154369320	1	1	TIMOTHY ASHMORE MD	5/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	175 HOSPITAL DR	None	CAMDEN	TN	38320	1617	00	None	36.05568893	-88.10820716	Benton County
113448	Fee-for-Service	1477675932	1477675932	1	1	TEN, IRINA S MD	10/24/2019	2080P0203X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	657 TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
113454	Fee-for-Service	1225033111	1225033111	1	1	TSAI, MARK C MD	7/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81875	41	Internal Medicine	0	In state provider	None	16415 COLORADO AVE	STE 101	PARAMOUNT	CA	90723	5051	19	06037	33.8853075	-118.1614695	Los Angeles County
113467	Fee-for-Service	1780742692	1780742692	1	1	TURNAGE, TERESA M PT	5/18/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
113513	Fee-for-Service	1124687199	1124687199	1	1	TURNER, BRIEANA B LMFT	9/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
113545	Fee-for-Service	1407114697	1407114697	1	1	TAWA, TIMOTHY MD	4/6/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	131163	None	None	0	In state provider	None	1707 EYE ST	100	BAKERSFIELD	CA	93301	5208	15	06029	35.37461686	-119.020062	Kern County
113546	Fee-for-Service	1649339375	1649339375	1	1	TROMPETTO, JULIETTE T NP	10/18/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13640 ROSCOE BLVD	None	PANORAMA CITY	CA	91402	3904	19	06037	34.22164249	-118.4299965	Los Angeles County
113661	Fee-for-Service	1730571712	1730571712	1	1	TRAYLER, LISA J LCSW	1/23/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3551 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
113728	Fee-for-Service	1881703296	1881703296	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STRE 6041	725 S FORTUNA BLVD	None	FORTUNA	CA	95540	3034	12	06023	40.583583	-124.146663	Humboldt County
113749	Fee-for-Service	1316488752	1316488752	1	1	THEODORIS, CHRISTINA V MD	9/26/2023	207SG0201X	NA	Other	026	PHYSICIANS	183963	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
113803	Fee-for-Service	1417066804	1417066804	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05450	6305 YORK BLVD	None	HIGHLAND PARK	CA	90042	3639	19	06037	34.1147409	-118.1822799	Los Angeles County
113829	Fee-for-Service	1891946950	1891946950	1	1	TAFRESHI, GILDA M MD	3/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103111	13	Neurology (M.D. only)	0	In state provider	None	4033 3RD AVENUE	SUITE 206	SAN DIEGO	CA	92103	2137	37	06073	32.75053781	-117.1627168	San Diego County
113866	Fee-for-Service	1518082304	1518082304	1	1	TRINH, LIEN N MD	6/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87921	67	Endocrinology	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
113887	Fee-for-Service	1275950628	1275950628	1	1	TRAN, ANGELA MD	9/23/2019	390200000X	NA	Other	026	PHYSICIANS	156172	15	Obstetrics (D.O. only)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
113903	Fee-for-Service	1851519417	1851519417	1	1	TRAN, VIET Q MD	1/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90484	14	Neurological Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
113923	Fee-for-Service	1528000791	1528000791	1	1	TANG, LINDA J MD	6/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80493	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
113946	Fee-for-Service	1679730923	1679730923	1	3	TOTAL REHABILITATION	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	97751	25	Physical Medicine and Rehabilitation	0	In state provider	None	5635 CAHUENGA BLVD	None	NORTH HOLLYWOOD	CA	91601	2104	19	06037	34.17322232	-118.3616105	Los Angeles County
114061	Fee-for-Service	1548435738	1548435738	1	1	TIONGSON, DANIELLE M MD	12/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98673	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
114068	Fee-for-Service	1821551342	1821551342	1	1	TEIXEIRA, FERNANDO J MD	11/25/2019	207P00000X	NA	Other	026	PHYSICIANS	161342	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
114105	Fee-for-Service	1578576815	1578576815	1	1	TENG, DEELING L MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68260	41	Internal Medicine	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
114116	Fee-for-Service	1508192873	1508192873	1	1	THOMAS, LARISSA R MD	8/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111841	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
114152	Fee-for-Service	1518082304	1518082304	1	1	TRINH, LIEN N MD	6/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87921	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
114166	Fee-for-Service	1598854093	1598854093	1	1	TUVERA, FERNANDO P MD	12/31/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51847	08	Family Practice	0	In state provider	None	5475 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02627053	-117.684846	San Bernardino County
114181	Fee-for-Service	1780793174	1780793174	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05438	6130 W SUNSET BLVD	None	HOLLYWOOD	CA	90028	6424	19	06037	34.09798448	-118.323162	Los Angeles County
114193	Fee-for-Service	1871098087	1871098087	1	1	TRAN, MI T MD MPH	10/14/2022	207R00000X	NA	Other	026	PHYSICIANS	178898	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
114211	Fee-for-Service	1790811339	1790811339	1	1	THIENEMANN, MARGO L MD	2/28/1996	2084P0800X	NA	Psychiatry	026	PHYSICIANS	58450	36	Psychiatry	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
114366	Fee-for-Service	1083032841	1083032841	1	1	TON, JIMMY MD	3/16/2021	2085R0204X	NA	Other	026	PHYSICIANS	139505	None	None	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
114374	Fee-for-Service	1831208297	1831208297	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05494	8508 PAINTER AVE	None	WHITTIER	CA	90602	3335	19	06037	33.96110758	-118.0348562	Los Angeles County
114383	Fee-for-Service	1770830325	1770830325	1	7	TWO TREES PHYSICAL THERAPY &	4/18/2024	225X00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS	5725 RALSTON ST.	STE. 103	VENTURA	CA	93003	6053	56	06111	34.26095488	-119.2125269	Ventura County
114387	Fee-for-Service	1477766434	1477766434	1	1	THOMPSON, AURELIA C	5/2/2004	163WC0400X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4155 CHANDON CIRCLE	None	CORONA	CA	92883	0796	33	06065	33.81608298	-117.5434763	Riverside County
114388	Fee-for-Service	1730644519	1730644519	1	1	TABESH, ALIREZA MD INC	2/11/2019	193400000X	NA	Other	026	PHYSICIANS	104245	10	Gastroenterology (M.D. only)	0	In state provider	None	2000 STADIUM WAY	None	LOS ANGELES	CA	90026	2606	19	06037	34.07578277	-118.248587	Los Angeles County
114389	Fee-for-Service	1104174192	1104174192	1	1	TOBIAS, LORI C LPCC	2/15/2022	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1130 CONROY LN	SUITE 150	ROSEVILLE	CA	95661	4154	31	06061	38.73792807	-121.2748427	Placer County
114395	Fee-for-Service	1538265780	1538265780	1	1	TAHOE FOREST HOSP DIST	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
114397	Fee-for-Service	1316618218	1316618218	1	1	THOMAS, NADIYA S OD	11/16/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
114408	Fee-for-Service	1427120278	1427120278	1	1	TITTIRANONDA, KITTIPAT	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65068	42	Nuclear Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
114432	Fee-for-Service	1053482059	1053482059	1	1	THOMAS N SWANSON MD	7/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	751 NE BLAKELY DR	None	ISSAQUAH	WA	98029	6201	00	None	47.53652154	-122.0220045	King County
114436	Fee-for-Service	1659429538	1659429538	1	1	TRAN, JACQUELINE D MD	3/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82359	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
114437	Fee-for-Service	1104589647	1104589647	1	1	TOLLADAY, ALISON	6/3/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
114461	Fee-for-Service	1972504173	1972504173	1	1	TRAN, JIM D DO	1/13/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	6589	08	Family Practice	0	In state provider	None	1174 S DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	2203	19	06037	34.00160909	-117.8106063	Los Angeles County
114491	Fee-for-Service	1871753699	1871753699	1	1	TSANG, JANET M MD	1/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109116	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
114494	Fee-for-Service	1386964823	1386964823	1	1	TOSTE, PAUL A MD	10/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119869	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
114498	Fee-for-Service	1790811339	1790811339	1	1	THIENEMANN, MARGO L MD	2/28/1996	2084P0800X	NA	Psychiatry	026	PHYSICIANS	58450	26	Psychiatry (child)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
114531	Fee-for-Service	1750519880	1750519880	1	1	TRAN, YEN H DO	8/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12726	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
114621	Fee-for-Service	1033547153	1033547153	1	1	TRUSTED HEALTHCARE INC	10/24/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	310 E ROWLAND STREET	STE B	COVINA	CA	91723	3193	19	06037	34.07886604	-117.8855304	Los Angeles County
114624	Fee-for-Service	1225688617	1225688617	1	1	THE ELI HOME, INC.	7/1/2024	172V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	1175 N EAST ST	None	ANAHEIM	CA	92805	1429	30	06059	33.85067984	-117.9067249	Orange County
114626	Fee-for-Service	1598876856	1598876856	1	1	TSAI, WILLIAM T DO INC	4/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	7115	08	Family Practice	0	In state provider	None	4950 SAN BERNARDINO	STE 218	MONTCLAIR	CA	91763	2328	36	06071	34.07768363	-117.6968874	San Bernardino County
114633	Fee-for-Service	1194827576	1194827576	1	1	TING, JAMES H MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77720	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
114642	Fee-for-Service	1831433986	1831433986	1	1	TOTAL RENAL CARE INC	7/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	11913 FIRESTONE BLVD	None	NORWALK	CA	90650	2904	19	06037	33.91128982	-118.0789878	Los Angeles County
114670	Fee-for-Service	1770830325	1770830325	1	7	TWO TREES PHYSICAL THERAPY &	7/10/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	WELLNESS	5725 RALSTON ST.	STE. 103	VENTURA	CA	93003	6053	56	06111	34.26095488	-119.2125269	Ventura County
114675	Fee-for-Service	1730644519	1730644519	1	1	TABESH, ALIREZA MD INC	2/11/2019	193400000X	NA	Other	026	PHYSICIANS	104245	41	Internal Medicine	0	In state provider	None	2000 STADIUM WAY	None	LOS ANGELES	CA	90026	2606	19	06037	34.07578277	-118.248587	Los Angeles County
114677	Fee-for-Service	1477766434	1477766434	1	1	THOMPSON, AURELIA C	5/2/2004	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4155 CHANDON CIRCLE	None	CORONA	CA	92883	0796	33	06065	33.81608298	-117.5434763	Riverside County
114682	Fee-for-Service	1538265780	1538265780	1	1	TAHOE FOREST HOSP DIST	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
114698	Fee-for-Service	1427120278	1427120278	1	1	TITTIRANONDA, KITTIPAT	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65068	30	Radiology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
114745	Fee-for-Service	1558872465	1558872465	1	1	TO, AMY OD	8/27/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4403 S VERMONT AVE	None	LOS ANGELES	CA	90037	2413	19	06037	34.00342736	-118.2915892	Los Angeles County
114748	Fee-for-Service	1699398545	1699398545	1	1	TUNG, LILLIAN MD	7/4/2023	208M00000X	NA	Other	026	PHYSICIANS	187167	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
114753	Fee-for-Service	1740779180	1740779180	1	1	TRAN, NGOC N MD	8/14/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163345	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
114783	Fee-for-Service	1619310497	1619310497	1	1	TYLER, MATTHEW A MD	6/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155062	02	General Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
114791	Fee-for-Service	1861485807	1861485807	1	1	TABOR, GEORGE S MD	4/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	14903	07	Dermatology	0	In state provider	None	3808 W RIVERSIDE DR	None	BURBANK	CA	91505	4325	19	06037	34.15252315	-118.3412174	Los Angeles County
114817	Fee-for-Service	1194722322	1194722322	1	1	TOIBER,FREDY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1951 N WILMOT RD	BLDG #4	TUCSON	AZ	85712	0000	00	None	32.246379	-110.859084	Pima County
114843	Fee-for-Service	1083060792	1083060792	1	1	TORRES, PATRICIA B A LMFT	9/12/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	305 N HARBOR BLVD	STE 202	FULLERTON	CA	92832	1901	30	06059	33.872697	-117.924428	Orange County
114847	Fee-for-Service	1063850840	1063850840	1	1	TARTAR, DANIELLE M MD	7/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132577	07	Dermatology	0	In state provider	None	3301 C STREET	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
114850	Fee-for-Service	1710407101	1710407101	1	1	TRUST MEDICAL TRANSPORTATION	11/24/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	(TMT)	291 EMARON DR	None	SAN BRUNO	CA	94066	1612	41	06081	37.63161262	-122.4578586	San Mateo County
114852	Fee-for-Service	1841388303	1841388303	1	1	TRAN, SANG H OD	2/1/2001	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PACIFIC VISION	6930 65TH ST	STE 113	SACRAMENTO	CA	95823	2341	34	06067	38.50056	-121.4345385	Sacramento County
114894	Fee-for-Service	1679760698	1679760698	1	1	TULLOCH, ALLAN W JR MD	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	104567	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
114935	Fee-for-Service	1518046986	1518046986	1	1	TRAVER, CHRISTOPHER N	7/1/1995	208600000X	NA	General Surgery	026	PHYSICIANS	76524	02	General Surgery	0	In state provider	None	725 E SANTA CLARA ST	STE 303	SAN JOSE	CA	95112	1938	43	06085	37.34328626	-121.8756374	Santa Clara County
114938	Fee-for-Service	1376532051	1376532051	1	1	TOWN AND COUNTRY MANOR OF	11/1/1975	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	THE CHRISTIAN MISSIONARY	555 E MEMORY LN	None	SANTA ANA	CA	92706	1708	30	06059	33.7738613	-117.8614019	Orange County
114957	Fee-for-Service	1770830325	1770830325	1	7	TWO TREES PHYSICAL THERAPY &	10/10/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS	5725 RALSTON ST.	STE. 103	VENTURA	CA	93003	6053	56	06111	34.26095488	-119.2125269	Ventura County
115072	Fee-for-Service	1619310497	1619310497	1	1	TYLER, MATTHEW A MD	6/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155062	04	Otology, Laryngology, Rhinology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
115088	Fee-for-Service	1326157819	1326157819	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05756	6767 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	3706	30	06059	33.75915852	-118.0079325	Orange County
115102	Fee-for-Service	1992788616	1992788616	1	1	TORBATI, SAM S MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64409	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
115113	Fee-for-Service	1386210664	1386210664	1	1	TRUONG, JULIE M MD	10/31/2024	207R00000X	NA	Other	026	PHYSICIANS	190778	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
115116	Fee-for-Service	1265766166	1265766166	1	1	TAM, JONATHAN N MD INC	12/31/1990	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	66009	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	105 N HILL	STE 203	PASADENA	CA	91106	1934	19	06037	34.147827	-118.121406	Los Angeles County
115132	Fee-for-Service	1154409647	1154409647	1	1	TANCUN, MARY ANN S MD	12/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95808	08	Family Practice	0	In state provider	None	7601 STONERIDGE DR	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
115169	Fee-for-Service	1124269675	1124269675	1	1	TRAN, HAI T MD	7/7/2022	207L00000X	NA	Other	026	PHYSICIANS	176222	None	None	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
115172	Fee-for-Service	1346535168	1346535168	1	1	TOFIGH, SOHRAB MD	6/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136502	18	Ophthalmology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
115216	Fee-for-Service	1114352721	1114352721	1	1	TORRES OSEGUERA, RUBEN A	4/29/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
115223	Fee-for-Service	1518046986	1518046986	1	1	TRAVER, CHRISTOPHER N	7/1/1995	208600000X	NA	General Surgery	026	PHYSICIANS	76524	89	Surgery-Traumatic	0	In state provider	None	725 E SANTA CLARA ST	STE 303	SAN JOSE	CA	95112	1938	43	06085	37.34328626	-121.8756374	Santa Clara County
115227	Fee-for-Service	1972717510	1972717510	1	1	TRAN, MACLONG TONY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5201 HARRY HINES BLVD	None	DALLAS	TX	75235	7708	00	None	32.81161328	-96.83715929	Dallas County
115244	Fee-for-Service	1093917080	1093917080	1	1	THAO, LENG H DO	11/18/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	9920	08	Family Practice	0	In state provider	None	30979 ROAD 67	None	GOSHEN	CA	93227	9303	54	06107	36.35186208	-119.4241029	Tulare County
115261	Fee-for-Service	1538489927	1538489927	1	1	THOMAS, SHARON T MD	4/1/2019	2080P0203X	NA	Other	026	PHYSICIANS	125019	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
115290	Fee-for-Service	1437460516	1437460516	1	1	TENDULKAR, AMOD P MD INC	8/2/2010	193400000X	NA	Other	026	PHYSICIANS	81369	33	Thoracic Surgery	0	In state provider	None	1617 N CALIFORNIA ST	STE 1D	STOCKTON	CA	95204	6117	39	06077	37.9697906	-121.2890104	San Joaquin County
115292	Fee-for-Service	1790757227	1790757227	1	1	TODD J KOWALSKI	5/4/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1910 SOUTH AVE	None	LA CROSSE	WI	54601	5467	00	None	43.79473653	-91.24623835	La Crosse County
115393	Fee-for-Service	1346359734	1346359734	1	1	THRIFTY PAYLESS INC	2/21/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	616 ALAMO PINTADO RD	None	SOLVANG	CA	93463	2202	42	06083	34.60020428	-120.128559	Santa Barbara County
115516	Fee-for-Service	1518305911	1518305911	1	1	TSAI, JUSTIN Y MD	11/12/2018	207LP3000X	NA	Other	026	PHYSICIANS	155609	05	Anesthesiology	0	In state provider	None	6235 N FRESNO ST	STE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
115528	Fee-for-Service	1265958235	1265958235	1	1	THORBROGGER, DANESSA NP	7/29/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	500 OLD RIVER RD	250	BAKERSFIELD	CA	93311	9515	15	06029	35.35127492	-119.1142991	Kern County
115588	Fee-for-Service	1407861974	1407861974	1	1	TULLY, ELIZABETH MD	9/3/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	46228	36	Psychiatry	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
115606	Fee-for-Service	1972680825	1972680825	1	1	THAI, MAY D MD	3/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78974	05	Anesthesiology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
115621	Fee-for-Service	1679102149	1679102149	1	1	TRAUTNER, EMILY MD	11/15/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1650 LOS GAMOS DR	None	SAN RAFAEL	CA	94903	1850	21	06041	38.02105246	-122.5420674	Marin County
115658	Fee-for-Service	1619041225	1619041225	1	1	TIN, VIVIEN L MD	1/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95296	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
115726	Fee-for-Service	1407866445	1407866445	1	1	THOMAS, ALEX MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55125	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
115765	Fee-for-Service	1215495031	1215495031	1	1	THOMPSON, MICHAEL G LMFT	6/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2196 UNION ST	None	SAN FRANCISCO	CA	94123	4004	38	06075	37.79713526	-122.4353341	San Francisco County
115801	Fee-for-Service	1790829562	1790829562	1	1	TRAN, AMY T MD	8/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85364	40	Pediatrics	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
115822	Fee-for-Service	1336170786	1336170786	1	1	TOBE,BRAINE A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	STRAUB CLINIC & HOSPITAL	888 SOUTH KING STREET	None	HONOLULU	HI	96813	3083	00	None	21.30218603	-157.8505732	Honolulu County
115846	Fee-for-Service	1538265780	1538265780	1	12	TAHOE FOREST HOSP DIST	3/4/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS RD	SUITE 130	TRUCKEE	CA	96161	4862	29	06057	39.32625521	-120.2012059	Nevada County
115914	Fee-for-Service	1346778057	1346778057	1	1	THEIS, CARISSA LMFT	7/11/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2617 K ST	SUITE 125	SACRAMENTO	CA	95816	5133	34	06067	38.573595	-121.4715825	Sacramento County
115918	Fee-for-Service	1598307431	1598307431	1	1	TAPPER, SOPHIA NP	12/6/2022	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
115934	Fee-for-Service	1114380326	1114380326	1	1	TOURTELLOTTE, JOEL MD	7/8/2022	207R00000X	NA	Other	026	PHYSICIANS	150517	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
115954	Fee-for-Service	1528058617	1528058617	1	1	TOWNSEND, SEAN R MD	3/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111480	41	Internal Medicine	0	In state provider	None	2351 CLAY ST	STE 501	SAN FRANCISCO	CA	94115	1931	38	06075	37.79101512	-122.4316059	San Francisco County
115955	Fee-for-Service	1104947761	1104947761	1	1	THI, TRACY L OD	8/5/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15855 SOQUEL CANYON PKWY	120	CHINO HILLS	CA	91709	7866	36	06071	33.9641021	-117.6923301	San Bernardino County
115978	Fee-for-Service	1336351220	1336351220	1	1	TALWAR, JAMIE L CRNA	10/24/2017	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
115986	Fee-for-Service	1114119328	1114119328	1	1	TRAN, DIANA N MD	7/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92818	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
115997	Fee-for-Service	1891706362	1891706362	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5578	4200 CHINO HILLS PKWY	STE 500	CHINO HILLS	CA	91709	3779	36	06071	33.98274451	-117.7129305	San Bernardino County
116032	Fee-for-Service	1437112414	1437112414	1	1	TOTAL RENAL CARE INC	1/1/1995	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	6840 SEPULVEDA BLVD	STE 101	VAN NUYS	CA	91405	4401	19	06037	34.195203	-118.4661715	Los Angeles County
116034	Fee-for-Service	1396113171	1396113171	1	1	TSE, TINNY T OT	11/4/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
116086	Fee-for-Service	1649541954	1649541954	1	1	TOTAL RENAL CARE INC	5/1/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1309 E CARSON ST	None	CARSON	CA	90745	1631	19	06037	33.83179551	-118.2505095	Los Angeles County
116109	Fee-for-Service	1699139782	1699139782	1	1	TONTHAT, SAM DO	4/20/2022	207R00000X	NA	Other	026	PHYSICIANS	15865	None	None	0	In state provider	None	11180 WARNER AVE	SUITE 167	FOUNTAIN VALLEY	CA	92708	7515	30	06059	33.71632048	-117.9334575	Orange County
116116	Fee-for-Service	1083887228	1083887228	1	1	TESFAYE, BERHANU MD	1/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	112354	41	Internal Medicine	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
116121	Fee-for-Service	1043292410	1043292410	1	1	TRAN, LOAN N MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75743	None	None	0	In state provider	None	15400 NATIONAL AVE	STE 100	LOS GATOS	CA	95032	2433	43	06085	37.24429169	-121.9493834	Santa Clara County
116130	Fee-for-Service	1033211974	1033211974	1	1	TARCZY-HORNOCH, KRISTINA	9/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71782	18	Ophthalmology	0	In state provider	MD	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
116141	Fee-for-Service	1942286711	1942286711	1	1	TIPNIS, SUJATA R MD	2/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52315	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
116151	Fee-for-Service	1053157438	1053157438	1	1	TSAO, TIFFANI OD	10/29/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3658 NOGALES ST	None	WEST COVINA	CA	91792	2714	19	06037	34.0113478	-117.8866414	Los Angeles County
116155	Fee-for-Service	1972539047	1972539047	1	1	TAM, DIANE MD	9/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86805	22	Pathology (M.D. only)	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
116169	Fee-for-Service	1326428970	1326428970	1	1	TENORE, CHRISTOPHER L MD	7/24/2020	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	166890	40	Pediatrics	0	In state provider	None	1120 W LA VETA AVE	STE 125	ORANGE	CA	92868	4235	30	06059	33.78029455	-117.864369	Orange County
116196	Fee-for-Service	1629156104	1629156104	1	1	TISKA, HEATHER L MD	3/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84207	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
116205	Fee-for-Service	1487718367	1487718367	1	1	TRAN, JIMMY D T MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98406	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
116216	Fee-for-Service	1881826659	1881826659	1	1	TING, BRIAN T OD	2/7/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	44444 20TH ST WEST	None	LANCASTER	CA	93534	2714	19	06037	34.69063406	-118.1656452	Los Angeles County
116219	Fee-for-Service	1073741724	1073741724	1	1	TURNER, RACHEL R MD	2/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114350	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
116255	Fee-for-Service	1033477849	1033477849	1	1	TOVAR, ERIKA J LCSW	8/17/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	190 SIERRA CT	SUITE A304	PALMDALE	CA	93550	7608	19	06037	34.64013337	-118.1280539	Los Angeles County
116291	Fee-for-Service	1346803152	1346803152	1	2	TRAN, UYEN H NP	2/14/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95011615	-	NOT APPLICABLE	0	In state provider	None	955 E THOMPSON BLVD	None	VENTURA	CA	93001	3008	56	06111	34.27831162	-119.286174	Ventura County
116337	Fee-for-Service	1689779860	1689779860	1	1	THOMAS CHRISTOPHER	2/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	PATIEN FINANCIAL SERV	650 VANDENBOSH PKWY	None	GALLUP	NM	87301	0000	00	None	35.52212859	-108.6681433	McKinley County
116382	Fee-for-Service	1245674068	1245674068	1	1	THOMAS, SHAWN MD	8/16/2017	390200000X	NA	Other	026	PHYSICIANS	148202	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
116446	Fee-for-Service	1427036201	1427036201	2	1	TWINS MEDICAL SUPPLY LLC	11/24/2020	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1571 NORTH E STREET	None	SAN BERNARDINO	CA	92405	4510	36	06071	34.128189	-117.2941415	San Bernardino County
116502	Fee-for-Service	1821580945	1821580945	1	1	TORRES, VICTORIA PSYD	2/2/2025	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
116512	Fee-for-Service	1902038292	1902038292	1	1	TIWANA, HARPREET K MD	4/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121272	41	Internal Medicine	0	In state provider	None	400 E OAK AVE	None	VISALIA	CA	93291	5034	54	06107	36.332253	-119.288691	Tulare County
116526	Fee-for-Service	1487774949	1487774949	1	1	TRUMLER-SEBRING, ANYA A MD	7/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108479	18	Ophthalmology	0	In state provider	None	3085 LOMA VISTA ROAD	None	VENTURA	CA	93003	2916	56	06111	34.2757721	-119.2550726	Ventura County
116570	Fee-for-Service	1053467274	1053467274	1	1	TROMPETA, BELLAFLOR V MD	5/11/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	26147	40	Pediatrics	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
116575	Fee-for-Service	1083756852	1083756852	1	1	THIRUMALA, KRISHNA MD	8/21/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182807	None	None	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
116592	Fee-for-Service	1023491339	1023491339	1	1	TEKLE, SAMRAWIT A MD	2/28/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	162885	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
116684	Fee-for-Service	1295971638	1295971638	1	1	THURINGER, STEVEN J	1/12/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2651 HIGHLAND AVE	None	SELMA	CA	93662	3392	10	06019	36.57182292	-119.6287694	Fresno County
116704	Fee-for-Service	1093158263	1093158263	1	1	TSOU, TSUNG L MD	9/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132569	05	Anesthesiology	0	In state provider	None	2601 E CHAPMAN AVE	None	ORANGE	CA	92869	3206	30	06059	33.78785251	-117.826365	Orange County
116726	Fee-for-Service	1275827347	1275827347	1	1	TSE, TIFFANIE P MD	4/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123965	40	Pediatrics	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
116757	Fee-for-Service	1275820375	1275820375	1	1	TESMER, MAGDALENA DO	1/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13516	05	Anesthesiology	0	In state provider	None	555 EAST HARDY STREET	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
116782	Fee-for-Service	1932435302	1932435302	1	1	TOTAL RENAL CARE INC	11/12/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1000 MARSHALL ST	None	REDWOOD CITY	CA	94063	2027	41	06081	37.48762444	-122.224106	San Mateo County
116795	Fee-for-Service	1699898932	1699898932	1	1	TRAN, TIEN N MD	12/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	45628	36	Psychiatry	0	In state provider	None	2008 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
116822	Fee-for-Service	1124559828	1124559828	1	1	TYSON, BRITTANY A MD	9/17/2020	207P00000X	NA	Other	026	PHYSICIANS	157551	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1350 W COVINA BLVD	None	SAN DIMAS	CA	91773	3219	19	06037	34.09906108	-117.8343639	Los Angeles County
116918	Fee-for-Service	1548344625	1548344625	1	1	TAN, BENITA B MD INC	10/5/1994	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	53599	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	19682 HESPERIAN BLVD	SUITE 202	HAYWARD	CA	94541	4752	01	06001	37.66812177	-122.1194688	Alameda County
116994	Fee-for-Service	1609339258	1609339258	1	1	TRACY ZIVIN-TUTELA MD	1/6/2020	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	None	None	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
117065	Fee-for-Service	1962504340	1962504340	1	1	TEXAS HEART HOSP SW LLP	11/30/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1100 ALLIED DR	None	PLANO	TX	75093	5348	00	None	33.01526077	-96.79009576	Collin County
117103	Fee-for-Service	1083813422	1083813422	1	1	TRAN, CHAU N DO	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8105	None	None	0	In state provider	None	450 E HUNTINGTON DR	None	ARCADIA	CA	91006	3748	19	06037	34.14015053	-118.0208745	Los Angeles County
117107	Fee-for-Service	1932402476	1932402476	1	1	TABRIZI, MARYAM K MD	12/3/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	118850	08	Family Practice	0	In state provider	None	699 W TEFFT STREET	SUITE A	NIPOMO	CA	93444	9288	40	06079	35.03414619	-120.4894206	San Luis Obispo County
117114	Fee-for-Service	1295957546	1295957546	1	1	THOMAS-RIDDLE, F ROBIN	10/21/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PHD	472-100 RICHMOND ROAD N	None	SUSANVILLE	CA	96130	5115	18	06035	40.37825226	-120.6532856	Lassen County
117133	Fee-for-Service	1457323222	1457323222	1	1	TAN, GIM H MD	9/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108547	40	Pediatrics	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
117207	Fee-for-Service	1013619162	1013619162	1	1	TORRES, SARAH A CLD	4/12/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	12	06023	0	0	None
117302	Fee-for-Service	1508856725	1508856725	1	1	TRUJILLO, TRACY T MD	4/30/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	72064	40	Pediatrics	0	In state provider	None	200 PORTER DR	STE 300	SAN RAMON	CA	94583	1524	07	06013	37.77372204	-121.9911155	Contra Costa County
117328	Fee-for-Service	1528043023	1528043023	1	1	TELANDER, DAVID G MD	4/25/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82894	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
117331	Fee-for-Service	1821128844	1821128844	1	1	TO'O, KATHERINE J MD	7/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	98082	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
117334	Fee-for-Service	1194006122	1194006122	1	1	TRUONG, TONY MD	10/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118335	08	Family Practice	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
117335	Fee-for-Service	1659389708	1659389708	1	1	TORTOSA, LORRAINE N MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	33741	41	Internal Medicine	0	In state provider	None	480 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13286634	-121.6142652	Sutter County
117345	Fee-for-Service	1457468720	1457468720	1	1	TASH, CONSTANCE LMFT	12/3/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12842 VALLEY VIEW ST	STE 201	GARDEN GROVE	CA	92845	2515	30	06059	33.77717962	-118.0346285	Orange County
117353	Fee-for-Service	1962504340	1962504340	1	1	TEXAS HEART HOSP SW LLP	11/30/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1100 ALLIED DR	None	PLANO	TX	75093	5348	00	None	33.01526077	-96.79009576	Collin County
117390	Fee-for-Service	1619439213	1619439213	1	1	TAVARES, EMMANUEL	8/26/2024	208800000X	NA	Other	026	PHYSICIANS	179377	34	Urology and Urological Surgery	0	In state provider	None	THREE MEDICAL PLAZA	STE 120	ROSEVILLE	CA	95661	3088	31	06061	38.76566391	-121.2457432	Placer County
117410	Fee-for-Service	1831658145	1831658145	1	1	TOPICO, JOSE JEFFREY C NP	10/21/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
117426	Fee-for-Service	1992883573	1992883573	1	1	TSAO, MICHAEL MD	10/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91604	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
117474	Fee-for-Service	1750613899	1750613899	1	1	TORRENS, SALLY S LMFT	6/22/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	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
117496	Fee-for-Service	1700264264	1700264264	1	1	THOMAS, KELSEY PHD	2/6/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
117513	Fee-for-Service	1760689715	1760689715	1	3	TOTALCARE WALK-IN CLINIC INC	4/23/2020	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1973 FOOTHILL PKWY	104	CORONA	CA	92881	4110	33	06065	33.83172462	-117.530378	Riverside County
117542	Fee-for-Service	1407265788	1407265788	1	1	TAYAL, SEEMA MD	11/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145464	01	General Practice	0	In state provider	None	685 TWELVE BRIDGES DRIVE	None	LINCOLN	CA	95648	8689	31	06061	38.85108687	-121.2886018	Placer County
117549	Fee-for-Service	1881831030	1881831030	1	1	TAN-TRUONG, SOPHIA T MD	10/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105263	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
117606	Fee-for-Service	1053541581	1053541581	1	1	THARPE, CHET A MD	5/4/2022	207KA0200X	NA	Other	026	PHYSICIANS	163192	None	None	0	In state provider	None	4199 CAMPUS DR	SUITE 550, OFFICE 57	IRVINE	CA	92612	4684	30	06059	33.650775	-117.838296	Orange County
117609	Fee-for-Service	1487620720	1487620720	1	1	TAYLOR, ANGELA C MD	4/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9035	08	Family Practice	0	In state provider	None	2601 W ALAMEDA AVE	STE 111	BURBANK	CA	91505	4810	19	06037	34.15783817	-118.3293969	Los Angeles County
117628	Fee-for-Service	1770939225	1770939225	1	1	TRAYNHAM, VALERIE LPCC	9/20/2020	101YP2500X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	256 CAJON ST	SUITE E	REDLANDS	CA	92373	5278	36	06071	34.05204454	-117.1802319	San Bernardino County
117693	Fee-for-Service	1467977546	1467977546	1	1	TICHE, KALEIGH	2/1/2019	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
117714	Fee-for-Service	1477945228	1477945228	1	1	TAJRISHI, ROKHSAREH INC	3/27/2015	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	133047	41	Internal Medicine	0	In state provider	None	12601 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	1908	30	06059	33.77450951	-117.913014	Orange County
117741	Fee-for-Service	1083717359	1083717359	1	1	TSAI, SANDRA A MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65925	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
117806	Fee-for-Service	1730191800	1730191800	1	1	THE VITREO-RETINAL ASSOC	7/31/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	160 E ARTEISA	STE 345	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
117811	Fee-for-Service	1629007992	1629007992	1	1	TABUENCA, ARNOLDO D MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48934	01	General Practice	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
117827	Fee-for-Service	1699057885	1699057885	1	1	TRIVEDI, SURAJ MD	12/10/2019	207L00000X	NA	Other	026	PHYSICIANS	122196	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
117859	Fee-for-Service	1316981277	1316981277	1	1	TSOU, THOMAS J MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	32927	66	Emergency Medicine (Urgent Care)	0	In state provider	None	408 S BEACH BLVD	STE 110	ANAHEIM	CA	92804	1862	30	06059	33.82709101	-117.9932293	Orange County
117863	Fee-for-Service	1093124844	1093124844	1	1	TRUONG, JOEE Q CNP	1/14/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
117864	Fee-for-Service	1780844340	1780844340	1	1	TRINH, LONG N MD	8/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110279	30	Radiology	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
117915	Fee-for-Service	1336433507	1336433507	1	1	THOMPSON, MATTHEW M DO	1/29/2020	207L00000X	NA	Other	026	PHYSICIANS	17688	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
117919	Fee-for-Service	1568760577	1568760577	1	1	TATEL, EMILY Z NP	9/29/2020	363LX0001X	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
117921	Fee-for-Service	1063908853	1063908853	1	1	TATUM, CHRISTOPHER L DPM	10/28/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	650 COMMERCE AVE	STE D	PALMDALE	CA	93551	3884	19	06037	34.58955354	-118.141074	Los Angeles County
117928	Fee-for-Service	1295780880	1295780880	1	1	THOMPSON, KENNETH J	8/5/2008	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	420 B ST	None	YUBA CITY	CA	95991	5070	51	06101	39.13415904	-121.6121453	Sutter County
117931	Fee-for-Service	1598938680	1598938680	1	1	THOMAS, JAMES C MD APC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	24677	30	Radiology	0	In state provider	None	1122 N IRWIN	None	HANFORD	CA	93230	2828	16	06031	36.336348	-119.647699	Kings County
117937	Fee-for-Service	1306857339	1306857339	1	1	THOMPSON, GEOFFREY G MD	4/30/1991	207L00000X	NA	Other	026	PHYSICIANS	70700	05	Anesthesiology	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
117939	Fee-for-Service	1881182327	1881182327	1	1	THORDARSON, DANIELLE N MD	3/25/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	165731	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
117945	Fee-for-Service	1679176754	1679176754	1	1	TAHER SAIFULLAH MD A PROFESS	3/25/2021	207LP2900X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	NGELES	625 S FAIR OAKS AVE	SUITE 230	PASADENA	CA	91105	2663	19	06037	34.134894	-118.1504155	Los Angeles County
117952	Fee-for-Service	1649253998	1649253998	1	1	TOOR, SADDAD MD	1/29/2025	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	184891	30	Radiology	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
117955	Fee-for-Service	1710519814	1710519814	1	1	THIELEN, AMANDA C OT	3/9/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	740 S PLACENTIA AVE	STE 100	PLACENTIA	CA	92870	6832	30	06059	33.86285731	-117.8822066	Orange County
117975	Fee-for-Service	1477945228	1477945228	1	1	TAJRISHI, ROKHSAREH INC	3/27/2015	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	133047	77	Infectious Disease	0	In state provider	None	12601 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	1908	30	06059	33.77450951	-117.913014	Orange County
117987	Fee-for-Service	1376677096	1376677096	1	1	TAN, SU YING SHARON PSYD	4/3/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4110 EDISON AVE	206A	CHINO	CA	91710	8417	36	06071	33.99723746	-117.7140555	San Bernardino County
117990	Fee-for-Service	1467454835	1467454835	1	1	TARAKJI, ELIAS A MD	9/28/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61002	10	Gastroenterology (M.D. only)	0	In state provider	None	622 W DUARTE RD	STE 304	ARCADIA	CA	91007	9280	19	06037	34.12645266	-118.0521552	Los Angeles County
118070	Fee-for-Service	1629058466	1629058466	1	1	THOUSAND OAKS RAD MED GR	4/13/1982	293D00000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	227 W JANSS RD	STE 150	THOUSAND OAKS	CA	91360	1859	56	06111	34.20611691	-118.883861	Ventura County
118131	Fee-for-Service	1346239241	1346239241	1	1	TURNER, GARY E MD	6/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	1600 MEDICAL PARKWAY	None	CARSON CITY	NV	89073	4625	00	None	39.202263	-119.7841095	Consolidated Municipality of Carson City
118148	Fee-for-Service	1316981277	1316981277	1	1	TSOU, THOMAS J MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	32927	08	Family Practice	0	In state provider	None	408 S BEACH BLVD	STE 110	ANAHEIM	CA	92804	1862	30	06059	33.82709101	-117.9932293	Orange County
118202	Fee-for-Service	1073757936	1073757936	1	1	TRUONG, SAM LCSW	9/2/2022	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
118249	Fee-for-Service	1275688194	1275688194	1	1	TESLUK, MARGARET M	1/31/1995	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 E ORANGEBURG AVE	STE 1	MODESTO	CA	95350	5342	50	06099	37.66360555	-120.9877687	Stanislaus County
118261	Fee-for-Service	1205945656	1205945656	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7859 FIRESTONE BLVD	None	DOWNEY	CA	90241	4220	19	06037	33.9442823	-118.1406868	Los Angeles County
118267	Fee-for-Service	1265766166	1265766166	1	2	TAM, JONATHAN N MD INC	12/31/1992	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	66009	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1118 S GARFIELD AVE	STE 202	ALHAMBRA	CA	91801	4713	19	06037	34.08203532	-118.1230362	Los Angeles County
118270	Fee-for-Service	1306395165	1306395165	1	1	T&J UNLIMITED TRANSPORTATION	1/17/2020	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	840 W AVENUE J	D	LANCASTER	CA	93534	3427	19	06037	34.6893897	-118.1443748	Los Angeles County
118298	Fee-for-Service	1871040956	1871040956	1	1	TAYLOR, EMMA M	12/7/2020	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
118299	Fee-for-Service	1093239089	1093239089	1	1	TUDOR, MEGAN E PHD	8/22/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2230 STOCKTON BLVD	STE 2800	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
118327	Fee-for-Service	1407999089	1407999089	1	1	TENG, DANIEL Y MD	2/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89088	08	Family Practice	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
118391	Fee-for-Service	1447740824	1447740824	1	1	TRANSGENDER HEALTH AND	12/22/2021	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTER	340 S FARRELL DRIVE	SUITE A208	PALM SPRINGS	CA	92262	7931	33	06065	33.81788398	-116.5180079	Riverside County
118439	Fee-for-Service	1316981277	1316981277	1	1	TSOU, THOMAS J MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	32927	03	Allergy	0	In state provider	None	408 S BEACH BLVD	STE 110	ANAHEIM	CA	92804	1862	30	06059	33.82709101	-117.9932293	Orange County
118455	Fee-for-Service	1578004156	1578004156	1	1	TANZIL, MICHELLE A DO	9/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	13882	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
118473	Fee-for-Service	1790927721	1790927721	1	1	TORRES, CARMEN M MD	12/9/2013	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
118488	Fee-for-Service	1942408562	1942408562	1	1	TRAN, HUNG C MD	9/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94583	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
118516	Fee-for-Service	1083970438	1083970438	1	1	TRIAS, ERMA C NP	4/23/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
118523	Fee-for-Service	1154904704	1154904704	1	2	TRANSFORMATIONAL FAMILY COUN	8/10/2022	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROGRAM	3400 CENTRAL AVE	SUITE 215	RIVERSIDE	CA	92506	2175	33	06065	33.95355249	-117.385407	Riverside County
118551	Fee-for-Service	1326372830	1326372830	1	1	TAJAV TOOMARI DO INC	8/6/2009	261QP2300X	NA	Other	026	PHYSICIANS	10433	40	Pediatrics	0	In state provider	None	16661 VENTURA BLVD	408	ENCINO	CA	91436	1914	19	06037	34.15820737	-118.496492	Los Angeles County
118556	Fee-for-Service	1689192122	1689192122	1	1	TAHA, DANA M LCSW	2/9/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	22365 BARTON RD	STE 302	GRAND TERRACE	CA	92313	5078	36	06071	34.03387854	-117.316818	San Bernardino County
118660	Fee-for-Service	1851374847	1851374847	1	1	TRIONE, JIM M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	PARKVIEW MEDICAL CENTER	400 W 16TH STREET	None	PUEBLO	CO	81003	0000	00	None	38.28171999	-104.6119963	Pueblo County
118685	Fee-for-Service	1962922369	1962922369	1	1	TOMBY, CHRISTOPHER DO	4/18/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
118710	Fee-for-Service	1740557511	1740557511	1	1	TOBIN, EVAN M DO	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11550	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
118747	Fee-for-Service	1609952514	1609952514	1	1	TUTEUR, JENNIFER M MD	3/28/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	61904	08	Family Practice	0	In state provider	None	3177 OCEAN VIEW BLVD	None	SAN DIEGO	CA	92113	1432	37	06073	32.7011883	-117.1261025	San Diego County
118776	Fee-for-Service	1568410348	1568410348	1	1	TULLIS, BRANDON L DPM	5/30/2003	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3612 DALE RD	None	MODESTO	CA	95356	0500	50	06099	37.69097901	-121.0498748	Stanislaus County
118786	Fee-for-Service	1578049672	1578049672	1	1	TINAWI, MICHAEL	7/7/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
118827	Fee-for-Service	1629149661	1629149661	1	1	TARZYNSKI, STEPHEN F MD	7/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37186	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
118854	Fee-for-Service	1841049038	1841049038	1	1	THRIVE NEUROLOGY, PC	12/5/2024	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	12555 GARDEN GROVE BLVD	STE 401	GARDEN GROVE	CA	92843	1903	30	06059	33.77450946	-117.913041	Orange County
118855	Fee-for-Service	1164977088	1164977088	1	1	TREKI, WALAA M MD	12/24/2019	208M00000X	NA	Other	026	PHYSICIANS	166771	41	Internal Medicine	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
118860	Fee-for-Service	1497787857	1497787857	1	1	TAMARA BRENNER	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1653 W CONGRESS PKWY	None	CHICAGO	IL	60612	0000	00	None	41.87509308	-87.6693474	Cook County
118867	Fee-for-Service	1487211009	1487211009	1	1	THOMPSON, MARILYN OT	4/4/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1640 MARENGO ST	SUITE 500	LOS ANGELES	CA	90033	1036	19	06037	34.05946374	-118.213356	Los Angeles County
118869	Fee-for-Service	1467474262	1467474262	1	1	TAN, SHIRLEY MD	1/1/1982	207L00000X	NA	Other	026	PHYSICIANS	23044	05	Anesthesiology	0	In state provider	None	23580 WESTWOOD ST	None	COLTON	CA	92324	4803	36	06071	34.03657613	-117.29004	San Bernardino County
118876	Fee-for-Service	1679267934	1679267934	1	1	TRAEGER, JANNA NP	7/17/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
118893	Fee-for-Service	1558430678	1558430678	1	1	THADANI, SAMIR R MD	7/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	104376	02	General Surgery	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
118920	Fee-for-Service	1962435594	1962435594	2	1	TAGALOA-TULIFAU, MAFUTAG	9/29/2020	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5220 CLARK AVE	STE 315	LAKEWOOD	CA	90712	2635	19	06037	33.8527092	-118.1337623	Los Angeles County
119001	Fee-for-Service	1780619221	1780619221	1	1	TARNAY, CHRISTOPHER M MD	6/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	60495	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
119014	Fee-for-Service	1952908964	1952908964	1	1	TALK TO ME PSYCHOLOGICAL SER	3/15/2021	103TC0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	VICES, INC.	16200 VENTURA BLVD	403	ENCINO	CA	91436	4692	19	06037	34.15659457	-118.485532	Los Angeles County
119015	Fee-for-Service	1083667943	1083667943	1	1	THOMAS ECCLES MD	11/29/2016	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
119042	Fee-for-Service	1063564870	1063564870	1	1	TURK, CARL R MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	68530	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
119142	Fee-for-Service	1720199797	1720199797	1	1	THE CENTER FOR INTERVENTION	7/31/1992	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	8631 W 3RD ST	STE 1140E	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
119177	Fee-for-Service	1649673989	1649673989	1	1	TUTTLE-KAMON, STEPHANIE	6/21/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
119184	Fee-for-Service	1902946585	1902946585	1	1	TMG MEDICAL GROUP INC	4/20/2012	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	18536	01	General Practice	0	In state provider	None	24237 MAIN ST	None	NEWHALL	CA	91321	2907	19	06037	34.37768435	-118.5271562	Los Angeles County
119188	Fee-for-Service	1396744801	1396744801	1	1	TRAMBERT, MICHAEL MD	11/30/1987	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	57268	30	Radiology	0	In state provider	None	225 DICKINSON ST	# H756	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
119282	Fee-for-Service	1194160168	1194160168	1	1	TAVANGARI, FAREES R MD	10/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136652	02	General Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
119301	Fee-for-Service	1952908964	1952908964	1	1	TALK TO ME PSYCHOLOGICAL SER	3/15/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	VICES, INC.	16200 VENTURA BLVD	403	ENCINO	CA	91436	4692	19	06037	34.15659457	-118.485532	Los Angeles County
119343	Fee-for-Service	1770271264	1770271264	1	2	TERRELL B VANAKEN MD INC	7/12/2023	207QG0300X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	585 NUT TREE CT	None	VACAVILLE	CA	95687	3353	48	06095	38.36167248	-121.9482153	Solano County
119359	Fee-for-Service	1396907408	1396907408	1	1	THOMAN, CHARITY A MD	3/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102547	41	Internal Medicine	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
119400	Fee-for-Service	1295789972	1295789972	1	1	TSIMERINOV, EVGENY I MD	2/8/2015	2084N0400X	NA	Neurology	026	PHYSICIANS	87842	13	Neurology (M.D. only)	0	In state provider	None	2679 ZOE AVE	None	HUNTINGTON PARK	CA	90255	4567	19	06037	33.9793143	-118.2229961	Los Angeles County
119411	Fee-for-Service	1912085457	1912085457	1	1	TRAN, TAM T MD	1/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91673	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
119439	Fee-for-Service	1609069947	1609069947	2	1	TONY HOANG MD	2/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	99196	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2031 17TH ST	STE 1	BAKERSFIELD	CA	93301	4203	15	06029	35.37431549	-119.025621	Kern County
119448	Fee-for-Service	1609887157	1609887157	1	1	TEMPLE CITY DIALYSIS	1/13/2003	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	FACILITY INC	9945 LOWER AZUSA RD	None	TEMPLE CITY	CA	91780	4041	19	06037	34.09058971	-118.0498973	Los Angeles County
119534	Fee-for-Service	1306926209	1306926209	1	1	TRAUSCHT-VAN HORN,JENNIFER	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	50 N MEDICAL DR	None	SALT LAKE CTY	UT	84132	0001	00	None	40.77197161	-111.8352608	Salt Lake County
119571	Fee-for-Service	1154663425	1154663425	1	1	TAT, SONYA MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137544	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
119641	Fee-for-Service	1083005474	1083005474	1	1	TRACY, ROBERT DO INC	9/19/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3056 FLETCHER DRIVE	None	LOS ANGELES	CA	90065	2207	19	06037	34.11590478	-118.2443234	Los Angeles County
119674	Fee-for-Service	1154538023	1154538023	1	1	TANAGHO, AMAL B	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	51476	-	NOT APPLICABLE	0	In state provider	None	716 WEST COMPTON	None	COMPTON	CA	90220	3015	19	06037	33.8958327	-118.2369398	Los Angeles County
119689	Fee-for-Service	1679998298	1679998298	1	1	TANNER, BRIAN J MD	2/10/2019	207P00000X	NA	Other	026	PHYSICIANS	154384	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
119701	Fee-for-Service	1821125188	1821125188	1	1	THORNTON, KEVIN C MD	6/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91602	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	BOX 0648	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
119718	Fee-for-Service	1619965670	1619965670	1	1	TRAN, DI DAC MD	1/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52125	40	Pediatrics	0	In state provider	None	2395 MONTPELIER DR	STE 6	SAN JOSE	CA	95116	1619	43	06085	37.36538903	-121.8473325	Santa Clara County
119750	Fee-for-Service	1316001373	1316001373	1	1	TA, PHUONG N MD	10/31/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79560	41	Internal Medicine	0	In state provider	None	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	4200	30	06059	33.77387145	-117.9966555	Orange County
119766	Fee-for-Service	1275984171	1275984171	1	1	TANK, NEEL DO	12/18/2020	207P00000X	NA	Other	026	PHYSICIANS	17050	None	None	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
119779	Fee-for-Service	1215174602	1215174602	1	1	TSUKAMAKI, JASON C MD	5/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101995	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	54	06107	36.327888	-119.294919	Tulare County
119788	Fee-for-Service	1467536045	1467536045	1	1	TADROS, ALLISON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 STADIUM DR	None	MORGANTOWN	WV	26506	7911	00	None	39.65345878	-79.95562791	Monongalia County
119840	Fee-for-Service	1447221056	1447221056	1	1	THE HEALTH CARE AUTHORITY OF	9/7/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	THE CITY OF HUNTSVILLE	101 SIVLEY ROAD	None	HUNTSVILLE	AL	35801	4421	00	None	34.72122889	-86.58120307	Madison County
119852	Fee-for-Service	1174942056	1174942056	1	1	TRAN, PHUC D MD	10/30/2023	208M00000X	NA	Other	026	PHYSICIANS	175404	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
119856	Fee-for-Service	1255871554	1255871554	1	1	TIZANO, ANDREA M NP	4/24/2017	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
119872	Fee-for-Service	1477173375	1477173375	1	1	THEEUWEN, HAILEY A MD	8/1/2023	208600000X	NA	General Surgery	026	PHYSICIANS	183062	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
119883	Fee-for-Service	1356303846	1356303846	1	1	TAN, HONGYING MD	10/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85887	22	Pathology (M.D. only)	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
119887	Fee-for-Service	1437319167	1437319167	1	1	TENSER, MATTHEW S MD	4/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104309	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	STE #B200	LOS ANGELES	CA	90095	6975	19	06037	34.06473399	-118.445865	Los Angeles County
119952	Fee-for-Service	1053400408	1053400408	1	1	TAPPER, SHARON R MD	1/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	57735	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
119963	Fee-for-Service	1710339114	1710339114	1	1	TIEN, PETER OD	3/15/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
119990	Fee-for-Service	1629520804	1629520804	1	1	TERNDRUP, ALEXIS C CCC-SLP	7/31/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3518 JEFFERSON AVE	None	REDWOOD CITY	CA	94062	3136	41	06081	37.46715891	-122.2492205	San Mateo County
120011	Fee-for-Service	1215375456	1215375456	1	1	TSANG, HARRISON G OD	9/18/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	26506 BOUQUET CANYON RD	None	SAUGUS	CA	91350	2353	19	06037	34.42742329	-118.5368396	Los Angeles County
120024	Fee-for-Service	1003073826	1003073826	1	1	TELLALIAN, DAVID M MD	1/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	110417	77	Infectious Disease	0	In state provider	None	8635 W 3RD STREET	SUITE 1190W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
120044	Fee-for-Service	1548721400	1548721400	1	1	TURIAN, LAVINIA	9/1/2024	390200000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
120050	Fee-for-Service	1174561898	1174561898	1	1	TUERO, SANDRA O MD	11/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	69023	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
120061	Fee-for-Service	1669702502	1669702502	1	2	TIERNEY, KATHERINE MD	12/30/2024	207VX0201X	NA	Obstetrics & Gynecology	026	PHYSICIANS	110278	09	Gynecology (D.O. only)	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
120075	Fee-for-Service	1184811424	1184811424	1	1	TEMMINS, CAROLINE J MD	6/8/2010	207ZP0102X	NA	Other	026	PHYSICIANS	92555	22	Pathology (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
120127	Fee-for-Service	1447221056	1447221056	1	1	THE HEALTH CARE AUTHORITY OF	9/7/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	THE CITY OF HUNTSVILLE	101 SIVLEY ROAD	None	HUNTSVILLE	AL	35801	4421	00	None	34.72122889	-86.58120307	Madison County
120181	Fee-for-Service	1851854293	1851854293	1	1	TRANG, DIANA T DO	7/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21014	08	Family Practice	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
120190	Fee-for-Service	1356428296	1356428296	1	1	TRUONG, DIEM P MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	81474	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
120224	Fee-for-Service	1649246448	1649246448	1	1	TREWN, RAJINDER MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48178	41	Internal Medicine	0	In state provider	None	2585 SAMARITAN DR	None	SAN JOSE	CA	95124	4107	43	06085	37.25083752	-121.9503884	Santa Clara County
120232	Fee-for-Service	1043239064	1043239064	1	1	THOMAS, SANDRA LCSW	7/16/2004	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	160 N 7TH ST	STE A	GROVER BEACH	CA	93433	2075	40	06079	35.1222291	-120.6226498	San Luis Obispo County
120239	Fee-for-Service	1053400408	1053400408	1	1	TAPPER, SHARON R MD	1/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	57735	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
120309	Fee-for-Service	1124137583	1124137583	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05426	1815 S VERMONT AVE	None	LOS ANGELES	CA	90006	4525	19	06037	34.04116942	-118.2915995	Los Angeles County
120322	Fee-for-Service	1942731815	1942731815	1	1	TAYLOR, MALLORY M MD	9/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160930	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
120375	Fee-for-Service	1629078050	1629078050	1	1	TAYLOR, TERESA M OD	12/23/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7075 N SHARON AVE	None	FRESNO	CA	93720	3329	10	06019	36.83882737	-119.7590708	Fresno County
120426	Fee-for-Service	1225089972	1225089972	1	1	TIPNIS, SAJANI M MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68772	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
120434	Fee-for-Service	1447511969	1447511969	1	1	TAYLOR, JEFFREY S PHD	9/25/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
120437	Fee-for-Service	1275095523	1275095523	1	1	THOMPSON, PAUL MD	7/20/2022	208M00000X	NA	Other	026	PHYSICIANS	179438	None	None	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
120532	Fee-for-Service	1811779085	1811779085	1	1	TANOTO, ALEXA N	11/13/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	301 LENNON LN	202	WALNUT CREEK	CA	94598	2483	07	06013	37.92672613	-122.0291022	Contra Costa County
120568	Fee-for-Service	1578508362	1578508362	1	1	TOBIN, JOSHUA M MD	6/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92457	05	Anesthesiology	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
120571	Fee-for-Service	1992852990	1992852990	1	2	TERRY, ERIC S PSYD	2/24/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	101 S KRAEMER BLVD	SUITE 114	PLACENTIA	CA	92870	6102	30	06059	33.87035522	-117.8630104	Orange County
120595	Fee-for-Service	1255522926	1255522926	2	1	TAY EE	6/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
120631	Fee-for-Service	1811978216	1811978216	1	1	THE EVANGELICAL LUTHERAN	4/22/2014	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	1	Border provider	GOOD SAMARITAN SOCIETY	1 PARK AVENUE	None	BROOKINGS	OR	97415	9145	00	None	42.05433242	-124.2828848	Curry County
120659	Fee-for-Service	1326064049	1326064049	1	1	THRASHER, ROBERT C LMFT	11/16/2018	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	610 PACIFIC COAST HWY.	SUITE 201	SEAL BEACH	CA	90740	6650	30	06059	33.74620612	-118.1052058	Orange County
120679	Fee-for-Service	1255374583	1255374583	1	1	TONG, TRI C MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77598	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
120716	Fee-for-Service	1932271277	1932271277	1	1	TRAN, THANH Q MD	11/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	61167	08	Family Practice	0	In state provider	None	3356 W BALL RD	STE 216	ANAHEIM	CA	92804	3728	30	06059	33.81726453	-118.007451	Orange County
120761	Fee-for-Service	1194834622	1194834622	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5988	1550 HAMILTON AVE	None	SAN JOSE	CA	95125	4539	43	06085	37.29439847	-121.91193	Santa Clara County
120763	Fee-for-Service	1740338540	1740338540	1	1	TAFT, CHRISTINE P MD	10/15/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51111	40	Pediatrics	0	In state provider	None	593 E ELDER ST	None	FALLBROOK	CA	92028	5000	37	06073	33.3801147	-117.2453962	San Diego County
120770	Fee-for-Service	1033280912	1033280912	1	1	TAN, LARISSA R MD	1/31/1993	208600000X	NA	General Surgery	026	PHYSICIANS	71354	02	General Surgery	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
120808	Fee-for-Service	1356449722	1356449722	1	1	TRI-CITY MEDICAL SUPPLY INC	2/2/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TRI-CITY MEDICAL SUPPLY	11900 S AVALON BLVD	SUITE 201	LOS ANGELES	CA	90061	2837	19	06037	33.92451047	-118.2652101	Los Angeles County
120822	Fee-for-Service	1205976115	1205976115	1	1	TUCKER, JOHN R MD	2/23/1982	207P00000X	NA	Other	026	PHYSICIANS	32127	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
120825	Fee-for-Service	1407355548	1407355548	1	1	TELECARE CORPORATION	12/23/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	R SUTS	298 BERNAL	STE B	SAN JOSE	CA	95119	1809	43	06085	37.215603	-121.7858355	Santa Clara County
120851	Fee-for-Service	1154430569	1154430569	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05560	3825 E THOUSAND OAKS BLV	None	THOUSAND OAKS	CA	91362	3639	56	06111	34.16243394	-118.8254491	Ventura County
120862	Fee-for-Service	1447376454	1447376454	1	1	TACHDJIAN, RAFFI MD	4/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88034	03	Allergy	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
120865	Fee-for-Service	1760689715	1760689715	1	1	TOTALCARE WALK-IN CLINIC INC	10/9/2008	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	13768 ROSWELL AVENUE	SUITE 118	CHINO	CA	91710	1402	36	06071	34.0038	-117.7218555	San Bernardino County
120881	Fee-for-Service	1790833606	1790833606	1	1	TAIRA, CAROLE S MD	5/21/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	68632	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
120888	Fee-for-Service	1255657425	1255657425	1	1	TITTLE, ROBIN L MD	5/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118989	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
120940	Fee-for-Service	1710763628	1710763628	1	1	THE NURTURED BUTTERFLY LLC	9/8/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	48	06095	0	0	None
121003	Fee-for-Service	1932271277	1932271277	1	1	TRAN, THANH Q MD	11/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	61167	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3356 W BALL RD	STE 216	ANAHEIM	CA	92804	3728	30	06059	33.81726453	-118.007451	Orange County
121040	Fee-for-Service	1356813711	1356813711	1	1	TOTAL VISION, P.C.	12/21/2022	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2280 E CARSON ST	None	LONG BEACH	CA	90807	3044	19	06037	33.83241248	-118.164456	Los Angeles County
121151	Fee-for-Service	1447376454	1447376454	1	1	TACHDJIAN, RAFFI MD	4/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88034	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
121159	Fee-for-Service	1255519948	1255519948	1	1	THAKKAR, KRUTI N MD	11/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109330	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
121165	Fee-for-Service	1356800411	1356800411	1	1	TETRI, LAURA H MD	5/8/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	180032	05	Anesthesiology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
121226	Fee-for-Service	1487709747	1487709747	1	1	TRAN, DAN MD	5/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	78976	38	Geriatrics	0	In state provider	None	3012 SAN GABRIEL BLVD	None	ROSEMEAD	CA	91770	2536	19	06037	34.06363316	-118.090457	Los Angeles County
121255	Fee-for-Service	1770299216	1770299216	1	1	TAYLOR, CHRISTINA S CRNA	3/8/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
121256	Fee-for-Service	1003029372	1003029372	1	1	TANAGHO, YOUSSEF S MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125924	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
121260	Fee-for-Service	1144204249	1144204249	1	1	TAO, MAY L MD MPH	8/7/1998	2085R0001X	NA	Other	026	PHYSICIANS	84776	78	Neoplastic Diseases/Oncology	0	In state provider	None	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
121261	Fee-for-Service	1255745311	1255745311	1	1	TRAN, JENNIFER D DO	8/14/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	14342	08	Family Practice	0	In state provider	None	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	43	06085	37.39572142	-122.1051204	Santa Clara County
121274	Fee-for-Service	1619360625	1619360625	1	1	TOMITA, KEVIN M OD	1/23/2018	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
121290	Fee-for-Service	1275643041	1275643041	1	1	THRIFTY PAYLESS INC	2/25/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5653	5270 BALBOA AVE	None	SAN DIEGO	CA	92117	6902	37	06073	32.81920281	-117.1825682	San Diego County
121300	Fee-for-Service	1902565716	1902565716	1	2	TSI, MULIKA Y NP	3/18/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	555 WASHINGTON STREET	None	SAN DIEGO	CA	92103	2289	37	06073	32.74986289	-117.1599343	San Diego County
121353	Fee-for-Service	1013103472	1013103472	1	1	TOPEROFF, WILL E NP	10/24/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
121362	Fee-for-Service	1518291442	1518291442	1	1	THOMAS, STACIE E CCC-SLP	3/25/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
121389	Fee-for-Service	1659491298	1659491298	1	1	TIRUMALA, VENKAT R MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	127488	None	None	0	In state provider	None	1004 FOWLER WAY	STE 4	PLACERVILLE	CA	95667	5746	09	06017	38.72683597	-120.7921028	El Dorado County
121398	Fee-for-Service	1861578361	1861578361	1	1	THENEMANN, GORDON J MD	9/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	35834	10	Gastroenterology (M.D. only)	0	In state provider	None	270 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
121410	Fee-for-Service	1134183338	1134183338	1	1	TAILLONCRANE, PHYLLIS H PHD	11/15/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	14486	-	NOT APPLICABLE	0	In state provider	None	14140 BEACH BLVD	STE 120, 155, 200	WESTMINSTER	CA	92683	4453	30	06059	33.756966	-117.9894915	Orange County
121442	Fee-for-Service	1326698218	1326698218	1	1	TOLENTINO, REBECCA F	12/5/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3843 GRANDVIEW DR	None	PALMDALE	CA	93551	5229	19	06037	34.61115619	-118.1999132	Los Angeles County
121452	Fee-for-Service	1356800411	1356800411	1	1	TETRI, LAURA H MD	5/8/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	180032	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
121487	Fee-for-Service	1194893248	1194893248	1	1	THE LOS ANGELES FREE CLINIC	12/10/1996	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	19	06037	34.07607952	-118.373418	Los Angeles County
121513	Fee-for-Service	1487709747	1487709747	1	1	TRAN, DAN MD	5/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	78976	41	Internal Medicine	0	In state provider	None	3012 SAN GABRIEL BLVD	None	ROSEMEAD	CA	91770	2536	19	06037	34.06363316	-118.090457	Los Angeles County
121520	Fee-for-Service	1073016804	1073016804	1	1	TRAN, CINDY MD	10/14/2021	207R00000X	NA	Other	026	PHYSICIANS	164048	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
121539	Fee-for-Service	1982788964	1982788964	1	1	THOMPSON, DEAN A MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51740	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
121542	Fee-for-Service	1649910365	1649910365	1	2	TARZANA TREATMENT CENTERS, I	3/1/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC.	12021 S. WILMINGTON AVE	STE 301, BUILDING #18	LOS ANGELES	CA	90059	3019	19	06037	33.922575	-118.2391785	Los Angeles
121548	Fee-for-Service	1144204249	1144204249	1	1	TAO, MAY L MD MPH	8/7/1998	2085R0001X	NA	Other	026	PHYSICIANS	84776	30	Radiology	0	In state provider	None	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
121578	Fee-for-Service	1801850854	1801850854	1	1	TENG, JOYCE M MD	8/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55362	07	Dermatology	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
121592	Fee-for-Service	1972643245	1972643245	1	1	T&T CARE PLUS MED SUP	9/18/2007	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	T&T CARE PLUS MED SUP	2235 S PACIFIC AVE	None	SAN PEDRO	CA	90731	5933	19	06037	33.72386493	-118.2880589	Los Angeles County
121628	Fee-for-Service	1710176102	1710176102	1	1	TRINGHAM, KAREN SUE	2/8/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	670 AVENIDA DE DIAMANTE	None	ARROYO GRANDE	CA	93420	1938	40	06079	35.12912779	-120.5914138	San Luis Obispo County
121635	Fee-for-Service	1346637352	1346637352	1	1	TONG, CRYSTAL OD	11/6/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
121692	Fee-for-Service	1225511009	1225511009	1	1	TRAN, ANHTHY T NP	10/24/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
121702	Fee-for-Service	1932665437	1932665437	1	1	TOP CARE MEDICAL GROUP INC	9/2/2020	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2820 ALUM ROCK AVE.	SUITE 20	SAN JOSE	CA	95127	5608	43	06085	37.3631929	-121.8334108	Santa Clara County
121734	Fee-for-Service	1326698218	1326698218	1	1	TOLENTINO, REBECCA F	12/5/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3843 GRANDVIEW DR	None	PALMDALE	CA	93551	5229	19	06037	34.61115619	-118.1999132	Los Angeles County
121739	Fee-for-Service	1063724169	1063724169	1	1	TRAN, ANH V OD	9/2/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
121772	Fee-for-Service	1922001015	1922001015	1	1	TREGO COUNTY LEME MEORIAL H	5/17/2021	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	320 N 13TH ST	None	WAKEENEY	KS	67672	2002	00	None	39.02804525	-99.87164171	Trego County
121777	Fee-for-Service	1194893248	1194893248	1	1	THE LOS ANGELES FREE CLINIC	2/1/1997	261QC1500X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	19	06037	34.07607952	-118.373418	Los Angeles County
121795	Fee-for-Service	1912472580	1912472580	1	1	TSANG, IAN PSYD	1/27/2025	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
121824	Fee-for-Service	1710484183	1710484183	1	1	TUFFERY, SYDNEY MD	8/28/2021	207P00000X	NA	Other	026	PHYSICIANS	164136	None	None	0	In state provider	None	13100 STUDEBAKER ROAD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
121850	Fee-for-Service	1417987512	1417987512	1	1	THOMAS C EDEWAARD, O.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	705 OLD TROLLEY RD	STE A	SUMMERVILLE	SC	29485	5212	00	None	32.97687113	-80.17252001	Dorchester County
121852	Fee-for-Service	1982662045	1982662045	1	1	TING, VIVIAN MD	4/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86853	24	Plastic Surgery	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
121865	Fee-for-Service	1689962441	1689962441	1	1	TADI, PRASANNA K MD	11/1/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	188058	None	None	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
121889	Fee-for-Service	1558483685	1558483685	1	1	TOURANGEAU, LOUANNE M MD	3/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105146	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
121975	Fee-for-Service	1639346281	1639346281	1	1	THORBURN, LAURA CCC-SLP	5/11/2022	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
121976	Fee-for-Service	1871729038	1871729038	1	1	TIZON EMERGENCY ASSOCIATES	7/2/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	1	Border provider	PLLC	101 CIVIC CTR LN	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
122020	Fee-for-Service	1376885061	1376885061	1	1	TCHENG, ERICSCOTT W MD	1/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	133329	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
122031	Fee-for-Service	1982624599	1982624599	1	1	TAW, MALCOLM B MD	9/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82265	41	Internal Medicine	0	In state provider	None	2428 SANTA MONICA BLVD	STE 208	SANTA MONICA	CA	90404	2046	19	06037	34.0317559	-118.4762013	Los Angeles County
122062	Fee-for-Service	1194893248	1194893248	1	1	THE LOS ANGELES FREE CLINIC	12/10/1996	261QC1500X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	19	06037	34.07607952	-118.373418	Los Angeles County
122086	Fee-for-Service	1154305639	1154305639	1	1	TANG, RICKEY P MD	6/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	70284	41	Internal Medicine	0	In state provider	None	6250 CLAY ST	None	RIVERSIDE	CA	92509	6005	33	06065	33.974892	-117.462183	Riverside County
122091	Fee-for-Service	1023767852	1023767852	1	1	TSIYER, ALLEN	10/3/2024	390200000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
122103	Fee-for-Service	1649524216	1649524216	1	1	TRAN, MICHAEL OD	7/17/2014	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4898 CONVOY ST	STE 103	SAN DIEGO	CA	92111	1633	37	06073	32.83056081	-117.15328	San Diego County
122107	Fee-for-Service	1912525817	1912525817	1	1	TELEMEDICINE365 INC	5/12/2021	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	898 N PACIFIC COAST HWY	STE 600	EL SEGUNDO	CA	90245	2747	19	06037	33.92874	-118.3962025	Los Angeles County
122157	Fee-for-Service	1942235411	1942235411	1	1	THIBAULT, ANNE M NP	5/29/2013	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
122169	Fee-for-Service	1861467573	1861467573	1	1	THE MEDICAL CENTER OF	2/6/2017	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SOUTHEAST TEXAS LP	2555 JIMMY JOHNSON BLVD	None	PORT ARTHUR	TX	77640	2007	00	None	29.935683	-93.989286	Jefferson County
122281	Fee-for-Service	1265875975	1265875975	1	1	TAYLOR, ERICA J LMFT	5/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
122293	Fee-for-Service	1366553588	1366553588	1	1	TAYLOR, RONALD D MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29414	30	Radiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
122351	Fee-for-Service	1194893248	1194893248	1	1	THE LOS ANGELES FREE CLINIC	4/28/1997	261QC1500X	NA	Other	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	19	06037	34.07607952	-118.373418	Los Angeles County
122405	Fee-for-Service	1699705426	1699705426	1	1	TENET HOSPITALS LIMILED	6/10/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	WHITE ROCK LAKE	9440 POPPY DR	None	DALLAS	TX	75218	3652	00	None	32.83537363	-96.70529992	Dallas County
122434	Fee-for-Service	1093756413	1093756413	1	1	TOWER INFECTIOUS DISEASE	1/1/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	MEDICAL ASSOCIATES	8631 W 3RD ST	STE 1015E	LOS ANGELES	CA	90048	5913	19	06037	34.07361928	-118.3803143	Los Angeles County
122440	Fee-for-Service	1669797668	1669797668	1	1	TOLBOE, CHRISTIAN	4/18/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1401 SPANOS CT	STE 125	MODESTO	CA	95355	2814	50	06099	37.66975543	-120.9724048	Stanislaus County
122457	Fee-for-Service	1861467573	1861467573	1	1	THE MEDICAL CENTER OF	2/6/2017	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SOUTHEAST TEXAS LP	2555 JIMMY JOHNSON BLVD	None	PORT ARTHUR	TX	77640	2007	00	None	29.935683	-93.989286	Jefferson County
122484	Fee-for-Service	1093807679	1093807679	1	1	TAN, VIVIAN R MD	1/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70063	41	Internal Medicine	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
122511	Fee-for-Service	1801893276	1801893276	1	1	TUJO, CHARLES A MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85193	30	Radiology	0	In state provider	None	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
122521	Fee-for-Service	1831672997	1831672997	1	1	TRAN, LIEN T NP	10/24/2018	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
122527	Fee-for-Service	1306854450	1306854450	1	1	TARIQ, ERUM MD	6/21/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79568	None	None	0	In state provider	None	444 PLUMAS BLVD	None	YUBA CITY	CA	95991	5071	51	06101	39.13178911	-121.6141048	Sutter County
122564	Fee-for-Service	1013080944	1013080944	1	1	TURNER, JAMES E MD	2/8/2015	207RC0200X	NA	Other	026	PHYSICIANS	38566	41	Internal Medicine	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	6606	58	06115	39.13872267	-121.5944372	Yuba County
122585	Fee-for-Service	1720674484	1720674484	1	1	TANG, CHRISTIE ANGELIE CRNA	3/12/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
122647	Fee-for-Service	1659687994	1659687994	1	1	TALYA, EDWARD D MD	9/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123964	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
122692	Fee-for-Service	1699705426	1699705426	1	1	TENET HOSPITALS LIMILED	6/10/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	WHITE ROCK LAKE	9440 POPPY DR	None	DALLAS	TX	75218	3652	00	None	32.83537363	-96.70529992	Dallas County
122695	Fee-for-Service	1538265780	1538265780	1	10	TAHOE FOREST HOSP DIST	6/4/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS ROAD	SUITE 130	TRUCKEE	CA	96161	4860	29	06057	39.32625521	-120.2012059	Nevada County
122710	Fee-for-Service	1124663588	1124663588	1	1	THE CARING BUNCH	4/14/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	19278 KNAPP ST	None	NORTHRIDGE	CA	91324	2717	19	06037	34.23815851	-118.553292	Los Angeles County
122751	Fee-for-Service	1760469548	1760469548	1	1	TIRMAN, PHILLIP F J MD	2/28/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	49148	None	None	0	In state provider	None	700 RIVER DR	None	FORT BRAGG	CA	95437	5403	23	06045	39.43163763	-123.8007631	Mendocino County
122772	Fee-for-Service	1922153139	1922153139	1	1	TANGCUANGCO, LAURO D MD	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93045	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
122799	Fee-for-Service	1215950043	1215950043	1	1	THOMPSON, JESSE E MD	8/31/1982	208600000X	NA	General Surgery	026	PHYSICIANS	27578	02	General Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
122804	Fee-for-Service	1821179581	1821179581	1	1	THEUS, JOHN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4301 W MARKHAM ST	SLOT 521	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
122820	Fee-for-Service	1124072251	1124072251	1	1	TRACEY L BUSBY M.D.	1/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
123063	Fee-for-Service	1346378007	1346378007	2	1	THE GREAT COMPANY	8/19/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2554 E. WASHINGTON BLVD	#B	PASADENA	CA	91107	1445	19	06037	34.1691145	-118.0973925	Los Angeles County
123153	Fee-for-Service	1114296704	1114296704	1	1	THOMPSON, KIRSTEN L MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119385	36	Psychiatry	0	In state provider	None	760 WESTWOOD BLVD	None	LOS ANGELES	CA	90095	8631	19	06037	34.07067	-118.4432445	Los Angeles County
123216	Fee-for-Service	1760427322	1760427322	1	1	TRUJILLO, ANA M MD	3/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77770	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27212 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63229023	-122.0896425	Alameda County
123225	Fee-for-Service	1811268964	1811268964	1	1	TE MEDICAL CENTER, INC	2/20/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	2148 ANAHEIM ST	None	LONG BEACH	CA	90804	3408	19	06037	33.78257051	-118.165896	Los Angeles County
123295	Fee-for-Service	1801923164	1801923164	1	1	TOTAL RENAL CARE, INC	8/1/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CERES DIALYSIS CENTER	1768 MITCHELL RD	None	CERES	CA	95307	2156	50	06099	37.605564	-120.9387115	Stanislaus County
123340	Fee-for-Service	1568495703	1568495703	1	2	TIZNADO, ERNESTO G MD	12/6/2007	2080P0006X	NA	Psychiatry	026	PHYSICIANS	45183	79	Neurology-Child	0	In state provider	None	2417 MARSHALL AVE	STE 1	IMPERIAL	CA	92251	9401	13	06025	32.82850658	-115.5688272	Imperial County
123381	Fee-for-Service	1366731986	1366731986	1	1	TOM, SABRINA M MD	1/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125221	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	19	06037	37.97026329	-121.2890849	San Joaquin County
123397	Fee-for-Service	1346771607	1346771607	1	1	TU, CHRISTIN J MD	7/15/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163292	40	Pediatrics	0	In state provider	None	250 E CAROLINE ST	STE J	SAN BERNARDINO	CA	92408	3758	36	06071	34.0615203	-117.2793274	San Bernardino County
123438	Fee-for-Service	1285044511	1285044511	1	1	TERKAWI, ABDULLAH S MD	6/4/2021	207L00000X	NA	Other	026	PHYSICIANS	169977	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
123445	Fee-for-Service	1619022837	1619022837	1	1	TALEGON, ELIF T MD INC	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63262	08	Family Practice	0	In state provider	None	365 PEARSON DR	STE 5	PORTERVILLE	CA	93257	3360	54	06107	36.07254288	-119.0276371	Tulare County
123500	Fee-for-Service	1811956436	1811956436	1	1	THURSTON, LEE MD	6/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1003 WILLOW CREEK RD	None	PRESCOTT	AZ	86301	1641	00	None	34.558992	-112.481901	Yavapai County
123503	Fee-for-Service	1760427322	1760427322	1	1	TRUJILLO, ANA M MD	3/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77770	41	Internal Medicine	0	In state provider	None	27212 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63229023	-122.0896425	Alameda County
123519	Fee-for-Service	1962901975	1962901975	1	1	THOUSAND OAK FAMILY	11/29/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRY	518 N MOORPARK RD	None	THOUSAND OAKS	CA	91360	3703	56	06111	34.18562678	-118.8750019	Ventura County
123586	Fee-for-Service	1538265780	1538265780	1	9	TAHOE FOREST HOSP DIST	9/17/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	900 GREENLEY RD	SUITE 904	SONORA	CA	95370	5287	55	06109	37.9777038	-120.3700429	Tuolumne County
123604	Fee-for-Service	1891715090	1891715090	1	1	TIMMERMAN, JOHN M MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	76297	None	None	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
123613	Fee-for-Service	1679802276	1679802276	1	1	TURKEL, HENRY W MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	25631	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
123616	Fee-for-Service	1124286885	1124286885	1	3	TUOLUMNE ME-WUK INDIAN	4/25/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	19969 GREENLEY RD	STE A	SONORA	CA	95370	5908	55	06109	37.98497262	-120.3669198	Tuolumne County
123625	Fee-for-Service	1821377961	1821377961	1	1	TULIANI, TUSHAR A MD	9/11/2018	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	1	Border provider	None	520 MEDICAL CENTER DR	STE 200	MEDFORD	OR	97504	4314	00	None	42.318801	-122.831728	Jackson County
123626	Fee-for-Service	1568495703	1568495703	1	2	TIZNADO, ERNESTO G MD	12/6/2007	2080P0006X	NA	Psychiatry	026	PHYSICIANS	45183	40	Pediatrics	0	In state provider	None	2417 MARSHALL AVE	STE 1	IMPERIAL	CA	92251	9401	13	06025	32.82850658	-115.5688272	Imperial County
123627	Fee-for-Service	1275215063	1275215063	1	1	THE PROSTHETICS AND ORTHOTIC	10/26/2023	224P00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	OTICS	766 JAMACHA RD	None	EL CAJON	CA	92019	3201	37	06073	32.78616732	-116.927991	San Diego County
123652	Fee-for-Service	1972527489	1972527489	1	1	TAN, SANDRA H MD	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64303	08	Family Practice	0	In state provider	None	2201 MISSION AVE	STE 120	OCEANSIDE	CA	92054	2328	37	06073	33.20742226	-117.3612486	San Diego County
123674	Fee-for-Service	1992916399	1992916399	1	1	TUPAZ HOME LLC	1/3/2006	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	18241 VANDERBILT DR	None	SARATOGA	CA	95070	4718	43	06085	37.27866412	-121.9898254	Santa Clara County
123685	Fee-for-Service	1124461025	1124461025	1	1	TSE, MONICA Y MD	11/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137187	01	General Practice	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
123687	Fee-for-Service	1346771607	1346771607	1	1	TU, CHRISTIN J MD	7/15/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163292	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 E CAROLINE ST	STE J	SAN BERNARDINO	CA	92408	3758	36	06071	34.0615203	-117.2793274	San Bernardino County
123746	Fee-for-Service	1649473109	1649473109	1	1	TORRONE, MARIA R MD	6/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107587	30	Radiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
123753	Fee-for-Service	1568704245	1568704245	1	1	THORSTED, RICHARD S MD	10/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150232	05	Anesthesiology	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
123783	Fee-for-Service	1023281904	1023281904	1	1	TINKELENBERG, TATIANA A MD	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106112	41	Internal Medicine	0	In state provider	None	700 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
123835	Fee-for-Service	1982714655	1982714655	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5518	601 PINE AVE	None	LONG BEACH	CA	90802	1331	19	06037	33.774381	-118.192417	Los Angeles County
123838	Fee-for-Service	1033196423	1033196423	1	1	TSAO, ALICE K MD	1/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117743	34	Urology and Urological Surgery	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
123869	Fee-for-Service	1477566040	1477566040	1	1	TOMIZAWA, HITOSHI MD	6/1/1998	174400000X	NA	Other	026	PHYSICIANS	64986	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
123872	Fee-for-Service	1144533977	1144533977	1	1	TORRADAS, JOSE R MD	2/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126062	66	Emergency Medicine (Urgent Care)	0	In state provider	None	875 S FAIRMONT AVE	None	LODI	CA	95240	5179	39	06077	38.12299057	-121.2859223	San Joaquin County
123904	Fee-for-Service	1326681321	1326681321	1	1	TIERNEY, ELYSE LCSW	9/26/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	108097	-	NOT APPLICABLE	0	In state provider	None	26 CENTRAL AVENUE	None	REDWOOD CITY	CA	94061	3823	41	06081	37.46901343	-122.2229191	San Mateo County
123906	Fee-for-Service	1124286885	1124286885	1	3	TUOLUMNE ME-WUK INDIAN	5/17/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	19969 GREENLEY RD	STE A	SONORA	CA	95370	5908	55	06109	37.98497262	-120.3669198	Tuolumne County
123941	Fee-for-Service	1831255439	1831255439	1	1	THOMPSON, JOHN P LCSW	11/19/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1341 W ROBINHOOD DR	STE B2	STOCKTON	CA	95207	5517	39	06077	37.99838007	-121.3243901	San Joaquin County
123946	Fee-for-Service	1134166382	1134166382	1	1	TRAN, BA-NGOC MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	42182	40	Pediatrics	0	In state provider	None	11801 INGLEWOOD AVE	STE 1	HAWTHORNE	CA	90250	2701	19	06037	33.927039	-118.361338	Los Angeles County
123963	Fee-for-Service	1568517050	1568517050	1	1	THE CAMP RECOVERY CENTER, LL	4/8/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	7064 CORLINE CT	SUITE A	SEBASTOPOL	CA	95472	4528	49	06097	38.38993034	-122.813403	Sonoma County
123966	Fee-for-Service	1023798733	1023798733	1	1	TIDWELL, ABIGAIL OT	9/8/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 EAST MAIN ST.	STE 104	EL CAJON	CA	92021	5223	37	06073	32.80969963	-116.9203429	San Diego County
123993	Fee-for-Service	1063844223	1063844223	1	1	TAI, HIU LAM PSYD	4/15/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
124004	Fee-for-Service	1437470176	1437470176	1	2	TRAPPEY, ALFRED F III MD	11/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144671	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
124006	Fee-for-Service	1821004110	1821004110	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5715	6075 MAGNOLIA AVE	None	RIVERSIDE	CA	92506	2525	33	06065	33.95971391	-117.3925772	Riverside County
124049	Fee-for-Service	1326172966	1326172966	1	1	TERRAZAS, PAUL	9/18/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	820 E GILBERT ST	None	SAN BERNARDINO	CA	92415	0928	36	06071	34.1268333	-117.2687417	San Bernardino County
124082	Fee-for-Service	1043579170	1043579170	1	1	TIMOTHY S. DAVIE, M.D.	6/16/2015	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
124127	Fee-for-Service	1861540486	1861540486	1	1	TOUB, DANIEL R MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66495	08	Family Practice	0	In state provider	None	499 HUMBOLDT ST	None	SANTA ROSA	CA	95404	4214	49	06097	38.442762	-122.7139875	Sonoma County
124155	Fee-for-Service	1134573827	1134573827	1	1	TRANQUILLE, YVAN P MD	10/23/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	162036	08	Family Practice	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
124170	Fee-for-Service	1053751941	1053751941	1	2	TEMECULA MEDICAL GROUP INC	4/10/2020	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	27555 YNEZ RD	STE 102	TEMECULA	CA	92591	4677	33	06065	33.50370608	-117.1492569	Riverside County
124204	Fee-for-Service	1649243197	1649243197	1	1	TSENG, ELAINE E MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86536	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
124231	Fee-for-Service	1942570130	1942570130	1	1	TYD EXECUTIVE MEDICAL CLINIC	3/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	44887	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	411 N CENTRAL AVE	SUITE 305	GLENDALE	CA	91203	2020	19	06037	34.15248444	-118.2579448	Los Angeles County
124272	Fee-for-Service	1568661478	1568661478	1	1	THRIFTY PAYLESS INC	9/26/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6529	895 OAK VALLEY PKWY	None	BEAUMONT	CA	92223	1464	33	06065	33.94677813	-116.9989532	Riverside County
124277	Fee-for-Service	1720166572	1720166572	1	1	TOWNSEND, DALE MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	46770	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
124278	Fee-for-Service	1295844579	1295844579	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	139 N GRAND AVE	None	COVINA	CA	91724	2957	19	06037	34.087113	-117.8726385	Los Angeles County
124346	Fee-for-Service	1144829094	1144829094	1	1	TRU FOUNDATION	3/5/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	11509 TAGUS DRIVE	None	BAKERSFIELD	CA	93311	9641	15	06029	35.29763879	-119.1308707	Kern County
124362	Fee-for-Service	1184898553	1184898553	1	1	THUNG, ELAINE G MD	5/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120443	18	Ophthalmology	0	In state provider	None	200 STEIN PLZ	RM 1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06482757	-118.4443441	Los Angeles County
124373	Fee-for-Service	1902169584	1902169584	1	1	TOM, JANELLE N	9/24/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
124381	Fee-for-Service	1275733016	1275733016	1	1	THOMAS, GAIL E MD	1/19/2016	208600000X	NA	General Surgery	026	PHYSICIANS	71045	02	General Surgery	0	In state provider	None	301 N R ST	None	LOMPOC	CA	93436	7845	42	06083	34.6423983	-120.4705911	Santa Barbara County
124439	Fee-for-Service	1447740824	1447740824	1	3	TRANSGENDER HEALTH AND	7/26/2022	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3737 MORAGA AVE	STE A204	SAN DIEGO	CA	92117	5489	37	06073	32.8086683	-117.2109991	San Diego County
124441	Fee-for-Service	1134283906	1134283906	1	1	THOMASON, CINDY	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
124454	Fee-for-Service	1801840483	1801840483	1	1	TRUONG, THAN V DPM	4/2/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1045 W REDONDO BEACH BLV	STE 106	GARDENA	CA	90247	4183	19	06037	33.89247044	-118.2931941	Los Angeles County
124459	Fee-for-Service	1457332777	1457332777	1	1	TETZ, EMMETT L MD INC	5/5/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	11748	02	General Surgery	0	In state provider	None	660 SANITARIUM RD	None	DEER PARK	CA	94576	9714	28	06055	38.54206023	-122.47561	Napa County
124521	Fee-for-Service	1942570130	1942570130	1	1	TYD EXECUTIVE MEDICAL CLINIC	3/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	44887	41	Internal Medicine	0	In state provider	INC	411 N CENTRAL AVE	SUITE 305	GLENDALE	CA	91203	2020	19	06037	34.15248444	-118.2579448	Los Angeles County
124535	Fee-for-Service	1518076967	1518076967	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5998	6445 PACIFIC AVE	None	STOCKTON	CA	95207	3715	39	06077	38.00885138	-121.3198384	San Joaquin County
124553	Fee-for-Service	1447740824	1447740824	1	6	TRANSGENDER HEALTH AND	4/9/2025	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3500 5TH AVENUE	SUITE 304	SAN DIEGO	CA	92103	5094	37	06073	32.74173	-117.1604085	San Diego County
124619	Fee-for-Service	1073866356	1073866356	1	1	TORRES, MIGUEL M LCSW	9/28/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2001 SANTA MONICA	370W, 380W, 860W, 1070	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
124626	Fee-for-Service	1902869035	1902869035	1	1	TOTAL RENAL CARE INC	5/10/1995	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	13039 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	4415	19	06037	33.9138	-118.3528075	Los Angeles County
124631	Fee-for-Service	1639593189	1639593189	1	1	TALLEY, NELITA	1/22/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1502 EISENHOWER DRIVE	None	SANTA CLARA	CA	95054	1616	43	06085	37.40114297	-121.9559953	Santa Clara County
124669	Fee-for-Service	1952833451	1952833451	1	1	TRAN, HUYEN V MD	11/10/2020	208M00000X	NA	Other	026	PHYSICIANS	169555	None	None	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
124671	Fee-for-Service	1275733016	1275733016	1	1	THOMAS, GAIL E MD	1/19/2016	208600000X	NA	General Surgery	026	PHYSICIANS	71045	01	General Practice	0	In state provider	None	301 N R ST	None	LOMPOC	CA	93436	7845	42	06083	34.6423983	-120.4705911	Santa Barbara County
124673	Fee-for-Service	1205881398	1205881398	1	1	THOMAS, CARLTON W JR MD	8/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88112	None	None	0	In state provider	None	292 EUCLID AVE	STE 115	SAN DIEGO	CA	92114	3629	37	06073	32.70706919	-117.0850896	San Diego County
124758	Fee-for-Service	1245252071	1245252071	1	1	TRINH, DAT Q DO	9/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9050	08	Family Practice	0	In state provider	None	360 E MISSION BLVD	None	POMONA	CA	91766	1847	19	06037	34.05514856	-117.7475076	Los Angeles County
124779	Fee-for-Service	1255793295	1255793295	1	1	TERAO, NAOMI N MD	2/27/2020	207P00000X	NA	Other	026	PHYSICIANS	152623	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
124786	Fee-for-Service	1548279003	1548279003	1	1	THOMPSON T KAMBA	9/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 3RD AVE SW	None	MINOT	ND	58701	3880	00	None	48.23336909	-101.2951165	Ward County
124811	Fee-for-Service	1265468094	1265468094	1	1	TAO, KEITH E M MD	8/31/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	42441	30	Radiology	0	In state provider	None	1844 SAN MIGUEL DR	STE 302	WALNUT CREEK	CA	94596	8612	07	06013	37.89504879	-122.0529911	Contra Costa County
124892	Fee-for-Service	1881181386	1881181386	1	1	THOMPSON, JACK R DO	8/25/2021	207P00000X	NA	Other	026	PHYSICIANS	18136	None	None	0	In state provider	None	400 N MCDOWELL BLVD	None	PETALUMA	CA	94954	2339	49	06097	38.25477	-122.63175	Sonoma County
124916	Fee-for-Service	1831240522	1831240522	1	1	TULARE CO EDUCATION	7/1/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	23024 AVE 198	PO BOX 247	STRATHMORE	CA	93267	0247	54	06107	36.1492503	-119.057796	Tulare County
124982	Fee-for-Service	1053924720	1053924720	1	1	TRUSTED ANGELS HOSPICE INC	3/14/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	13615 VICTORY BLVD	STE 104	VAN NUYS	CA	91401	1763	19	06037	34.18671049	-118.429353	Los Angeles County
124998	Fee-for-Service	1376685214	1376685214	1	1	TAI, JACQUELINE S MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91736	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
125012	Fee-for-Service	1629310743	1629310743	1	1	TUZNIK, IAN MD	9/7/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	172139	None	None	0	In state provider	None	6620 COYLE AVE	STE 212	CARMICHAEL	CA	95608	6337	34	06067	38.66751	-121.310028	Sacramento County
125032	Fee-for-Service	1144584434	1144584434	1	1	TIWARY, KAUSHIK MD	1/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139071	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LN	STE 450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
125075	Fee-for-Service	1073536520	1073536520	1	1	TABIBIAN, ALLEN B MD APC	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	54761	01	General Practice	0	In state provider	ADVANCED CARDIAC CARE	16500 VENTURA BLVD	STE 418	ENCINO	CA	91436	2062	19	06037	34.15756758	-118.4926374	Los Angeles County
125082	Fee-for-Service	1902570047	1902570047	1	1	TRUJILLO, MADELINE	6/14/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
125163	Fee-for-Service	1033161641	1033161641	1	1	TSAI, JOHN Y MD	7/26/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69320	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
125164	Fee-for-Service	1285861799	1285861799	1	1	TSANG, WALTER Y MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106910	68	Hematology	0	In state provider	None	7000 BOULDER AVENUE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
125202	Fee-for-Service	1588041487	1588041487	1	1	TISSOT, CRISTINA	5/14/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	493 MAIN ST	None	WEAVERVILLE	CA	96093	0000	53	06105	40.73385602	-122.9408655	Trinity County
125269	Fee-for-Service	1053924720	1053924720	1	1	TRUSTED ANGELS HOSPICE INC	3/14/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	13615 VICTORY BLVD	STE 104	VAN NUYS	CA	91401	1763	19	06037	34.18671049	-118.429353	Los Angeles County
125280	Fee-for-Service	1013987890	1013987890	1	1	TAYEFEH, FARZIN, MD INC	5/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73083	05	Anesthesiology	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
125286	Fee-for-Service	1942829718	1942829718	1	1	THAMBIAIYAH, VITHYA MD	10/5/2023	208M00000X	NA	Other	026	PHYSICIANS	187852	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
125289	Fee-for-Service	1548654007	1548654007	1	1	TSAI, TIFFANY MD	6/23/2021	2085N0700X	NA	MRI Provider	026	PHYSICIANS	168129	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
125336	Fee-for-Service	1609985597	1609985597	1	1	TANGORRA, MATTHEW DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1945 CORLIES AVE	None	NEPTUNE	NJ	07753	4859	00	None	40.20750349	-74.0406949	Monmouth County
125357	Fee-for-Service	1578927083	1578927083	1	1	TSO, JASON V MD	8/8/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	153564	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
125362	Fee-for-Service	1073536520	1073536520	1	1	TABIBIAN, ALLEN B MD APC	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	54761	06	Cardiovascular Disease (M.D. only)	0	In state provider	ADVANCED CARDIAC CARE	16500 VENTURA BLVD	STE 418	ENCINO	CA	91436	2062	19	06037	34.15756758	-118.4926374	Los Angeles County
125367	Fee-for-Service	1700885076	1700885076	1	1	TH HEALTHCARE LTD	1/27/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4920 NE STALLINGS DR	None	NACOGDOCHES	TX	75965	1254	00	None	31.65212263	-94.65388609	Nacogdoches County
125373	Fee-for-Service	1033771589	1033771589	1	1	TKAC, VINCENT J OT	5/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
125381	Fee-for-Service	1336312891	1336312891	1	1	TURMAN, LISA M MD	7/31/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	97956	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
125453	Fee-for-Service	1821231101	1821231101	1	1	TIEU, LINH A DO	7/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11505	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	5300	36	06071	34.04824949	-117.2401425	San Bernardino County
125455	Fee-for-Service	1285861799	1285861799	1	1	TSANG, WALTER Y MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106910	78	Neoplastic Diseases/Oncology	0	In state provider	None	7000 BOULDER AVENUE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
125484	Fee-for-Service	1154740819	1154740819	1	1	TRAN, DAVID L MD	8/13/2018	207QH0002X	NA	Adult Primary Care	026	PHYSICIANS	139964	08	Family Practice	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
125509	Fee-for-Service	1023030137	1023030137	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5959	431 CORTE MADERA TOWN CT	None	CORTE MADERA	CA	94925	1215	21	06041	37.926729	-122.5181105	Marin County
125544	Fee-for-Service	1851734248	1851734248	1	1	TERESA DELORES RUCKER	4/10/2013	163W00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	310 FAIRBANKS DRIVE	None	RIO VISTA	CA	94571	5105	48	06095	38.18578351	-121.7097617	Solano County
125550	Fee-for-Service	1992716260	1992716260	1	1	THRIFTY PAYLESS INC	4/1/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5778	3941 SPRING RD	None	MOORPARK	CA	93021	2300	56	06111	34.26371099	-118.8648608	Ventura County
125560	Fee-for-Service	1235219197	1235219197	1	1	THOMAS, RANDOLPH C MD	8/13/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48302	66	Emergency Medicine (Urgent Care)	0	In state provider	None	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
125621	Fee-for-Service	1659677029	1659677029	1	1	TEEL, ROBERT L PHD	10/18/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8775 AERO DRIVE	STE 238	SAN DIEGO	CA	92123	1756	37	06073	32.80965551	-117.1391563	San Diego County
125652	Fee-for-Service	1073536520	1073536520	1	1	TABIBIAN, ALLEN B MD APC	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	54761	41	Internal Medicine	0	In state provider	ADVANCED CARDIAC CARE	16500 VENTURA BLVD	STE 418	ENCINO	CA	91436	2062	19	06037	34.15756758	-118.4926374	Los Angeles County
125658	Fee-for-Service	1700885076	1700885076	1	1	TH HEALTHCARE LTD	1/27/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4920 NE STALLINGS DR	None	NACOGDOCHES	TX	75965	1254	00	None	31.65212263	-94.65388609	Nacogdoches County
125661	Fee-for-Service	1235746942	1235746942	1	1	TOUCH OF HOPE HOSPICE, INC	7/17/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5311 TOPANGA CANYON BLVD	STE 306	WOODLAND HILLS	CA	91364	1754	19	06037	34.166313	-118.6059365	Los Angeles County
125737	Fee-for-Service	1902156581	1902156581	1	1	TORRES, MATTHEW A LCSW	3/8/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
125800	Fee-for-Service	1518223197	1518223197	1	1	THANGAVEL, ARUL MD	9/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129306	01	General Practice	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
125831	Fee-for-Service	1851734248	1851734248	1	1	TERESA DELORES RUCKER	4/10/2013	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	310 FAIRBANKS DRIVE	None	RIO VISTA	CA	94571	5105	48	06095	38.18578351	-121.7097617	Solano County
125847	Fee-for-Service	1235219197	1235219197	1	1	THOMAS, RANDOLPH C MD	8/13/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48302	40	Pediatrics	0	In state provider	None	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
125878	Fee-for-Service	1508390766	1508390766	1	1	TZAN, KATHLEEN MD	9/29/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	158875	40	Pediatrics	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
125882	Fee-for-Service	1942375688	1942375688	1	1	TAYLOR, SHERRY L MD	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	69273	14	Neurological Surgery	0	In state provider	None	1200 B GALE WILSON RD	None	FAIRFIELD	CA	94533	0000	48	06095	38.26109552	-122.0470245	Solano County
125922	Fee-for-Service	1164593026	1164593026	1	1	TAYLOR,CORNELIA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3181 SW SAM JACKSON PK	RD	PORTLAND	OR	97239	0000	00	None	45.49936609	-122.6856232	Multnomah County
125934	Fee-for-Service	1598874919	1598874919	1	1	THRIFTY DRUG STORE 5423	2/21/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1534 E FLORENCE AVE	None	LOS ANGELES	CA	90001	2536	19	06037	33.97471853	-118.2463515	Los Angeles County
125943	Fee-for-Service	1730467770	1730467770	1	1	TURNING POINT OF CENTRAL	12/16/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA, INC	460 WEST HICKORY STREET	None	LINDSAY	CA	93247	1410	54	06107	36.2177697	-119.0776883	Tulare County
125951	Fee-for-Service	1235746942	1235746942	1	1	TOUCH OF HOPE HOSPICE, INC	7/17/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5311 TOPANGA CANYON BLVD	STE 306	WOODLAND HILLS	CA	91364	1754	19	06037	34.166313	-118.6059365	Los Angeles County
125957	Fee-for-Service	1992138556	1992138556	1	1	TAYAG, MARIE C S MD	11/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142912	41	Internal Medicine	0	In state provider	None	525 W ACACIA ST	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
125959	Fee-for-Service	1073899878	1073899878	1	1	TRAN, NHU NP	3/23/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
125976	Fee-for-Service	1811563174	1811563174	1	1	TAM, ANDREA OD	10/18/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	615 WEST AVE L	None	LANCASTER	CA	93545	7211	19	06037	34.6603515	-118.1419695	Los Angeles County
125987	Fee-for-Service	1134108525	1134108525	1	1	TAPEN, ELIZABETH M MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	77353	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X STREET	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
126024	Fee-for-Service	1568518983	1568518983	1	1	THE WOMEN'S CARE CENTER	3/11/2005	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL GROUP	2021 22ND ST	None	BAKERSFIELD	CA	93301	3802	15	06029	35.37907949	-119.025603	Kern County
126030	Fee-for-Service	1992182257	1992182257	1	1	TAFET, KELLIE A MD	1/5/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	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
126036	Fee-for-Service	1962913004	1962913004	1	1	THEECK, AMANDA N	1/23/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	217 W CERRITOS AVE	None	ANAHEIM	CA	92805	6549	30	06059	33.81058193	-117.9065445	Orange County
126124	Fee-for-Service	1962525006	1962525006	1	2	TON-THAT, CHAU DO INC	2/9/2009	2084P0800X	NA	Psychiatry	026	PHYSICIANS	7177	36	Psychiatry	0	In state provider	None	6 B LIBERTY	SUITE 115	ALISO VIEJO	CA	92656	5833	30	06059	33.55963577	-117.7295376	Orange County
126128	Fee-for-Service	1003104423	1003104423	1	1	TRUJILLO, DALE M NP	3/12/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
126149	Fee-for-Service	1659441830	1659441830	1	1	TAPSON, GREGORY S MD INC	5/22/2013	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	71123	None	None	0	In state provider	None	26366 CARMEL RANCHO LANE	STE H	CARMEL	CA	93923	8721	27	06053	36.54073084	-121.9069263	Monterey County
126170	Fee-for-Service	1336265883	1336265883	1	1	TAMSE, MICHELE M DO	10/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10768	40	Pediatrics	0	In state provider	None	1555 DOOLITTLE DR	STE 180	SAN LEANDRO	CA	94577	2239	01	06001	37.71160019	-122.184628	Alameda County
126187	Fee-for-Service	1669548814	1669548814	1	1	THOMAS, ALICE A	2/8/2015	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2031B W AVENUE K	None	LANCASTER	CA	93536	5217	19	06037	34.6750593	-118.1670255	Los Angeles County
126210	Fee-for-Service	1598870248	1598870248	1	1	TAN, CATHERINE A MD	9/30/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	78137	40	Pediatrics	0	In state provider	None	17577 ARROW BLVD	None	FONTANA	CA	92335	4011	36	06071	34.09938951	-117.421272	San Bernardino County
126248	Fee-for-Service	1619057593	1619057593	1	1	TUCKER, DOUGLAS A MD	5/31/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53759	41	Internal Medicine	0	In state provider	None	201 OLD SAN FRANCISCO RD	None	SANTA CLARA	CA	95051	0000	43	06085	37.36672196	-122.0186015	Santa Clara
126292	Fee-for-Service	1932301165	1932301165	1	1	THRIFTY PAYLESS INC	7/23/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6520	4830 J ST	None	SACRAMENTO	CA	95819	3742	34	06067	38.566548	-121.443642	Sacramento County
126308	Fee-for-Service	1588082820	1588082820	1	1	TYLER, JEFFREY M MD	6/4/2019	208M00000X	NA	Other	026	PHYSICIANS	140085	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
126311	Fee-for-Service	1568518983	1568518983	1	1	THE WOMEN'S CARE CENTER	10/22/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	A MEDICAL GROUP	2021 22ND ST	None	BAKERSFIELD	CA	93301	3802	15	06029	35.37907949	-119.025603	Kern County
126324	Fee-for-Service	1730997024	1730997024	1	1	TENNY, TAMMY NP	2/10/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8150 HAGEMAN RD	None	BAKERSFIELD	CA	93312	1959	15	06029	35.40166449	-119.0933415	Kern County
126356	Fee-for-Service	1326204702	1326204702	1	1	TUTTLE, RAZAN	10/15/2024	101YP2500X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15260 VENTURA BLVD	1200	SHERMAN OAKS	CA	91403	5307	19	06037	34.15370926	-118.4656644	Los Angeles County
126384	Fee-for-Service	1558848481	1558848481	1	1	THE SALVATION ARMY	8/10/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	423 CHAPALA ST	None	SANTA BARBARA	CA	93101	3409	42	06083	34.41532813	-119.6961695	Santa Barbara County
126413	Fee-for-Service	1861891897	1861891897	1	1	TABORA, HANZ K PT	7/11/2022	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1401 BAILEY AVE	None	NEEDLES	CA	92363	3103	36	06071	34.832997	-114.618293	San Bernardino County
126431	Fee-for-Service	1023404910	1023404910	1	1	TAN, TIMOTHY L MD	8/3/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	167215	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
126493	Fee-for-Service	1205060340	1205060340	1	1	TAM, TERRENCE W MD	2/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115982	40	Pediatrics	0	In state provider	None	276 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
126513	Fee-for-Service	1538798822	1538798822	1	1	TERRAZAS, MICHELLE LMFT	7/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11455 PARAMOUNT BLVD	SUITE F	DOWNEY	CA	90241	4550	19	06037	33.94022241	-118.1398143	Los Angeles County
126514	Fee-for-Service	1972148401	1972148401	1	1	TRAN, WILSON PT	7/5/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
126526	Fee-for-Service	1750716007	1750716007	1	1	THENO, JESSICA L NP	6/25/2018	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
126573	Fee-for-Service	1417532920	1417532920	1	1	TAMAYO, ERNESTVID M LCSW	1/27/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
126584	Fee-for-Service	1861987745	1861987745	1	1	TRUSSLER, JAMES	9/26/2023	208800000X	NA	Other	026	PHYSICIANS	187245	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
126632	Fee-for-Service	1396983805	1396983805	1	1	TURNER, BARBARA LMFT	7/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	720 SOUTH POINT BOULEVAR	207	PETALUMA	CA	94954	8017	49	06097	38.25846424	-122.6470803	Sonoma County
126646	Fee-for-Service	1023024510	1023024510	1	1	THOMAS,TIMM C MD	6/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NS	None	ALBUQUERQUE	NM	87131	0001	00	None	35.08771808	-106.6192188	Bernalillo County
126678	Fee-for-Service	1447740824	1447740824	1	5	TRANSGENDER HEALTH AND	10/23/2024	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3001 E. TAHQUITZ CANYONG	STE 103/104	PALM SPRINGS	CA	92262	6900	33	06065	33.82306725	-116.5130848	Riverside County
126712	Fee-for-Service	1922215045	1922215045	1	1	TOM, WYNNIS L MD	7/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99290	07	Dermatology	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
126716	Fee-for-Service	1518926534	1518926534	1	1	TAYLOR DOWSLEY	9/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 BROADWAY N	None	FARGO	ND	58102	3641	00	None	46.885068	-96.7872375	Cass County
126742	Fee-for-Service	1649485558	1649485558	1	1	THRIDANDAM, BHARATHY LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
126744	Fee-for-Service	1518426675	1518426675	1	1	TORABI MOGHADDAM, SHAYAN MD	12/18/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	20421	None	None	0	In state provider	DO	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
126769	Fee-for-Service	1457403826	1457403826	1	1	TAN, CISSY MD	4/30/1989	2086S0122X	NA	General Surgery	026	PHYSICIANS	46348	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
126776	Fee-for-Service	1013379171	1013379171	1	1	TRESENRITER, MEGAN R MD	7/1/2020	207P00000X	NA	Other	026	PHYSICIANS	151634	66	Emergency Medicine (Urgent Care)	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
126801	Fee-for-Service	1407297781	1407297781	1	1	TAYAG, ARMINE T NP	10/19/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
126826	Fee-for-Service	1588957310	1588957310	1	1	TOLENTINO, CRINEL J	6/20/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
126856	Fee-for-Service	1245318708	1245318708	1	1	TOMI INTERNATIONAL INC	2/26/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TOMI MEDICAL SUPPLY	2289 W ROSECRANS AVE	None	GARDENA	CA	90249	2947	19	06037	33.9019773	-118.3185512	Los Angeles County
126867	Fee-for-Service	1396969945	1396969945	1	1	TEDESCO, KURTIS LEE MD	6/8/2009	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	0002	00	None	32.240493	-110.9460825	Pima County
126873	Fee-for-Service	1457367757	1457367757	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	220 E GRAND AVE	None	EL SEGUNDO	CA	90245	3827	19	06037	33.91933277	-118.4140491	Los Angeles County
126955	Fee-for-Service	1306565528	1306565528	1	1	TITAN HEALTH PHARMACY LLC	3/9/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1206 W AVENUE J	#101	LANCASTER	CA	93534	2956	19	06037	34.68937853	-118.1525805	Los Angeles County
126958	Fee-for-Service	1689945990	1689945990	1	2	THE RETINA PARTNERS	8/31/2022	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	23929 MCBEAN PKWY	SUITE 208	SANTA CLARITA	CA	91355	4466	19	06037	34.39588575	-118.5538975	Los Angeles County
127001	Fee-for-Service	1912946062	1912946062	1	1	TORRES, LOURDES LMFT	2/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8247 E STOCKTON BLVD	None	SACRAMENTO	CA	95828	8200	34	06067	38.459187	-121.4080245	Sacramento County
127004	Fee-for-Service	1336195924	1336195924	1	1	TONYA L STRUBLE NP	8/13/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2905 3RD AVE SE	None	ABERDEEN	SD	57401	5420	00	None	45.46217797	-98.44647558	Brown County
127018	Fee-for-Service	1295716108	1295716108	1	1	TSUI, PHILIP M MD	5/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	62104	02	General Surgery	0	In state provider	None	168 W BADILLO ST	None	COVINA	CA	91723	2015	19	06037	34.0861946	-117.8913779	Los Angeles County
127060	Fee-for-Service	1730779760	1730779760	1	1	THE HEIGHTS PHYSICAL THERAPY	8/21/2023	193200000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	3620 LONG BEACH BLVD	STE C11	LONG BEACH	CA	90807	6016	19	06037	33.822837	-118.1893245	Los Angeles County
127085	Fee-for-Service	1275922130	1275922130	1	1	TAM, DEREK C MD	7/1/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	168598	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
127152	Fee-for-Service	1053479055	1053479055	1	1	TU, SOPHIE X 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
127168	Fee-for-Service	1154889681	1154889681	1	1	TOOHEY, JAMES W LMFT	8/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5800 HANNUM AVE	105	CULVER CITY	CA	90230	6553	19	06037	33.98724995	-118.3858338	Los Angeles County
127181	Fee-for-Service	1356539365	1356539365	1	1	TAYLOR, MICHAEL LEE DC	2/8/2015	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CHIRO CORP	1421 STANIFORD AVE	STE B	MODESTO	CA	95350	0730	50	06099	37.68941947	-121.0154895	Stanislaus County
127212	Fee-for-Service	1568539393	1568539393	1	1	TANG, DOUGLAS MD	12/3/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	54087	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
127225	Fee-for-Service	1013980390	1013980390	1	1	TOM, ANDREA M MD	12/31/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77143	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
127263	Fee-for-Service	1841619277	1841619277	1	1	TRIPP, ADRIAN MD	11/2/2018	207R00000X	NA	Other	026	PHYSICIANS	139969	41	Internal Medicine	0	In state provider	None	15095 AMARGOSA RD	280	VICTORVILLE	CA	92394	1885	36	06071	34.52479785	-117.3303132	San Bernardino County
127288	Fee-for-Service	1194991430	1194991430	1	1	TRAN, KHANG VAN MD	6/11/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33941	08	Family Practice	0	In state provider	None	6947 LINDA VISTA RD	STE A	SAN DIEGO	CA	92111	6363	37	06073	32.78613154	-117.1704273	San Diego County
127316	Fee-for-Service	1235151150	1235151150	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE 5680	1501 W MAIN ST	None	EL CENTRO	CA	92243	2211	13	06025	32.79277553	-115.5706425	Imperial County
127327	Fee-for-Service	1063426310	1063426310	1	1	TB2G, INC.	10/10/2007	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	HANMI MED SUPPLY & EQUIP	17637-B SHERMAN WAY	None	VAN NUYS	CA	91406	3510	19	06037	34.20123846	-118.517679	Los Angeles County
127343	Fee-for-Service	1023640935	1023640935	1	1	THEBE, SMRITI S NP	12/27/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
127426	Fee-for-Service	1962400051	1962400051	1	1	TERRA, KATHLEEN M MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70180	08	Family Practice	0	In state provider	None	1600 WEEOT WAY	None	ARCATA	CA	95521	4734	12	06023	40.89808837	-124.0923819	Humboldt County
127438	Fee-for-Service	1164582425	1164582425	1	1	TSAO, BRIDGET J OD	8/1/2001	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	115 PIRIE RD	STE E	OJAI	CA	93023	3100	56	06111	34.44311416	-119.2657233	Ventura County
127442	Fee-for-Service	1528375078	1528375078	1	1	TESTA, ABRAHAM J MD	10/29/2024	208M00000X	NA	Other	026	PHYSICIANS	178551	41	Internal Medicine	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
127446	Fee-for-Service	1053807487	1053807487	1	1	TETTEH PEDIATRIC HEALTH, INC	2/4/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	.	7248 S. LAND PARK DRIVE	SUITE 118	SACRAMENTO	CA	95831	3661	34	06067	38.494602	-121.513743	Sacramento County
127455	Fee-for-Service	1639635923	1639635923	1	1	TANG, KELLIE	10/18/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
127462	Fee-for-Service	1265895114	1265895114	1	1	TEH, PHILDRICH G MD	9/12/2022	207RR0500X	NA	Other	026	PHYSICIANS	152699	None	None	0	In state provider	None	25150 HANCOCK AVE	STE 206	MURRIETA	CA	92562	5989	33	06065	33.56635084	-117.1823956	Riverside County
127469	Fee-for-Service	1366651101	1366651101	1	1	THERAPEUTIC LIVING CNTRS	4/2/1997	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR THE BLIND	9530 DONNA AVE	None	NORTHRIDGE	CA	91324	1815	19	06037	34.2438543	-118.5474935	Los Angeles County
127475	Fee-for-Service	1467771055	1467771055	1	1	THIESSEN, CARRIE F MD	7/31/2019	208600000X	NA	General Surgery	026	PHYSICIANS	161353	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
127501	Fee-for-Service	1568539393	1568539393	1	1	TANG, DOUGLAS MD	12/3/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	54087	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
127508	Fee-for-Service	1104833516	1104833516	1	1	TELLEZ, EDWARDO C MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63350	40	Pediatrics	0	In state provider	None	16510 BLOOMFIELD AVE	None	CERRITOS	CA	90703	2115	19	06037	33.88108335	-118.0639087	Los Angeles County
127586	Fee-for-Service	1659661148	1659661148	1	1	TSO, CHI PT	12/10/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	289 W. HUNTINGTON DR.	STE 103	ARCADIA	CA	91007	3492	19	06037	34.13549119	-118.0419175	Los Angeles County
127658	Fee-for-Service	1851326698	1851326698	1	1	TAHIR, LISA LCSW	12/14/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
127660	Fee-for-Service	1689214074	1689214074	1	1	TRIEU, AIZZEL R NP	10/6/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	14390 PARK AVE.	None	VICTORVILLE	CA	92392	2910	36	06071	34.512453	-117.324936	San Bernardino County
127671	Fee-for-Service	1568865715	1568865715	1	1	THOMAS & REID INNOVATIONS L	1/14/2015	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	402 W BROADWAY	SUITE 400	SAN DIEGO	CA	92101	3554	37	06073	32.71578647	-117.166941	San Diego County
127755	Fee-for-Service	1851389696	1851389696	1	1	TIBURCIO VASQUEZ HLTH CT	1/1/1992	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	33255 9TH ST	None	UNION CITY	CA	94587	2137	01	06001	37.60286569	-122.0260874	Alameda County
127812	Fee-for-Service	1205250263	1205250263	1	3	THE CHILDRENS CLINIC SERVING	1/12/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1955 LONG BEACH BLVD	STE 150	LONG BEACH	CA	90806	5501	19	06037	33.79290697	-118.1895017	Los Angeles County
127855	Fee-for-Service	1659105815	1659105815	1	1	TURIYA ANESTHESIA OF CITRUS	10/16/2024	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	VALLEY	210 W SAN BERNARDINO RD	None	COVINA	CA	91723	1515	19	06037	34.088004	-117.893475	Los Angeles County
127886	Fee-for-Service	1629605084	1629605084	1	1	TOM, ZACHARY J MD	9/20/2024	207R00000X	NA	Other	026	PHYSICIANS	184843	41	Internal Medicine	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
127944	Fee-for-Service	1790873149	1790873149	2	1	TRINITY HOME HEALTH SVS INC	4/8/2007	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6729 NORTH WILLOW AVE	SUITE 103	FRESNO	CA	93710	5952	10	06019	36.83425452	-119.731148	Fresno County
127965	Fee-for-Service	1629284971	1629284971	1	1	TSAI, ELIZABETH F MD	3/18/2008	207R00000X	NA	Other	026	PHYSICIANS	10020	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
128042	Fee-for-Service	1851389696	1851389696	1	1	TIBURCIO VASQUEZ HLTH CT	3/3/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	33255 9TH ST	None	UNION CITY	CA	94587	2137	01	06001	37.60286569	-122.0260874	Alameda County
128084	Fee-for-Service	1548786049	1548786049	1	1	TRAN, THAI HANG T NP	6/3/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
128102	Fee-for-Service	1003143041	1003143041	1	1	TESORIO, CLYTIE M PT	12/6/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12411 SLAUSON AVE	STE H	WHITTIER	CA	90606	2835	19	06037	33.96028839	-118.0529975	Los Angeles County
128103	Fee-for-Service	1205250263	1205250263	1	3	THE CHILDRENS CLINIC SERVING	1/12/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1955 LONG BEACH BLVD	STE 150	LONG BEACH	CA	90806	5501	19	06037	33.79290697	-118.1895017	Los Angeles County
128172	Fee-for-Service	1003396615	1003396615	1	1	TRICITY RIVERSIDE DIALYSIS	3/23/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	7275 INDIANA AVE	SUITE 100	RIVERSIDE	CA	92504	4543	33	06065	33.93753005	-117.4003016	Riverside County
128178	Fee-for-Service	1720690118	1720690118	1	1	TOWAR, JILLIAN LPCC	11/8/2024	390200000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	814 BROADWAY	None	SONOMA	CA	95476	7584	49	06097	38.28627132	-122.4586519	Sonoma County
128205	Fee-for-Service	1447369970	1447369970	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05968	6123 HIGHWAY 9	None	FELTON	CA	95018	9701	44	06087	37.05007537	-122.0733365	Santa Cruz County
128211	Fee-for-Service	1316388028	1316388028	1	1	THIARA, SIMRAN K MD	10/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138782	83	Rheumatology	0	In state provider	None	1020 29TH ST	STE 120	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
128328	Fee-for-Service	1730166067	1730166067	1	1	TEMPO, TAMDING MD INC	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	30993	05	Anesthesiology	0	In state provider	None	44301 LORIMER AVE	None	LANCASTER	CA	93534	3700	19	06037	34.68798563	-118.1601762	Los Angeles County
128332	Fee-for-Service	1851389696	1851389696	1	1	TIBURCIO VASQUEZ HLTH CT	1/1/1992	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	33255 9TH ST	None	UNION CITY	CA	94587	2137	01	06001	37.60286569	-122.0260874	Alameda County
128344	Fee-for-Service	1114336658	1114336658	1	1	THOMAS, ANN G CNP	2/22/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1707 EYE ST	100	BAKERSFIELD	CA	93301	5208	15	06029	35.37461686	-119.020062	Kern County
128391	Fee-for-Service	1518283134	1518283134	1	1	TRAN, SUSANNA MD	4/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	120588	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	50 W BELLEFONTAINE ST	STE 405	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
128450	Fee-for-Service	1558706432	1558706432	1	1	TRAN, JESSE H MD	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137005	41	Internal Medicine	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
128461	Fee-for-Service	1740200914	1740200914	1	1	TA, SONY A MD	10/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90931	None	None	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
128505	Fee-for-Service	1083479828	1083479828	1	1	THOMAS, TIFFANI N DOULA	4/24/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	48	06095	0	0	None
128517	Fee-for-Service	1124174925	1124174925	1	1	TAYLOR, WARREN	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4343 WHITTLE AVE	None	OAKLAND	CA	94602	2547	01	06001	37.81063625	-122.2050648	Alameda County
128522	Fee-for-Service	1235194507	1235194507	1	2	TEA HEALTHCARE SERVICES INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1025 W SAN BERNARDINO RD	None	COVINA	CA	91722	4106	19	06037	34.08886982	-117.9105459	Los Angeles County
128526	Fee-for-Service	1831271055	1831271055	1	1	TIEN, YING-KAN MD	3/1/1984	207L00000X	NA	Other	026	PHYSICIANS	33940	05	Anesthesiology	0	In state provider	None	12832 GARDEN GROVE BLVD	STE 230	GARDEN GROVE	CA	92843	2033	30	06059	33.77433247	-117.908712	Orange County
128576	Fee-for-Service	1073717815	1073717815	1	1	TROST, MARGARET J MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116363	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
128591	Fee-for-Service	1003994864	1003994864	1	1	TAPPER, DOUGLAS P MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	59948	01	General Practice	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
128612	Fee-for-Service	1477520864	1477520864	1	1	TEICHEIRA, DAVID P MD	8/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	60747	05	Anesthesiology	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
128614	Fee-for-Service	1851389696	1851389696	1	1	TIBURCIO VASQUEZ HLTH CT	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	33255 9TH ST	None	UNION CITY	CA	94587	2137	01	06001	37.60286569	-122.0260874	Alameda County
128646	Fee-for-Service	1093729691	1093729691	1	1	TANG, EDDIE MD	3/1/1998	208G00000X	NA	General Surgery	026	PHYSICIANS	75213	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1 SHRADER ST	STE 600	SAN FRANCISCO	CA	94117	1018	38	06075	37.77467326	-122.4529451	San Francisco County
128686	Fee-for-Service	1114409190	1114409190	1	1	TERAN-HERNANDEZ, ROXANA LCS	10/29/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	130 N BRAND BLVD	202	GLENDALE	CA	91203	2644	19	06037	34.147521	-118.2549325	Los Angeles County
128688	Fee-for-Service	1770927014	1770927014	1	1	THOMAS, ADRIANA MD	1/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139321	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
128707	Fee-for-Service	1427326594	1427326594	1	1	TAYLOR, KATHLEEN	11/16/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2810 E DEL MAR BLVD	None	PASADENA	CA	91107	4320	19	06037	34.14212984	-118.092328	Los Angeles County
128720	Fee-for-Service	1962402966	1962402966	1	1	TRAN, NINH H MD INC	5/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	70342	18	Ophthalmology	0	In state provider	None	619 LAUREL ST	None	SAN CARLOS	CA	94070	3111	41	06081	37.50599903	-122.260524	San Mateo County
128721	Fee-for-Service	1205874088	1205874088	1	1	TAKATA, MICHELLE N MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	60494	05	Anesthesiology	0	In state provider	None	1441 AVOCADO AVE	STE 103	NEWPORT BEACH	CA	92660	7702	30	06059	33.61338536	-117.8693961	Orange County
128809	Fee-for-Service	1821521733	1821521733	1	1	TRIVEDI, RADHIKA R MD	7/25/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	176430	None	None	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
128824	Fee-for-Service	1295764421	1295764421	1	1	TRAUSCH, JOSEFINA Q MD	5/31/1992	207R00000X	NA	Other	026	PHYSICIANS	50160	41	Internal Medicine	0	In state provider	None	5030 BONITA RD	None	BONITA	CA	91902	1701	37	06073	32.66930417	-117.022787	San Diego County
128859	Fee-for-Service	1598176497	1598176497	1	1	TSAI, MONICA S MD	10/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142506	41	Internal Medicine	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
128881	Fee-for-Service	1548239635	1548239635	1	1	TAM, TACKSON MD	10/15/1990	207R00000X	NA	Other	026	PHYSICIANS	70073	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
128891	Fee-for-Service	1700027679	1700027679	1	1	TWOMBLY, ALISA C LCSW	12/23/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
128913	Fee-for-Service	1043475213	1043475213	1	1	TAHER, NEGIN MD	11/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114593	08	Family Practice	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
128922	Fee-for-Service	1871987396	1871987396	1	1	TSAI, JESSICA MD	2/27/2024	2080P0207X	NA	Hematology	026	PHYSICIANS	192029	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
128923	Fee-for-Service	1699200709	1699200709	1	1	TSENG, DAVID DO	6/30/2020	390200000X	NA	Other	026	PHYSICIANS	17261	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
128977	Fee-for-Service	1437268869	1437268869	1	1	THRIFTY PAYLESS INC	8/28/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5975	16000 MONTEREY ST	None	MORGAN HILL	CA	95037	5404	43	06085	37.11343849	-121.643209	Santa Clara County
128981	Fee-for-Service	1538265780	1538265780	1	4	TAHOE FOREST HOSP DIST	6/4/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10051 LAKE BLVD	SUITE 4	TRUCKEE	CA	96161	4870	29	06057	39.32550268	-120.2025066	Nevada County
129036	Fee-for-Service	1972065936	1972065936	1	1	TRAN, PETER	6/21/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	183099	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
129060	Fee-for-Service	1336469600	1336469600	1	1	TRAN, BRYANT W MD	8/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128968	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	MC5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
129076	Fee-for-Service	1417982646	1417982646	1	1	TALLMAN, JONATHAN B MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	69336	36	Psychiatry	0	In state provider	None	12 W BEACH ST	# 219	WATSONVILLE	CA	95076	4504	44	06087	36.90969681	-121.7577164	Santa Cruz County
129077	Fee-for-Service	1679725261	1679725261	1	1	TUBURAN, SMYRNA P MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	112192	30	Radiology	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
129190	Fee-for-Service	1942369525	1942369525	1	1	TERASAKI, KEITH MD	7/31/1990	2085R0204X	NA	Other	026	PHYSICIANS	54704	30	Radiology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
129221	Fee-for-Service	1902888985	1902888985	1	1	THOMAS KELLY	4/20/2016	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
129240	Fee-for-Service	1851389696	1851389696	1	2	TIBURCIO VASQUEZ HLTH CT	1/29/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	23640 REED WAY	None	HAYWARD	CA	94541	7326	01	06001	37.6561685	-122.1075871	Alameda County
129367	Fee-for-Service	1669581682	1669581682	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 5671	300 S HIGHLAND AVE	STE 9	BANNING	CA	92220	6504	33	06065	33.92503257	-116.9467329	Riverside County
129380	Fee-for-Service	1992791149	1992791149	1	1	TOMANENG, NEIL MD	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76786	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
129419	Fee-for-Service	1225116924	1225116924	1	1	TRAN, KIM H MD	5/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72875	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
129423	Fee-for-Service	1710175229	1710175229	1	1	TEJANI, SABIRA N MD INC	11/30/1979	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	31513	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3325 PALO VERDE AVE	STE 203	LONG BEACH	CA	90808	4132	19	06037	33.81701249	-118.1078791	Los Angeles County
129440	Fee-for-Service	1568781037	1568781037	1	1	TYNES, SARAH	9/25/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	74602	-	NOT APPLICABLE	0	In state provider	None	265 SOUTH ANITA DRIVE	SUITES 202, 301, 302	ORANGE	CA	92868	3355	30	06059	33.78499409	-117.8811837	Orange County
129480	Fee-for-Service	1497833156	1497833156	1	1	TENDERO, CLARISSA S	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	60536	18	Ophthalmology	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
129528	Fee-for-Service	1851389696	1851389696	1	2	TIBURCIO VASQUEZ HLTH CT	1/29/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	23640 REED WAY	None	HAYWARD	CA	94541	7326	01	06001	37.6561685	-122.1075871	Alameda County
129535	Fee-for-Service	1053738021	1053738021	1	1	TAKEDA, ALISA DO	6/23/2017	390200000X	NA	Other	026	PHYSICIANS	14368	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
129549	Fee-for-Service	1063871291	1063871291	1	2	TARDANICO, PHILLIP G LCSW	6/29/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15409 ANACAPA	A	VICTORVILLE	CA	92392	2463	36	06071	34.50499906	-117.3255382	San Bernardino County
129556	Fee-for-Service	1255795977	1255795977	1	1	TANNER CARE, LLC	8/11/2020	261Q00000X	NA	Other	102	DIABETES PREVENTION PROGRAM SUPPLIER	-	-	NOT APPLICABLE	0	In state provider	None	1851 HUNTINGTON	None	DUARTE	CA	91010	2635	19	06037	34.1398293	-117.9647218	Los Angeles County
129560	Fee-for-Service	1760527311	1760527311	1	1	TRUONG, TRA M T OD	7/25/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9430 WARNER AVE	STE M	FOUNTAIN VALLEY	CA	92708	2826	30	06059	33.71589551	-117.9644238	Orange County
129561	Fee-for-Service	1396737037	1396737037	1	1	THAKER, PANKAJ D MD	5/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52146	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	999 S FAIRMONT AVE	STE 230	LODI	CA	95240	5142	39	06077	38.1206163	-121.2858323	San Joaquin County
129580	Fee-for-Service	1811490659	1811490659	1	1	TIFFANY THU INC	3/21/2018	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2323 MONTPELIER DR	SUITE D	SAN JOSE	CA	95116	1611	43	06085	37.36477892	-121.84828	Santa Clara County
129622	Fee-for-Service	1679626428	1679626428	1	1	TOVAR, SONIA Y PROFESSIONAL	1/21/2011	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	CORPORATION NURSING	1019 E HOLT AVE	None	POMONA	CA	91767	5720	19	06037	34.06292287	-117.7302993	Los Angeles County
129644	Fee-for-Service	1386839231	1386839231	1	1	TZANNES, GWENDOLYN E LMFT	6/5/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	520 CHADBOURNE RD	None	FAIRFIELD	CA	94534	0000	48	06095	38.235248	-122.0817079	Solano County
129691	Fee-for-Service	1932712239	1932712239	1	1	TANWANGCO-BARKER, KRIZZETTE	11/3/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	M NP	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
129695	Fee-for-Service	1346328077	1346328077	1	1	TSENG, STEPHEN	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69139	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
129716	Fee-for-Service	1154784593	1154784593	1	1	TRAVERS, TAMRA J MD	9/16/2019	390200000X	NA	Other	026	PHYSICIANS	162430	08	Family Practice	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
129725	Fee-for-Service	1124522784	1124522784	1	1	TONTHAT, ALEXANDER MD	8/14/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	164621	10	Gastroenterology (M.D. only)	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
129767	Fee-for-Service	1578665014	1578665014	1	1	TZENG, ROBERT F Y MD	5/16/2007	207R00000X	NA	Other	026	PHYSICIANS	39498	41	Internal Medicine	0	In state provider	None	420 N GARFIELD AVE	STE 205	MONTEREY PARK	CA	91754	1206	19	06037	34.0670077	-118.1228585	Los Angeles County
129814	Fee-for-Service	1841507431	1841507431	1	1	TAYLOR, SNEHA K MD	11/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125453	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
129857	Fee-for-Service	1568687317	1568687317	1	1	T SRI MD A PROFESS CORP	3/1/1994	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	44725 10TH ST W	STE 230	LANCASTER	CA	93534	3048	19	06037	34.695693	-118.1480965	Los Angeles County
129945	Fee-for-Service	1598930067	1598930067	1	1	THE WEST OAKLAND HEALTH COU	11/26/2019	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HARMACY	700 ADELINE ST	None	OAKLAND	CA	94607	2608	01	06001	37.80430011	-122.2879962	Alameda County
129949	Fee-for-Service	1972629129	1972629129	1	1	TRUONG, ANNIE A DPM	5/9/2011	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	8250 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5427	19	06037	34.22078654	-118.4326211	Los Angeles County
129991	Fee-for-Service	1396164109	1396164109	1	1	TANTIYAVARONG, TANNY DO MD	9/27/2017	390200000X	NA	Other	026	PHYSICIANS	14753	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
130038	Fee-for-Service	1821280710	1821280710	1	1	TSAI, PHIL B MD	1/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	101896	05	Anesthesiology	0	In state provider	None	27401 LOS ALTOS	STE 180	MISSION VIEJO	CA	92691	8580	30	06059	33.56489118	-117.665546	Orange County
130040	Fee-for-Service	1760576706	1760576706	1	1	TABRIZI, PAYAM MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76682	20	Orthopedic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
130049	Fee-for-Service	1366628018	1366628018	1	1	TRISTAR CENTER RAVENWOOD	6/27/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39755 MURRIETA HOT SPRIN	BLDG D STE 160	MURRIETA	CA	92563	9151	33	06065	33.55575954	-117.1627899	Riverside County
130057	Fee-for-Service	1215921457	1215921457	1	1	THE CHILDREN'S HOSPITAL	7/15/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	OF PHILADELPHIA	34TH & CIVIC CENTER BLVD	None	PHILADELPHIA	PA	19104	5127	00	None	39.94709074	-75.19535506	Philadelphia County
130059	Fee-for-Service	1710029350	1710029350	1	1	TRUJILLO, CHRISTOPHER S LMFT	5/21/2020	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
130062	Fee-for-Service	1952300592	1952300592	1	1	TISON, JOSEPH B MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	38033	30	Radiology	0	In state provider	None	1100 W STEWART DRIVE	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
130080	Fee-for-Service	1881080216	1881080216	1	1	THE TEEN PROJECT, INC	11/19/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	14530 SYLVAN ST	None	VAN NUYS	CA	91411	2324	19	06037	34.18462249	-118.449855	Los Angeles County
130098	Fee-for-Service	1932640703	1932640703	1	1	TASOS, AMBER B DO	10/10/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15188	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
130116	Fee-for-Service	1215042973	1215042973	1	1	TABER,EVAN 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	0000	00	None	33.457203	-112.0262625	Maricopa County
130229	Fee-for-Service	1376149385	1376149385	1	1	TRI CITY HOSPICE INC	4/8/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	13096 BORDEN AVE	None	SYLMAR	CA	91342	4211	19	06037	34.30815084	-118.4439265	Los Angeles County
130230	Fee-for-Service	1669625125	1669625125	1	1	TAHER, PEDRAM MD	9/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105998	41	Internal Medicine	0	In state provider	None	2070 CLINTON AVENUE	STE 2113	ALAMEDA	CA	94501	4320	01	06001	37.76333626	-122.253868	Alameda County
130241	Fee-for-Service	1568482883	1568482883	1	1	TRUMAN, KIRSTEN C MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	63792	08	Family Practice	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
130261	Fee-for-Service	1831121789	1831121789	1	1	THISTLETHWAITE, PATRICIA	7/31/1996	208600000X	NA	General Surgery	026	PHYSICIANS	84093	33	Thoracic Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
130278	Fee-for-Service	1356802805	1356802805	1	1	TRUONG, FRANK K DO	9/28/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19621	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
130297	Fee-for-Service	1235453846	1235453846	1	1	TORRES, WILFREDO A MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	1	Border provider	None	1707 W CHARLESTON BLVD	STE 120	LAS VEGAS	NV	89102	2312	00	None	36.15879353	-115.1643015	Clark County
130334	Fee-for-Service	1487290672	1487290672	1	1	TLC PALLIATIVE CARE LLC	8/8/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2750 N BELLFLOWER BLVD	STE 107	LONG BEACH	CA	90815	1143	19	06037	33.806259	-118.125183	Los Angeles County
130341	Fee-for-Service	1215921457	1215921457	1	1	THE CHILDREN'S HOSPITAL	7/15/2009	282NC2000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	OF PHILADELPHIA	34TH & CIVIC CENTER BLVD	None	PHILADELPHIA	PA	19104	5127	00	None	39.94709074	-75.19535506	Philadelphia County
130374	Fee-for-Service	1720295249	1720295249	1	1	THERAPEUTIC PAIN MANAGEMENT	10/18/2010	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	MEDICAL CLINIC	1335 BUENAVENTURA BLVD	# 100	REDDING	CA	96001	0160	45	06089	40.58222519	-122.4261823	Shasta County
130423	Fee-for-Service	1871792168	1871792168	1	1	TRAVIS ABELE MD	3/2/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2500 NE NEFF RD	None	BEND	OR	97701	6015	00	None	44.067735	-121.268187	Deschutes County
130496	Fee-for-Service	1326791765	1326791765	1	1	TRINH, SHANNON LMFT	12/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
130517	Fee-for-Service	1376149385	1376149385	1	1	TRI CITY HOSPICE INC	4/8/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	13096 BORDEN AVE	None	SYLMAR	CA	91342	4211	19	06037	34.30815084	-118.4439265	Los Angeles County
130526	Fee-for-Service	1942793336	1942793336	1	1	TRAN, JACQUELINE H OD	8/3/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
130530	Fee-for-Service	1568482883	1568482883	1	1	TRUMAN, KIRSTEN C MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	63792	01	General Practice	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
130621	Fee-for-Service	1487290672	1487290672	1	1	TLC PALLIATIVE CARE LLC	8/8/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2750 N BELLFLOWER BLVD	STE 107	LONG BEACH	CA	90815	1143	19	06037	33.806259	-118.125183	Los Angeles County
130626	Fee-for-Service	1730797705	1730797705	1	1	TOBIN, RYAN J CRNA	9/28/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
130639	Fee-for-Service	1588674634	1588674634	1	1	THOMAS, MICHELLE A MD	11/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	62122	08	Family Practice	0	In state provider	INC	6061 N 1ST ST	STE 102	FRESNO	CA	93710	5470	10	06019	36.824157	-119.774304	Fresno County
130662	Fee-for-Service	1831841253	1831841253	1	1	TAMBUNAN, CATHERINE D CNP	12/26/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
130701	Fee-for-Service	1952802225	1952802225	1	1	TEMECULA VALLEY SKILLED	10/18/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	NURSING AND REHAB	25924 JACKSON AVE	None	MURRIETA	CA	92563	6447	33	06065	33.54776561	-117.1782383	Riverside County
130782	Fee-for-Service	1134539232	1134539232	1	1	TRAN, ANN MD	3/28/2022	208M00000X	NA	Other	026	PHYSICIANS	171177	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
130837	Fee-for-Service	1275592552	1275592552	1	1	TAI, DAVID W MD	5/31/1989	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	65780	20	Orthopedic Surgery	0	In state provider	None	2801 K ST	STE 500	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
130844	Fee-for-Service	1346337268	1346337268	1	1	TUCKER, GEORGE H PHD	6/5/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	6783	-	NOT APPLICABLE	0	In state provider	None	1412 E CHAPMAN AVE	None	ORANGE	CA	92866	2229	30	06059	33.78779778	-117.8387666	Orange County
130863	Fee-for-Service	1134271232	1134271232	1	1	TAN, BRENT T MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86418	22	Pathology (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
130933	Fee-for-Service	1588674634	1588674634	1	1	THOMAS, MICHELLE A MD	11/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	62122	01	General Practice	0	In state provider	INC	6061 N 1ST ST	STE 102	FRESNO	CA	93710	5470	10	06019	36.824157	-119.774304	Fresno County
130952	Fee-for-Service	1013046713	1013046713	2	1	TEPLOW PHARMACY LLC	1/20/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	404 E MAIN STREET	None	BARSTOW	CA	92311	2326	36	06071	34.8987035	-117.0233235	San Bernardino County
130967	Fee-for-Service	1508856402	1508856402	1	1	TODD, DOUGLAS MD	7/30/1991	174400000X	NA	Other	026	PHYSICIANS	66549	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 E 4TH ST	None	NATIONAL CITY	CA	91950	1350	37	06073	32.68038513	-117.1040623	San Diego County
131033	Fee-for-Service	1194718254	1194718254	1	1	TROMPETTO, BRENT T MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	55198	41	Internal Medicine	0	In state provider	None	3605 ALAMO ST	STE 100	SIMI VALLEY	CA	93063	2186	56	06111	34.28647147	-118.726119	Ventura County
131069	Fee-for-Service	1376882357	1376882357	1	1	THOMAS, DIANE R MD	10/1/2018	207VF0040X	NA	Obstetrics & Gynecology	026	PHYSICIANS	124465	34	Urology and Urological Surgery	0	In state provider	None	900 W OLIVE AVENUE	SUITE A	MERCED	CA	95348	2401	24	06047	37.31913547	-120.4842784	Merced County
131078	Fee-for-Service	1346381936	1346381936	1	1	THURBER, DEBORAH	9/1/2023	2084P0804X	NA	Psychiatry	026	PHYSICIANS	52126	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
131120	Fee-for-Service	1891008553	1891008553	1	1	THOMPSON, JOCELYN	9/26/2024	103K00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
131125	Fee-for-Service	1992945513	1992945513	1	1	TRIMMING, MICHAEL W MD	9/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98458	05	Anesthesiology	0	In state provider	None	3530 WILSHIRE BLVD	#350	LOS ANGELES	CA	90048	1804	19	06037	34.06171652	-118.301427	Los Angeles County
131138	Fee-for-Service	1477575744	1477575744	1	1	TREADWELL, ALLAN S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74876	66	Emergency Medicine (Urgent Care)	0	In state provider	PACIFIC WOUND CENTER MED	4533 QUAIL LAKES DR	None	STOCKTON	CA	95207	5257	39	06077	37.987785	-121.34268	San Joaquin County
131171	Fee-for-Service	1134450018	1134450018	1	1	THE OLIVE TREE EXPERIENCE	12/6/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	7834 VANALDEN AVE	None	RESEDA	CA	91335	1703	19	06037	34.21312351	-118.5491518	Los Angeles County
131216	Fee-for-Service	1588674634	1588674634	1	1	THOMAS, MICHELLE A MD	11/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	62122	66	Emergency Medicine (Urgent Care)	0	In state provider	INC	6061 N 1ST ST	STE 102	FRESNO	CA	93710	5470	10	06019	36.824157	-119.774304	Fresno County
131228	Fee-for-Service	1982282174	1982282174	1	1	TRAN, KEVIN MD	9/26/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	3000 Q STREET	2ND FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
131252	Fee-for-Service	1154538973	1154538973	1	1	TURNER, TIFFINY D LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
131263	Fee-for-Service	1326043738	1326043738	1	1	TANOUYE, GARY T MD	12/2/1987	207R00000X	NA	Other	026	PHYSICIANS	50249	41	Internal Medicine	0	In state provider	None	18370 BURBANK BLVD	STE 601	TARZANA	CA	91356	2831	19	06037	34.17173059	-118.5331881	Los Angeles County
131290	Fee-for-Service	1942323464	1942323464	1	1	THROP, MICHELLE	8/23/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4300 GOLDEN CENTER DR	STE D	PLACERVILLE	CA	95667	6278	09	06017	38.70657265	-120.82856	El Dorado County
131352	Fee-for-Service	1295781086	1295781086	1	1	TOPPER, BRUCE M MD	12/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	STE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
131358	Fee-for-Service	1497862510	1497862510	1	1	TARAZI, SHARI R MD	5/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91463	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
131367	Fee-for-Service	1871880419	1871880419	1	1	TRINH, DENISE T MD	10/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134001	None	None	0	In state provider	None	1541 FLORIDA AVE.	STE 200	MODESTO	CA	95354	0105	50	06099	37.666863	-120.9962775	Stanislaus County
131374	Fee-for-Service	1801022926	1801022926	1	1	TUDORICA, NICOLAE MD	5/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120023	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
131390	Fee-for-Service	1275028938	1275028938	1	1	TODI, NIKET MD	8/1/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
131426	Fee-for-Service	1477575744	1477575744	1	1	TREADWELL, ALLAN S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74876	41	Internal Medicine	0	In state provider	PACIFIC WOUND CENTER MED	4533 QUAIL LAKES DR	None	STOCKTON	CA	95207	5257	39	06077	37.987785	-121.34268	San Joaquin County
131431	Fee-for-Service	1629572334	1629572334	1	1	TOKUNAGA, SEIYA DO	7/30/2021	207R00000X	NA	Other	026	PHYSICIANS	17872	None	None	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
131436	Fee-for-Service	1578641312	1578641312	1	1	TSONG, EDWARD D MD	8/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87843	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
131440	Fee-for-Service	1770936569	1770936569	1	1	TSOLOKIAN ZOGRAB AND	2/13/2018	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TSOLOKIAN VIKTORIA	468 W HERNDON	None	PINEDALE	CA	93650	1361	10	06019	36.83741448	-119.8011465	Fresno County
131455	Fee-for-Service	1588773956	1588773956	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10465 SUNLAND BLVD	None	SUNLAND	CA	91040	1905	19	06037	34.25979448	-118.3260105	Los Angeles County
131466	Fee-for-Service	1134548209	1134548209	1	1	TUCKER, JAMES F MD	2/26/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	143159	18	Ophthalmology	0	In state provider	None	1830 SIERRA GARDENS DR	STE 100	ROSEVILLE	CA	95661	2942	31	06061	38.7469982	-121.2600775	Placer County
131473	Fee-for-Service	1366418865	1366418865	1	1	TENNEN, DEBRA GAYLE MD	12/31/1995	207W00000X	NA	Ophthalmology	026	PHYSICIANS	72013	18	Ophthalmology	0	In state provider	None	29525 CANWOOD ST	STE 210	AGOURA HILLS	CA	91301	4231	19	06037	34.14724223	-118.7675471	Los Angeles County
131487	Fee-for-Service	1881615276	1881615276	1	1	THOMPSON, MARK T MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	23215	41	Internal Medicine	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
131492	Fee-for-Service	1386077139	1386077139	1	1	TIGER, JOSHUA R DO	10/14/2020	207R00000X	NA	Other	026	PHYSICIANS	15404	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
131563	Fee-for-Service	1710619127	1710619127	1	1	TRAN, HELEN NP	1/27/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2222 S MAIN ST	None	SANTA ANA	CA	92707	3220	30	06059	33.717168	-117.867929	Orange County
131593	Fee-for-Service	1811918543	1811918543	1	1	TRAUTH, JAMES W MD	8/1/1993	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	68877	08	Family Practice	0	In state provider	None	500 UNIVERSITY AVE	None	SACRAMENTO	CA	95825	6504	34	06067	38.568402	-121.418019	Sacramento County
131598	Fee-for-Service	1306344825	1306344825	1	1	TSEGAY, DANIEL W NP	5/17/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1255 TRAVIS BLVD	None	FAIRFIELD	CA	94533	4801	48	06095	38.25815459	-122.0487714	Solano County
131671	Fee-for-Service	1306827670	1306827670	1	1	TRINH, DUNG D MD	10/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63616	41	Internal Medicine	0	In state provider	None	23512 MADERO	None	MISSION VIEJO	CA	92691	2743	30	06059	33.62192373	-117.6765103	Orange County
131720	Fee-for-Service	1437669637	1437669637	1	1	TSOU, TINA PSYD	5/10/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
131733	Fee-for-Service	1508686007	1508686007	1	1	TROPHY MED TRANS LLC	12/3/2024	No Taxonomy Provided	NMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	829 S LEMON AVE	STE A11B	DIAMOND BAR	CA	91789	2901	19	06037	34.00224193	-117.855401	Los Angeles County
131770	Fee-for-Service	1134181761	1134181761	1	1	THURMAN,RICHARD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1050 E S TEMPLE	None	SALT LAKE CTY	UT	84102	1507	00	None	40.76933651	-111.8610765	Salt Lake County
131773	Fee-for-Service	1790100642	1790100642	1	1	TRILLIUM HEALTH CARE INC	6/23/2014	332B00000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	239 S JUNIPER ST	None	ESCONDIDO	CA	92025	4220	37	06073	33.1214465	-117.0776559	San Diego County
131782	Fee-for-Service	1134623788	1134623788	1	1	TAMBE, NEAL A MD	8/2/2021	208M00000X	NA	Other	026	PHYSICIANS	164254	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
131822	Fee-for-Service	1760784474	1760784474	1	1	THOST, ERIKA MD	11/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	45489	01	General Practice	0	In state provider	None	189 N FAIRVIEW AVE	None	GOLETA	CA	93117	2304	42	06083	34.44296614	-119.8307495	Santa Barbara County
131825	Fee-for-Service	1780667790	1780667790	1	1	TAYLOR, DOUGLAS S, MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85352	68	Hematology	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
131853	Fee-for-Service	1578736625	1578736625	1	1	TSANG, BOBBY L MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106606	05	Anesthesiology	0	In state provider	None	250 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
131868	Fee-for-Service	1528268802	1528268802	1	1	THOMAS, NATASHA G MD	1/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	115473	01	General Practice	0	In state provider	None	17100 EUCLID	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
131876	Fee-for-Service	1386392991	1386392991	1	1	TAPALLA, MICHELLE M CCC-SLP	4/13/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
131913	Fee-for-Service	1104969153	1104969153	1	1	TRAN, PHUOC Q MD	9/10/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	69833	36	Psychiatry	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
131923	Fee-for-Service	1952489700	1952489700	1	1	TA, DANH P DO	8/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7744	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
131939	Fee-for-Service	1952478745	1952478745	1	1	TRYON, BRIAN C MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	842 E MAIN ST	None	MEDFORD	OR	97504	7155	00	None	42.32787853	-122.863311	Jackson County
131940	Fee-for-Service	1942319355	1942319355	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06090	1583 HIGHWAY 99	None	GRIDLEY	CA	95948	3107	04	06007	39.362769	-121.6879395	Butte County
131997	Fee-for-Service	1770514077	1770514077	1	1	TEXAS HEALTH PRESBYTERIAN	1/3/2017	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL PLANO	6200 W PARKER ROAD	None	PLANO	TX	75093	8185	00	None	33.04511253	-96.836904	Collin County
132012	Fee-for-Service	1871106294	1871106294	1	1	TAYLOR, KAITLYN E NP	8/15/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
132042	Fee-for-Service	1295803583	1295803583	1	1	THOMAN, DAVID S INC	2/28/2012	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	520 W JUNIPERO STREET	None	SANTA BARBARA	CA	93105	4212	42	06083	34.4292679	-119.7255944	Santa Barbara County
132046	Fee-for-Service	1417066861	1417066861	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05754	13151 JAMBOREE RD	None	TUSTIN	CA	92782	9150	30	06059	33.73010139	-117.7876893	Orange County
132098	Fee-for-Service	1679583009	1679583009	1	1	TURNER, MARTHA A CNM	2/8/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	110 BOULDER ST	STE B	NEVADA CITY	CA	95959	2647	29	06057	39.26208406	-121.0156703	Nevada County
132113	Fee-for-Service	1780667790	1780667790	1	1	TAYLOR, DOUGLAS S, MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85352	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
132119	Fee-for-Service	1396945465	1396945465	1	1	THRIFTY PAYLESS INC.	1/30/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5034 COAKLEY CIRCLE	None	MARIPOSA	CA	95338	1159	22	06043	37.48872243	-119.9715788	Mariposa County
132191	Fee-for-Service	1659626240	1659626240	1	1	TENG, STEPHEN	2/4/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3501 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2150	15	06029	35.35408422	-119.0424307	Kern County
132193	Fee-for-Service	1578131603	1578131603	1	1	TAGLE, CHRISTIAN A DO	8/8/2024	207R00000X	NA	Other	026	PHYSICIANS	22608	41	Internal Medicine	0	In state provider	None	1800 SPRING RIDGE	None	SUSANVILLE	CA	96130	6100	18	06035	40.43816059	-120.6279677	Lassen County
132223	Fee-for-Service	1568963262	1568963262	1	1	THAKKAR, LANISE A LMFT	4/12/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6800 INDIANA AVE STE 130	None	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
132227	Fee-for-Service	1538265780	1538265780	1	6	TAHOE FOREST HOSP DIST	6/4/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	925 N LAKE BLVD	SUITE C201	TAHOE CITY	CA	96145	0000	31	06061	39.17441644	-120.1374812	Placer County
132259	Fee-for-Service	1780070268	1780070268	1	1	TECSON, VICTORIA S DO	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15150	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
132274	Fee-for-Service	1912585035	1912585035	1	1	TOMPKINS, ALEXANDER D MD	10/24/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1595 SOQUEL DR	STE 400	SANTA CRUZ	CA	95065	1724	44	06087	36.98879599	-121.9826354	Santa Cruz County
132286	Fee-for-Service	1770514077	1770514077	1	1	TEXAS HEALTH PRESBYTERIAN	1/3/2017	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL PLANO	6200 W PARKER ROAD	None	PLANO	TX	75093	8185	00	None	33.04511253	-96.836904	Collin County
132313	Fee-for-Service	1164499901	1164499901	1	1	TALWAR, VIKRAM MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69678	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
132323	Fee-for-Service	1790371961	1790371961	1	1	TOUCH OF LOVE HOSPICE CARE,	9/12/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	10231 SLATER AVE	STE 218	FOUNTAIN VALLEY	CA	92708	4752	30	06059	33.70909648	-117.950625	Orange County
132332	Fee-for-Service	1295803583	1295803583	1	1	THOMAN, DAVID S INC	4/28/2006	208600000X	NA	General Surgery	026	PHYSICIANS	72445	None	None	0	In state provider	None	520 W JUNIPERO STREET	None	SANTA BARBARA	CA	93105	4212	42	06083	34.4292679	-119.7255944	Santa Barbara County
132346	Fee-for-Service	1184007486	1184007486	1	1	TAMASHIRO TAIRAKU, PAULA MD	8/15/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	176919	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
132348	Fee-for-Service	1407078058	1407078058	1	1	TAMRAZI, BENITA MD	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120696	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
132372	Fee-for-Service	1922245554	1922245554	2	1	TRANSITIONAL CARE SOLUTIONS	3/28/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	7920 ALTA SUNRISE DR	SUITE 240 & 250	CITRUS HEIGHTS	CA	95610	7980	34	06067	38.66652	-121.270581	Sacramento County
132401	Fee-for-Service	1780667790	1780667790	1	1	TAYLOR, DOUGLAS S, MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85352	78	Neoplastic Diseases/Oncology	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
132458	Fee-for-Service	1730623661	1730623661	1	1	TRAUTMAN, KELLY OT	10/18/2018	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	39180 FARWELL DR	SUITE 211	FREMONT	CA	94538	1000	01	06001	37.53211262	-121.9981587	Alameda County
132481	Fee-for-Service	1043427388	1043427388	1	1	TEHAMA COUNTY	3/3/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1850 WALNUT ST	None	RED BLUFF	CA	96080	3611	52	06103	40.16904822	-122.2542817	Tehama County
132493	Fee-for-Service	1881317972	1881317972	1	1	TURNER, RENEE N	9/29/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3634 E AVENUE	H13	LANCASTER	CA	93535	2225	19	06037	34.70443776	-118.0651913	Los Angeles County
132507	Fee-for-Service	1801354691	1801354691	1	1	TRINITY HOME HEALTH CARE INC	6/16/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	19531 VENTURA BLVD	SUITE 15	TARZANA	CA	91356	2957	19	06037	34.17281748	-118.5590745	Los Angeles County
132514	Fee-for-Service	1982713327	1982713327	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05999	230 S MAIN ST	None	ANGELS CAMP	CA	95222	9998	05	06009	38.0797175	-120.5549541	Calaveras County
132519	Fee-for-Service	1407909005	1407909005	1	1	TRAN, LONG DO	3/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7806	31	Roentgenology, Radiology (M.D. only)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
132540	Fee-for-Service	1528283785	1528283785	1	1	TRANKINA, FRANK J JR PHD	2/8/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11144 BUCKSKIN AVE	None	MONTCLAIR	CA	91763	6400	36	06071	34.05109103	-117.7045479	San Bernardino County
132566	Fee-for-Service	1114313913	1114313913	1	1	TRUONG, NHAN-AI MD	1/19/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	179299	None	None	0	In state provider	None	1720 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
132575	Fee-for-Service	1538113931	1538113931	1	1	TAN-CHIU, ELIZABETH MD	11/26/2019	174400000X	NA	Other	026	PHYSICIANS	50593	41	Internal Medicine	0	In state provider	None	1510 S CENTRAL AVE	SUITE 240	GLENDALE	CA	91204	2570	19	06037	34.12709764	-118.2577911	Los Angeles County
132587	Fee-for-Service	1326485459	1326485459	1	1	TSUI, STEPHANIE M	11/8/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1425 SOUTH MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
132593	Fee-for-Service	1033731567	1033731567	1	1	TARAZI, MICHELLE A OT	10/19/2021	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
132612	Fee-for-Service	1790371961	1790371961	1	1	TOUCH OF LOVE HOSPICE CARE,	9/12/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	10231 SLATER AVE	STE 218	FOUNTAIN VALLEY	CA	92708	4752	30	06059	33.70909648	-117.950625	Orange County
132674	Fee-for-Service	1871878504	1871878504	1	1	TAHMASEB ZAMANIAN, DENA OT	5/13/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	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
132715	Fee-for-Service	1225499015	1225499015	1	1	TEAM PHYSICIANS OF SOUTHERN	6/1/2016	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	CALIFORNIA MED GROUP INC	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
132734	Fee-for-Service	1598766446	1598766446	1	1	TOVAR, EDUARDO A MD	10/9/2010	208G00000X	NA	General Surgery	026	PHYSICIANS	38670	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	100 E VALENCIA MESA DR	STE 301	FULLERTON	CA	92835	3800	30	06059	33.89343304	-117.9279349	Orange County
132737	Fee-for-Service	1235901240	1235901240	1	1	TERRON, RACHEL AU	11/8/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 EXPOSITION BLVD	BLDG 700	SACRAMENTO	CA	95815	4300	34	06067	38.598876	-121.4502885	Sacramento County
132756	Fee-for-Service	1386961969	1386961969	1	1	TAGMAZYAN, KARINE MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122509	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
132760	Fee-for-Service	1477967479	1477967479	1	1	TURNING POINT OF CENTRAL	8/25/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA, INC	3636 N FIRST STREET	SUITE 135 AND 154	FRESNO	CA	93726	6818	10	06019	36.78322578	-119.7724022	Fresno County
132767	Fee-for-Service	1285043703	1285043703	1	1	TRINH, MYLINH MD INC	10/19/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	127452	None	None	0	In state provider	None	9143 VALLEY BLVD	SUITE 201A	ROSEMEAD	CA	91770	1992	19	06037	34.08096534	-118.0700742	Los Angeles County
132769	Fee-for-Service	1043427388	1043427388	1	1	TEHAMA COUNTY	9/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1850 WALNUT ST	None	RED BLUFF	CA	96080	3611	52	06103	40.16904822	-122.2542817	Tehama County
132780	Fee-for-Service	1881317972	1881317972	1	1	TURNER, RENEE N	9/29/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3634 E AVENUE	H13	LANCASTER	CA	93535	2225	19	06037	34.70443776	-118.0651913	Los Angeles County
132781	Fee-for-Service	1992742993	1992742993	1	1	THATAI, DEEPAK MD	4/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53076	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
132782	Fee-for-Service	1912951385	1912951385	1	1	TICE, JEFFREY A MD	1/1/2000	207R00000X	NA	Other	026	PHYSICIANS	60233	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
132847	Fee-for-Service	1598031395	1598031395	1	1	THORP, SARA E DO	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13129	41	Internal Medicine	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
132860	Fee-for-Service	1043398696	1043398696	1	1	TING, ALVIN T MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75457	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
132871	Fee-for-Service	1457902397	1457902397	1	1	TRIGLIA, ALLYSON T LMFT	2/22/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	131100	-	NOT APPLICABLE	0	In state provider	None	24953 PASEO DE VALENCIA	1B	LAGUNA HILLS	CA	92653	4340	30	06059	33.60028568	-117.7010887	Orange County
132877	Fee-for-Service	1831744770	1831744770	1	1	TRUONG, TIFFANIE OD	10/12/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1575 B STREET	None	HAYWARD	CA	94541	3017	01	06001	37.67905755	-122.072805	Alameda County
132890	Fee-for-Service	1871554766	1871554766	1	1	TOLKAN, STEVEN R	4/18/1997	207RN0300X	NA	Nephrology	026	PHYSICIANS	83696	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
132897	Fee-for-Service	1871999573	1871999573	1	1	TSENG, EMILY DO	8/17/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	14647	None	None	0	In state provider	None	3200 BELL RD	None	AUBURN	CA	95603	9244	31	06061	38.94193574	-121.103139	Placer County
132898	Fee-for-Service	1114036563	1114036563	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	35 S MILPAS ST	None	SANTA BARBARA	CA	93103	3305	42	06083	34.42105388	-119.6780239	Santa Barbara County
132995	Fee-for-Service	1538265780	1538265780	1	8	TAHOE FOREST HOSP DIST	6/4/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS RD	SUITE 230	TRUCKEE	CA	96161	4862	29	06057	39.32625521	-120.2012059	Nevada County
133023	Fee-for-Service	1598766446	1598766446	1	1	TOVAR, EDUARDO A MD	10/9/2010	208G00000X	NA	General Surgery	026	PHYSICIANS	38670	33	Thoracic Surgery	0	In state provider	None	100 E VALENCIA MESA DR	STE 301	FULLERTON	CA	92835	3800	30	06059	33.89343304	-117.9279349	Orange County
133058	Fee-for-Service	1043427388	1043427388	1	1	TEHAMA COUNTY	5/5/1988	261QR1300X	NA	Rural Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1850 WALNUT ST	None	RED BLUFF	CA	96080	3611	52	06103	40.16904822	-122.2542817	Tehama County
133099	Fee-for-Service	1487323572	1487323572	1	1	THE MAVEN GROUP INC.	10/28/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	None	None	0	In state provider	None	1850 N RIVERSIDE AVE	180	RIALTO	CA	92376	8071	36	06071	34.132905	-117.3704675	San Bernardino County
133102	Fee-for-Service	1184983264	1184983264	1	1	TEMECULA VALLEY	7/11/2012	193400000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	ANESTHESIOLOGISTS, INC	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
133138	Fee-for-Service	1598031395	1598031395	1	1	THORP, SARA E DO	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13129	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
133181	Fee-for-Service	1871554766	1871554766	1	1	TOLKAN, STEVEN R	4/18/1997	207RN0300X	NA	Nephrology	026	PHYSICIANS	83696	45	Nephrology (Renal-Kidney)	0	In state provider	None	1261 TRAVIS BLVD	STE 170	FAIRFIELD	CA	94533	4825	48	06095	38.25812361	-122.0495417	Solano County
133196	Fee-for-Service	1972821601	1972821601	1	1	TAIT, LAUREN M MD	8/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121850	78	Neoplastic Diseases/Oncology	0	In state provider	None	100 CASA STREET	SUITE C	SAN LUIS OBISPO	CA	93405	8804	40	06079	35.29273885	-120.6647926	San Luis Obispo County
133197	Fee-for-Service	1891722948	1891722948	1	1	TESHOME, MARCUS N MD	4/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	107301	25	Physical Medicine and Rehabilitation	0	In state provider	None	12660 RIVERSIDE DRIVE	SUITE 310	NORTH HOLLYWOOD	CA	91607	3431	19	06037	34.1575795	-118.409499	Los Angeles County
133200	Fee-for-Service	1073114807	1073114807	1	1	THE HEALING SANCTUM-GREENMEA	8/17/2022	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5302 E GREENMEADOW RD	None	LONG BEACH	CA	90808	1602	19	06037	33.8332725	-118.1291715	Los Angeles County
133229	Fee-for-Service	1508018110	1508018110	1	1	TARANGO, STACY M MD	7/13/2010	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	105731	40	Pediatrics	0	In state provider	None	5220 CLAREMONT AVE	None	OAKLAND	CA	94618	1033	01	06001	37.83868281	-122.2612035	Alameda County
133240	Fee-for-Service	1144515149	1144515149	1	2	THE SAN FRANCISCO AIDS	2/8/2015	No Taxonomy Provided	NA	None	040	FREE CLINIC	-	-	NOT APPLICABLE	0	In state provider	FOUNDATION	470 CASTRO ST	None	SAN FRANCISCO	CA	94114	2020	38	06075	37.76132744	-122.4350734	San Francisco County
133260	Fee-for-Service	1477815348	1477815348	1	1	TRAN, PAULA MD	8/1/2017	2084P0804X	NA	Psychiatry	026	PHYSICIANS	127451	36	Psychiatry	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
133274	Fee-for-Service	1467544908	1467544908	1	1	TASOVAC, MARC N CCC-SLP	6/1/2021	235Z00000X	NA	Other	037	SPEECH 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
133277	Fee-for-Service	1801833033	1801833033	1	1	TAIFER, JOSHUA MD	4/30/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	38930	30	Radiology	0	In state provider	None	44725 10TH ST W	STE 150	LANCASTER	CA	93534	3000	19	06037	34.695693	-118.1480965	Los Angeles County
133289	Fee-for-Service	1144205352	1144205352	1	1	TOLLEFSON, TRAVIS T MD	6/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83024	24	Plastic Surgery	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
133311	Fee-for-Service	1659589414	1659589414	1	1	TARKHANIANS, SEDA MD	4/13/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	42317	01	General Practice	0	In state provider	SUITE 105	540 N CENTRAL AVE	STE 305	GLENDALE	CA	91203	3361	19	06037	34.15437	-118.257912	Los Angeles County
133345	Fee-for-Service	1043427388	1043427388	1	1	TEHAMA COUNTY	7/1/1994	261QR1300X	NA	Rural Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1850 WALNUT ST	None	RED BLUFF	CA	96080	3611	52	06103	40.16904822	-122.2542817	Tehama County
133416	Fee-for-Service	1811400948	1811400948	1	1	THERACARE PHYSICAL THERAPY	5/23/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	19634 VENTURA BOULEVARD	SUITE 303	TARZANA	CA	91356	6022	19	06037	34.17264197	-118.5613482	Los Angeles County
133430	Fee-for-Service	1235198797	1235198797	1	1	TOTAL RENAL CARE	9/1/2001	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	INC	11854 S WILMINGTON AVE	None	LOS ANGELES	CA	90059	3016	19	06037	33.925059	-118.237041	Los Angeles County
133436	Fee-for-Service	1619972130	1619972130	1	1	TOTAL EMEDICAL INC	11/16/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	TOTAL EMEDICAL INC	3111 SW 10TH ST	None	POMPANO BEACH	FL	33069	4828	00	None	26.21619685	-80.16701294	Broward County
133458	Fee-for-Service	1306296181	1306296181	1	1	THAKARAR, RISHI DO	1/5/2024	207P00000X	NA	Other	026	PHYSICIANS	18015	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
133485	Fee-for-Service	1972821601	1972821601	1	1	TAIT, LAUREN M MD	8/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121850	30	Radiology	0	In state provider	None	100 CASA STREET	SUITE C	SAN LUIS OBISPO	CA	93405	8804	40	06079	35.29273885	-120.6647926	San Luis Obispo County
133502	Fee-for-Service	1720240096	1720240096	1	1	TURNER, SARAH MD	11/27/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	117465	None	None	0	In state provider	None	2216 BUENAVENTURA BLVD	SUITE B	REDDING	CA	96001	3838	45	06089	40.55453352	-122.3904825	Shasta County
133509	Fee-for-Service	1154636389	1154636389	1	1	TIEDEMAN, JILL M LMFT	2/18/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1833 W MARCH LN	SUITE 6	STOCKTON	CA	95207	6415	39	06077	37.9875446	-121.3283031	San Joaquin County
133517	Fee-for-Service	1205047891	1205047891	1	1	TOM, DAVID TAIWAI LMFT	5/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
133532	Fee-for-Service	1265623003	1265623003	1	1	THRIFTY PAYLESS INC	4/11/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6514	16120 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	8706	36	06071	34.47076249	-117.3117419	San Bernardino County
133551	Fee-for-Service	1356572770	1356572770	1	1	THOMPSON, VANESSA V MD	6/8/2010	207R00000X	NA	Other	026	PHYSICIANS	107808	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
133567	Fee-for-Service	1629394895	1629394895	1	1	TURNER, JESSE H MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120301	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
133575	Fee-for-Service	1215960844	1215960844	1	1	TANASOVICH, CHERYL A MD	2/8/2015	207NS0135X	NA	Dermatology	026	PHYSICIANS	53455	07	Dermatology	0	In state provider	None	1300 S ELISEO DR	STE 207	GREENBRAE	CA	94904	2015	21	06041	37.94447529	-122.53657	Marin County
133577	Fee-for-Service	1699711564	1699711564	1	1	T W MACLENNAN MD, AMC	11/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
133601	Fee-for-Service	1659589414	1659589414	1	1	TARKHANIANS, SEDA MD	4/13/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	42317	40	Pediatrics	0	In state provider	SUITE 105	540 N CENTRAL AVE	STE 305	GLENDALE	CA	91203	3361	19	06037	34.15437	-118.257912	Los Angeles County
133624	Fee-for-Service	1851416531	1851416531	1	1	THORUP, HOLLY R OT	8/27/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	621 W MICHELTORENA ST	STE B	SANTA BARBARA	CA	93101	4195	42	06083	34.41914194	-119.7157341	Santa Barbara County
133639	Fee-for-Service	1982854287	1982854287	1	1	THOMPSON, KEITH A MD	10/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110610	41	Internal Medicine	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
133646	Fee-for-Service	1043427388	1043427388	1	1	TEHAMA COUNTY	5/5/1988	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1850 WALNUT ST	None	RED BLUFF	CA	96080	3611	52	06103	40.16904822	-122.2542817	Tehama County
133672	Fee-for-Service	1891248050	1891248050	1	1	TEESDALE VILLA, INC	2/14/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7663 TEESDALE AVE	None	NORTH HOLLYWOOD	CA	91605	2139	19	06037	34.21009821	-118.4095303	Los Angeles County
133681	Fee-for-Service	1922494905	1922494905	1	1	TRAN, JESSE DO	9/6/2022	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	102 E LAKE MEAD PKWY	None	HENDERSON	NV	89015	5575	00	None	36.03815706	-114.9842287	Clark County
133739	Fee-for-Service	1750490116	1750490116	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06103	310 W LAKE ST	None	MOUNT SHASTA	CA	96067	2119	47	06093	41.31151566	-122.315786	Siskiyou County
133752	Fee-for-Service	1417044785	1417044785	1	1	TRAN, ANH C MD	7/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	79019	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL CORP	1714 N BUSH ST	None	SANTA ANA	CA	92706	2812	30	06059	33.76058786	-117.866405	Orange County
133792	Fee-for-Service	1306016464	1306016464	1	1	THANT, RONALD MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103630	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
133849	Fee-for-Service	1487741427	1487741427	1	1	THE UNION MEMORIAL HOSP	1/14/2007	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	201 E UNIVERSITY PKWY	None	BALTIMORE	MD	21218	2829	00	None	39.33014991	-76.61405034	Baltimore city
133870	Fee-for-Service	1063538205	1063538205	1	1	TRUAX, DEBORAH A NP	11/4/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2040 PACIFIC COAST HWY	None	LOMITA	CA	90717	2660	19	06037	33.78948351	-118.316493	Los Angeles County
133887	Fee-for-Service	1932305844	1932305844	1	1	TERMEFOROOSH, FARNOUSH LMFT	10/9/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
133907	Fee-for-Service	1780854398	1780854398	1	1	TADAYON, HEATHER M DO	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
133909	Fee-for-Service	1023450228	1023450228	1	1	TOLUCA ACUPUNCTURE CENTER IN	1/11/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	C	10659 RIVERSIDE DR	None	TOLUCA LAKE	CA	91602	2341	19	06037	34.15226231	-118.3635143	Los Angeles County
133913	Fee-for-Service	1952346298	1952346298	1	1	TERRAPIN TECHNOLOGIES	2/6/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TERRAPIN TECHNOLOGIES	1508 CABRILLO AVE	UNIT A	TORRANCE	CA	90501	2899	19	06037	33.83349898	-118.3143081	Los Angeles County
133922	Fee-for-Service	1043427388	1043427388	1	1	TEHAMA COUNTY	6/4/2001	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	1850 WALNUT ST	None	RED BLUFF	CA	96080	3611	52	06103	40.16904822	-122.2542817	Tehama County
133929	Fee-for-Service	1821484718	1821484718	1	1	TRAGER, EVAN J MD	7/31/2024	2084P0804X	NA	Psychiatry	026	PHYSICIANS	145885	36	Psychiatry	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
133958	Fee-for-Service	1821482183	1821482183	1	1	TAMURA, LESLIE K DO	10/18/2018	208M00000X	NA	Other	026	PHYSICIANS	16248	41	Internal Medicine	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
133971	Fee-for-Service	1538541065	1538541065	1	1	TECH PLUS MED SOLUTIONS CORP	5/23/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6650-6652 ROSEMEAD BLVD	None	PICO RIVERA	CA	90660	3533	19	06037	33.98444005	-118.0959576	Los Angeles County
133973	Fee-for-Service	1730132150	1730132150	1	1	TOBIN, MICHAEL L MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	45908	30	Radiology	0	In state provider	None	12620 MONTE VISTA RD	STE A	POWAY	CA	92064	2531	37	06073	32.99536145	-117.056826	San Diego County
133990	Fee-for-Service	1124286885	1124286885	1	1	TUOLUMNE ME-WUK INDIAN	5/17/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH	22044 CEDAR RD	None	SONORA	CA	95370	5908	55	06109	37.98532934	-120.3651951	Tuolumne County
134006	Fee-for-Service	1073798674	1073798674	1	1	TOTAL RENAL CARE INC	1/7/2009	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1650 W YOSEMITE AVENUE	None	MANTECA	CA	95337	5193	39	06077	37.79730154	-121.243869	San Joaquin County
134014	Fee-for-Service	1336362656	1336362656	1	1	THOMAS,DAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1067 N 500 W	None	PROVO	UT	84604	0000	00	None	40.249827	-111.667438	Utah County
134022	Fee-for-Service	1134595937	1134595937	1	1	TORRES M, MICHELLE S LCSW	10/19/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
134039	Fee-for-Service	1417044785	1417044785	1	1	TRAN, ANH C MD	7/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	79019	08	Family Practice	0	In state provider	MEDICAL CORP	1714 N BUSH ST	None	SANTA ANA	CA	92706	2812	30	06059	33.76058786	-117.866405	Orange County
134116	Fee-for-Service	1952834822	1952834822	1	1	TRAN, VICTORIA M MD	8/16/2021	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	158925	None	None	0	In state provider	None	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
134137	Fee-for-Service	1487741427	1487741427	1	1	THE UNION MEMORIAL HOSP	1/14/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	201 E UNIVERSITY PKWY	None	BALTIMORE	MD	21218	2829	00	None	39.33014991	-76.61405034	Baltimore city
134145	Fee-for-Service	1588028476	1588028476	1	1	TRUONG, LINH Y MD	3/31/2021	207RR0500X	NA	Other	026	PHYSICIANS	153108	None	None	0	In state provider	None	2020 SANTA MONICA BLVD	540	SANTA MONICA	CA	90404	2000	19	06037	34.02901811	-118.4795396	Los Angeles County
134166	Fee-for-Service	1215972336	1215972336	1	1	TRAN, DAN N MD FACS	8/23/2021	208600000X	NA	General Surgery	026	PHYSICIANS	168002	None	None	0	In state provider	None	328 S 1ST STREET	SUITES F AND G	ALHAMBRA	CA	91801	3789	19	06037	34.09104553	-118.1252904	Los Angeles County
134167	Fee-for-Service	1427106251	1427106251	1	1	TAWIL, MELINA M MD	10/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	50381	08	Family Practice	0	In state provider	MGA OFFICE	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
134168	Fee-for-Service	1861599714	1861599714	1	1	TANSEY, PATRICIA A MD	2/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	77352	40	Pediatrics	0	In state provider	None	9281 OFFICE PARK CIR	STE 120	ELK GROVE	CA	95758	8069	34	06067	38.418264	-121.39641	Sacramento County
134208	Fee-for-Service	1043427388	1043427388	1	1	TEHAMA COUNTY	9/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1850 WALNUT ST	None	RED BLUFF	CA	96080	3611	52	06103	40.16904822	-122.2542817	Tehama County
134216	Fee-for-Service	1285638916	1285638916	1	1	TRAN, TUAN H MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71566	41	Internal Medicine	0	In state provider	None	2790 S ELM AVE	None	FRESNO	CA	93706	5435	10	06019	36.700533	-119.7908665	Fresno County
134251	Fee-for-Service	1114937992	1114937992	1	1	TRIVEDI, ROHITKUMAR R MD	4/25/2006	174400000X	NA	Other	026	PHYSICIANS	37268	02	General Surgery	0	In state provider	None	160 E ARTESIA ST	STE 355	POMONA	CA	91767	2927	19	06037	34.07556833	-117.7507835	Los Angeles County
134263	Fee-for-Service	1285769190	1285769190	1	1	TAHA, MERCEDES O	10/1/2007	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1530 S OLIVE STREET	None	LOS ANGELES	CA	90015	3023	19	06037	34.03542552	-118.2652073	Los Angeles County
134275	Fee-for-Service	1124286885	1124286885	1	1	TUOLUMNE ME-WUK INDIAN	8/19/2008	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH	22044 CEDAR RD	None	SONORA	CA	95370	5908	55	06109	37.98532934	-120.3651951	Tuolumne County
134291	Fee-for-Service	1689945990	1689945990	1	1	THE RETINA PARTNERS	9/26/2012	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	16500 VENTURA BLVD	SUITE 250	ENCINO	CA	91436	2018	19	06037	34.15756758	-118.4926374	Los Angeles County
134315	Fee-for-Service	1689945990	1689945990	1	4	THE RETINA PARTNERS	8/31/2022	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	100 EAST THOUSAND OAKS B	SUITE 112	THOUSAND OAKS	CA	91360	5705	19	06037	34.17902886	-118.8749335	Ventura County
134319	Fee-for-Service	1851389696	1851389696	1	4	TIBURCIO VASQUEZ HLTH CT	12/23/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	27035 WHITMAN STREET	ROOM A-1	HAYWARD	CA	94544	4027	01	06001	37.642579	-122.0660134	Alameda County
134326	Fee-for-Service	1326447707	1326447707	1	2	THRIFTY PAYLESS INC	11/7/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9340 DESCHUTTES ROAD	None	PALO CEDRO	CA	96073	9763	45	06089	40.55890407	-122.2386007	Shasta County
134360	Fee-for-Service	1427242916	1427242916	1	1	TSEGHAI, SEWIT LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	90999	-	NOT APPLICABLE	0	In state provider	None	1625 W OLYMPIC BLVD	SUITE 600	LOS ANGELES	CA	90015	3809	19	06037	34.04957404	-118.2750068	Los Angeles County
134361	Fee-for-Service	1922087527	1922087527	1	1	TRI-CITY EMER MED GRP	11/9/1983	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
134367	Fee-for-Service	1871727859	1871727859	1	1	TAREMI, MAHNAZ MD	11/25/2019	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	162369	77	Infectious Disease	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
134408	Fee-for-Service	1184981797	1184981797	1	1	TITCHEN, KANANI E	11/14/2019	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	163273	40	Pediatrics	0	In state provider	None	7910 FROST ST	STE 350	SAN DIEGO	CA	92123	2753	37	06073	32.80027449	-117.153846	San Diego County
134415	Fee-for-Service	1881045359	1881045359	1	1	TINNA, HARMANDEEP S MD	8/5/2019	207R00000X	NA	Other	026	PHYSICIANS	159528	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
134447	Fee-for-Service	1104549054	1104549054	1	2	T P MEDICAL TRANSPORTATION I	10/28/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	NC	22777 LYONS AVE.	SUITE 103	NEWHALL	CA	91321	2800	19	06037	34.38063512	-118.5316765	Los Angeles County
134455	Fee-for-Service	1811250277	1811250277	1	1	TAPIA, AMERICA O LMFT	3/9/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
134461	Fee-for-Service	1972859320	1972859320	1	1	TULL, BLAIR H MD	5/15/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154598	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	250 SAN JOSE STREET	None	SALINAS	CA	93901	3901	27	06053	36.65817286	-121.6460674	Monterey County
134504	Fee-for-Service	1285638916	1285638916	1	1	TRAN, TUAN H MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71566	08	Family Practice	0	In state provider	None	2790 S ELM AVE	None	FRESNO	CA	93706	5435	10	06019	36.700533	-119.7908665	Fresno County
134519	Fee-for-Service	1639584568	1639584568	1	1	TAYLOR, MARCIE LMFT	12/4/2024	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
134562	Fee-for-Service	1609194513	1609194513	1	1	TRIPURANENI, SRAVANTHI MD	2/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128240	08	Family Practice	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
134587	Fee-for-Service	1639247372	1639247372	1	1	TAHA, MANUEL R 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
134605	Fee-for-Service	1851389696	1851389696	1	4	TIBURCIO VASQUEZ HLTH CT	12/23/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	27035 WHITMAN STREET	ROOM A-1	HAYWARD	CA	94544	4027	01	06001	37.642579	-122.0660134	Alameda County
134620	Fee-for-Service	1730685173	1730685173	1	1	TSE, BEVERLY C MD	10/3/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	163428	None	None	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
134665	Fee-for-Service	1932856382	1932856382	1	2	TOTAL SPINE INSTITUTE INC	1/17/2023	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	23632 CALABASAS RD	100	CALABASAS	CA	91302	1553	19	06037	34.15613926	-118.6421933	Los Angeles County
134673	Fee-for-Service	1447567276	1447567276	1	1	TRAN, MARY-HANG K DO	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11471	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
134714	Fee-for-Service	1548259286	1548259286	1	1	TU, THUAN D MD	10/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	50439	05	Anesthesiology	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
134725	Fee-for-Service	1568540060	1568540060	1	1	TAI, JENNY L MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88469	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
134770	Fee-for-Service	1326544917	1326544917	1	1	TYLER, MOUNIR LCSW	1/19/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	402 COLUSA AVE	None	EL CERRITO	CA	94530	3327	07	06013	37.90450365	-122.2912318	Contra Costa County
134785	Fee-for-Service	1578547741	1578547741	1	1	THOMPSON, JEFFREY S MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	49798	40	Pediatrics	0	In state provider	None	260 STATION WAY	STE D	ARROYO GRANDE	CA	93420	3359	40	06079	35.11996545	-120.5781386	San Luis Obispo County
134828	Fee-for-Service	1275822082	1275822082	1	1	TOROSIAN, KARO DO	8/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12445	41	Internal Medicine	0	In state provider	None	4077 5TH AVENUE	MER 35	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
134852	Fee-for-Service	1609194513	1609194513	1	1	TRIPURANENI, SRAVANTHI MD	2/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128240	41	Internal Medicine	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
134862	Fee-for-Service	1033141486	1033141486	1	1	TRAN, NHAT Q MD	9/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82754	41	Internal Medicine	0	In state provider	None	3101 W PACIFIC COAST HWY	STE 300	NEWPORT BEACH	CA	92663	0000	30	06059	33.62102445	-117.925997	Orange County
134901	Fee-for-Service	1760689715	1760689715	1	4	TOTALCARE WALK-IN CLINIC INC	8/24/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4784 PECK RD	STE A	EL MONTE	CA	91732	1360	19	06037	34.09071973	-118.0144474	Los Angeles County
134908	Fee-for-Service	1457394363	1457394363	1	1	TRAN, HUY T DO	12/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8795	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
134952	Fee-for-Service	1336575380	1336575380	1	1	TRISTAN, KATHERINE C LCSW	10/28/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	255 N D ST STE 220	None	SAN BERNARDINO	CA	92401	1713	36	06071	34.1036709	-117.291874	San Bernardino County
134967	Fee-for-Service	1871129288	1871129288	1	1	TRUSTED HOME HEALTH CARE	3/20/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES	229 N CENTRAL AVE	UNIT 202	GLENDALE	CA	91203	3550	19	06037	34.14910181	-118.2579537	Los Angeles County
134974	Fee-for-Service	1396765111	1396765111	1	1	THOMAS, JEFFREY J MD	9/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	68446	01	General Practice	0	In state provider	None	1220 ROSSMOOR PKWY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
134980	Fee-for-Service	1073838611	1073838611	1	1	TWITO, TORY R DO	9/25/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	12114	40	Pediatrics	0	In state provider	None	865 3RD AVE	STE 101	CHULA VISTA	CA	91911	1349	37	06073	32.62189562	-117.0722453	San Diego County
135005	Fee-for-Service	1215046669	1215046669	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05690	1380 BARSTOW RD	None	BARSTOW	CA	92311	4944	36	06071	34.877448	-117.022899	San Bernardino County
135014	Fee-for-Service	1902923451	1902923451	1	2	THAI, WARREN P MD	6/19/2020	207R00000X	NA	Other	026	PHYSICIANS	108762	41	Internal Medicine	0	In state provider	None	1800 SPRING RIDGE	None	SUSANVILLE	CA	96130	6100	18	06035	40.43816059	-120.6279677	Lassen County
135029	Fee-for-Service	1376730937	1376730937	1	1	TRENT, GRACE L RN	6/30/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
135086	Fee-for-Service	1205983434	1205983434	1	1	TENNYSON, CHRISTOPHER LMFT	1/11/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
135110	Fee-for-Service	1740776848	1740776848	1	1	TAN, PATRICIA Z PHD	7/19/2018	No Taxonomy Provided	NA	None	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
135129	Fee-for-Service	1750064200	1750064200	1	1	TSAI, CHIAHONG PT	8/14/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	32246 CLINTON KEITH	STE 103	WILDOMAR	CA	92595	7320	33	06065	33.59200657	-117.2501269	Riverside County
135201	Fee-for-Service	1992068332	1992068332	1	1	TEIXEIRA, JANE LMFT	8/17/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13620 LINCOLN WAY	380	AUBURN	CA	95603	3261	31	06061	38.93032866	-121.0549381	Placer County
135203	Fee-for-Service	1679794085	1679794085	1	1	TAVAKOLI, BABAK MD	9/8/2022	207L00000X	NA	Other	026	PHYSICIANS	175302	None	None	0	In state provider	None	23625 WR HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
135256	Fee-for-Service	1487607685	1487607685	1	1	TIONGSON, JONATHAN T DPM	7/15/2008	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	16 E FERN AVE	STE B	REDLANDS	CA	92373	4000	36	06071	34.05074826	-117.1781289	San Bernardino County
135270	Fee-for-Service	1033530746	1033530746	1	1	TELECARE CORPORATION	3/1/2014	No Taxonomy Provided	NA	None	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1904 RICHLAND AVE	None	CERES	CA	95307	0000	50	06099	37.60031128	-120.9658226	Stanislaus County
135292	Fee-for-Service	1831670769	1831670769	1	1	TLC HOME HEALTH, LLC	6/2/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4869 TOPANGA CYN BLVD	SUITE 205	WOODLAND HILLS	CA	91364	4230	19	06037	34.156404	-118.605838	Los Angeles County
135409	Fee-for-Service	1871119032	1871119032	1	2	TRANSITION CARE TELEMETRY	11/1/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	30320 RANCHO VIEJO ROAD	STE 12	SAN JUAN CAPISTRA	CA	92675	1581	30	06059	33.52176033	-117.6652056	Orange County
135456	Fee-for-Service	1700821147	1700821147	1	1	TALLEY, BRAD MD	8/7/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184120	None	None	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
135470	Fee-for-Service	1427086370	1427086370	1	1	TAYLOR PETERS, SUSAN	6/14/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1650 LOS GAMOS DR	None	SAN RAFAEL	CA	94903	1850	21	06041	38.02105246	-122.5420674	Marin County
135477	Fee-for-Service	1093867590	1093867590	1	1	TRAN, BICH C N	10/26/2017	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	24953 PASEO DE VALENCIA	STE 24A	LAGUNA HILLS	CA	92653	4343	30	06059	33.60028568	-117.7010887	Orange County
135492	Fee-for-Service	1942595806	1942595806	1	2	TRENT, ANDREW R MD	9/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2865 DAGGETT AVENUE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25240042	-121.7859055	Klamath County
135530	Fee-for-Service	1184884819	1184884819	1	1	TU, DIANA M MD	10/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111440	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
135539	Fee-for-Service	1447899323	1447899323	1	1	TIONGCO, CARMINE P PT	5/28/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
135543	Fee-for-Service	1609213230	1609213230	1	1	TRIPURARI MISHRA	3/23/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
135558	Fee-for-Service	1508987652	1508987652	1	1	THE WEST OAKLAND HEALTH	3/19/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	COUNCIL	7501 INTERNATIONAL BLVD	None	OAKLAND	CA	94621	2843	01	06001	37.75840438	-122.18549	Alameda County
135572	Fee-for-Service	1598871659	1598871659	1	1	TUSHAR C SHAH MD	4/11/2017	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9851 BROOK RD	None	GLEN ALLEN	VA	23059	4559	00	None	37.66782277	-77.46074377	Henrico County
135605	Fee-for-Service	1184231326	1184231326	1	1	TOLENTINO, CINDY F CNP	4/26/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1792 GARNET AVE	None	SAN DIEGO	CA	92109	3350	37	06073	32.80054833	-117.2374979	San Diego County
135611	Fee-for-Service	1316194103	1316194103	1	1	TOM MBEKE-EKANEM	6/25/2007	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	9438 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3746	33	06065	33.92095353	-117.4453473	Riverside County
135620	Fee-for-Service	1306944814	1306944814	1	1	TESHIMA, DONALD R OD	10/3/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1595 E 17TH ST	None	SANTA ANA	CA	92705	8506	30	06059	33.75994752	-117.84573	Orange County
135635	Fee-for-Service	1972612323	1972612323	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2021 SOLANO AVE	None	VALLEJO	CA	94590	6456	48	06095	38.10497083	-122.2327512	Solano County
135638	Fee-for-Service	1225499015	1225499015	1	2	TEAM PHYSICIANS OF SOUTHERN	10/1/2021	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
135685	Fee-for-Service	1912017211	1912017211	1	1	TSENG, THOMAS M DO	2/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	6968	41	Internal Medicine	0	In state provider	None	850 S ATLANTIC BLVD	STE 200	MONTEREY PARK	CA	91754	4728	19	06037	34.05097684	-118.1379979	Los Angeles County
135688	Fee-for-Service	1437547056	1437547056	1	1	TRINANES, JENNIFER PT	2/17/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
135696	Fee-for-Service	1851615611	1851615611	1	1	TOVAR HIRASHIMA, EVA MD	6/5/2017	207P00000X	NA	Other	026	PHYSICIANS	144860	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
135699	Fee-for-Service	1871119032	1871119032	1	2	TRANSITION CARE TELEMETRY	11/1/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	30320 RANCHO VIEJO ROAD	STE 12	SAN JUAN CAPISTRA	CA	92675	1581	30	06059	33.52176033	-117.6652056	Orange County
135750	Fee-for-Service	1124063789	1124063789	1	1	TASK, SHERI L MD	12/31/1993	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	79269	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
135865	Fee-for-Service	1457641714	1457641714	1	1	TANGCHAIVANG, NICHOLAS MD	2/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123647	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
135873	Fee-for-Service	1942244967	1942244967	1	1	TAYLOR, THOMAS H MD	9/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	75697	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
135883	Fee-for-Service	1366897274	1366897274	1	1	TON, THAT NAM TRAN S MD	7/13/2020	2080P0210X	NA	Nephrology	026	PHYSICIANS	140320	45	Nephrology (Renal-Kidney)	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
135936	Fee-for-Service	1164008942	1164008942	1	1	TENG, CHIH YUN ANGELICA	3/24/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191975	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
135953	Fee-for-Service	1437651395	1437651395	1	1	THOMAS, CAROLINE M LCSW LLC	10/17/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1350 HAYES ST	B12	BENICIA	CA	94510	2933	48	06095	38.04764833	-122.139033	Solano County
136056	Fee-for-Service	1396963799	1396963799	1	1	TALACH, SARAH S	12/27/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
136058	Fee-for-Service	1972099893	1972099893	1	1	TAPIERO, SHLOMI MD	7/23/2019	208800000X	NA	Other	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
136111	Fee-for-Service	1245245166	1245245166	1	1	TEMPLEMAN, JEANNE M LCSW	8/24/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
136112	Fee-for-Service	1336589100	1336589100	1	1	THAKKAR, JAY H MD	8/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139180	01	General Practice	0	In state provider	None	3 MEDICAL PLAZA	None	ROSEVILLE	CA	95661	3087	31	06061	38.76566391	-121.2457432	Placer County
136145	Fee-for-Service	1386205490	1386205490	1	1	TILSON, BRITTANY MD	8/28/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178445	None	None	0	In state provider	None	28780 SINGLE OAK DRIVE	SUITE 160	TEMECULA	CA	92590	5528	33	06065	33.49890392	-117.1612965	Riverside County
136170	Fee-for-Service	1366897274	1366897274	1	1	TON, THAT NAM TRAN S MD	7/13/2020	2080P0210X	NA	Nephrology	026	PHYSICIANS	140320	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
136211	Fee-for-Service	1609187392	1609187392	1	1	THOMAS, RYAN C DPM	1/11/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	480 REDWOOD ST STE 10	None	VALLEJO	CA	94590	2958	48	06095	38.12315545	-122.2597619	Solano County
136271	Fee-for-Service	1851966154	1851966154	1	1	TELON, KRISTEN M LMFT	10/13/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39755 MURRIETA HOT SPRIN	SUITE D160	MURRIETA	CA	92563	9113	33	06065	33.55575954	-117.1627899	Riverside County
136275	Fee-for-Service	1033533195	1033533195	1	1	TOMPKINS, BRETT DO	9/13/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	14201	None	None	0	In state provider	None	23521 PASEO DE VALENCIA	None	LAGUNA HILLS	CA	92653	3126	30	06059	33.61113028	-117.7126684	Orange County
136321	Fee-for-Service	1689784811	1689784811	1	1	THIENHAUS, OLE J MD	3/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	13	Neurology (M.D. only)	1	Border provider	None	3006 S MARYLAND PKWY	STE 315	LAS VEGAS	NV	89109	2218	00	None	36.135288	-115.1368705	Clark County
136359	Fee-for-Service	1639227853	1639227853	1	1	TADIMETI, LAKSHMINARA-	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	66982	41	Internal Medicine	0	In state provider	YANA MD	1801 W ROMNEYA DR	STE 504	ANAHEIM	CA	92801	1827	30	06059	33.8506615	-117.946413	Orange County
136364	Fee-for-Service	1437298379	1437298379	1	1	TRINITY CO OFFICE OF ED	3/12/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	201 MEMORIAL DR	None	WEAVERVILLE	CA	96093	1256	53	06105	40.73643307	-122.9476084	Trinity County
136396	Fee-for-Service	1689818940	1689818940	1	1	TJOE, ANDREAS MD	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120858	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
136515	Fee-for-Service	1245307164	1245307164	1	1	TOMITA, MITSUO MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	25054	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
136536	Fee-for-Service	1013211523	1013211523	1	1	TRAN, KARI OD	2/6/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2722 ABORN RD	None	SAN JOSE	CA	95121	1204	43	06085	37.31364749	-121.7928998	Santa Clara County
136539	Fee-for-Service	1154436988	1154436988	1	1	TODAYS WOMAN MEDICAL GROUP	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	18350 ROSCOE BLVD	STE 405	NORTHRIDGE	CA	91325	4173	19	06037	34.22071855	-118.5341175	Los Angeles County
136551	Fee-for-Service	1407934599	1407934599	1	1	TING, KATHLEEN M MD	11/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51669	07	Dermatology	0	In state provider	None	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
136594	Fee-for-Service	1306284849	1306284849	1	1	THOMPSON, LISA M LMFT	4/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11840 MAGNOLIA	STE C	RIVERSIDE	CA	92503	7112	33	06065	33.89540021	-117.4902651	Riverside County
136609	Fee-for-Service	1689784811	1689784811	1	1	THIENHAUS, OLE J MD	3/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	36	Psychiatry	1	Border provider	None	3006 S MARYLAND PKWY	STE 315	LAS VEGAS	NV	89109	2218	00	None	36.135288	-115.1368705	Clark County
136619	Fee-for-Service	1073019881	1073019881	1	1	TANG, JENNIFER C MD	10/4/2023	207R00000X	NA	Other	026	PHYSICIANS	164469	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
136646	Fee-for-Service	1639227853	1639227853	1	1	TADIMETI, LAKSHMINARA-	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	66982	29	Pulmonary Diseases (M.D. only)	0	In state provider	YANA MD	1801 W ROMNEYA DR	STE 504	ANAHEIM	CA	92801	1827	30	06059	33.8506615	-117.946413	Orange County
136651	Fee-for-Service	1437298379	1437298379	1	1	TRINITY CO OFFICE OF ED	1/17/1994	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	201 MEMORIAL DR	None	WEAVERVILLE	CA	96093	1256	53	06105	40.73643307	-122.9476084	Trinity County
136660	Fee-for-Service	1326176199	1326176199	1	2	THAO-THANH PHAM OD INC	12/23/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6160 ARLINGTON AVE	C-1	RIVERSIDE	CA	92504	1944	33	06065	33.9459066	-117.4360336	Riverside County
136679	Fee-for-Service	1225105232	1225105232	1	1	TADROS, ELYZABAT A MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	52933	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
136719	Fee-for-Service	1831752377	1831752377	1	1	THE CARE CENTER ON HAZELTINE	5/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	6835 HAZELTINE AVE	None	VAN NUYS	CA	91405	3218	19	06037	34.19496	-118.440009	Los Angeles County
136843	Fee-for-Service	1114956695	1114956695	1	1	TAKEUCHI, SEAN Y MD	4/5/2002	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	78590	30	Radiology	0	In state provider	None	2110 PROFESSIONAL DR	STE 100	ROSEVILLE	CA	95661	3752	31	06061	38.74234873	-121.2521259	Placer County
136879	Fee-for-Service	1053609602	1053609602	1	1	THAKUR, NEIL H MD	7/1/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	122027	None	None	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
136900	Fee-for-Service	1164888913	1164888913	1	1	TALKWAYS A SPEECH-LANGUAGE P	6/1/2016	193400000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ATHOLOGY P.C.	4420 MIRALOMA	A	ANAHEIM	CA	92807	1837	30	06059	33.86201793	-117.8200765	Orange County
136962	Fee-for-Service	1689745580	1689745580	1	1	TZAGOURNIS, MARK P MD	4/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	75689	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
137009	Fee-for-Service	1912160243	1912160243	1	1	TUNG, SHIRLEY S MD	5/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109231	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
137044	Fee-for-Service	1194731489	1194731489	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 5617	2230 OTAY LAKES RD	None	CHULA VISTA	CA	91915	1000	37	06073	32.64706978	-116.9680962	San Diego County
137053	Fee-for-Service	1518004373	1518004373	1	1	TANSAVTDI, KATHARINE MD	10/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	98404	30	Radiology	0	In state provider	None	1401 W MERCED AVE	102	WEST COVINA	CA	91790	3401	19	06037	34.061711	-117.9466197	Los Angeles County
137107	Fee-for-Service	1750478293	1750478293	2	1	TRINITY HOME HEALTH SERVICES	7/1/2009	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6729 NORTH WILLOW AVE	SUITE 103	FRESNO	CA	93710	5952	10	06019	36.83425452	-119.731148	Fresno County
137119	Fee-for-Service	1407159726	1407159726	1	1	TANAKA, TIFFANY N MD	2/13/2017	207RH0003X	NA	Oncology	026	PHYSICIANS	119740	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
137128	Fee-for-Service	1114036050	1114036050	1	1	TSUANG, JOHN W MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	45602	36	Psychiatry	0	In state provider	None	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	19	06037	33.83155851	-118.2920625	Los Angeles County
137181	Fee-for-Service	1891720884	1891720884	1	1	TRANI, SERGIO I JR MD	1/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	48853	01	General Practice	0	In state provider	None	3175 FIRESTONE BLVD	None	SOUTH GATE	CA	90280	2951	19	06037	33.95501624	-118.2136584	Los Angeles County
137242	Fee-for-Service	1871042366	1871042366	1	1	THUET, SADIE LMFT	10/31/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1070 GRAVENSTEIN HWY S	SUITE 120	SEBASTOPOL	CA	95472	4529	49	06097	38.38922357	-122.815358	Sonoma County
137296	Fee-for-Service	1033278643	1033278643	1	1	TING, NATALIE DO	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7466	08	Family Practice	0	In state provider	None	10132 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2564	19	06037	33.90196842	-118.1176136	Los Angeles County
137301	Fee-for-Service	1992215263	1992215263	1	1	TAYLOR, LORRAINE B NP	1/22/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
137320	Fee-for-Service	1225231137	1225231137	1	1	THOMPSON, KENNITH O MD	2/5/1982	208600000X	NA	General Surgery	026	PHYSICIANS	41918	None	None	0	In state provider	None	12470 WASHINGTON BLVD	None	WHITTIER	CA	90602	1005	19	06037	33.96774843	-118.0457572	Los Angeles County
137393	Fee-for-Service	1750478293	1750478293	2	1	TRINITY HOME HEALTH SERVICES	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6729 NORTH WILLOW AVE	SUITE 103	FRESNO	CA	93710	5952	10	06019	36.83425452	-119.731148	Fresno County
137408	Fee-for-Service	1215961735	1215961735	1	1	TAKAHASHI, STEFANI R MD	9/1/1998	207N00000X	NA	Dermatology	026	PHYSICIANS	55242	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
137434	Fee-for-Service	1639183056	1639183056	1	1	TORBATI, KAMRAN	3/31/1992	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	48821	None	None	0	In state provider	None	5363 BALBOA BLVD	STE 245	ENCINO	CA	91316	2827	19	06037	34.169058	-118.5011265	Los Angeles County
137581	Fee-for-Service	1811645997	1811645997	1	1	TRAN, STEPHANIE NP	2/20/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
137636	Fee-for-Service	1063445609	1063445609	1	1	THIERRY, NORRETTE L PHD	7/27/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	D	16168 BEACH BLVD.	241	HUNTINGTON BEACH	CA	92647	3805	30	06059	33.728283	-117.9891305	Orange County
137687	Fee-for-Service	1568991701	1568991701	1	1	THOMAS, RAHITHA M CNP	8/24/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 342	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
137703	Fee-for-Service	1699312207	1699312207	1	1	TREJO, JESSICA R CCC-SLP	5/17/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	38	06075	37.76850146	-122.3949365	San Francisco County
137719	Fee-for-Service	1063871291	1063871291	1	1	TARDANICO, PHILLIP G LCSW	5/29/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18387 US HWY 18	STE 3A	APPLE VALLEY	CA	92307	2214	36	06071	34.53962294	-117.2628021	San Bernardino County
137722	Fee-for-Service	1316920374	1316920374	1	1	TRAN, TUYET H MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74335	66	Emergency Medicine (Urgent Care)	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
137755	Fee-for-Service	1831110378	1831110378	1	1	TRAN, SON B MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70649	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
137761	Fee-for-Service	1558423319	1558423319	1	1	THOMAS, CATHLEEN C	4/21/2023	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
137778	Fee-for-Service	1619913720	1619913720	1	1	TUNG, SING L MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33253	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2621 S BRISTOL ST	STE 202	SANTA ANA	CA	92704	5718	30	06059	33.711876	-117.885371	Orange County
137796	Fee-for-Service	1942450291	1942450291	2	1	TRAM PHAM PHARMD INC	9/24/2018	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10224 WESTMINSTER AVE	None	GARDEN GROVE	CA	92843	4830	30	06059	33.75948472	-117.9509181	Orange County
137797	Fee-for-Service	1003152794	1003152794	1	1	TRINGALE, ERICA CNP	4/19/2019	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
137824	Fee-for-Service	1396939005	1396939005	1	1	TWIN TOWERS MEDICAL	5/18/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	EQUIPMENT INC	1168 GLENDALE BLVD	None	LOS ANGELES	CA	90026	3203	19	06037	34.07778367	-118.2606063	Los Angeles County
137825	Fee-for-Service	1629007067	1629007067	1	1	TAWFIK, ATEF S MD	3/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55524	01	General Practice	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
137891	Fee-for-Service	1144657925	1144657925	1	1	TONG, ANHTUAN MD INC	9/9/2013	261Q00000X	NA	Other	026	PHYSICIANS	67846	41	Internal Medicine	0	In state provider	None	3584 REDONDO BEACH BLVD	None	TORRANCE	CA	90504	1404	19	06037	33.88027435	-118.3345809	Los Angeles County
137901	Fee-for-Service	1013114719	1013114719	1	1	TATSIS, VASILIKI A MD	6/2/2009	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	100473	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	210 CANAL STREET	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
137933	Fee-for-Service	1114093879	1114093879	1	1	TOP UNITED INC	9/14/1998	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1730 S SAN GABRIEL BLVD	STE A	SAN GABRIEL	CA	91776	3928	19	06037	34.077654	-118.0907045	Los Angeles County
137977	Fee-for-Service	1326028986	1326028986	1	1	TERRANCE A MCBURNEY, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11212 STATE HIGHWAY 151	None	SAN ANTONIO	TX	78251	4498	00	None	29.46743939	-98.69462674	Bexar County
138006	Fee-for-Service	1154432490	1154432490	1	1	TRANDUC, MATTHEW H MD	3/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	90429	02	General Surgery	0	In state provider	None	625 LINCOLN AVE	None	SAN JOSE	CA	95126	3705	43	06085	37.31809479	-121.9082315	Santa Clara County
138053	Fee-for-Service	1275612798	1275612798	1	1	TYLEE, LAFAYETTE M MD	2/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52123	01	General Practice	0	In state provider	None	15080 7TH ST	STE 6	VICTORVILLE	CA	92395	3865	36	06071	34.52622936	-117.3022567	San Bernardino County
138055	Fee-for-Service	1760419204	1760419204	1	1	TAN, MICHAEL DO	5/10/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	6875	None	None	0	In state provider	None	1200 S ATLANTIC BLVD	128	ALHAMBRA	CA	91803	5406	19	06037	34.079274	-118.1344905	Los Angeles County
138066	Fee-for-Service	1346803152	1346803152	1	1	TRAN, UYEN H CNP	11/11/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2651 S C ST	200	OXNARD	CA	93033	3560	56	06111	34.17497898	-119.1811966	Ventura County
138067	Fee-for-Service	1710046321	1710046321	1	1	TANG, SONJA W MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	54614	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
138150	Fee-for-Service	1932309168	1932309168	1	1	TIEN, SUSAN MD	9/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99411	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	555 CASTRO STREET	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38946454	-122.0815711	Santa Clara County
138151	Fee-for-Service	1124350657	1124350657	1	1	TRUONG, CO T MD	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104378	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
138163	Fee-for-Service	1386869147	1386869147	1	1	THOMAS, SEAN R MD INC	11/1/2001	207Q00000X	NA	Adult Primary Care	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	55585 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	2505	36	06071	34.11800429	-116.451382	San Bernardino County
138195	Fee-for-Service	1417480310	1417480310	1	1	TAN, JESSICA NP	2/6/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
138203	Fee-for-Service	1689722217	1689722217	1	1	TETTEH, NII-ARYEE E MD INC	11/7/2005	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76579	08	Family Practice	0	In state provider	None	502 EUCLID AVE	STE 204	NATIONAL CITY	CA	91950	6119	37	06073	32.68505421	-117.0832793	San Diego County
138245	Fee-for-Service	1578126504	1578126504	1	1	TRAN, KHANH HIEN MD	8/22/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	185122	None	None	0	In state provider	None	THREE MEDICAL PLAZA	STE 120	ROSEVILLE	CA	95661	3088	31	06061	38.76566391	-121.2457432	Placer County
138286	Fee-for-Service	1821227711	1821227711	1	1	TSUI, JESSICA L MD	7/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126064	26	Psychiatry (child)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
138288	Fee-for-Service	1497795520	1497795520	1	1	TORRES, REBECCA MD	1/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91739	08	Family Practice	0	In state provider	None	10563 MILLS AVE	None	MONTCLAIR	CA	91763	4610	36	06071	34.0619883	-117.7176403	San Bernardino County
138310	Fee-for-Service	1366413387	1366413387	1	1	TANDOC, JOSE S MD	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70555	None	None	0	In state provider	None	612 W DUARTE RD	STE 101	ARCADIA	CA	91007	9220	19	06037	34.12647805	-118.051994	Los Angeles County
138321	Fee-for-Service	1427057058	1427057058	1	1	TOUMEH, KHALED MD	2/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	50853	30	Radiology	0	In state provider	None	323 N PRAIRIE AVE	STE 114	INGLEWOOD	CA	90301	4503	19	06037	33.966333	-118.3439975	Los Angeles County
138336	Fee-for-Service	1134569791	1134569791	1	1	THIEL, CATHERINE E LCSW	1/22/2024	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
138342	Fee-for-Service	1861414807	1861414807	2	1	TOROUSSIAN, GRETA OD	11/27/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	STE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
138348	Fee-for-Service	1093135055	1093135055	1	1	TURABOVA, CHAROSKHON MD	3/1/2022	2084V0102X	NA	Neurology	026	PHYSICIANS	175508	None	None	0	In state provider	None	1798 N GAREY AVE	2ND FLOOR CATH LAB	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
138369	Fee-for-Service	1346679693	1346679693	1	1	TRI-CITY CARDIOLOGY AND	11/14/2014	281P00000X	NA	Hospitals	026	PHYSICIANS	60730	06	Cardiovascular Disease (M.D. only)	0	In state provider	ARRHYTHMIA SERVICES	2424 VISTA WAY	STE 300-301	OCEANSIDE	CA	92054	6178	37	06073	33.18326195	-117.3355017	San Diego County
138450	Fee-for-Service	1386869147	1386869147	1	1	THOMAS, SEAN R MD INC	11/1/2001	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	55585 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	2505	36	06071	34.11800429	-116.451382	San Bernardino County
138493	Fee-for-Service	1376885293	1376885293	1	1	THOMAS, MOTTSIN E L MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131508	36	Psychiatry	0	In state provider	None	15400 FOOTHILL BLVD	None	SAN LEANDRO	CA	94578	1009	01	06001	37.7069698	-122.1191104	Alameda County
138517	Fee-for-Service	1760593644	1760593644	1	1	THUKRAL, VIJAY K MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	42307	41	Internal Medicine	0	In state provider	None	2664 BERRYESSA RD	STE 118	SAN JOSE	CA	95132	2906	43	06085	37.38924657	-121.856946	Santa Clara County
138567	Fee-for-Service	1487083689	1487083689	1	1	TRAYLOR, JANET LMFT	1/28/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16935 W BERNARDO DR	100	SAN DIEGO	CA	92127	1635	37	06073	33.02335619	-117.0804364	San Diego County
138573	Fee-for-Service	1821227711	1821227711	1	1	TSUI, JESSICA L MD	7/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126064	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
138576	Fee-for-Service	1952377582	1952377582	1	1	TEUTEBERG, JEFFREY J MD	8/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150673	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
138602	Fee-for-Service	1356528566	1356528566	1	1	TIENG, ANDREA S	11/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106477	None	None	0	In state provider	None	10408 INDUSTRIAL CIR	None	REDLANDS	CA	92374	4848	36	06071	34.06469012	-117.2361582	San Bernardino County
138609	Fee-for-Service	1942434667	1942434667	1	1	TIMPONE, VINCENT M MD	10/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
138627	Fee-for-Service	1588781629	1588781629	1	1	THERMALITO UNION SD	1/1/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	400 GRAND AVE	None	OROVILLE	CA	95965	4007	04	06007	39.51923423	-121.5743044	Butte County
138726	Fee-for-Service	1164702122	1164702122	1	1	TORRANCE PHARMACY INC	1/7/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ING CENTER	23600 TELO AVE	155	TORRANCE	CA	90505	4005	19	06037	33.81215054	-118.3384029	Los Angeles County
138741	Fee-for-Service	1578742664	1578742664	1	1	TO, JOE M MD	2/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100783	08	Family Practice	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
138747	Fee-for-Service	1750656971	1750656971	1	1	TRETTIN, JAMES R MD	10/25/2017	207P00000X	NA	Other	026	PHYSICIANS	144952	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 NORTH 1ST STREET	None	BLYTHE	CA	92225	1702	33	06065	33.61293	-114.5955035	Riverside County
138751	Fee-for-Service	1255713186	1255713186	1	1	TRELEAVEN, MIRANDA S LMFT	3/12/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
138793	Fee-for-Service	1780695304	1780695304	1	1	TWOREK, SHELLEY L PT	12/8/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6850 BROCKTON AVE	STE 212	RIVERSIDE	CA	92506	3808	33	06065	33.9493261	-117.3967206	Riverside County
138796	Fee-for-Service	1003001645	1003001645	1	1	TRIVEDI, VINOD MD	8/1/2012	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	55354	77	Infectious Disease	0	In state provider	None	77 CADILLAC DR	SUITE 210	SACRAMENTO	CA	95825	5480	34	06067	38.572551	-121.4181585	Sacramento County
138906	Fee-for-Service	1639494172	1639494172	1	1	TO, NHAT M MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119070	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
138913	Fee-for-Service	1588781629	1588781629	1	1	THERMALITO UNION SD	7/31/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	400 GRAND AVE	None	OROVILLE	CA	95965	4007	04	06007	39.51923423	-121.5743044	Butte County
138921	Fee-for-Service	1639240666	1639240666	1	1	TUN, SOVANRITH MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82644	20	Orthopedic Surgery	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
138932	Fee-for-Service	1831866615	1831866615	1	1	THOMPSON, JEREMIAH LMFT	10/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1622 4TH ST	None	SANTA ROSA	CA	95404	4020	49	06097	38.448162	-122.6995335	Sonoma County
138968	Fee-for-Service	1164153664	1164153664	1	1	THE BRICE GROUP INC	1/18/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	149 OAK AVE	None	CLOVIS	CA	93611	7228	10	06019	36.84426144	-119.7091283	Fresno County
138998	Fee-for-Service	1629123286	1629123286	1	1	TRIVEDI, NEHA A MD	7/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93561	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
139013	Fee-for-Service	1285657841	1285657841	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5797	5530 LAKE ISABELLA BLVD	None	LAKE ISABELLA	CA	93240	0000	15	06029	35.61813077	-118.4773869	Kern County
139060	Fee-for-Service	1821588518	1821588518	1	1	TRAN, LIEM T MD	2/17/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	175639	None	None	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
139084	Fee-for-Service	1225692221	1225692221	1	1	TWITTY, ALISON LMFT	4/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1620 MINERAL KING AVE	SUITE C	VISALIA	CA	93291	4440	54	06107	36.327699	-119.311002	Tulare County
139189	Fee-for-Service	1801214903	1801214903	1	1	TULPULE, VARSHA MD	8/16/2020	207RX0202X	NA	Oncology	026	PHYSICIANS	144044	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
139190	Fee-for-Service	1083231781	1083231781	1	1	TREEHOUSE CHILD THERAPY PROF	1/27/2021	261QM0855X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1916 ORANGE TREE LANE	SUITE 450G	REDLANDS	CA	92374	4520	36	06071	34.06785848	-117.2189386	San Bernardino County
139210	Fee-for-Service	1902540685	1902540685	1	1	TERAPIA EN ESPANOL FAMILY CO	7/12/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	UNSELING APC	4199 FLAT ROCK DR	U100 OFFICE 105	RIVERSIDE	CA	92505	7115	33	06065	33.90364208	-117.4931242	Riverside County
139223	Fee-for-Service	1285825414	1285825414	1	1	TAGAWA, TOMOKO MD	8/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98428	41	Internal Medicine	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
139246	Fee-for-Service	1962684282	1962684282	1	1	TOLENTINO, ARTHUR R MD	11/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	52281	41	Internal Medicine	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
139286	Fee-for-Service	1013942952	1013942952	1	1	TAM, JONATHAN N MD INC	12/31/1990	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	66009	None	None	0	In state provider	None	193 E ORANGE GROVE BLVD	None	PASADENA	CA	91103	3424	19	06037	34.15787172	-118.1462979	Los Angeles County
139288	Fee-for-Service	1457653545	1457653545	1	1	TRAN, NGUYEN	12/17/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1101 CALIFORNIA AVE	SUITE 100	CORONA	CA	92881	6472	33	06065	33.86171794	-117.5440764	Riverside County
139328	Fee-for-Service	1487837159	1487837159	1	1	TYLER CHURCH M.D.	5/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3555 S VAL VISTA DR	None	GILBERT	AZ	85296	0000	00	None	33.286572	-111.7527525	Maricopa County
139401	Fee-for-Service	1316056799	1316056799	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5520	3300 E ANAHEIM ST	None	LONG BEACH	CA	90804	4025	19	06037	33.78257254	-118.1534265	Los Angeles County
139476	Fee-for-Service	1629182159	1629182159	1	1	TODOROV, IRINA MD	9/6/2006	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	92316	08	Family Practice	0	In state provider	None	101 THE CITY DR ST	None	ORANGE	CA	92868	3201	30	06059	33.7866615	-117.8888206	Orange County
139480	Fee-for-Service	1083231781	1083231781	1	1	TREEHOUSE CHILD THERAPY PROF	9/1/2020	261QM0855X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1916 ORANGE TREE LANE	SUITE 450G	REDLANDS	CA	92374	4520	36	06071	34.06785848	-117.2189386	San Bernardino County
139483	Fee-for-Service	1033563531	1033563531	1	1	TALAISHAHIR, MARYAM MD	2/20/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	157622	41	Internal Medicine	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
139506	Fee-for-Service	1346686656	1346686656	1	1	TRINH, BAO V	4/20/2023	103TF0200X	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
139512	Fee-for-Service	1285825414	1285825414	1	1	TAGAWA, TOMOKO MD	8/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98428	68	Hematology	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
139551	Fee-for-Service	1821524133	1821524133	1	1	TE, TUE THI DUC MD	10/24/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	185404	None	None	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
139575	Fee-for-Service	1851548986	1851548986	1	1	TAKAZAKI, AMY M	6/22/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	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
139585	Fee-for-Service	1700447794	1700447794	1	1	THP INDIVIDUAL AND FAMILY TH	2/20/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ERAPY, INC.	25000 AVENUE STANFORD	STE 218	VALENCIA	CA	91355	4596	19	06037	34.43847322	-118.5729968	Los Angeles County
139616	Fee-for-Service	1881974533	1881974533	1	1	TURNER, SASHA PSYD	3/9/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
139619	Fee-for-Service	1780068726	1780068726	1	1	THAMSOPIT, TOM OD	11/16/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	43767 15TH STREET WEST	None	LANCASTER	CA	93534	4754	19	06037	34.67817042	-118.1568546	Los Angeles County
139643	Fee-for-Service	1215168653	1215168653	1	1	TACKIE, IRMGARD U MD	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118539	40	Pediatrics	0	In state provider	None	742 W HIGHLAND AVE	None	SAN BERNARDINO	CA	92405	3839	36	06071	34.13604853	-117.29952	San Bernardino County
139680	Fee-for-Service	1639592264	1639592264	1	1	TRIO HOME HEALTH CARE OF SAN	11/6/2014	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	1991 VILLAGE PARK WAY	SUITE 2L	ENCINITAS	CA	92024	1994	37	06073	33.05330323	-117.2457609	San Diego County
139703	Fee-for-Service	1952960460	1952960460	1	1	THRIVE HEALTH INC	8/27/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12061-B W. JEFFERSON BLV	None	LOS ANGELES	CA	90230	6219	19	06037	33.98274684	-118.4067894	Los Angeles County
139766	Fee-for-Service	1912537465	1912537465	1	1	THE PILOT CHILDREN'S COUNSEL	5/27/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	719 SAN BENITO STREET	SUITE F	HOLLISTER	CA	95023	1111	35	06069	36.84904855	-121.4020859	San Benito County
139767	Fee-for-Service	1972697597	1972697597	1	1	TAKHER, RAMANDEEP K OD	4/1/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1145 COLUSA AVE	STE C	YUBA CITY	CA	95991	3630	51	06101	39.14185356	-121.6322619	Sutter County
139801	Fee-for-Service	1285825414	1285825414	1	1	TAGAWA, TOMOKO MD	8/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98428	78	Neoplastic Diseases/Oncology	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
139807	Fee-for-Service	1912099417	1912099417	1	1	TOUSSI, REZA M MD	7/10/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79782	08	Family Practice	0	In state provider	None	480 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13286634	-121.6142652	Sutter County
139813	Fee-for-Service	1891373510	1891373510	1	1	TUROCY, MARY J MD	8/28/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182858	08	Family Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
139858	Fee-for-Service	1316014541	1316014541	1	1	TRAN, MICHAEL J MD	3/26/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	83740	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
139874	Fee-for-Service	1821172800	1821172800	1	1	TEICHMAN, PETER J MD	2/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	32392	08	Family Practice	0	In state provider	None	5788 ERLAND RD	None	SANTA ROSA	CA	95404	8430	49	06097	38.50504986	-122.606844	Sonoma County
139878	Fee-for-Service	1215369459	1215369459	1	1	TO, DONG D MD	10/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124715	41	Internal Medicine	0	In state provider	None	1701 E CESAR E CHAVEZ AV	SUITE 100	LOS ANGELES	CA	90033	2488	19	06037	34.05112725	-118.2173921	Los Angeles County
139905	Fee-for-Service	1053508192	1053508192	1	1	TYLER, FRANK A PSYD	9/13/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
139919	Fee-for-Service	1861938227	1861938227	1	1	THOMPSON, STEPHANIE G LCSW	10/16/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	75185	-	NOT APPLICABLE	0	In state provider	None	1341 N ESCONDIDO BLVD	None	ESCONDIDO	CA	92026	2507	37	06073	33.14046993	-117.0924096	San Diego County
139941	Fee-for-Service	1528128709	1528128709	1	1	TRAN, HUAN N MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84599	30	Radiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
140012	Fee-for-Service	1982164851	1982164851	1	1	TRIUMPHANT ELDERLY CARE LLC	2/13/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	8106 LOMA VERDE AVENUE	None	CANOGA PARK	CA	91304	4306	19	06037	34.217235	-118.5896125	Los Angeles County
140026	Fee-for-Service	1275770885	1275770885	1	1	TARI, MAHYAR S MD	11/10/2009	282N00000X	NA	Hospitals	026	PHYSICIANS	106508	41	Internal Medicine	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
140136	Fee-for-Service	1174512792	1174512792	1	1	TUCSON MEDICAL CENTER	10/16/2016	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5301 E GRANT RD	None	TUCSON	AZ	85712	2805	00	None	32.252391	-110.8790055	Pima County
140156	Fee-for-Service	1073858361	1073858361	1	1	TOTAL RENAL CARE INC	10/24/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	777 LAWRENCE EXPRESSWAY	SUITE 18	SANTA CLARA	CA	95051	5118	43	06085	37.336437	-121.995583	Santa Clara County
140162	Fee-for-Service	1407934029	1407934029	1	1	TAWADROUS, MAGDY F MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79503	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
140166	Fee-for-Service	1972982213	1972982213	1	1	TERESITA PEDROSO	7/24/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7229 ZEST ST.	None	SAN DIEGO	CA	92139	1253	37	06073	32.69066436	-117.0394088	San Diego County
140183	Fee-for-Service	1346645090	1346645090	1	1	TROUTMAN, SHAWN E PT	3/26/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3989 STETSON	105	HEMET	CA	92545	9695	33	06065	33.72929866	-117.0132375	Riverside County
140232	Fee-for-Service	1760689046	1760689046	1	1	TRAVIS DEE NELSON, 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	1600 W ANTELOPE DR	None	LAYTON	UT	84041	1142	00	None	41.091012	-111.995523	Davis County
140240	Fee-for-Service	1396983730	1396983730	1	1	THAI, HUNG L OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
140267	Fee-for-Service	1992212732	1992212732	1	1	TRUONG, TIFFANY LMFT	1/31/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
140271	Fee-for-Service	1871096685	1871096685	1	1	THAN, AYE A MD	2/22/2022	207R00000X	NA	Other	026	PHYSICIANS	173953	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
140297	Fee-for-Service	1134699218	1134699218	1	2	THEY, MICHAEL NP	12/24/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	802 14TH STREET	SUITE N	MODESTO	CA	95354	1029	50	06099	37.64172216	-120.9944627	Stanislaus County
140394	Fee-for-Service	1235766486	1235766486	1	1	TAN, CHARMAINE CAMILLE D DO	9/21/2023	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	657 NORTH TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
140424	Fee-for-Service	1174512792	1174512792	1	1	TUCSON MEDICAL CENTER	10/16/2016	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5301 E GRANT RD	None	TUCSON	AZ	85712	2805	00	None	32.252391	-110.8790055	Pima County
140428	Fee-for-Service	1720560840	1720560840	1	1	TRAN, TIFFANY LCSW	10/31/2024	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
140441	Fee-for-Service	1336336007	1336336007	1	1	TAIRA, GAIL A	7/6/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
140542	Fee-for-Service	1003159427	1003159427	1	1	TOMASSETTI, SARAH E MD	2/11/2021	207RX0202X	NA	Oncology	026	PHYSICIANS	133560	None	None	0	In state provider	None	21840 S NORMANDIE AVE	STE 100A	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
140544	Fee-for-Service	1760591184	1760591184	1	1	THRIFTY PAYLESS INC	1/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5837	9482 CALIFORNIA CITY BLV	None	CALIFORNIA CITY	CA	93505	2803	15	06029	35.12583455	-117.9591978	Kern County
140551	Fee-for-Service	1548351240	1548351240	1	1	TANNER, ALAN J MD	5/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	72011	30	Radiology	0	In state provider	None	890 W STETSON AVE	STE B	HEMET	CA	92543	7311	33	06065	33.72939753	-116.9797995	Riverside County
140556	Fee-for-Service	1386638609	1386638609	1	1	TSUKAMOTO, DIANA K OD	6/15/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15068 GOLDENWEST ST	None	WESTMINSTER	CA	92683	6152	30	06059	33.743178	-118.0069006	Orange County
140640	Fee-for-Service	1851680797	1851680797	1	1	TANG, MICHELE W MD	8/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	91737	77	Infectious Disease	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
140703	Fee-for-Service	1750676227	1750676227	1	1	TO, PATRICIA L MD	4/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123019	08	Family Practice	0	In state provider	None	2020 SUTTER PLACE	#101	DAVIS	CA	95618	6217	57	06113	38.56287659	-121.7715536	Yolo County
140709	Fee-for-Service	1407965999	1407965999	1	1	THRIFTY DRUG STORE 5745	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	5881 WARNER AVE	None	HUNTINGTON BEACH	CA	92649	4657	30	06059	33.71554113	-118.0250987	Orange County
140727	Fee-for-Service	1447522974	1447522974	1	1	TURPIN, IVAN M MD INC	7/21/1972	No Taxonomy Provided	NA	None	026	PHYSICIANS	22754	24	Plastic Surgery	0	In state provider	None	1310 W STEWART DRIVE	SUITE 610	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
140785	Fee-for-Service	1508099888	1508099888	1	1	TA, ANH LMFT	1/3/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
140814	Fee-for-Service	1356658223	1356658223	1	1	TRAMONTANA, ZACCARIO M PHD	11/5/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8775 AERO DRIVE	STE 238	SAN DIEGO	CA	92123	1756	37	06073	32.80965551	-117.1391563	San Diego County
140826	Fee-for-Service	1922770551	1922770551	1	1	TRAN, TIFFANY T CNP	9/29/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
140865	Fee-for-Service	1043672413	1043672413	1	1	TRAN, DIENHONG MD	7/19/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	162092	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
140892	Fee-for-Service	1366468118	1366468118	1	1	TERRILL, RUSSELL T	12/3/2007	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3770 JANES RD	None	ARCATA	CA	95521	4744	12	06023	40.89583739	-124.0932916	Humboldt County
140904	Fee-for-Service	1093725855	1093725855	1	1	THOMAS, SEAN R MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60305	08	Family Practice	0	In state provider	None	73737 29 PALMS HWY	None	TWENTYNINE PALMS	CA	92277	3101	36	06071	34.13559094	-116.0538324	San Bernardino County
140933	Fee-for-Service	1730686635	1730686635	1	1	TUN, AUNG M MD	12/13/2021	390200000X	NA	Other	026	PHYSICIANS	175277	None	None	0	In state provider	None	43112 N 15TH ST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
140949	Fee-for-Service	1770907446	1770907446	1	1	TANG, JENNIFER S	12/7/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
140959	Fee-for-Service	1063963312	1063963312	1	1	THE MEDICINE CABINET INC	9/7/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7037 ATLANTIC AVE	None	BELL	CA	90201	3648	19	06037	33.97129359	-118.1881304	Los Angeles County
141000	Fee-for-Service	1770024101	1770024101	1	1	TSAO, JEFFREY Z MD	1/21/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	158327	None	None	0	In state provider	None	160 GREEN VALLEY RD	STE 202	FREEDOM	CA	95019	3160	44	06087	36.93732602	-121.7715374	Santa Cruz County
141004	Fee-for-Service	1053750265	1053750265	1	1	TRAN, TONY T DO	10/22/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	15767	36	Psychiatry	0	In state provider	None	12865 MAIN ST	STE 105	GARDEN GROVE	CA	92840	8205	30	06059	33.7757526	-117.9410457	Orange County
141056	Fee-for-Service	1821104126	1821104126	1	1	TZACHANIS, KATHARINE H NP	10/13/2017	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
141107	Fee-for-Service	1003870676	1003870676	1	1	TAN, ANTONI0 A MD APC	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	45416	41	Internal Medicine	0	In state provider	None	12980 FREDERICK ST	STE D	MORENO VALLEY	CA	92553	5263	33	06065	33.931872	-117.2613835	Riverside County
141117	Fee-for-Service	1043733215	1043733215	1	1	TUALA, ALBERT V PT	6/19/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
141180	Fee-for-Service	1437619160	1437619160	1	1	TAL, NOA MD	4/27/2023	207R00000X	NA	Other	026	PHYSICIANS	177342	None	None	0	In state provider	None	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	19	06037	34.06704253	-118.3835029	Los Angeles County
141257	Fee-for-Service	1457310807	1457310807	1	1	TOTAL RENAL CARE, INC	10/15/1991	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1936 TYLER AVE	# J169	SOUTH EL MONTE	CA	91733	3620	19	06037	34.05108484	-118.0374601	Los Angeles County
141259	Fee-for-Service	1508865528	1508865528	1	7	TAHOE CARSON VALLEY	9/28/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	1	Border provider	MEDICAL GROUP INC	155 HIGHWAY 50	None	STATELINE	NV	89449	0000	00	None	38.96860553	-119.9356859	Douglas County
141264	Fee-for-Service	1407854771	1407854771	1	1	THE TOLEDO HOSPITAL	1/20/2004	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2142 NORTH COVE BLVD	None	TOLEDO	OH	43606	9984	00	None	41.67237388	-83.59344326	Lucas County
141278	Fee-for-Service	1285013490	1285013490	1	1	TROY LAMAR MD, INC.	12/31/2018	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	51 N 5TH AVE	SUITE 202	ARCADIA	CA	91006	3710	19	06037	34.1412293	-118.0205477	Los Angeles County
141346	Fee-for-Service	1720350184	1720350184	1	1	TUMAN, CHRISTINA LMFT	1/9/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	101321	-	NOT APPLICABLE	0	In state provider	None	1002 PICO BLVD	None	SANTA MONICA	CA	90405	1326	19	06037	34.01333344	-118.4809119	Los Angeles County
141359	Fee-for-Service	1952595076	1952595076	1	1	TIERNEY, JOHN J MD	3/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103330	40	Pediatrics	0	In state provider	None	4733 WEST SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
141397	Fee-for-Service	1710314752	1710314752	1	1	TOLUCA 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 301	ENCINO	CA	91436	2216	19	06037	34.15659457	-118.485532	Los Angeles County
141490	Fee-for-Service	1922284223	1922284223	1	1	THRIFTY PAYLESS INC.	5/19/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06548	14115 LAKERIDGE CIRCLE	None	MAGALIA	CA	95954	9470	04	06007	39.81837111	-121.5917558	Butte County
141530	Fee-for-Service	1740395417	1740395417	1	1	TSOI, DAN W MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	40951	41	Internal Medicine	0	In state provider	None	11775 EDUCATION ST	STE 201	AUBURN	CA	95602	2453	31	06061	38.94431947	-121.0999275	Placer County
141548	Fee-for-Service	1508865528	1508865528	1	7	TAHOE CARSON VALLEY	12/26/2007	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	1	Border provider	MEDICAL GROUP INC	155 HIGHWAY 50	None	STATELINE	NV	89449	0000	00	None	38.96860553	-119.9356859	Douglas County
141552	Fee-for-Service	1407854771	1407854771	1	1	THE TOLEDO HOSPITAL	1/20/2004	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2142 NORTH COVE BLVD	None	TOLEDO	OH	43606	9984	00	None	41.67237388	-83.59344326	Lucas County
141575	Fee-for-Service	1205076569	1205076569	1	1	TAYLOR, BRIAN MD	6/1/2024	208M00000X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	30 MARK WEST SPRINGS RD	None	SANTA ROSA	CA	95403	1436	49	06097	38.4962723	-122.752117	Sonoma County
141586	Fee-for-Service	1881127926	1881127926	1	1	TATINENI, VINEETH MD	8/23/2024	207R00000X	NA	Other	026	PHYSICIANS	None	68	Hematology	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
141659	Fee-for-Service	1760942460	1760942460	1	1	TRAN, KHIEM	3/25/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	21322	05	Anesthesiology	0	In state provider	None	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
141671	Fee-for-Service	1427837665	1427837665	1	1	TOUKHTARIAN, ALINE G MD	1/27/2025	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
141680	Fee-for-Service	1508885336	1508885336	2	1	THOMPSON, PAUL A MD	3/31/2023	207L00000X	NA	Other	026	PHYSICIANS	155883	None	None	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
141686	Fee-for-Service	1710314752	1710314752	1	1	TOLUCA HOSPICE CARE, INC	7/23/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	16200 VENTURA BLVD	SUITE 301	ENCINO	CA	91436	2216	19	06037	34.15659457	-118.485532	Los Angeles County
141705	Fee-for-Service	1104872415	1104872415	1	1	TIERNEY, MICHAEL J MD	3/19/2018	207R00000X	NA	Other	026	PHYSICIANS	55929	41	Internal Medicine	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
141771	Fee-for-Service	1851587240	1851587240	1	1	TRAN, MARY A MD	11/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98615	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
141772	Fee-for-Service	1598110686	1598110686	1	1	TRAN, NAMPHUONG MD	7/15/2020	390200000X	NA	Other	026	PHYSICIANS	156686	None	None	0	In state provider	None	845 JACKSON ST	None	SAN FRANCISCO	CA	94133	4851	38	06075	37.79571919	-122.4089166	San Francisco County
141779	Fee-for-Service	1366024986	1366024986	1	1	TOCTOCAN, DOMINIC	12/20/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22825	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
141785	Fee-for-Service	1235102054	1235102054	1	1	TERNIAN, ALEN MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80847	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
141797	Fee-for-Service	1114094141	1114094141	1	1	TRUXTUN PSYCHIATRIC	1/1/1997	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	MEDICAL GROUP, LP	6001 TRUXTUN AVE	STE 160	BAKERSFIELD	CA	93309	0693	15	06029	35.36252236	-119.072932	Kern County
141814	Fee-for-Service	1902842370	1902842370	1	1	TYLER, CAROL P PSYD	7/30/2018	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
141847	Fee-for-Service	1508865528	1508865528	1	7	TAHOE CARSON VALLEY	8/7/2018	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	1	Border provider	MEDICAL GROUP INC	155 HIGHWAY 50	None	STATELINE	NV	89449	0000	00	None	38.96860553	-119.9356859	Douglas County
141850	Fee-for-Service	1891720355	1891720355	1	1	TRAN, UYEN-THAO P MD	11/8/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76709	None	None	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
141860	Fee-for-Service	1497864805	1497864805	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05853	456 S MADERA AVE	None	KERMAN	CA	93630	1019	10	06019	36.72850927	-120.0601494	Fresno County
141873	Fee-for-Service	1881127926	1881127926	1	1	TATINENI, VINEETH MD	8/23/2024	207R00000X	NA	Other	026	PHYSICIANS	None	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
141877	Fee-for-Service	1972795821	1972795821	1	1	TOMLIN, SHELLY L CNM	12/2/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
141885	Fee-for-Service	1205211109	1205211109	1	1	TATTAN, JULIA K	11/2/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
141937	Fee-for-Service	1205889136	1205889136	1	1	TOBE, CHRISTOPHER 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	1717 ARLINGTON AVE	None	CALDWELL	ID	83605	4802	00	None	43.654374	-116.694738	Canyon County
141968	Fee-for-Service	1437258027	1437258027	1	1	TSE, DANIEL Y MD	7/1/1999	207R00000X	NA	Other	026	PHYSICIANS	69138	41	Internal Medicine	0	In state provider	None	266 N JACKSON AVE	STE 7	SAN JOSE	CA	95116	1606	43	06085	37.36445516	-121.8492308	Santa Clara County
142008	Fee-for-Service	1407960669	1407960669	1	1	TODD L WILLIAMS 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	10 EAST 31ST ST	None	KEARNEY	NE	98847	0000	00	None	40.70647332	-99.08130081	Buffalo County
142013	Fee-for-Service	1356333579	1356333579	1	1	THE CHESTER COUNTY HOSPI	11/25/2007	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	701 EAST MARSHALL ST	None	WEST CHESTER	PA	19380	4412	00	None	39.972996	-75.6018225	Chester County
142115	Fee-for-Service	1790745834	1790745834	1	1	TUCKER, ROBERT B MD	2/10/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183819	None	None	0	In state provider	None	1306 MARICOPA HIGHWAY	None	OJAI	CA	93023	3131	56	06111	34.44229705	-119.2645703	Ventura County
142124	Fee-for-Service	1508865528	1508865528	1	7	TAHOE CARSON VALLEY	9/15/2021	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	1	Border provider	MEDICAL GROUP INC	155 HIGHWAY 50	None	STATELINE	NV	89449	0000	00	None	38.96860553	-119.9356859	Douglas County
142141	Fee-for-Service	1316025018	1316025018	1	1	TAGUE, AUDREY A MD	11/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92127	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
142159	Fee-for-Service	1376910984	1376910984	1	1	TATLOCK, SARAH CATHERINE LC	11/21/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
142200	Fee-for-Service	1457429912	1457429912	1	1	TAYLOR-HODGE, BONNIE C	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66891	36	Psychiatry	0	In state provider	None	1187 UNIVERSITY DR	None	MENLO PARK	CA	94025	4423	41	06081	37.45052953	-122.1873948	San Mateo County
142213	Fee-for-Service	1316340136	1316340136	1	1	TRI, THY A CNM	5/26/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	25824 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78917595	-118.2936802	Los Angeles County
142219	Fee-for-Service	1073848107	1073848107	1	1	TESSIE CLEVELAND COMMUNITY	7/7/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICE CORPORATION	18220 S BROADWAY AVENUE	None	GARDENA	CA	90248	3534	19	06037	33.864894	-118.278473	Los Angeles County
142226	Fee-for-Service	1205858891	1205858891	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05907	130 ALAMO PLZ	None	ALAMO	CA	94507	1550	07	06013	37.85229963	-122.0349279	Contra Costa County
142302	Fee-for-Service	1356333579	1356333579	1	1	THE CHESTER COUNTY HOSPI	11/25/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	701 EAST MARSHALL ST	None	WEST CHESTER	PA	19380	4412	00	None	39.972996	-75.6018225	Chester County
142319	Fee-for-Service	1124066329	1124066329	1	1	TOM, PRENTICE A MD	10/31/1990	207P00000X	NA	Other	026	PHYSICIANS	70900	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
142381	Fee-for-Service	1366448243	1366448243	1	1	TREGER, PAUL L MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	26803	18	Ophthalmology	0	In state provider	None	5555 RESERVOIR DR	STE 300	SAN DIEGO	CA	92120	5194	37	06073	32.77628471	-117.0563688	San Diego County
142413	Fee-for-Service	1750589412	1750589412	1	1	TRAN, JULIE K MD	8/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103761	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
142456	Fee-for-Service	1821351487	1821351487	1	1	TRINH, VAN T MD	6/7/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	172260	None	None	0	In state provider	None	11420 WARNER AVE.	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
142547	Fee-for-Service	1275508863	1275508863	2	1	THOMAS, JEANINE M MD	1/1/2009	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	2912	00	None	35.208594	-111.645099	Coconino County
142556	Fee-for-Service	1518922392	1518922392	1	1	TREMAIN, NICOLE MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71914	41	Internal Medicine	0	In state provider	None	625 E GRAND AVE	None	ESCONDIDO	CA	92025	4402	37	06073	33.12475309	-117.0733326	San Diego County
142577	Fee-for-Service	1316532831	1316532831	1	1	TADEO, CYNTHIA B NP	8/30/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16745 W BERNARDO DR	STE 240	SAN DIEGO	CA	92127	1907	37	06073	33.01539521	-117.0824934	San Diego County
142588	Fee-for-Service	1679647879	1679647879	1	1	TOPCHIAN, ARMINE	9/1/1996	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1111 VENTURA BLVD	STE 560	GLENDALE	CA	91202	0000	19	06037	34.15344392	-118.277566	Los Angeles County
142597	Fee-for-Service	1548250806	1548250806	1	1	TLACHAC, CHARLOTTE A	1/31/1990	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1429 HIGH ST	None	ALAMEDA	CA	94501	3102	01	06001	37.75896301	-122.2311801	Alameda County
142637	Fee-for-Service	1073139739	1073139739	1	1	TAYLOR, CHRISTOPHER G LMFT	1/19/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
142671	Fee-for-Service	1366448243	1366448243	1	1	TREGER, PAUL L MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	26803	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 RESERVOIR DR	STE 300	SAN DIEGO	CA	92120	5194	37	06073	32.77628471	-117.0563688	San Diego County
142715	Fee-for-Service	1407839327	1407839327	1	1	TAKEI, HIDEHISA T MD	4/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	68345	02	General Surgery	0	In state provider	None	3660 ARLINGTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94621853	-117.3953655	Riverside County
142717	Fee-for-Service	1841656766	1841656766	1	1	TANYA Y. EVANS, MD, INC.	6/21/2019	261QM2500X	NA	Other	026	PHYSICIANS	None	07	Dermatology	0	In state provider	LASER CARE	27020 ALICIA PKWY	SUITE G	LAGUNA NIGUEL	CA	92677	3420	30	06059	33.57034461	-117.7145124	Orange County
142781	Fee-for-Service	1184251357	1184251357	1	1	TSOUVALAS, CHARLES MD	1/1/2024	208M00000X	NA	Other	026	PHYSICIANS	None	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
142823	Fee-for-Service	1891811642	1891811642	1	1	TIMOTHY SMITH MD	1/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
142825	Fee-for-Service	1104999077	1104999077	1	1	TRANQUADA, KIM E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2800 E AJO WAY	None	TUCSON	AZ	85713	0000	00	None	32.175801	-110.9306925	Pima County
142846	Fee-for-Service	1245339761	1245339761	1	1	TAYLOR, THOMAS S MD	2/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	66279	24	Plastic Surgery	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
142866	Fee-for-Service	1790296630	1790296630	1	1	TALAMAYAN, CLAUDINE	4/9/2025	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	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
142887	Fee-for-Service	1588683031	1588683031	1	1	TRAN, TOAN Q MD	10/16/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72332	41	Internal Medicine	0	In state provider	None	1776 N MILPITAS BLVD	None	MILPITAS	CA	95035	2713	43	06085	37.45539924	-121.9110048	Santa Clara County
142952	Fee-for-Service	1801661947	1801661947	1	1	TURK, TREVOR J PT	12/27/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1222 W COLONY RD	STE 130	RIPON	CA	95366	9480	39	06077	37.75395862	-121.136171	San Joaquin County
142973	Fee-for-Service	1700104403	1700104403	1	1	TAYLOR, LESLEY A MD	2/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117229	78	Neoplastic Diseases/Oncology	0	In state provider	None	120 S SPALDING DRIVE	STE 205	BEVERLY HILLS	CA	90212	1800	19	06037	34.06625419	-118.4088854	Los Angeles County
142976	Fee-for-Service	1932723277	1932723277	1	1	TRAN, XUANCHINH DO	11/3/2023	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
142977	Fee-for-Service	1619969201	1619969201	2	2	TH PHARMACEUTICALS, INC.	3/19/2021	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 E HOLT AVE	SUITE F	POMONA	CA	91767	5800	19	06037	34.06297561	-117.7280971	Los Angeles County
143029	Fee-for-Service	1518153055	1518153055	1	1	TIAN, YINGZHONG MD	6/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101390	05	Anesthesiology	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
143047	Fee-for-Service	1154492064	1154492064	1	1	TADROS, WADIE, S	4/30/1988	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	45415	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
143206	Fee-for-Service	1982143533	1982143533	1	1	THOMAS, KEVIN	12/30/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	964 5TH AVENUE	SUITE 535	SAN DIEGO	CA	92101	6102	37	06073	32.71539477	-117.1601872	San Diego County
143219	Fee-for-Service	1629205216	1629205216	1	1	TO, DUC DOAN MD	10/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101947	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
143232	Fee-for-Service	1255751426	1255751426	1	1	THOMAS, MATHEW MD	9/19/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	164230	30	Radiology	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
143237	Fee-for-Service	1124286885	1124286885	1	2	TUOLUMNE ME-WUK INDIAN	5/17/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	19969 GREENLEY RD	STE D	SONORA	CA	95370	5908	55	06109	37.98497262	-120.3669198	Tuolumne County
143257	Fee-for-Service	1073017596	1073017596	1	1	TRAN, KHOA N MD	9/16/2022	207L00000X	NA	Other	026	PHYSICIANS	164396	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
143261	Fee-for-Service	1700104403	1700104403	1	1	TAYLOR, LESLEY A MD	2/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117229	02	General Surgery	0	In state provider	None	120 S SPALDING DRIVE	STE 205	BEVERLY HILLS	CA	90212	1800	19	06037	34.06625419	-118.4088854	Los Angeles County
143283	Fee-for-Service	1154507648	1154507648	1	1	TITTLE, LARISSA A LMFT	10/9/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
143299	Fee-for-Service	1538263108	1538263108	1	1	TRIMOR-TAMORIA, MARIA MD	4/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	55589	08	Family Practice	0	In state provider	None	2240 E PLAZA BLVD	STE A	NATIONAL CITY	CA	91950	5165	37	06073	32.67873894	-117.0818176	San Diego County
143379	Fee-for-Service	1194725358	1194725358	1	1	TOLENTINO, JEANETTE MD	3/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
143407	Fee-for-Service	1740214709	1740214709	1	1	TOGETHER WE GROW, INC	9/2/2005	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	5055 VIEWRIDGE AVE	None	SAN DIEGO	CA	92123	4313	37	06073	32.82836789	-117.1216246	San Diego County
143508	Fee-for-Service	1003447772	1003447772	1	1	THOMPSON, TAMAIAH LCSW	7/6/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
143530	Fee-for-Service	1124286885	1124286885	1	2	TUOLUMNE ME-WUK INDIAN	2/7/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	19969 GREENLEY RD	STE D	SONORA	CA	95370	5908	55	06109	37.98497262	-120.3669198	Tuolumne County
143535	Fee-for-Service	1407934078	1407934078	1	1	TORRIS, JOHN C MD	8/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87464	20	Orthopedic Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
143567	Fee-for-Service	1568750032	1568750032	1	1	TRIPATHI, ABHISHEK MD	9/1/2022	207RX0202X	NA	Oncology	026	PHYSICIANS	181620	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
143570	Fee-for-Service	1053726133	1053726133	1	1	TRIVEDI, TORAL B MD	8/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154117	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3975 JACKSON ST	STE 110	RIVERSIDE	CA	92503	3946	33	06065	33.92729721	-117.4413503	Riverside County
143590	Fee-for-Service	1760506901	1760506901	1	1	TSAI, VIRGINIA W MD	7/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93048	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
143625	Fee-for-Service	1013078674	1013078674	1	1	THIBAULT, KEITH M NP	10/2/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
143636	Fee-for-Service	1326584731	1326584731	1	1	THE REFINERY INTEGRATED WELL	2/4/2020	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	NESS SERVICES MARRIAGE A	45445 PORTOLA AVE	SUITE 1	PALM DESERT	CA	92260	4844	33	06065	33.7186073	-116.3737698	Riverside County
143657	Fee-for-Service	1093341984	1093341984	1	1	TREASURE, MADELINE L MD	4/12/2023	207R00000X	NA	Other	026	PHYSICIANS	184918	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
143683	Fee-for-Service	1881953016	1881953016	1	1	TRAN, THANH T MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139365	40	Pediatrics	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
143718	Fee-for-Service	1881973865	1881973865	1	1	TAGAKCHYAN, AMALYA LCSW	7/26/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	245 E OLIVE AVE	STE 400	BURBANK	CA	91502	1214	19	06037	34.18145335	-118.3081834	Los Angeles County
143724	Fee-for-Service	1477569960	1477569960	1	1	TODD, CHANDLER	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
143742	Fee-for-Service	1659480176	1659480176	1	1	THRIFTY PAYLESS INC	8/9/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4221 NORWOOD AVE	None	SACRAMENTO	CA	95838	2686	34	06067	38.644452	-121.4576415	Sacramento County
143743	Fee-for-Service	1578505079	1578505079	1	1	TRUXTUN SURGERY CENTER	9/20/1996	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	INC	4260 TRUXTUN AVE	STE 120	BAKERSFIELD	CA	93309	0682	15	06029	35.37298449	-119.0486115	Kern County
143837	Fee-for-Service	1346702602	1346702602	1	1	TANDLER, CHARLES	9/26/2024	111NR0200X	NA	Other	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
143878	Fee-for-Service	1275035263	1275035263	1	1	TELEHEALTH SERVICES USA	6/8/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
143925	Fee-for-Service	1326584731	1326584731	1	1	THE REFINERY INTEGRATED WELL	2/4/2020	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	NESS SERVICES MARRIAGE A	45445 PORTOLA AVE	SUITE 1	PALM DESERT	CA	92260	4844	33	06065	33.7186073	-116.3737698	Riverside County
143937	Fee-for-Service	1750568242	1750568242	1	1	TAVIS, JEFFREY H MD	7/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102252	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
143943	Fee-for-Service	1144505835	1144505835	1	1	TAYLOR, LISA J NP	8/24/2018	No Taxonomy Provided	NA	None	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
143966	Fee-for-Service	1003838434	1003838434	1	1	TIFFANY S GLASGOW, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
144069	Fee-for-Service	1518472950	1518472950	1	1	TRI-STATE MEDICAL ALLIANCE,	12/30/2019	293D00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	1	Border provider	None	1510 E WAGON WHEEL LN	STE 103	FORT MOHAVE	AZ	86426	6698	00	None	35.000343	-114.5962755	Mohave County
144094	Fee-for-Service	1255774808	1255774808	1	1	TJANDRA, CHRISTINE	11/19/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	132169	13	Neurology (M.D. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
144104	Fee-for-Service	1760689715	1760689715	1	5	TOTALCARE WALK-IN CLINIC INC	5/4/2022	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2097 E WASHINGTON ST	1C	COLTON	CA	92324	4716	36	06071	34.04919893	-117.2909954	San Bernardino County
144132	Fee-for-Service	1447288345	1447288345	1	9	TEAM PHYSICIANS OF CALIFORNI	6/1/2024	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	A MEDICAL GROUP, INC	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
144155	Fee-for-Service	1124277546	1124277546	1	1	TOUNG, DOROTHY M MD	1/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102062	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
144167	Fee-for-Service	1275035263	1275035263	1	1	TELEHEALTH SERVICES USA	10/18/2022	193200000X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
144212	Fee-for-Service	1326584731	1326584731	1	1	THE REFINERY INTEGRATED WELL	10/1/2020	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	NESS SERVICES MARRIAGE A	45445 PORTOLA AVE	SUITE 1	PALM DESERT	CA	92260	4844	33	06065	33.7186073	-116.3737698	Riverside County
144273	Fee-for-Service	1942886171	1942886171	1	1	TRUCARE TELEHEALTH & HOUSE C	6/9/2021	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	20709 GOLDEN SPRINGS DR	SUITE 106	DIAMOND BAR	CA	91789	3847	19	06037	33.99775563	-117.8528231	Los Angeles County
144301	Fee-for-Service	1326105685	1326105685	1	1	TIPTON, JEFFREY ALAN DO	9/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	6104	01	General Practice	0	In state provider	None	5151 STATE UNIVERSITY DR	None	LOS ANGELES	CA	90032	4226	19	06037	34.066206	-118.1683485	Los Angeles County
144303	Fee-for-Service	1306907456	1306907456	1	1	TAMIRISA, KRIS V MD	8/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	50754	05	Anesthesiology	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
144327	Fee-for-Service	1952525297	1952525297	1	1	TANG, LYNDA M OD	4/30/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10176 MASON AVE	None	CHATSWORTH	CA	91311	3301	19	06037	34.255611	-118.5798115	Los Angeles County
144392	Fee-for-Service	1760689715	1760689715	1	5	TOTALCARE WALK-IN CLINIC INC	5/4/2022	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2097 E WASHINGTON ST	1C	COLTON	CA	92324	4716	36	06071	34.04919893	-117.2909954	San Bernardino County
144400	Fee-for-Service	1124349139	1124349139	1	1	TARNG, GRACE MD	7/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125452	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6501 COYLE AVENUE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
144403	Fee-for-Service	1861854069	1861854069	1	1	TRAN, PAULINA N DO	9/27/2022	207KA0200X	NA	Other	026	PHYSICIANS	15925	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
144423	Fee-for-Service	1093863946	1093863946	1	1	TRILLING, YVONNE K MD	2/28/1991	207R00000X	NA	Other	026	PHYSICIANS	66726	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
144425	Fee-for-Service	1447288345	1447288345	1	9	TEAM PHYSICIANS OF CALIFORNI	6/1/2024	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	A MEDICAL GROUP, INC	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
144454	Fee-for-Service	1275035263	1275035263	1	1	TELEHEALTH SERVICES USA	11/3/2023	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
144471	Fee-for-Service	1508865528	1508865528	1	8	TAHOE CARSON VALLEY	9/28/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2158 JEAN AVE	None	SOUTH LAKE TAHOE	CA	96150	3412	09	06017	38.91508934	-119.9978421	El Dorado County
144494	Fee-for-Service	1508865528	1508865528	1	9	TAHOE CARSON VALLEY	9/15/2021	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2175 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	7024	09	06017	38.91234551	-119.9972565	El Dorado County
144553	Fee-for-Service	1841727518	1841727518	1	1	TURNER, HEATHER LCSW	2/28/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
144594	Fee-for-Service	1306907456	1306907456	1	1	TAMIRISA, KRIS V MD	8/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	50754	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
144632	Fee-for-Service	1841267689	1841267689	1	3	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	3400 CALLOWAY DR	600	BAKERSFIELD	CA	93312	2513	15	06029	35.39110123	-119.1097878	Kern County
144633	Fee-for-Service	1225013923	1225013923	1	1	TONG, KATHLEEN L MD	7/21/2009	207R00000X	NA	Other	026	PHYSICIANS	88802	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
144664	Fee-for-Service	1831709617	1831709617	1	1	TOM, SARA CNP	3/24/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	19353 VICTORY BLVD	None	RESEDA	CA	91335	6302	19	06037	34.18659936	-118.5552114	Los Angeles County
144693	Fee-for-Service	1710388905	1710388905	1	1	TENORIO, REYNA	9/20/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3825 HOPYARD RD	STE 140	PLEASANTON	CA	94566	8528	01	06001	37.683009	-121.9036935	Alameda County
144718	Fee-for-Service	1548599251	1548599251	1	1	TOTAL RENAL CARE INC	4/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	252 MARCH ST	None	SANTA PAULA	CA	93060	2511	56	06111	34.34912167	-119.0783491	Ventura County
144744	Fee-for-Service	1275035263	1275035263	1	1	TELEHEALTH SERVICES USA	3/15/2023	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
144760	Fee-for-Service	1508865528	1508865528	1	8	TAHOE CARSON VALLEY	4/24/2008	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2158 JEAN AVE	None	SOUTH LAKE TAHOE	CA	96150	3412	09	06017	38.91508934	-119.9978421	El Dorado County
144763	Fee-for-Service	1124379946	1124379946	2	1	TRUJILLO, VANESSA N LCSW	10/12/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	G SERVICES	30244 GOLDENRAIN DR.	None	MENIFEE	CA	92584	0200	33	06065	33.68206955	-117.2000502	Riverside County
144783	Fee-for-Service	1508865528	1508865528	1	9	TAHOE CARSON VALLEY	9/28/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2175 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	7024	09	06017	38.91234551	-119.9972565	El Dorado County
144789	Fee-for-Service	1114098035	1114098035	1	1	TROYAN, ERIC, J MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65381	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
144815	Fee-for-Service	1376632463	1376632463	1	1	TIO, DAVID L MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	45598	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
144861	Fee-for-Service	1356502553	1356502553	1	1	TAMURA,KRISTEN P MD	10/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114723	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
144864	Fee-for-Service	1477735603	1477735603	1	1	TER ZAKARIAN MEDICAL	2/20/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	CLINIC AND LABORATORY	5250 SANTA MONICA BLVD	STE 310	LOS ANGELES	CA	90029	1252	19	06037	34.09077051	-118.3046976	Los Angeles County
144894	Fee-for-Service	1306074687	1306074687	1	1	TON-THAT, DIEN DO	10/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11609	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
144903	Fee-for-Service	1972982213	1972982213	1	2	TERESITA PEDROSO	5/1/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2204 GROVEVIEW RD	None	SAN DIEGO	CA	92139	3439	37	06073	32.68774243	-117.0350639	San Diego County
144919	Fee-for-Service	1841267689	1841267689	1	3	TERRIO PHYSICAL THERAPY - FI	6/25/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	3400 CALLOWAY DR	600	BAKERSFIELD	CA	93312	2513	15	06029	35.39110123	-119.1097878	Kern County
144930	Fee-for-Service	1972776540	1972776540	1	1	TRAN, ANH C MD MEDICAL CORP	3/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	79019	None	None	0	In state provider	None	1714 N BUSH ST	None	SANTA ANA	CA	92706	2812	30	06059	33.76058786	-117.866405	Orange County
144943	Fee-for-Service	1770993925	1770993925	1	1	TAN, MEGAN E MD	2/4/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	139458	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
144965	Fee-for-Service	1871660464	1871660464	1	1	TANG, YEN-LEN MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68259	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
145014	Fee-for-Service	1770759177	1770759177	1	1	TAHERNIA, AMIR H MD	1/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	77142	41	Internal Medicine	0	In state provider	None	12021 WILSHIRE BLVD	STE 745	LOS ANGELES	CA	90025	1206	19	06037	34.04543773	-118.4658404	Los Angeles County
145030	Fee-for-Service	1275035263	1275035263	1	1	TELEHEALTH SERVICES USA	5/15/2023	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
145039	Fee-for-Service	1801029566	1801029566	1	1	THOMAS, DAYNA R CCC-SLP	9/25/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	151 N SUNRISE AVE	SUITE 1105	ROSEVILLE	CA	95661	2924	31	06061	38.74746043	-121.2655348	Placer County
145047	Fee-for-Service	1508865528	1508865528	1	8	TAHOE CARSON VALLEY	9/15/2021	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2158 JEAN AVE	None	SOUTH LAKE TAHOE	CA	96150	3412	09	06017	38.91508934	-119.9978421	El Dorado County
145062	Fee-for-Service	1821674532	1821674532	1	1	TORRE VALDIVIESO, EDUARDO M	4/18/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	180086	07	Dermatology	0	In state provider	D	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
145070	Fee-for-Service	1508865528	1508865528	1	9	TAHOE CARSON VALLEY	6/24/2008	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2175 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	7024	09	06017	38.91234551	-119.9972565	El Dorado County
145074	Fee-for-Service	1104821990	1104821990	1	1	THOMAS, ROBERT D MD	10/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	52297	30	Radiology	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
145078	Fee-for-Service	1184183493	1184183493	1	1	TIERNEY, CASSIDY E MD	8/4/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	180108	None	None	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
145088	Fee-for-Service	1245670694	1245670694	1	1	TROCHA, KASPAR MD	2/7/2024	2086S0129X	NA	General Surgery	026	PHYSICIANS	189792	None	None	0	In state provider	None	1 DANIEL BURNHAM CT	STE 205C	SAN FRANCISCO	CA	94109	5472	38	06075	37.78693724	-122.4225429	San Francisco County
145105	Fee-for-Service	1376632463	1376632463	1	1	TIO, DAVID L MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	45598	18	Ophthalmology	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
145119	Fee-for-Service	1225051360	1225051360	1	1	TRAN-NGUYEN, JACKLYN B	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	MD	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2997	41	06081	37.48093988	-122.2531826	San Mateo County
145133	Fee-for-Service	1366446890	1366446890	1	1	TRUBEK, SIMON MD	5/20/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	191570	30	Radiology	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
145142	Fee-for-Service	1831295427	1831295427	1	1	THIER, M DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	20927	18	Ophthalmology	0	In state provider	None	2100 WEBSTER ST	STE 212	SAN FRANCISCO	CA	94115	2375	38	06075	37.7904826	-122.4324477	San Francisco County
145145	Fee-for-Service	1669408621	1669408621	1	1	TRAN, ANDREW A MD	7/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96131	66	Emergency Medicine (Urgent Care)	0	In state provider	None	14662 NEWPORT AVE	None	TUSTIN	CA	92780	6064	30	06059	33.73088521	-117.8293385	Orange County
145149	Fee-for-Service	1710010483	1710010483	1	1	TERU KANAZAWA SHEEHAN	12/8/2011	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	12304 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2551	19	06037	34.03948285	-118.4656304	Los Angeles County
145150	Fee-for-Service	1477735603	1477735603	1	1	TER ZAKARIAN MEDICAL	2/20/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	CLINIC AND LABORATORY	5250 SANTA MONICA BLVD	STE 310	LOS ANGELES	CA	90029	1252	19	06037	34.09077051	-118.3046976	Los Angeles County
145185	Fee-for-Service	1407016900	1407016900	1	1	TSCHERNYAVSKY, SYLVIA J	10/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	139062	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2700 DOLBEER STREET	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
145295	Fee-for-Service	1710951645	1710951645	1	1	TILEM, CLAIRE T	2/10/1995	207R00000X	NA	Other	026	PHYSICIANS	52854	41	Internal Medicine	0	In state provider	None	960 E GREEN ST	STE 290	PASADENA	CA	91106	2401	19	06037	34.14451994	-118.1301695	Los Angeles County
145371	Fee-for-Service	1447432653	1447432653	1	1	TOKITA, KENNETH M MD	9/17/2018	2085R0001X	NA	Other	026	PHYSICIANS	18258	30	Radiology	0	In state provider	None	351 HOSPITAL RD	STE 507	NEWPORT BEACH	CA	92663	3500	30	06059	33.62579141	-117.9299554	Orange County
145384	Fee-for-Service	1942406640	1942406640	1	1	TORRES, ERIKA H LMFT	6/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
145390	Fee-for-Service	1376632463	1376632463	1	1	TIO, DAVID L MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	45598	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
145461	Fee-for-Service	1205892908	1205892908	1	1	TIRGARI, REZA H MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76540	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	33	06065	33.89552551	-117.186021	Riverside County
145470	Fee-for-Service	1295154219	1295154219	1	1	TABAAC, BURTON J MD	2/18/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	-	13	Neurology (M.D. only)	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
145479	Fee-for-Service	1386883494	1386883494	1	1	TRATHEN, ANGELA M LMFT	6/28/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	673 S AUBURN ST	STE B	GRASS VALLEY	CA	95945	7576	29	06057	39.2060146	-121.0613316	Nevada County
145522	Fee-for-Service	1659920403	1659920403	1	1	TARLE, STEPHANIE J PHD	6/21/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
145568	Fee-for-Service	1992865182	1992865182	1	1	TRAN, JOHN D MD	8/23/1995	207R00000X	NA	Other	026	PHYSICIANS	81140	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
145616	Fee-for-Service	1649382995	1649382995	1	1	THEODORE FORREST, M.D.	5/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 AUDUBON PLAZA DR	None	LOUISVILLE	KY	40217	1318	00	None	38.21500013	-85.72191064	Jefferson County
145643	Fee-for-Service	1922119577	1922119577	1	1	TRAPP, JENNIFER	12/31/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	67755	66	Emergency Medicine (Urgent Care)	0	In state provider	JANZEN JOHNSTON ROCKWELL	1225 15TH ST	None	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
145678	Fee-for-Service	1790196178	1790196178	1	1	TELECARE CORPORATION	8/4/2014	No Taxonomy Provided	NA	None	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	47-915 OASIS STREET	None	INDIO	CA	92201	6950	33	06065	33.72305277	-116.220673	Riverside County
145703	Fee-for-Service	1366423410	1366423410	1	1	TILLIM, JEREMY D MD	12/31/1987	207P00000X	NA	Other	026	PHYSICIANS	57659	None	None	0	In state provider	None	2800 BENEDICT DR	None	SAN LEANDRO	CA	94577	6840	01	06001	37.71593435	-122.131151	Alameda County
145715	Fee-for-Service	1861839201	1861839201	1	1	TIONGKO, PAMELA M LCSW	11/28/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	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
145754	Fee-for-Service	1255782033	1255782033	1	1	TATCO-VILLAMAYOR, GENEVIEVE	5/26/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	M NP	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
145795	Fee-for-Service	1841267689	1841267689	1	2	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	7900 DISTRICT BLVD	C	BAKERSFIELD	CA	93313	4844	15	06029	35.31318383	-119.0908089	Kern County
145800	Fee-for-Service	1053306803	1053306803	1	1	TIDIK, STEPHEN J MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	57086	23	Peripheral Vascular Disease or Surgery (D.O. only)	0	In state provider	None	77 CASA ST	STE 103	SAN LUIS OBISPO	CA	93405	5804	40	06079	35.29306786	-120.6650709	San Luis Obispo County
145837	Fee-for-Service	1649766700	1649766700	1	1	TEHRANI, NICOLE LMFT	3/19/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4401 SEPULVEDA BLVD	210	SHERMAN OAKS	CA	91403	3934	19	06037	34.150356	-118.467397	Los Angeles County
145878	Fee-for-Service	1114697513	1114697513	1	1	TRULIFE HOME HEALTH INC	9/25/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	26250 INDUSTRIAL BLVD	STE 45	HAYWARD	CA	94545	2922	01	06001	37.63381267	-122.1111642	Alameda County
145902	Fee-for-Service	1316067044	1316067044	1	1	THORNBORROW, EDWARD C MD	7/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92413	22	Pathology (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2722	38	06075	37.76332993	-122.4582988	San Francisco County
145962	Fee-for-Service	1770894099	1770894099	1	1	TARRILLION, DORIS C CRNA	3/17/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3828 DELMAS TER	None	CULVER CITY	CA	90232	2713	19	06037	34.02308948	-118.3972101	Los Angeles County
146030	Fee-for-Service	1275859548	1275859548	1	1	TAKEI, GLENN K MD INC	11/30/1985	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	35093	20	Orthopedic Surgery	0	In state provider	None	931 BUENA VISTA STREET	SUITE 505	DUARTE	CA	91010	1727	19	06037	34.141635	-117.9775755	Los Angeles County
146035	Fee-for-Service	1053655217	1053655217	1	1	TRINOOSON, CRYSTAL D CRNA	12/14/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
146064	Fee-for-Service	1326176199	1326176199	1	1	THAO-THANH PHAM OD INC	5/7/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5261 ARLINGTON AVE	None	RIVERSIDE	CA	92504	2604	33	06065	33.94609195	-117.4170522	Riverside County
146086	Fee-for-Service	1841267689	1841267689	1	2	TERRIO PHYSICAL THERAPY - FI	6/25/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	7900 DISTRICT BLVD	C	BAKERSFIELD	CA	93313	4844	15	06029	35.31318383	-119.0908089	Kern County
146089	Fee-for-Service	1053306803	1053306803	1	1	TIDIK, STEPHEN J MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	57086	02	General Surgery	0	In state provider	None	77 CASA ST	STE 103	SAN LUIS OBISPO	CA	93405	5804	40	06079	35.29306786	-120.6650709	San Luis Obispo County
146111	Fee-for-Service	1679007751	1679007751	1	1	THOTTACHERRY, ELIZABETH D MD	8/17/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	178875	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
146119	Fee-for-Service	1841386927	1841386927	1	1	TONKEN, HEIDI P MD	10/31/1989	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	68633	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
146191	Fee-for-Service	1700865482	1700865482	1	1	TSAI, ALBERT M MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83032	20	Orthopedic Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
146221	Fee-for-Service	1144458191	1144458191	1	1	TAUB, JACLYN B DO	10/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13959	09	Gynecology (D.O. only)	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
146222	Fee-for-Service	1396241758	1396241758	1	1	THOMPSON, DOMINIQUE A LCSW	10/25/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
146250	Fee-for-Service	1942257639	1942257639	1	1	TENISON, MICHAEL D MD	9/25/2020	207P00000X	NA	Other	026	PHYSICIANS	155379	None	None	0	In state provider	None	1675 ALHAMBRA	STE B	SACRAMENTO	CA	95816	7047	34	06067	38.563983	-121.4679915	Sacramento County
146285	Fee-for-Service	1407923030	1407923030	1	1	TRAN, ANH T MD	8/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	72608	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
146295	Fee-for-Service	1821070681	1821070681	1	1	TESSLER, IRVING R MD	11/15/1973	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	14307	40	Pediatrics	0	In state provider	None	50 BELLEFONTAINE ST	STE 405	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
146299	Fee-for-Service	1902528441	1902528441	1	1	THE MEDICAL PARTNERS GROUP,	4/20/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC.	568 E HERNDON AVE	SUITE 101	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
146319	Fee-for-Service	1629449467	1629449467	1	1	TEKLU, ABEBE MD	5/12/2023	207ZC0500X	NA	Other	026	PHYSICIANS	168211	None	None	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
146351	Fee-for-Service	1891821351	1891821351	1	1	TALAMANTEZ, OLGA V LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
146375	Fee-for-Service	1801002175	1801002175	1	1	TSENG, MICHAEL D MD	8/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107811	20	Orthopedic Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2721	38	06075	37.76386986	-122.4568084	San Francisco County
146430	Fee-for-Service	1659486660	1659486660	1	1	TAFAZZOLI, ALIREZA MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	77595	22	Pathology (M.D. only)	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
146431	Fee-for-Service	1396831889	1396831889	1	1	TRAN, KIEN P MD	3/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88769	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
146443	Fee-for-Service	1962646992	1962646992	1	1	TSENG, JENNIFER MD	4/12/2022	2086X0206X	NA	General Surgery	026	PHYSICIANS	176432	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
146457	Fee-for-Service	1841309200	1841309200	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4037 BALL RD	None	CYPRESS	CA	90630	3463	30	06059	33.81766547	-118.061856	Orange County
146507	Fee-for-Service	1144458191	1144458191	1	1	TAUB, JACLYN B DO	10/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13959	15	Obstetrics (D.O. only)	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
146519	Fee-for-Service	1710514658	1710514658	1	1	TAKIMOTO, SARAH W MD	4/21/2023	207R00000X	NA	Other	026	PHYSICIANS	185418	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
146533	Fee-for-Service	1164410965	1164410965	1	1	THOMAS H HAUGEN MD	8/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
146535	Fee-for-Service	1730267212	1730267212	1	1	THOMSEN, RANDALL V MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	83903	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
146540	Fee-for-Service	1306955349	1306955349	1	1	TAYLOR, LORI B MD	1/31/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	55826	40	Pediatrics	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
146570	Fee-for-Service	1841488079	1841488079	1	2	THE ALLIANCE FOR COMMUNITY W	5/27/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1319 FRUITVALE AVE	None	OAKLAND	CA	94601	2927	01	06001	37.77708782	-122.2261804	Alameda County
146584	Fee-for-Service	1821070681	1821070681	1	1	TESSLER, IRVING R MD	11/15/1973	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	14307	41	Internal Medicine	0	In state provider	None	50 BELLEFONTAINE ST	STE 405	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
146585	Fee-for-Service	1902528441	1902528441	1	1	THE MEDICAL PARTNERS GROUP,	4/20/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	INC.	568 E HERNDON AVE	SUITE 101	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
146609	Fee-for-Service	1356407076	1356407076	1	1	TAYLOR, EMMA J MD	12/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102254	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	SUITE 450	LOS ANGELES	CA	90095	6957	19	06037	34.06527974	-118.4462792	Los Angeles County
146624	Fee-for-Service	1124418546	1124418546	1	1	TANG, LIYANG MD	8/1/2022	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	159391	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
146626	Fee-for-Service	1891912382	1891912382	1	1	THOMAS, DEBBIE A NP	2/16/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
146627	Fee-for-Service	1033491709	1033491709	1	1	TRANQUILITY HOSPICE, INC	8/12/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12631 IMPERIAL HWY	STE F208	SANTA FE SPRINGS	CA	90670	6740	19	06037	33.91718487	-118.0627524	Los Angeles County
146635	Fee-for-Service	1225173537	1225173537	1	1	TIUTORRES, LALAINE L MD	8/1/1997	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	63191	01	General Practice	0	In state provider	None	1200 SMITH ST	None	KINGSBURG	CA	93631	2216	10	06019	36.51294219	-119.54905	Fresno County
146639	Fee-for-Service	1023327467	1023327467	1	1	TOTAL RENAL CARE INC	12/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1043 MARSH ST	None	SAN LUIS OBISPO	CA	93401	3629	40	06079	35.28077589	-120.6594118	San Luis Obispo County
146682	Fee-for-Service	1386872489	1386872489	1	2	THAI, BAO KHANH M DO	12/10/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	11806	08	Family Practice	0	In state provider	None	210 S GRAND AVE	SUITE 415	GLENDORA	CA	91741	4292	19	06037	34.133859	-117.872523	Los Angeles County
146777	Fee-for-Service	1316139066	1316139066	1	1	TESHOME, KOKEB MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	93599	41	Internal Medicine	0	In state provider	None	400 N MCDOWELL BLVD	None	PETALUMA	CA	94954	2339	49	06097	38.25477	-122.63175	Sonoma County
146780	Fee-for-Service	1629267406	1629267406	1	2	TRIUNE HOME HEALTH	2/8/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PROVIDER INC	6030 RIVERSIDE DR	SUITE H	CHINO	CA	91710	4423	36	06071	34.01922782	-117.6733524	San Bernardino County
146782	Fee-for-Service	1275618910	1275618910	1	1	TIBBETTS, JULIEANN E NP	1/15/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	2	Out of state provider	None	13123 E 16TH AVE	None	AURORA	CO	80045	7106	00	None	39.742164	-104.8350375	Adams County
146785	Fee-for-Service	1275091746	1275091746	1	1	TODD, SHANNA LMFT	7/25/2024	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
146820	Fee-for-Service	1356589410	1356589410	1	1	TULARE LOCAL HEALTHCARE DIST	8/3/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1062 SOUTH K STREET	None	TULARE	CA	93274	2207	54	06107	36.19548226	-119.3433058	Tulare County
146841	Fee-for-Service	1538658927	1538658927	1	1	TOMLINSON, HUNTER C LMFT	1/16/2024	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
146849	Fee-for-Service	1710514120	1710514120	1	1	TOWNES, SHATARA V MD	3/17/2023	207R00000X	NA	Other	026	PHYSICIANS	184806	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
146872	Fee-for-Service	1821070681	1821070681	1	1	TESSLER, IRVING R MD	11/15/1973	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	14307	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	50 BELLEFONTAINE ST	STE 405	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
146898	Fee-for-Service	1316714397	1316714397	1	1	THEOS, LINDSEY	5/10/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
146900	Fee-for-Service	1629284500	1629284500	1	1	TRACY UNIFIED SCHOOL	7/1/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	1975 W LOWELL AVE	None	TRACY	CA	95376	2238	39	06077	37.74716854	-121.452859	San Joaquin County
146914	Fee-for-Service	1033491709	1033491709	1	1	TRANQUILITY HOSPICE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12631 IMPERIAL HWY	STE F208	SANTA FE SPRINGS	CA	90670	6740	19	06037	33.91718487	-118.0627524	Los Angeles County
146923	Fee-for-Service	1225173537	1225173537	1	1	TIUTORRES, LALAINE L MD	8/1/1997	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	63191	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 SMITH ST	None	KINGSBURG	CA	93631	2216	10	06019	36.51294219	-119.54905	Fresno County
146928	Fee-for-Service	1245557636	1245557636	1	1	TELUSCA, NATACHA MD	7/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117857	05	Anesthesiology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
146995	Fee-for-Service	1447541966	1447541966	1	1	THOMPSON, DANIELLE CCC-SLP	1/1/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
147029	Fee-for-Service	1164582367	1164582367	1	1	TRAN, THUAN L MD	7/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	52857	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
147067	Fee-for-Service	1912092859	1912092859	1	1	TAN, JEFFREY P MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	81541	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
147068	Fee-for-Service	1649423286	1649423286	1	1	TSENG, SHARON Y	9/15/2011	207L00000X	NA	Other	026	PHYSICIANS	116250	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	1778	19	06037	34.06373445	-118.443537	Los Angeles County
147184	Fee-for-Service	1790144137	1790144137	1	1	TWIN RIVERS AT NATOMAS INC	6/25/2016	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	421 SAN JUAN RD	None	SACRAMENTO	CA	95834	1635	34	06067	38.629962	-121.472307	Sacramento County
147211	Fee-for-Service	1225173537	1225173537	1	1	TIUTORRES, LALAINE L MD	8/1/1997	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	63191	08	Family Practice	0	In state provider	None	1200 SMITH ST	None	KINGSBURG	CA	93631	2216	10	06019	36.51294219	-119.54905	Fresno County
147220	Fee-for-Service	1245557636	1245557636	1	1	TELUSCA, NATACHA MD	7/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117857	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
147230	Fee-for-Service	1336172105	1336172105	1	1	TEXAS HEALTH HARRIS	1/2/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	METHODIST HOSP FORT WORT	1301 PENNSYLVANIA AVE	None	FORT WORTH	TX	76104	2122	00	None	32.73844954	-97.339005	Tarrant County
147244	Fee-for-Service	1346241023	1346241023	1	1	TAWA, LAWRENCE S MD	1/1/2000	208M00000X	NA	Other	026	PHYSICIANS	81174	41	Internal Medicine	0	In state provider	None	13132 NEWPORT AVE	None	TUSTIN	CA	92780	3429	30	06059	33.74752359	-117.8125292	Orange County
147297	Fee-for-Service	1790056414	1790056414	1	1	TRINH, TRI M MD	9/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123238	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
147316	Fee-for-Service	1841455920	1841455920	1	1	TORRES, ERIKA PHD	7/11/2012	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
147321	Fee-for-Service	1578069746	1578069746	1	1	TAQUEE, MUSTAFA MD	1/27/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	184365	36	Psychiatry	0	In state provider	None	100 PINE ST	STE 1250	SAN FRANCISCO	CA	94111	5235	38	06075	37.79237874	-122.3989278	San Francisco County
147375	Fee-for-Service	1720424286	1720424286	1	2	TRAN, VU D	5/18/2021	207Q00000X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	138753	-	NOT APPLICABLE	0	In state provider	None	1601 BAKER ST	None	COSTA MESA	CA	92626	3701	30	06059	33.68079547	-117.923451	Orange County
147431	Fee-for-Service	1124260005	1124260005	1	1	TONEL, ELAINE A DO	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	8340	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
147463	Fee-for-Service	1902285760	1902285760	1	1	TANG, TIANYI MD	10/8/2021	207RH0000X	NA	Hematology	026	PHYSICIANS	151192	None	None	0	In state provider	None	5201 NORRIS CANYON	140	SAN RAMON	CA	94583	5411	07	06013	37.77779028	-121.9600626	Contra Costa County
147473	Fee-for-Service	1013204353	1013204353	1	1	TAYLOR, ALEXANDRA C LMFT	12/30/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28465 OLD TOWN FRONT ST	None	TEMECULA	CA	92590	1822	33	06065	33.49566437	-117.1516462	Riverside County
147480	Fee-for-Service	1275767840	1275767840	1	1	TSAI, RICHARD M MD	6/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124499	13	Neurology (M.D. only)	0	In state provider	None	100 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76491042	-122.449863	San Francisco County
147508	Fee-for-Service	1205945722	1205945722	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05757	19701 YORBA LINDA BLVD	None	YORBA LINDA	CA	92886	3532	30	06059	33.88873907	-117.7915488	Orange County
147520	Fee-for-Service	1336172105	1336172105	1	1	TEXAS HEALTH HARRIS	1/2/2017	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	METHODIST HOSP FORT WORT	1301 PENNSYLVANIA AVE	None	FORT WORTH	TX	76104	2122	00	None	32.73844954	-97.339005	Tarrant County
147528	Fee-for-Service	1184706616	1184706616	1	1	THAKRAN, PURNIMA MD INC	9/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	52465	13	Neurology (M.D. only)	0	In state provider	None	18387 HWY 18	SUITES 1 & 2	APPLE VALLEY	CA	92307	2214	36	06071	34.53962294	-117.2628021	San Bernardino County
147535	Fee-for-Service	1609211945	1609211945	1	1	TANGCHITNOB, PAMELA P DO	8/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13790	01	General Practice	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
147538	Fee-for-Service	1174844427	1174844427	1	1	TOCCHIO, SHANNON L MD	4/27/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	171454	None	None	0	In state provider	None	1504 N WISHON AVE	None	FRESNO	CA	93728	1827	10	06019	36.763497	-119.8010405	Fresno County
147566	Fee-for-Service	1669869640	1669869640	1	1	THOMPSON, CANDICE N MD	7/3/2021	208600000X	NA	General Surgery	026	PHYSICIANS	172813	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
147568	Fee-for-Service	1366530701	1366530701	1	1	TREMAIN, STEVEN C MD	12/2/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	39779	08	Family Practice	0	In state provider	None	521 1ST ST	None	BENICIA	CA	94510	3209	48	06095	38.04860955	-122.159463	Solano County
147662	Fee-for-Service	1356482392	1356482392	1	2	TABESH, ALIREZA MD	2/11/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	104245	41	Internal Medicine	0	In state provider	None	2000 STADIUM WAY	None	LOS ANGELES	CA	90026	2606	19	06037	34.07578277	-118.248587	Los Angeles County
147721	Fee-for-Service	1326669383	1326669383	1	1	TRUONG, LAURENT H MD	7/26/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186402	None	None	0	In state provider	None	15975 HARBOR BOULEVARD	None	FOUNTAIN VALLEY	CA	92708	1303	30	06059	33.73140379	-117.9200162	Orange County
147772	Fee-for-Service	1548336506	1548336506	1	1	THORNTON, MOSE C DPM	3/31/1992	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2820 SUMMIT ST	STE 203	OAKLAND	CA	94609	3610	01	06001	37.81679375	-122.2648384	Alameda County
147780	Fee-for-Service	1225085145	1225085145	1	1	THANASSI, WENDY T MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79869	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
147785	Fee-for-Service	1417954017	1417954017	1	1	THEIS, LAURA J MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68947	08	Family Practice	0	In state provider	None	5400 W HILLSDALE AVE	None	VISALIA	CA	93291	8222	54	06107	36.330327	-119.351943	Tulare County
147797	Fee-for-Service	1417536475	1417536475	1	1	TINY OASIS HOSPICE INC	10/18/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2600 FOOTHILL BLVD	SUITE 111	LA CRESCENTA	CA	91214	4578	19	06037	34.22121465	-118.2352382	Los Angeles County
147853	Fee-for-Service	1992171649	1992171649	1	1	TOMCZAK, AMY LMFT	12/27/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
147869	Fee-for-Service	1679662753	1679662753	1	1	TESMER, KATARZYNA J MD	7/1/1998	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	53721	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
147883	Fee-for-Service	1801841168	1801841168	1	1	TIMOTHY J CRAMER MD	5/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	877 JEFFERSON AVE	None	MEMPHIS	TN	38103	2807	00	None	35.14259562	-90.03187321	Shelby County
147908	Fee-for-Service	1205586062	1205586062	1	1	TRIANGLE MOLECULAR TOXICOLOG	10/17/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	Y LLC	4324 S ALSTON AVE	STE 202	DURHAM	NC	27713	2567	00	None	35.91135	-78.890229	Durham County
147949	Fee-for-Service	1356482392	1356482392	1	2	TABESH, ALIREZA MD	2/11/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	104245	10	Gastroenterology (M.D. only)	0	In state provider	None	2000 STADIUM WAY	None	LOS ANGELES	CA	90026	2606	19	06037	34.07578277	-118.248587	Los Angeles County
147988	Fee-for-Service	1578981304	1578981304	1	1	TSE, STEPHEN MD	12/16/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	163901	18	Ophthalmology	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
147994	Fee-for-Service	1174794952	1174794952	1	1	TURNER, ELIZABETH D MD	6/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111572	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
148047	Fee-for-Service	1750969614	1750969614	1	1	TELES, SAMUEL MD	6/1/2024	207P00000X	NA	Other	026	PHYSICIANS	192488	66	Emergency Medicine (Urgent Care)	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
148063	Fee-for-Service	1285863696	1285863696	1	1	TEMECULA CA ENDOSCOPY	10/5/2010	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	ASC LP	25150 HANCOCK AVE	STE 208	MURRIETA	CA	92562	5989	33	06065	33.56635084	-117.1823956	Riverside County
148086	Fee-for-Service	1417536475	1417536475	1	1	TINY OASIS HOSPICE INC	10/18/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2600 FOOTHILL BLVD	SUITE 111	LA CRESCENTA	CA	91214	4578	19	06037	34.22121465	-118.2352382	Los Angeles County
148133	Fee-for-Service	1801905344	1801905344	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5966	1475 41ST AVE	None	CAPITOLA	CA	95010	2908	44	06087	36.97236	-121.965016	Santa Cruz County
148142	Fee-for-Service	1912159989	1912159989	1	1	TRUONG, MARIE L DO	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11807	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
148146	Fee-for-Service	1710939988	1710939988	1	1	TOWLE, WILLARD M JR MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	26146	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 ALAMO PINTADO RD	None	SOLVANG	CA	93463	2269	42	06083	34.60203	-120.1262085	Santa Barbara County
148180	Fee-for-Service	1558380840	1558380840	1	1	TOUFIK P FARKOUH MD	10/30/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2209 GENESEE ST	None	UTICA	NY	13501	5930	00	None	43.08264	-75.266046	Oneida County
148183	Fee-for-Service	1790914430	1790914430	1	1	TRINH, BINH N MD	8/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	107725	33	Thoracic Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
148217	Fee-for-Service	1003836735	1003836735	1	1	TURNER, DUNCAN J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	33134	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	219 NOGALES AVE	STE A	SANTA BARBARA	CA	93105	3848	42	06083	34.43171016	-119.7220176	Santa Barbara County
148281	Fee-for-Service	1174794952	1174794952	1	1	TURNER, ELIZABETH D MD	6/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111572	41	Internal Medicine	0	In state provider	None	700 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
148330	Fee-for-Service	1629615752	1629615752	1	1	TREMBLAY, BRITTANY R NP	5/2/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	501 J ST	None	SACRAMENTO	CA	95814	2325	34	06067	38.582118	-121.499325	Sacramento County
148333	Fee-for-Service	1730145152	1730145152	1	1	THIELE, DWAIN LOUIS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
148511	Fee-for-Service	1699046102	1699046102	1	1	TOBEY, RAJIKA L MD	4/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	124964	05	Anesthesiology	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6429	30	06059	33.56008604	-117.6657795	Orange County
148539	Fee-for-Service	1548688872	1548688872	1	1	TENG, YU AN MD	12/23/2020	207L00000X	NA	Other	026	PHYSICIANS	154895	None	None	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
148584	Fee-for-Service	1033370358	1033370358	1	1	TARIQ, SHAMAIL S MD	2/27/2023	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	116248	None	None	0	In state provider	None	100 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3813	30	06059	33.89343304	-117.9279349	Orange County
148621	Fee-for-Service	1235450958	1235450958	1	1	TJOA, TJOSON MD	5/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119742	04	Otology, Laryngology, Rhinology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
148622	Fee-for-Service	1518944032	1518944032	1	1	THE KATELLA WELLNESS	2/22/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CENTER INC	5122 KATELLA AVE	STE 210	LOS ALAMITOS	CA	90720	6836	30	06059	33.80290311	-118.0433422	Orange County
148630	Fee-for-Service	1023645363	1023645363	1	1	THIPPHAVONG, CHRISTOPHER MD	12/13/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
148632	Fee-for-Service	1518054071	1518054071	1	1	TUTSON, VALERIE A MD	4/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	51402	36	Psychiatry	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
148646	Fee-for-Service	1710292297	1710292297	1	1	TRAN, ANHTHU V MD	9/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124241	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
148648	Fee-for-Service	1558665562	1558665562	1	1	THAKKAR, PUJA A DO	4/23/2024	207RS0012X	NA	Other	026	PHYSICIANS	12339	41	Internal Medicine	0	In state provider	None	400 EL CERRO BLVD	SUITE 107	DANVILLE	CA	94526	1731	07	06013	37.82888506	-122.0021827	Contra Costa County
148778	Fee-for-Service	1093751091	1093751091	1	1	TANN, STEPHEN M MD	12/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112391	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2332 23RD ST	None	EUREKA	CA	95501	3231	12	06023	40.78684548	-124.1425485	Humboldt County
148783	Fee-for-Service	1710050158	1710050158	1	1	TRAN, DAO X MD	2/4/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	42308	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
148828	Fee-for-Service	1588621486	1588621486	1	1	TOBIAS, JOSHUA L MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69007	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
148837	Fee-for-Service	1508872896	1508872896	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5790	1976 CLIFF DR	None	SANTA BARBARA	CA	93109	1504	42	06083	34.40189282	-119.723497	Santa Barbara County
148849	Fee-for-Service	1427589175	1427589175	1	1	TIEN, MICHAEL MD	7/16/2022	207L00000X	NA	Other	026	PHYSICIANS	156920	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
148861	Fee-for-Service	1750589727	1750589727	1	1	TODD STEVEN DETTMER, 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	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2719	00	None	35.08771808	-106.6192188	Bernalillo County
148908	Fee-for-Service	1144515149	1144515149	1	4	THE SAN FRANCISCO AIDS	12/18/2020	No Taxonomy Provided	NA	None	040	FREE CLINIC	-	-	NOT APPLICABLE	0	In state provider	MOBILE	PIER 26	None	SAN FRANCISCO	CA	94105	0000	38	06075	37.789074	-122.387805	San Francisco County
148984	Fee-for-Service	1447481924	1447481924	1	1	THOMAS, AMY T DO	5/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	9564	05	Anesthesiology	0	In state provider	None	790 EAST COLORADO BLVD	STE 909A	PASADENA	CA	91101	2193	19	06037	34.14586347	-118.1342295	Los Angeles County
148994	Fee-for-Service	1508123522	1508123522	1	1	TANG, SHIRLEY H MD	1/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	129534	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
148998	Fee-for-Service	1679523617	1679523617	2	1	THOMAS, BRADLEY J MD	3/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	58233	05	Anesthesiology	0	In state provider	None	10121 PINE AVENUE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
149004	Fee-for-Service	1922519065	1922519065	1	1	TRIANA LEE, ADRIANA N LAC	3/18/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	801 N TUSTIN AVE	SUITE 302	SANTA ANA	CA	92705	3612	30	06059	33.752286	-117.8341735	Orange County
149067	Fee-for-Service	1093751091	1093751091	1	1	TANN, STEPHEN M MD	12/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112391	41	Internal Medicine	0	In state provider	None	2332 23RD ST	None	EUREKA	CA	95501	3231	12	06023	40.78684548	-124.1425485	Humboldt County
149072	Fee-for-Service	1427530864	1427530864	1	1	TONG, JENISE RCP	9/3/2024	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
149117	Fee-for-Service	1740650365	1740650365	1	1	TEMECULA CENTER FOR CARDIAC	8/8/2016	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CARE	31565 RANCHO PUEBLO ROAD	STE 201	TEMECULA	CA	92592	4839	33	06065	33.47937218	-117.1101551	Riverside County
149128	Fee-for-Service	1174100838	1174100838	1	1	TSOLINAS, RACHEL E MD	3/4/2025	207P00000X	NA	Other	026	PHYSICIANS	191691	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1 MARCELA DR	None	WILLITS	CA	95490	5769	23	06045	39.3901086	-123.339055	Mendocino County
149151	Fee-for-Service	1942469010	1942469010	1	1	TRINITY RESCUE LLC	6/17/2008	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	102 RED SHALE CT	None	FOLSOM	CA	95630	7152	34	06067	38.708784	-121.1935905	Sacramento County
149212	Fee-for-Service	1679836753	1679836753	1	1	TAROYAN, ROSE MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133033	01	General Practice	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5315	19	06037	34.06269295	-118.2030006	Los Angeles County
149220	Fee-for-Service	1861493553	1861493553	1	1	TAN, JOANNA K MD	12/24/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	36922	08	Family Practice	0	In state provider	None	4900 PROSPECT AVE	None	YORBA LINDA	CA	92886	2128	30	06059	33.88961003	-117.8379389	Orange County
149239	Fee-for-Service	1780793141	1780793141	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5521	4402 ATLANTIC AVE	None	LONG BEACH	CA	90807	2207	19	06037	33.83784	-118.184049	Los Angeles County
149248	Fee-for-Service	1073622403	1073622403	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	525 HEALDSBURG AVE	None	HEALDSBURG	CA	95448	3816	49	06097	38.61512214	-122.8719921	Sonoma County
149253	Fee-for-Service	1922050830	1922050830	1	1	THRIFTY PAYLESS INC	5/23/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6469	1325 6TH ST	None	NORCO	CA	92860	1360	33	06065	33.93844048	-117.550539	Riverside County
149262	Fee-for-Service	1053615740	1053615740	1	1	TESMAN, JOHN R MD INC	7/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	68726	None	None	0	In state provider	None	2705 LOMA VISTA RD	None	VENTURA	CA	93003	1581	56	06111	34.27504051	-119.2600018	Ventura County
149340	Fee-for-Service	1669880746	1669880746	1	1	TATEVOSSIAN, TIFFANY MD	9/5/2019	207R00000X	NA	Other	026	PHYSICIANS	155297	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
149370	Fee-for-Service	1689312993	1689312993	1	1	TADLE, AARON C	10/31/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2601 OSWELL STREET	SUITE 105	BAKERSFIELD	CA	93306	3101	15	06029	35.39259632	-118.9496489	Kern County
149393	Fee-for-Service	1700220902	1700220902	1	1	TONG, YUN MD	3/16/2022	390200000X	NA	Other	026	PHYSICIANS	145059	None	None	0	In state provider	None	8930 S SEPULVEDA BLVD	#114	LOS ANGELES	CA	90045	3616	19	06037	33.955128	-118.3961915	Los Angeles County
149431	Fee-for-Service	1578918355	1578918355	1	1	TRAN, VIVI T DO	7/29/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	16148	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	FLOOR 2	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
149443	Fee-for-Service	1558050088	1558050088	1	1	TWIN SOULZ LLC	5/3/2023	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	43	06085	0	0	None
149462	Fee-for-Service	1003838327	1003838327	1	1	TSUKAHARA, JOHN T MD	4/2/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	46483	66	Emergency Medicine (Urgent Care)	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94394	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
149481	Fee-for-Service	1548285927	1548285927	1	1	THOMPSON, JANINE MD	7/31/1983	207L00000X	NA	Other	026	PHYSICIANS	45937	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
149500	Fee-for-Service	1871778506	1871778506	1	1	TAYLOR, LAURIE L LMFT	10/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1600 HUMBOLDT RD	SUITE 3	CHICO	CA	95928	8100	04	06007	39.73660489	-121.8115227	Butte County
149509	Fee-for-Service	1205980182	1205980182	1	1	TEHAMA WOMENS HEALTH	2/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	64597	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	SPECIALISTS	2490 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4356	52	06103	40.14934625	-122.2206345	Tehama County
149526	Fee-for-Service	1275927394	1275927394	1	1	TAYLOR, SUSHMA D LMFT	11/17/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	24269	-	NOT APPLICABLE	0	In state provider	None	440 ARROWOOD DRIVE	None	SANTA ROSA	CA	95407	7503	49	06097	38.421684	-122.718069	Sonoma County
149590	Fee-for-Service	1235590951	1235590951	1	1	TIGGS, MERCEDES LCSW	3/8/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	811 W. 7TH ST.	12TH FLOOR	LOS ANGELES	CA	90017	3403	19	06037	34.0489635	-118.2591312	Los Angeles County
149645	Fee-for-Service	1053784504	1053784504	1	1	THRIFTY PAYLESS INC	8/4/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	160 E ANTELOPE AVE	None	WOODLAKE	CA	93286	1506	54	06107	36.4156395	-119.098008	Tulare County
149661	Fee-for-Service	1821118167	1821118167	1	1	TRAN, PENN M OD	1/26/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1299 UNIVERSITY AVE	SUITE 103	RIVERSIDE	CA	92507	7236	33	06065	33.97576948	-117.339417	Riverside County
149686	Fee-for-Service	1326676552	1326676552	1	1	TAILOR, PRASHANT D MD	4/11/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	100 STEIN PLZ	None	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
149696	Fee-for-Service	1871880500	1871880500	1	1	TOOMARI, TAJAV DO INC	9/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10433	40	Pediatrics	0	In state provider	None	7100 VAN NUYS BLVD	SUITE 110	VAN NUYS	CA	91405	3063	19	06037	34.19957761	-118.4487663	Los Angeles County
149700	Fee-for-Service	1033125729	1033125729	1	1	TIO, AUDREY O MD	12/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54871	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
149744	Fee-for-Service	1730112665	1730112665	1	1	TEITELL, MICHAEL A MD	11/1/2000	207ZP0101X	NA	Other	026	PHYSICIANS	81137	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
149748	Fee-for-Service	1003838327	1003838327	1	1	TSUKAHARA, JOHN T MD	4/2/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	46483	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94394	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
149780	Fee-for-Service	1144461765	1144461765	1	1	THRIFTY PAYLESS INC	7/14/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06458	990 PLEASANT GROVE RD	None	ROSEVILLE	CA	95678	6126	31	06061	38.77950233	-121.2875768	Placer County
149789	Fee-for-Service	1205294543	1205294543	1	1	TAHBAZZADEH, ASHKAN LMFT	6/29/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	87601	-	NOT APPLICABLE	0	In state provider	None	10201 MISSION GORGE RD	STE O	SANTEE	CA	92071	3027	37	06073	32.83844552	-116.9759925	San Diego County
149807	Fee-for-Service	1275930638	1275930638	1	1	TRIPLE S R PHARMACY INC	3/21/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	SUITE 155	GLENDALE	CA	91203	2324	19	06037	34.15116156	-118.2549512	Los Angeles County
149814	Fee-for-Service	1841634797	1841634797	1	1	TRUONG, NGOC B DO	8/21/2020	207LP2900X	NA	Other	026	PHYSICIANS	13556	05	Anesthesiology	0	In state provider	None	6010 HIDDEN VALLEY RD	SUITE 110	CARLSBAD	CA	92011	4213	37	06073	33.12288368	-117.3058276	San Diego County
149954	Fee-for-Service	1629217781	1629217781	1	1	TAGORDA, JESSICA M CRNA	9/30/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
149955	Fee-for-Service	1841267689	1841267689	1	12	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	2960 E NEES AVE	108	FRESNO	CA	93720	6012	10	06019	36.85224946	-119.731689	Fresno County
149964	Fee-for-Service	1952698946	1952698946	1	1	TRAN, KY-DIEU MD	11/9/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	167471	None	None	0	In state provider	None	11100 WARNER AVE	STE 252	FOUNTAIN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
149968	Fee-for-Service	1467470823	1467470823	1	1	TRAN, NGOC-MAI MD	10/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87065	01	General Practice	0	In state provider	CLINICA JUAN PABLO MED	3968 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2443	19	06037	34.02389048	-118.186929	Los Angeles County
149978	Fee-for-Service	1538652995	1538652995	1	1	TAI, THOMAS K PT	8/28/2018	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
150002	Fee-for-Service	1205250263	1205250263	1	2	THE CHILDRENS CLINIC SERVING	2/3/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2360 PACIFIC AVE	None	LONG BEACH	CA	90806	2755	19	06037	33.800049	-118.1936435	Los Angeles County
150075	Fee-for-Service	1164452116	1164452116	1	1	TIWARI-SHARMA, PRAGYA MD	4/18/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	176920	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
150145	Fee-for-Service	1083635486	1083635486	1	1	TURK IV, CLIFFORD P MD	10/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94827	None	None	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
150148	Fee-for-Service	1720309958	1720309958	1	1	TAGGAR, AJAY K MD	9/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	235 W 6TH ST	None	RENO	NV	89503	4548	00	None	39.53165987	-119.8181899	Washoe County
150160	Fee-for-Service	1063740272	1063740272	1	1	TORRESYAYA, ISABELL I NP	10/24/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
150180	Fee-for-Service	1285747253	1285747253	1	1	TRIETSCH, JAMES J DO	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7000	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
150182	Fee-for-Service	1417067810	1417067810	1	1	THOMPSON, JOHN S OD	11/27/1985	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6525 LA JOLLA BLVD	None	LA JOLLA	CA	92037	6016	37	06073	32.82740592	-117.276931	San Diego County
150222	Fee-for-Service	1174697551	1174697551	1	1	TANKERSLEY, JAMES D PA	4/18/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	18606	-	NOT APPLICABLE	0	In state provider	None	1841 E MAIN STREET	None	BARSTOW	CA	92311	3234	36	06071	34.8901829	-116.9978731	San Bernardino County
150225	Fee-for-Service	1497796767	1497796767	1	1	TING, GRACE S MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67999	66	Emergency Medicine (Urgent Care)	0	In state provider	None	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
150236	Fee-for-Service	1134478845	1134478845	1	1	TORRES, KARLA LMFT	7/31/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	112224	-	NOT APPLICABLE	0	In state provider	None	1370 SOUTH STATE ST	SUITE A	SAN JACINTO	CA	92583	4922	33	06065	33.773796	-116.9719185	Riverside County
150245	Fee-for-Service	1841267689	1841267689	1	12	TERRIO PHYSICAL THERAPY - FI	8/5/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	2960 E NEES AVE	108	FRESNO	CA	93720	6012	10	06019	36.85224946	-119.731689	Fresno County
150259	Fee-for-Service	1689012908	1689012908	1	1	TASSA, GRACE M MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141472	01	General Practice	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	0001	19	06037	34.06633051	-118.4452686	Los Angeles County
150272	Fee-for-Service	1023419207	1023419207	1	1	TORRES, MARIBEL LCSW	8/8/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
150287	Fee-for-Service	1205335403	1205335403	1	1	TERRELL, JESSICA R MD	12/18/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	189518	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
150290	Fee-for-Service	1205250263	1205250263	1	2	THE CHILDRENS CLINIC SERVING	2/3/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2360 PACIFIC AVE	None	LONG BEACH	CA	90806	2755	19	06037	33.800049	-118.1936435	Los Angeles County
150408	Fee-for-Service	1255828141	1255828141	1	1	TANIGUCHI, ANDREW H MD	6/29/2022	207L00000X	NA	Other	026	PHYSICIANS	163498	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
150448	Fee-for-Service	1417057068	1417057068	2	1	TYE, JONATHAN J MD	4/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	44747	41	Internal Medicine	0	In state provider	None	1250 S SUNSET AVE	SUITE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
150556	Fee-for-Service	1447663745	1447663745	1	1	THOMAS, ANDREA PSYD	3/14/2022	261QM1300X	NA	Other	031	PSYCHOLOGISTS	-	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
150581	Fee-for-Service	1407877632	1407877632	1	1	TAWADROS, BOTROUS K	10/31/1992	207R00000X	NA	Other	026	PHYSICIANS	50729	41	Internal Medicine	0	In state provider	None	300 N SAN ANTONIO RD	None	SANTA BARBARA	CA	93110	1316	42	06083	34.4458497	-119.779596	Santa Barbara County
150586	Fee-for-Service	1811007594	1811007594	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1035 N MAGNOLIA AVE	None	ANAHEIM	CA	92801	3116	30	06059	33.84612	-117.9761685	Orange County
150605	Fee-for-Service	1578767760	1578767760	1	1	TRAVIS GLENN BROWNING	4/23/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
150633	Fee-for-Service	1871757195	1871757195	1	1	THRIFTY PAYLESS, INC.	9/11/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06522	875 NORTH ATLA AVE.	None	DINUBA	CA	93618	3002	54	06107	36.55269	-119.3951265	Tulare County
150680	Fee-for-Service	1205907193	1205907193	1	1	TAN, MATTHEW S MD	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	43944	30	Radiology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
150681	Fee-for-Service	1578658266	1578658266	1	1	TAN, MARK MD	5/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94624	24	Plastic Surgery	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
150690	Fee-for-Service	1861503724	1861503724	1	1	TAN, SHIRLEY M MD	7/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	66276	41	Internal Medicine	0	In state provider	None	2 W FERN	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
150691	Fee-for-Service	1720353816	1720353816	1	1	TAKABAYASHI, KARL H MD	6/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141421	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
150701	Fee-for-Service	1427179779	1427179779	1	1	TESFAYE-KEDJELA, AIDA MD	7/26/2019	207L00000X	NA	Other	026	PHYSICIANS	161475	05	Anesthesiology	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
150745	Fee-for-Service	1669936514	1669936514	1	1	TILAHUN, LUBANJA CNP	9/7/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8491 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90069	4218	19	06037	34.08988507	-118.3757716	Los Angeles County
150747	Fee-for-Service	1154403681	1154403681	1	1	TAM, ROLAND K MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	108022	None	None	0	In state provider	None	100 S RAYMOND AVE	None	ALHAMBRA	CA	91801	3166	19	06037	34.09027878	-118.1450083	Los Angeles County
150761	Fee-for-Service	1770080731	1770080731	1	1	TUOT, JUSTIN MD	2/26/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	174009	08	Family Practice	0	In state provider	None	34675 YUCAIPA BLVD	SUITER 102	YUCAIPA	CA	92399	4155	36	06071	34.03384452	-117.048195	San Bernardino County
150767	Fee-for-Service	1124737531	1124737531	1	1	TODD, HEATHER R CRNA	10/19/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
150776	Fee-for-Service	1962029926	1962029926	1	1	TADINADA, RAMYA DPM	11/27/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
150814	Fee-for-Service	1902022031	1902022031	1	1	TENGAN, JOAN J PT	9/22/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9353 IMPERIAL HIGHWAY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
150830	Fee-for-Service	1033129945	1033129945	1	1	TYRELL, JON SANDS	11/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64687	02	General Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
150842	Fee-for-Service	1588619357	1588619357	1	1	TABAN, ASHER H MD	2/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	30808	14	Neurological Surgery	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91328	9105	19	06037	34.22073847	-118.532988	Los Angeles County
150860	Fee-for-Service	1588636716	1588636716	1	1	TATE, KATHLEEN M MD	3/29/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	183970	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
150935	Fee-for-Service	1932275906	1932275906	1	1	TAMURA, FRANK R MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	57212	30	Radiology	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
150942	Fee-for-Service	1942839014	1942839014	1	1	THOMPSON-MARTIN, LAURA MD	10/3/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	188262	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
150947	Fee-for-Service	1861782484	1861782484	1	1	TAWFIK, DANIEL S MD	5/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131001	40	Pediatrics	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
150950	Fee-for-Service	1033500277	1033500277	1	1	THOMPSON, LAUREN K MD	8/10/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	165761	None	None	0	In state provider	None	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
150964	Fee-for-Service	1003468034	1003468034	1	1	TOBAR, MAYRA LMFT	1/18/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11455 PARAMOUNT BLVD	SUITE F	DOWNEY	CA	90241	4550	19	06037	33.94022241	-118.1398143	Los Angeles County
150967	Fee-for-Service	1962058628	1962058628	1	1	TRAN, LONG K CNP	5/16/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8731 W PICO BLVD	None	LOS ANGELES	CA	90035	2205	19	06037	34.05456946	-118.3824636	Los Angeles County
151000	Fee-for-Service	1366709875	1366709875	1	1	TRAN, TUNG T LMFT	9/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3840 HOMESTEAD	None	SANTA CLARA	CA	95051	5173	43	06085	37.33774954	-122.002065	Santa Clara County
151069	Fee-for-Service	1821163460	1821163460	1	1	TORRES, JUAN G MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50648	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	TORRES MEDICAL GRP INC	1300 N VENTURA RD	STE 6	OXNARD	CA	93030	3836	56	06111	34.214742	-119.1943805	Ventura County
151070	Fee-for-Service	1437267135	1437267135	1	1	THRAILKILL, ROBERT W MD	12/10/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73114	41	Internal Medicine	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
151072	Fee-for-Service	1194955153	1194955153	1	1	THOMAS ALLIED PHYSICAL THERA	1/10/2024	193200000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	PY INC	801 W VALLEY BLVD	SUITE 204	ALHAMBRA	CA	91803	3257	19	06037	34.07808133	-118.1319851	Los Angeles County
151079	Fee-for-Service	1568675973	1568675973	1	1	TEAL, KATHLEEN M LMFT	6/8/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	75 DECLARATION DR	SUITE 7	CHICO	CA	95973	9414	04	06007	39.77193449	-121.8722331	Butte County
151080	Fee-for-Service	1366505968	1366505968	2	1	TLC COURTESY COACH INC	6/6/2008	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1901 E LAMBERT RD	STE 100E	LA HABRA	CA	90631	5756	30	06059	33.92464653	-117.92502	Orange County
151084	Fee-for-Service	1912163031	1912163031	1	1	TUPAZ HOMES LLC	7/1/2013	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	14716 UNION AVE	None	SAN JOSE	CA	95124	3574	43	06085	37.25490374	-121.9310936	Santa Clara County
151091	Fee-for-Service	1972659308	1972659308	2	1	TANGRI, RAJIV DO	8/18/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	9659	None	None	0	In state provider	None	4000 EMPIRE DR	STE 100	BAKERSFIELD	CA	93309	0401	15	06029	35.37480064	-119.0459033	Kern County
151114	Fee-for-Service	1033129945	1033129945	1	1	TYRELL, JON SANDS	11/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64687	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
151130	Fee-for-Service	1114086774	1114086774	1	1	TAYLOR, KIP MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	62207	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
151177	Fee-for-Service	1861745085	1861745085	1	1	TRAN, LE H NP	5/30/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
151232	Fee-for-Service	1841494226	1841494226	1	1	TERRI CUMMINS	9/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8300 W 38TH AVE	None	WHEAT RIDGE	CO	80033	6005	00	None	39.76932763	-105.0903492	Jefferson County
151233	Fee-for-Service	1619378775	1619378775	1	1	THAO, XENG LCSW	5/23/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
151317	Fee-for-Service	1114383296	1114383296	1	1	TOTAL CARE RX PHARMACY INC	10/14/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	18682 BEACH BLVD	SUITE 115	HUNTINGTON BEACH	CA	92648	2049	30	06059	33.69152695	-117.9887007	Orange County
151318	Fee-for-Service	1861861536	1861861536	1	1	TLJ HEALTH CARE INC	3/6/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1400 COLEMAN AVE	UNIT G23-24	SANTA CLARA	CA	95050	4309	43	06085	37.35715822	-121.9362064	Santa Clara County
151358	Fee-for-Service	1194955153	1194955153	1	1	THOMAS ALLIED PHYSICAL THERA	1/10/2024	193200000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	PY INC	801 W VALLEY BLVD	SUITE 204	ALHAMBRA	CA	91803	3257	19	06037	34.07808133	-118.1319851	Los Angeles County
151365	Fee-for-Service	1902875693	1902875693	1	1	TIQUIA, HERBERT S MD	3/1/1998	207RN0300X	NA	Nephrology	026	PHYSICIANS	63879	41	Internal Medicine	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
151386	Fee-for-Service	1407933369	1407933369	1	1	TASCH, EDWIN S MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84469	13	Neurology (M.D. only)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
151392	Fee-for-Service	1104381292	1104381292	1	1	TEXAS HEALTH HOSPITAL FRISCO	6/30/2020	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	12400 DALLAS PKWY	None	FRISCO	TX	75033	4224	00	None	33.181929	-96.8364945	Collin County
151396	Fee-for-Service	1013181924	1013181924	1	1	TILINA HU MD	2/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 W THOMAS RD	None	PHOENIX	AZ	85013	4409	00	None	33.480864	-112.0795155	Maricopa County
151423	Fee-for-Service	1609340736	1609340736	1	1	TRAN, KATHLEEN H LMFT	11/22/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
151428	Fee-for-Service	1235420829	1235420829	1	1	TOROSYAN, SRBUI LMFT	8/1/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	117309	-	NOT APPLICABLE	0	In state provider	None	2460 MAIN ST	None	MORRO BAY	CA	93442	1552	40	06079	35.3868704	-120.8576894	San Luis Obispo County
151456	Fee-for-Service	1508865528	1508865528	1	12	TAHOE CARSON VALLEY	8/6/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	1067 FOURTH ST	None	SOUTH LAKE TAHOE	CA	96150	3459	09	06017	38.91384447	-119.9985861	El Dorado County
151470	Fee-for-Service	1376610113	1376610113	1	1	TORRANCE, JESSICA M CNM	11/1/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1900 E 4TH ST	None	SANTA ANA	CA	92705	3910	30	06059	33.74805463	-117.8400671	Orange County
151491	Fee-for-Service	1891782256	1891782256	1	1	TELLES, JOHN G MD	1/26/1994	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	35213	None	None	0	In state provider	None	1313 E HERNDON AVE	STE 203	FRESNO	CA	93720	3306	10	06019	36.834984	-119.7641925	Fresno County
151588	Fee-for-Service	1912259946	1912259946	1	1	TENG, CHUN-WEN DO	7/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13648	01	General Practice	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4900	39	06077	37.80110374	-121.1974853	San Joaquin County
151635	Fee-for-Service	1285690867	1285690867	1	1	TUMBER, SUNDEEP S MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8419	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
151643	Fee-for-Service	1255779658	1255779658	1	1	TRAVIESO, ROBERTO MD	9/21/2021	208200000X	NA	General Surgery	026	PHYSICIANS	162038	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
151653	Fee-for-Service	1881653244	1881653244	1	1	TOTAL RENAL CARE, INC	3/10/2000	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	FLORIN DIALYSIS CARE	7000 STOCKTON BLVD	None	SACRAMENTO	CA	95823	2312	34	06067	38.500137	-121.431321	Sacramento County
151656	Fee-for-Service	1225173537	1225173537	1	2	TIUTORRES, LALAINE L MD	10/5/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	63191	-	NOT APPLICABLE	0	In state provider	None	1310 M STREET	None	FRESNO	CA	93721	1808	10	06019	36.73926478	-119.7905188	Fresno County
151680	Fee-for-Service	1104381292	1104381292	1	1	TEXAS HEALTH HOSPITAL FRISCO	6/30/2020	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	12400 DALLAS PKWY	None	FRISCO	TX	75033	4224	00	None	33.181929	-96.8364945	Collin County
151709	Fee-for-Service	1255891024	1255891024	1	1	TROUT, SUSAN S MD	12/30/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	177070	None	None	0	In state provider	None	1235 OSOS ST	STE 100	SAN LUIS OBISPO	CA	93401	3600	40	06079	35.27979518	-120.6596361	San Luis Obispo County
151719	Fee-for-Service	1255679577	1255679577	1	1	TAPANES, DANIEL K LMFT	7/17/2019	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
151737	Fee-for-Service	1336326917	1336326917	1	1	TRAN, HAI T DO	11/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10434	25	Physical Medicine and Rehabilitation	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
151742	Fee-for-Service	1508865528	1508865528	1	12	TAHOE CARSON VALLEY	9/28/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1067 FOURTH ST	None	SOUTH LAKE TAHOE	CA	96150	3459	09	06017	38.91384447	-119.9985861	El Dorado County
151760	Fee-for-Service	1801055132	1801055132	1	1	TOOMARI, TAJAV DO	7/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10433	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
151762	Fee-for-Service	1659568343	1659568343	1	1	TEJWANI, SAMIR G MD	4/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	78292	20	Orthopedic Surgery	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
151765	Fee-for-Service	1104573633	1104573633	1	3	THE BEACON HOUSE ASSOCIATION	8/6/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	OF SAN PEDRO	126 W 10TH ST	None	SAN PEDRO	CA	90731	3702	19	06037	33.73515384	-118.2811376	Los Angeles County
151813	Fee-for-Service	1497827562	1497827562	1	1	TAKEDA, PATRICIA A MD	2/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37296	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	# 997M	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
151846	Fee-for-Service	1245374354	1245374354	1	1	TRINITY UROLOGICAL	6/21/1995	208800000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGICAL	126 S MONTEBELLO BLVD	None	MONTEBELLO	CA	90640	4730	19	06037	34.00906663	-118.108353	Los Angeles County
151869	Fee-for-Service	1922234681	1922234681	1	1	THAKUR, NEETA MD	5/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107658	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
151926	Fee-for-Service	1275564833	1275564833	1	1	THOMPSON, ROBERT MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30548	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	11550 INDIAN HILLS RD	STE 310	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
151932	Fee-for-Service	1861261455	1861261455	1	1	THRASHER, KELLI NP	8/19/2024	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
151939	Fee-for-Service	1538689583	1538689583	1	2	TAHOE FOREST HOSPITAL DISTRI	3/26/2024	261QM1300X	NA	Other	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	12313 SOARING WAY	1C AND 2B	TRUCKEE	CA	96161	3370	29	06057	39.31711603	-120.1474965	Nevada County
152019	Fee-for-Service	1730708355	1730708355	1	1	TURVILLE DIALYSIS LLC	3/15/2021	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	172 N RAYMOND AVE	None	FULLERTON	CA	92831	4610	30	06059	33.87225402	-117.906965	Orange County
152024	Fee-for-Service	1144339532	1144339532	1	1	THRIFTY PAYLESS INC	5/15/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6291	1970 W GRANT LINE RD	None	TRACY	CA	95376	8812	39	06077	37.7540315	-121.4524358	San Joaquin County
152029	Fee-for-Service	1508865528	1508865528	1	12	TAHOE CARSON VALLEY	8/6/2018	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1067 FOURTH ST	None	SOUTH LAKE TAHOE	CA	96150	3459	09	06017	38.91384447	-119.9985861	El Dorado County
152043	Fee-for-Service	1578672093	1578672093	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5709	34420 YUCAIPA BLVD	None	YUCAIPA	CA	92399	2412	36	06071	34.03389345	-117.053685	San Bernardino County
152067	Fee-for-Service	1285733816	1285733816	1	1	TSUBOI, CRAIG N MD	4/1/1995	208M00000X	NA	Other	026	PHYSICIANS	79605	41	Internal Medicine	0	In state provider	None	8421 AUBURN BLVD	None	CITRUS HEIGHTS	CA	95610	0359	34	06067	38.719026	-121.291335	Sacramento County
152085	Fee-for-Service	1295359842	1295359842	1	1	TAI, KEVIN DO	10/24/2023	390200000X	NA	Other	026	PHYSICIANS	20746	None	None	0	In state provider	None	525 NORTH GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
152098	Fee-for-Service	1497827562	1497827562	1	1	TAKEDA, PATRICIA A MD	2/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37296	41	Internal Medicine	0	In state provider	None	505 PARNASSUS AVE	# 997M	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
152111	Fee-for-Service	1265580195	1265580195	1	1	THANARATNAM, MANOHAR MD	11/30/1986	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	41483	01	General Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
152116	Fee-for-Service	1760796346	1760796346	1	1	TRAN, TIEN H OD	1/17/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
152117	Fee-for-Service	1821031022	1821031022	1	1	TAYLOR,JOSEPH G III MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1000 TRENT DRIVE	None	DURHAM	NC	27710	0000	00	None	36.00547588	-78.93519663	Durham County
152157	Fee-for-Service	1922234681	1922234681	1	1	THAKUR, NEETA MD	5/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107658	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
152167	Fee-for-Service	1306866033	1306866033	1	1	TING, SHIRLEY F MD	10/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	43758	40	Pediatrics	0	In state provider	None	3002 LEIGH AVE	STE 100	SAN JOSE	CA	95124	2202	43	06085	37.26639	-121.9223435	Santa Clara County
152168	Fee-for-Service	1003416363	1003416363	1	1	TITENSKY, CHRISTINE U CNP	1/12/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3801 KATELLA AVE	STE 330	LOS ALAMITOS	CA	90720	6900	30	06059	33.80318951	-118.066068	Orange County
152214	Fee-for-Service	1225012982	1225012982	1	1	TARTER, CHAD I MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	92148	40	Pediatrics	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
152216	Fee-for-Service	1275564833	1275564833	1	1	THOMPSON, ROBERT MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30548	41	Internal Medicine	0	In state provider	None	11550 INDIAN HILLS RD	STE 310	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
152223	Fee-for-Service	1982912028	1982912028	1	1	TANENBAUM, MOLLY L PHD	9/1/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
152224	Fee-for-Service	1518491083	1518491083	1	1	TURK, ANTHONY MD	8/28/2023	2085R0204X	NA	Other	026	PHYSICIANS	158680	None	None	0	In state provider	None	9320 BASELINE RD	STE C	RANCHO CUCAMONGA	CA	91701	5829	36	06071	34.12156453	-117.6018255	San Bernardino County
152230	Fee-for-Service	1255418265	1255418265	1	1	TOMPKINS, STACY MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	52958	01	General Practice	0	In state provider	None	200 W ARBOR DR	DEPT 8201	SAN DIEGO	CA	92103	8201	37	06073	32.7537975	-117.1658298	San Diego County
152232	Fee-for-Service	1447740824	1447740824	1	2	TRANSGENDER HEALTH AND	7/26/2022	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6840 INDIANA AVE	STE 150	RIVERSIDE	CA	92506	4271	33	06065	33.94246965	-117.3926366	Riverside County
152317	Fee-for-Service	1508865528	1508865528	1	12	TAHOE CARSON VALLEY	9/15/2021	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1067 FOURTH ST	None	SOUTH LAKE TAHOE	CA	96150	3459	09	06017	38.91384447	-119.9985861	El Dorado County
152348	Fee-for-Service	1053335117	1053335117	1	1	TSANG, MICHAEL W MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78793	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2510 WEBER ST	# 200	BERKELEY	CA	94705	0000	01	06001	0	0	None
152359	Fee-for-Service	1144642109	1144642109	1	1	TAHERAN, CHRISTINE	6/7/2024	363LF0000X	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
152449	Fee-for-Service	1386987261	1386987261	1	1	TADDONIO, MICHAEL A MD	7/15/2019	2085R0204X	NA	Other	026	PHYSICIANS	134818	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
152465	Fee-for-Service	1174701825	1174701825	1	1	TONEY, RONALD	10/16/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1135 E ROUTE 66	STE 111	GLENDORA	CA	91740	3778	19	06037	34.12888853	-117.845127	Los Angeles County
152472	Fee-for-Service	1396223103	1396223103	1	1	TARZANA TREATMENT CENTERS	8/14/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	6022 VARIEL AVENUE	None	WOODLAND HILLS	CA	91367	3719	19	06037	34.180029	-118.592771	Los Angeles County
152474	Fee-for-Service	1568417616	1568417616	1	1	TARIN, LUCILA	2/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78418	08	Family Practice	0	In state provider	None	5823 YORK BLVD	None	LOS ANGELES	CA	90042	2634	19	06037	34.11850913	-118.1915335	Los Angeles County
152491	Fee-for-Service	1487696878	1487696878	2	1	TADROS, EMAD G MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	49500	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3914 3RD AVE	None	SAN DIEGO	CA	92103	3003	37	06073	32.74858431	-117.1627824	San Diego County
152504	Fee-for-Service	1346241452	1346241452	1	1	TAMSEN, MARK J MD	5/31/1991	207P00000X	NA	Other	026	PHYSICIANS	64400	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3475 KENYON ST	None	SAN DIEGO	CA	92110	5002	37	06073	32.74962645	-117.2151566	San Diego County
152519	Fee-for-Service	1255418265	1255418265	1	1	TOMPKINS, STACY MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	52958	07	Dermatology	0	In state provider	None	200 W ARBOR DR	DEPT 8201	SAN DIEGO	CA	92103	8201	37	06073	32.7537975	-117.1658298	San Diego County
152524	Fee-for-Service	1174734925	1174734925	1	1	TORRES, RODERICK PT	2/19/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	100 BARRANCA ST.	SUITE 920	WEST COVINA	CA	91791	1637	19	06037	34.073073	-117.8812535	Los Angeles County
152540	Fee-for-Service	1093743791	1093743791	1	1	TIRZAMAN, OLTITA	3/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82822	None	None	0	In state provider	None	888 S HILL RD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
152544	Fee-for-Service	1437218864	1437218864	1	1	THAO TRAN OD INC	4/24/2007	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	TRY	110 CIVIC CENTER DR	204	VISTA	CA	92084	6037	37	06073	33.2047104	-117.2368466	San Diego County
152578	Fee-for-Service	1184642258	1184642258	1	1	TRUONG, PETER T MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71046	18	Ophthalmology	0	In state provider	FACES	9497 N FORT WASHINGTON R	STE 103	FRESNO	CA	93720	0660	10	06019	36.87361129	-119.7752878	Fresno County
152650	Fee-for-Service	1013120260	1013120260	1	1	THIRUMALAISELVAN, GAYATH	1/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102994	41	Internal Medicine	0	In state provider	RI MD	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
152652	Fee-for-Service	1578122776	1578122776	1	1	TIOOWISHONIA COUNSELING	12/12/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES	2740 FULTON AVE	STE 118	SACRAMENTO	CA	95821	5801	34	06067	38.615157	-121.4009055	Sacramento County
152657	Fee-for-Service	1366476764	1366476764	1	1	TSAI, HENRY H MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	60125	66	Emergency Medicine (Urgent Care)	0	In state provider	None	201 W GARVEY AVE	STE 310	MONTEREY PARK	CA	91754	7424	19	06037	34.06256747	-118.1246805	Los Angeles County
152667	Fee-for-Service	1255512158	1255512158	1	1	TAYLOR, SHAYLALE Q LMFT	5/29/2020	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
152704	Fee-for-Service	1780872150	1780872150	1	1	TURNER-MEIER, JOANN PT	11/15/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	27107 TOURNEY RD	None	SANTA CLARITA	CA	91355	1860	19	06037	34.41607441	-118.5761057	Los Angeles County
152734	Fee-for-Service	1003871161	1003871161	1	1	TAKHAR, SUKHJIT S MD	4/1/2002	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	75198	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
152746	Fee-for-Service	1205086048	1205086048	1	1	THRIFTY PAYLESS INC.	12/11/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06512	1000 W MONTE VISTA AVE.	None	TURLOCK	CA	95382	0000	50	06099	37.52180053	-120.861567	Stanislaus County
152759	Fee-for-Service	1396223103	1396223103	1	1	TARZANA TREATMENT CENTERS	8/14/2018	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	6022 VARIEL AVENUE	None	WOODLAND HILLS	CA	91367	3719	19	06037	34.180029	-118.592771	Los Angeles County
152764	Fee-for-Service	1104014596	1104014596	1	1	TANEJA, NIDHIKA B MD	7/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116362	45	Nephrology (Renal-Kidney)	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
152774	Fee-for-Service	1508865528	1508865528	1	10	TAHOE CARSON VALLEY	3/17/2009	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	1139 THIRD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
152779	Fee-for-Service	1487696878	1487696878	2	1	TADROS, EMAD G MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	49500	36	Psychiatry	0	In state provider	None	3914 3RD AVE	None	SAN DIEGO	CA	92103	3003	37	06073	32.74858431	-117.1627824	San Diego County
152783	Fee-for-Service	1740243831	1740243831	1	1	TOTAL RENAL CARE, INC	4/1/1997	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	REDDING DIALYSIS CENTER	1876 PARK MARINA DR	None	REDDING	CA	96001	0913	45	06089	40.58519335	-122.3758091	Shasta County
152830	Fee-for-Service	1851454011	1851454011	1	1	THE PERMANENTE MED GRP INC	1/11/2010	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	914 MARINA WAY S	None	RICHMOND	CA	94804	3739	07	06013	37.919142	-122.3558945	Contra Costa County
152869	Fee-for-Service	1184642258	1184642258	1	1	TRUONG, PETER T MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71046	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	FACES	9497 N FORT WASHINGTON R	STE 103	FRESNO	CA	93720	0660	10	06019	36.87361129	-119.7752878	Fresno County
152894	Fee-for-Service	1427685338	1427685338	1	1	TE, SILENA MD	10/18/2023	208M00000X	NA	Other	026	PHYSICIANS	184379	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
152930	Fee-for-Service	1669576716	1669576716	1	1	THALL, MARC S OD INC	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10316 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	2422	19	06037	34.25912963	-118.4672869	Los Angeles County
152932	Fee-for-Service	1467031674	1467031674	1	1	TURNER, SYDNIE MD	2/24/2025	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	77	Infectious Disease	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
152945	Fee-for-Service	1366476764	1366476764	1	1	TSAI, HENRY H MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	60125	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	201 W GARVEY AVE	STE 310	MONTEREY PARK	CA	91754	7424	19	06037	34.06256747	-118.1246805	Los Angeles County
152964	Fee-for-Service	1073671087	1073671087	1	1	TRANG, CHAU H OD	1/31/1990	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6947 LINDA VISTA RD	STE A	SAN DIEGO	CA	92111	6363	37	06073	32.78613154	-117.1704273	San Diego County
152975	Fee-for-Service	1902398316	1902398316	1	1	TRUJILLO, JOSEPH F MD	12/10/2021	207R00000X	NA	Other	026	PHYSICIANS	174322	None	None	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
152978	Fee-for-Service	1306935242	1306935242	1	1	THANT, DIANA MD	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
152995	Fee-for-Service	1447356878	1447356878	1	1	TONG, HAI DO	12/1/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
153021	Fee-for-Service	1003871161	1003871161	1	1	TAKHAR, SUKHJIT S MD	4/1/2002	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	75198	66	Emergency Medicine (Urgent Care)	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
153034	Fee-for-Service	1023194743	1023194743	1	1	TU, SHIN-PING MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148529	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
153060	Fee-for-Service	1508865528	1508865528	1	10	TAHOE CARSON VALLEY	9/15/2021	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1139 THIRD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
153063	Fee-for-Service	1508912940	1508912940	1	1	TREMONTON CITY	3/24/2012	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	2	Out of state provider	None	102 SOUTH TREMONT STREET	None	TREMONTON	UT	84337	1636	00	None	41.7107302	-112.1660812	Box Elder County
153086	Fee-for-Service	1114379120	1114379120	1	1	TAPSCOTT, LEAH J NP	5/10/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
153137	Fee-for-Service	1962854059	1962854059	1	1	TAGORDA, JENNIFER CRNA	3/15/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
153140	Fee-for-Service	1740799725	1740799725	1	1	TELEHEALTHDOCS MEDICAL CORPO	1/3/2020	171W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	100 E NORTH STREET	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
153147	Fee-for-Service	1255911798	1255911798	1	1	TRUJILLO, EMILEE A MD	12/7/2022	390200000X	NA	Other	026	PHYSICIANS	183000	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
153159	Fee-for-Service	1184642258	1184642258	1	1	TRUONG, PETER T MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71046	24	Plastic Surgery	0	In state provider	FACES	9497 N FORT WASHINGTON R	STE 103	FRESNO	CA	93720	0660	10	06019	36.87361129	-119.7752878	Fresno County
153240	Fee-for-Service	1760745038	1760745038	1	1	TITEN, SIENNA V MD	8/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128806	15	Obstetrics (D.O. only)	0	In state provider	None	1779 DOMINICAN WAY	None	SANTA CRUZ	CA	95065	1526	44	06087	36.9902958	-121.9808957	Santa Cruz County
153310	Fee-for-Service	1578848818	1578848818	1	1	TEHAMA COUNTY HEALTH	4/1/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES AGENCY	275 SOLANO STREET	None	CORNING	CA	96021	3534	52	06103	39.927826	-122.1690043	Tehama County
153332	Fee-for-Service	1407535933	1407535933	1	1	TURLEA, IRINA CNP	3/26/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	800 E LUGONIA AVE	STE F	REDLANDS	CA	92374	2550	36	06071	34.07000118	-117.1731789	San Bernardino County
153350	Fee-for-Service	1508865528	1508865528	1	10	TAHOE CARSON VALLEY	9/28/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1139 THIRD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
153427	Fee-for-Service	1740799725	1740799725	1	1	TELEHEALTHDOCS MEDICAL CORPO	1/18/2023	171W00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	100 E NORTH STREET	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
153449	Fee-for-Service	1689648180	1689648180	1	1	TITAPIWATANAKUN, RUETIMA	6/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103821	78	Neoplastic Diseases/Oncology	0	In state provider	MD	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
153456	Fee-for-Service	1013026442	1013026442	1	1	THRIFTY PAYLESS INC	11/4/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2646 ALLEN RD	None	BAKERSFIELD	CA	93314	9542	15	06029	35.384175	-119.145541	Kern County
153466	Fee-for-Service	1922163310	1922163310	1	1	TO, SEAN S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75204	None	None	0	In state provider	None	25395 HANCOCK AVE	STE 240	MURRIETA	CA	92562	9054	33	06065	33.5591482	-117.185187	Riverside County
153488	Fee-for-Service	1811903115	1811903115	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6007 CLARK RD	None	PARADISE	CA	95969	4108	04	06007	39.75979897	-121.6065735	Butte County
153521	Fee-for-Service	1033980032	1033980032	1	1	TUCK, KATHY BIRTH DOULA	1/31/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	40	06079	0	0	None
153529	Fee-for-Service	1760745038	1760745038	1	1	TITEN, SIENNA V MD	8/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128806	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1779 DOMINICAN WAY	None	SANTA CRUZ	CA	95065	1526	44	06087	36.9902958	-121.9808957	Santa Cruz County
153556	Fee-for-Service	1811262967	1811262967	1	1	THOMAS, JACOB S MD	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	129536	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
153565	Fee-for-Service	1740245265	1740245265	1	1	TEBYANI, NEYSSAN MD	9/9/2022	174400000X	NA	Other	026	PHYSICIANS	62271	None	None	0	In state provider	None	23961 CALLE DE LA MAGDAL	500	LAGUNA HILLS	CA	92653	7622	30	06059	33.60999658	-117.7126577	Orange County
153570	Fee-for-Service	1750627402	1750627402	1	1	TUGGY, VICKI A	1/13/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	15775 LAGUNA CYN RD	SUITE 110	IRVINE	CA	92618	3192	30	06059	33.6663745	-117.760682	Orange County
153628	Fee-for-Service	1760689715	1760689715	1	2	TOTALCARE WALK-IN CLINIC INC	5/30/2018	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	13334 LIMONITE AVE.	130	EASTVALE	CA	92880	7257	33	06065	33.97534752	-117.5738985	Riverside County
153646	Fee-for-Service	1154797785	1154797785	1	1	TEMPLE, WILLIAM K LCSW	7/9/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	88336	-	NOT APPLICABLE	0	In state provider	None	1035 MARKET STREET	SUITE 400	SAN FRANCISCO	CA	94103	1665	38	06075	37.78152549	-122.4111668	San Francisco County
153652	Fee-for-Service	1528004306	1528004306	1	1	THE VONS COMPANIES INC	8/25/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5638 E KINGS CANYON RD	None	FRESNO	CA	93727	4627	10	06019	36.73578229	-119.6985397	Fresno County
153655	Fee-for-Service	1578082319	1578082319	1	1	THERAPY SOUTH, PC	11/14/2022	261QP2000X	NA	Physical Therapist	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1040 TIERRA DEL REY	SUITE 107	CHULA VISTA	CA	91910	7865	37	06073	32.63789897	-117.0176377	San Diego County
153688	Fee-for-Service	1346591997	1346591997	1	1	TAYLOR, NATALIE S PT	10/15/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	41990 COOK ST	BLDG G STE 602	PALM DESERT	CA	92211	6103	33	06065	33.748371	-116.356173	Riverside County
153692	Fee-for-Service	1720150543	1720150543	1	1	TIVAKARAN, SADHANANDHAM	4/1/1998	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	41051	10	Gastroenterology (M.D. only)	0	In state provider	MD	3939 J ST	STE 370	SACRAMENTO	CA	95819	3671	34	06067	38.570211	-121.45374	Sacramento County
153700	Fee-for-Service	1083811251	1083811251	1	1	TEDOCO, ANECITO	10/5/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
153717	Fee-for-Service	1740799725	1740799725	1	1	TELEHEALTHDOCS MEDICAL CORPO	3/23/2023	171W00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	100 E NORTH STREET	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
153733	Fee-for-Service	1881264174	1881264174	1	1	TOPOROWSKI, KAITLIN N CRNA	9/26/2022	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	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
153738	Fee-for-Service	1689648180	1689648180	1	1	TITAPIWATANAKUN, RUETIMA	6/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103821	40	Pediatrics	0	In state provider	MD	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
153754	Fee-for-Service	1366696635	1366696635	1	1	TERRANOVA, LINNEA PSYD	6/14/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	9829 BLUE LARKSPUR LN	SUITE 2	MONTEREY	CA	93940	6535	27	06053	36.57109892	-121.8021077	Monterey County
153835	Fee-for-Service	1861477010	1861477010	1	1	TOY, ELAINE K MD	1/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89718	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
153847	Fee-for-Service	1578720223	1578720223	1	1	TROLL, JAMES G MD	9/30/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51568	08	Family Practice	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
153858	Fee-for-Service	1285857722	1285857722	1	1	TULARE CO OFF OF ED	1/31/1993	251300000X	NA	Other	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	EDUCATION BLDG	2637 W BURREL AVE	None	VISALIA	CA	93291	4511	54	06107	36.328131	-119.3203485	Tulare County
153866	Fee-for-Service	1386847648	1386847648	1	1	THAKKER, JAYINI MD	10/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124009	24	Plastic Surgery	0	In state provider	None	400 N PEPPER AVE	STE 308	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
153916	Fee-for-Service	1376701318	1376701318	1	1	TORRES, RODRIGO J MD INC	9/9/2008	193400000X	NA	Other	026	PHYSICIANS	83341	18	Ophthalmology	0	In state provider	None	2650 ELM AVE	STE 108	LONG BEACH	CA	90806	1600	19	06037	33.805521	-118.1882945	Los Angeles County
153923	Fee-for-Service	1073548681	1073548681	1	1	TOWER PULMONARY ASSOC	10/1/1980	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	435 N ROXBURY DR	STE 311	BEVERLY HILLS	CA	90210	5005	19	06037	34.06777102	-118.4067032	Los Angeles County
153931	Fee-for-Service	1538528518	1538528518	1	2	TRENT, JOVAN V CRNA	3/1/2016	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
153954	Fee-for-Service	1528116498	1528116498	1	1	TIPTON, JAMES R MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45209	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
153993	Fee-for-Service	1275794307	1275794307	1	1	TRI-CITY PHARMACY	12/12/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	TRI-CITY PHARMACY	1132 CADILLAC CT	None	MILPITAS	CA	95035	3058	43	06085	37.44396885	-121.9185543	Santa Clara County
154004	Fee-for-Service	1740799725	1740799725	1	1	TELEHEALTHDOCS MEDICAL CORPO	1/3/2020	171W00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	100 E NORTH STREET	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
154005	Fee-for-Service	1083814297	1083814297	1	1	TUCKER, JOHN D MD	8/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	85484	30	Radiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
154027	Fee-for-Service	1689648180	1689648180	1	1	TITAPIWATANAKUN, RUETIMA	6/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103821	68	Hematology	0	In state provider	MD	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
154057	Fee-for-Service	1639617558	1639617558	1	1	TIM T LAI, MD, INC	4/4/2017	2084N0400X	NA	Neurology	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	None	11100 WARNER AVE	152	FOUNTAIN VALLEY	CA	92708	7506	30	06059	33.716291	-117.9355051	Orange County
154143	Fee-for-Service	1841770112	1841770112	1	1	THOMAS, DOMINIQUE LCSW	10/17/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	116010	-	NOT APPLICABLE	0	In state provider	None	845 E ARROW HWY	None	POMONA	CA	91767	2535	19	06037	34.09032048	-117.734769	Los Angeles County
154149	Fee-for-Service	1427380435	1427380435	1	1	TAVASSOLI, GITA MD	4/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110150	08	Family Practice	0	In state provider	None	5256 MISSION BLVD	None	RIVERSIDE	CA	92509	4624	33	06065	33.99261717	-117.3987262	Riverside County
154155	Fee-for-Service	1386847648	1386847648	1	1	THAKKER, JAYINI MD	10/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124009	02	General Surgery	0	In state provider	None	400 N PEPPER AVE	STE 308	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
154164	Fee-for-Service	1568672053	1568672053	1	1	THERAPEUTIC LIVING CTRS	2/22/1999	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HILTON HOUSE	7927A LINDLEY AVE	None	RESEDA	CA	91335	2122	19	06037	34.21434393	-118.527408	Los Angeles County
154168	Fee-for-Service	1104845015	1104845015	1	1	TEXAS HEALTH HARRIS	8/3/2015	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	METHODIST HOSPITAL HURST	1600 HOSPITAL PARKWAY	None	BEDFORD	TX	76022	6913	00	None	32.834619	-97.1251925	Tarrant County
154171	Fee-for-Service	1992329528	1992329528	1	1	TIFFANI TAFT MARRIAGE AND FA	7/8/2020	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	MILY THERAPY, PROFESSION	27412 ENTERPRISE CIR W	STE. 205	TEMECULA	CA	92590	4875	33	06065	33.51594134	-117.1669025	Riverside County
154211	Fee-for-Service	1073548681	1073548681	1	1	TOWER PULMONARY ASSOC	10/1/1980	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	435 N ROXBURY DR	STE 311	BEVERLY HILLS	CA	90210	5005	19	06037	34.06777102	-118.4067032	Los Angeles County
154220	Fee-for-Service	1982887659	1982887659	1	1	THORN, VALERIE L NP	10/18/2020	363LF0000X	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
154272	Fee-for-Service	1841338555	1841338555	1	1	TUASON, NORBERTO M MD	12/3/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	53601	-	NOT APPLICABLE	0	In state provider	None	1160 S GRAND AVE	None	GLENDORA	CA	91740	5000	19	06037	34.11736533	-117.8725213	Los Angeles County
154298	Fee-for-Service	1598783748	1598783748	1	1	TENG, CONNIE MD	12/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84602	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
154326	Fee-for-Service	1932639408	1932639408	1	1	THOMPSON, BENJAMIN AU	9/6/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1035 GRAYSON ST	None	BERKELEY	CA	94710	2642	01	06001	37.85605581	-122.2888417	Alameda County
154337	Fee-for-Service	1770902256	1770902256	1	1	TABRIZI, SARA MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145110	41	Internal Medicine	0	In state provider	None	100 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3813	30	06059	33.89343304	-117.9279349	Orange County
154349	Fee-for-Service	1952067498	1952067498	1	1	TRUE BLISS HOME HEALTH CARE	10/20/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4100 W ALAMEDA AVE	UNIT 352	BURBANK	CA	91505	4195	19	06037	34.1526111	-118.3447742	Los Angeles County
154375	Fee-for-Service	1760499958	1760499958	1	1	TIONGSON, CORRINNA T MD	5/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154327	40	Pediatrics	0	In state provider	None	1955 COWELL BLVD	None	DAVIS	CA	95618	6325	57	06113	38.5399459	-121.7284328	Yolo County
154442	Fee-for-Service	1386847648	1386847648	1	1	THAKKER, JAYINI MD	10/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124009	84	Surgery-Head and Neck	0	In state provider	None	400 N PEPPER AVE	STE 308	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
154456	Fee-for-Service	1104845015	1104845015	1	1	TEXAS HEALTH HARRIS	8/3/2015	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	METHODIST HOSPITAL HURST	1600 HOSPITAL PARKWAY	None	BEDFORD	TX	76022	6913	00	None	32.834619	-97.1251925	Tarrant County
154459	Fee-for-Service	1992329528	1992329528	1	1	TIFFANI TAFT MARRIAGE AND FA	7/8/2020	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MILY THERAPY, PROFESSION	27412 ENTERPRISE CIR W	STE. 205	TEMECULA	CA	92590	4875	33	06065	33.51594134	-117.1669025	Riverside County
154497	Fee-for-Service	1023030061	1023030061	1	1	TEELE, KEITH V	5/1/2001	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	9625 MONTE VISTA AVE	STE 102	MONTCLAIR	CA	91763	2234	36	06071	34.08006762	-117.6982272	San Bernardino County
154527	Fee-for-Service	1346663820	1346663820	1	2	THOMPSON, MICHELLE J CNP	8/4/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2550 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	52	06103	40.14847323	-122.2180997	Tehama County
154565	Fee-for-Service	1003237835	1003237835	1	1	TRUONG, JENNIFER H T	11/18/2014	156FX1800X	NA	Other	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	11421 E CARSON STREET	SUITE D	LAKEWOOD	CA	90715	2500	19	06037	33.8315703	-118.089522	Los Angeles County
154577	Fee-for-Service	1124361258	1124361258	1	1	THEIS, MORGAN MD	11/19/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	133677	08	Family Practice	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
154587	Fee-for-Service	1679940571	1679940571	1	1	T&K HOME HEALTH CARE	12/9/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14640 VICTORY BLVD	SUITE 204B	VAN NUYS	CA	91411	1623	19	06037	34.18663255	-118.452402	Los Angeles County
154593	Fee-for-Service	1013088244	1013088244	2	1	THERESA PHARMACY INC	3/17/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	2010 PHARMACY	7785 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4025	30	06059	33.75928003	-117.9931079	Orange County
154648	Fee-for-Service	1588959076	1588959076	1	1	THURSTON, JOHN L JR MD	8/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148344	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
154703	Fee-for-Service	1558383901	1558383901	1	1	TSENG, ANNE A MD	4/2/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	81559	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
154728	Fee-for-Service	1235160003	1235160003	1	1	TANNOUS, ZIAD A MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54040	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1180 N INDIAN CANYON DR	STE W208	PALM SPRINGS	CA	92262	4876	33	06065	33.839505	-116.5455735	Riverside County
154747	Fee-for-Service	1992329528	1992329528	1	1	TIFFANI TAFT MARRIAGE AND FA	7/8/2020	106H00000X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	MILY THERAPY, PROFESSION	27412 ENTERPRISE CIR W	STE. 205	TEMECULA	CA	92590	4875	33	06065	33.51594134	-117.1669025	Riverside County
154788	Fee-for-Service	1326811845	1326811845	1	1	TERAN, YESENIA LMFT	1/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	79875 BREWOOD WAY	None	INDIO	CA	92203	4879	33	06065	33.77763187	-116.271104	Riverside County
154817	Fee-for-Service	1932515152	1932515152	1	1	TRIVEDI, SONA LMFT	6/15/2020	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
154862	Fee-for-Service	1073700977	1073700977	1	1	TEEPLE, CYNTHIA M PHD	2/1/2008	103TC0700X	NA	Mental Health Outpatient Services	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
154898	Fee-for-Service	1851600175	1851600175	1	1	TRAN, JENNIE G OD	12/31/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	251 W BENCAMP ST	#A	SAN GABRIEL	CA	91776	3798	19	06037	34.07852743	-118.1028748	Los Angeles County
154902	Fee-for-Service	1760486534	1760486534	1	2	TRAN, JACQUELINE V MD	5/12/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	88236	13	Neurology (M.D. only)	0	In state provider	None	2800 L STREET	STE 300	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
154913	Fee-for-Service	1639288566	1639288566	1	1	TAYLOR ELIZABETH MARLOWE MD	5/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9000 W WISCONSIN AVE	None	MILWAUKEE	WI	53226	4874	00	None	43.040979	-88.023816	Milwaukee County
154936	Fee-for-Service	1679007074	1679007074	1	1	TAHERIAN, MEHRAN MD	8/1/2023	390200000X	NA	Other	026	PHYSICIANS	181576	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
154960	Fee-for-Service	1487721205	1487721205	1	1	TRIVEDI, NAVENDU C MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37190	05	Anesthesiology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
154997	Fee-for-Service	1063521557	1063521557	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05777	600 VENTURA ST	None	FILLMORE	CA	93015	1925	56	06111	34.39647873	-118.9154503	Ventura County
155006	Fee-for-Service	1841267689	1841267689	1	13	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	8800 STOCKDALE HWY	150	BAKERSFIELD	CA	93311	1012	15	06029	35.35448783	-119.0995578	Kern County
155245	Fee-for-Service	1699024703	1699024703	1	1	TAMANO FLETCHER CORP.	3/2/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	F OPTOMETRY	164 W. HOSPITALITY LANE	STE.7	SAN BERNARDINO	CA	92408	3329	36	06071	34.06586648	-117.2866005	San Bernardino County
155252	Fee-for-Service	1295752897	1295752897	1	1	TRAN, CHUONG N MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	83025	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
155294	Fee-for-Service	1841267689	1841267689	1	13	TERRIO PHYSICAL THERAPY - FI	8/3/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	8800 STOCKDALE HWY	150	BAKERSFIELD	CA	93311	1012	15	06029	35.35448783	-119.0995578	Kern County
155300	Fee-for-Service	1235288630	1235288630	1	1	TRAN, ALBERT C MD	5/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82267	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
155362	Fee-for-Service	1215913876	1215913876	1	1	TUOMINEN, KORY L MD	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103333	08	Family Practice	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 151	MISSION VIEJO	CA	92691	6306	30	06059	33.56347704	-117.66546	Orange County
155365	Fee-for-Service	1316909906	1316909906	1	1	TESKE, MILTON R MD	3/28/1985	207P00000X	NA	Other	026	PHYSICIANS	52038	None	None	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
155394	Fee-for-Service	1831364249	1831364249	1	1	TRAVIS SCOTT MICKELSON, 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	100 MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
155434	Fee-for-Service	1508865528	1508865528	1	4	TAHOE CARSON VALLEY	10/25/2017	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1090 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3462	09	06017	38.91492536	-119.9966528	El Dorado County
155469	Fee-for-Service	1952963498	1952963498	1	1	TAN, MICHELLE C CNP	9/20/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	660 BAKER STREET	STE A-102	COSTA MESA	CA	92626	4407	30	06059	33.68014263	-117.8842009	Orange County
155487	Fee-for-Service	1942283536	1942283536	1	1	TRAN, ANNIE DC	2/9/2005	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	DR ANNIE TRANS CHIROPRAC	899 WASHINGTON ST	STE 1	SAN FRANCISCO	CA	94108	1214	38	06075	37.79495957	-122.4078614	San Francisco County
155491	Fee-for-Service	1740409648	1740409648	1	1	TRACY OPTOMETRY GROUP INC	8/22/2006	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	36 W 10TH ST	None	TRACY	CA	95376	3902	39	06077	37.73844816	-121.426868	San Joaquin County
155494	Fee-for-Service	1841267689	1841267689	1	4	TERRIO PHYSICAL THERAPY - FI	9/28/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	1800 WESTWIND DR	500	BAKERSFIELD	CA	93301	3055	15	06029	35.37531587	-119.0424856	Kern County
155504	Fee-for-Service	1457394264	1457394264	1	1	TORRANCE RADIOLOGY MED	8/1/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
155539	Fee-for-Service	1124301189	1124301189	1	1	TORRES-FAJARDO, RAFAEL MD	8/1/2019	390200000X	NA	Other	026	PHYSICIANS	148105	89	Surgery-Traumatic	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
155573	Fee-for-Service	1952323669	1952323669	1	1	TRAN, MINHCHAU J MD	2/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56209	05	Anesthesiology	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
155607	Fee-for-Service	1023283447	1023283447	1	1	TAYLOR, JEANNE DO	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11070	01	General Practice	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
155637	Fee-for-Service	1780881409	1780881409	1	1	TON, JIMMY MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	95298	30	Radiology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
155638	Fee-for-Service	1538497128	1538497128	1	1	TALBOTT, JASON F MD	5/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108299	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
155654	Fee-for-Service	1023694684	1023694684	1	1	TRAN, TORRENCE	10/18/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182988	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
155660	Fee-for-Service	1114393311	1114393311	1	1	TEHRANI, PAYAM MD APC	12/13/2016	207R00000X	NA	Other	026	PHYSICIANS	126635	None	None	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
155664	Fee-for-Service	1609439553	1609439553	1	1	TURNAGE, ANDREA M NP	9/16/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1313 E HERNDON AVE	101B/203-206	FRESNO	CA	93720	3306	10	06019	36.834984	-119.7641925	Fresno County
155679	Fee-for-Service	1841267689	1841267689	1	5	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	11206 OLIVE DR	102	BAKERSFIELD	CA	93312	5846	15	06029	35.41981347	-119.1272175	Kern County
155692	Fee-for-Service	1144338898	1144338898	1	1	TAFRESHI, KAREN A DC	2/19/2021	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	18837 BROOKHURST ST STE	None	FOUNTAIN VALLEY	CA	92708	7302	30	06059	33.68919119	-117.9542204	Orange County
155725	Fee-for-Service	1508865528	1508865528	1	4	TAHOE CARSON VALLEY	7/2/2019	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1090 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3462	09	06017	38.91492536	-119.9966528	El Dorado County
155735	Fee-for-Service	1538107362	1538107362	1	1	TRAUGHBER, PAUL D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1000 STATE ST	None	MCCALL	ID	83638	3704	00	None	44.90904704	-116.1097318	Valley County
155736	Fee-for-Service	1841267689	1841267689	1	9	TERRIO PHYSICAL THERAPY - FI	8/4/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	4004 PANAMA LN	100	BAKERSFIELD	CA	93313	3769	15	06029	35.29595752	-119.0472075	Kern County
155737	Fee-for-Service	1720424286	1720424286	1	1	TRAN, VU D	7/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138753	None	None	0	In state provider	None	4849 VAN NUYS BLVD	100	SHERMAN OAKS	CA	91403	5885	19	06037	34.159113	-118.4487465	Los Angeles County
155743	Fee-for-Service	1407965817	1407965817	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5717	5225 CANYON CREST DR	STE 8	RIVERSIDE	CA	92507	6320	33	06065	33.95618617	-117.3293404	Riverside County
155769	Fee-for-Service	1437259348	1437259348	1	1	TRAN, ALEX L MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64056	08	Family Practice	0	In state provider	None	11822 FLORAL DR	None	WHITTIER	CA	90601	2900	19	06037	33.99172377	-118.0495187	Los Angeles County
155780	Fee-for-Service	1841267689	1841267689	1	4	TERRIO PHYSICAL THERAPY - FI	10/24/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	1800 WESTWIND DR	500	BAKERSFIELD	CA	93301	3055	15	06029	35.37531587	-119.0424856	Kern County
155791	Fee-for-Service	1346650637	1346650637	1	1	TSE, JONATHAN DO	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14496	41	Internal Medicine	0	In state provider	None	2500 GRANT RD	None	MOUTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
155826	Fee-for-Service	1124301189	1124301189	1	1	TORRES-FAJARDO, RAFAEL MD	8/1/2019	390200000X	NA	Other	026	PHYSICIANS	148105	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
155852	Fee-for-Service	1770774622	1770774622	1	1	THAIKKENDIYIL, PARVATHY MD	10/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56108	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
155880	Fee-for-Service	1578729422	1578729422	1	1	TETTEH, BEATRICE S MD MPH	7/1/2011	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	112691	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
155945	Fee-for-Service	1851775795	1851775795	1	1	THE CHILDRENS CLINIC SERVING	7/12/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CHILDREN AND THEIR FAMIL	1574 LINDEN AVE	None	LONG BEACH	CA	90813	2032	19	06037	33.786486	-118.1866335	Los Angeles County
155951	Fee-for-Service	1992816086	1992816086	1	1	THRIFTY PAYLESS INC	4/13/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6441	1700 W WHITTIER BLVD	None	LA HABRA	CA	90631	3621	30	06059	33.93952485	-117.9652746	Orange County
155966	Fee-for-Service	1841267689	1841267689	1	5	TERRIO PHYSICAL THERAPY - FI	10/28/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	11206 OLIVE DR	102	BAKERSFIELD	CA	93312	5846	15	06029	35.41981347	-119.1272175	Kern County
155984	Fee-for-Service	1104180835	1104180835	1	1	TABI, GEORGE MD	2/11/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	138828	08	Family Practice	0	In state provider	None	1671 W MAIN ST	D	EL CENTRO	CA	92243	5420	13	06025	32.79277051	-115.5732165	Imperial County
155997	Fee-for-Service	1871603662	1871603662	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5732	405 W IMPERIAL HWY	None	BREA	CA	92821	4818	30	06059	33.91754744	-117.9039472	Orange County
156012	Fee-for-Service	1508865528	1508865528	1	4	TAHOE CARSON VALLEY	8/31/1991	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	1090 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3462	09	06017	38.91492536	-119.9966528	El Dorado County
156024	Fee-for-Service	1841267689	1841267689	1	9	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	4004 PANAMA LN	100	BAKERSFIELD	CA	93313	3769	15	06029	35.29595752	-119.0472075	Kern County
156025	Fee-for-Service	1861567604	1861567604	1	1	THORSON, ANNE I MD	12/31/1987	207R00000X	NA	Other	026	PHYSICIANS	57740	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2100 WEBSTER ST	STE 516	SAN FRANCISCO	CA	94115	2382	38	06075	37.7904826	-122.4324477	San Francisco County
156066	Fee-for-Service	1184990814	1184990814	1	2	TAVARUA MEDICAL REHABILITATI	11/6/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ON SERVICES	474 S. CITRUS AVE	None	AZUSA	CA	91702	4733	19	06037	34.1148093	-117.8901388	Los Angeles County
156077	Fee-for-Service	1902903685	1902903685	1	1	TAN, SONG N MD	6/15/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	45182	40	Pediatrics	0	In state provider	None	1025 ATLANTIC AVE	None	LONG BEACH	CA	90813	3402	19	06037	33.779403	-118.1850775	Los Angeles County
156144	Fee-for-Service	1477545556	1477545556	1	1	TUKAJ, JOANNA MD INC	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	51499	40	Pediatrics	0	In state provider	DR JOANNA'S MED CLINIC	130 W ROUTE 66	STE 324	GLENDORA	CA	91740	6252	19	06037	34.12865951	-117.8651745	Los Angeles County
156224	Fee-for-Service	1104387406	1104387406	1	1	TU, MANUEL S MD	9/6/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	177747	None	None	0	In state provider	None	3733 SAN DIMAS ST	STE 104	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
156232	Fee-for-Service	1851775795	1851775795	1	1	THE CHILDRENS CLINIC SERVING	1/19/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CHILDREN AND THEIR FAMIL	1574 LINDEN AVE	None	LONG BEACH	CA	90813	2032	19	06037	33.786486	-118.1866335	Los Angeles County
156255	Fee-for-Service	1558818179	1558818179	1	1	TRISHA C. PATEL MD INC	7/1/2019	207LP2900X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	8245 E MONTE VISTA RD	200	ANAHEIM	CA	92808	1297	30	06059	33.86359381	-117.7415658	Orange County
156281	Fee-for-Service	1366540551	1366540551	1	1	TROTTER, ALVIN T MD	1/1/1979	207R00000X	NA	Other	026	PHYSICIANS	37072	41	Internal Medicine	0	In state provider	None	644 E REGENT ST	STE 200	INGLEWOOD	CA	90301	1444	19	06037	33.96448447	-118.345059	Los Angeles County
156297	Fee-for-Service	1508865528	1508865528	1	4	TAHOE CARSON VALLEY	9/15/2021	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1090 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3462	09	06017	38.91492536	-119.9966528	El Dorado County
156310	Fee-for-Service	1780874461	1780874461	1	1	TANG, MICHAEL D MD	5/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	118248	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
156324	Fee-for-Service	1346401148	1346401148	1	1	TRANVINH, ERIC MD	7/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123844	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
156329	Fee-for-Service	1679885883	1679885883	1	1	TADWALKAR, RIGVED V MD	5/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119697	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
156334	Fee-for-Service	1497190177	1497190177	1	1	TANGTIPHAIBOONTANA, JENNIFER	8/10/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	133494	20	Orthopedic Surgery	0	In state provider	MD	1001 POTRERO AVE	RM 3A36	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
156355	Fee-for-Service	1215461710	1215461710	1	1	TANQUILUT, CAMILLE MD	2/22/2019	390200000X	NA	Other	026	PHYSICIANS	158481	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
156394	Fee-for-Service	1235233222	1235233222	1	1	TOWBIN, NANCY A MD	7/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74730	None	None	0	In state provider	None	16671 YORBA LINDA BLVD	SUITE 210	YORBA LINDA	CA	92886	2025	30	06059	33.8884134	-117.8435449	Orange County
156466	Fee-for-Service	1487617353	1487617353	1	1	TAKAKI, HARVEY 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	1380 LUSITANA ST	SUITE 912	HONOLULU	HI	96813	2449	00	None	21.30808525	-157.8526581	Honolulu County
156474	Fee-for-Service	1417590241	1417590241	1	1	TINOCO, ADELA LCSW	2/10/2024	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
156505	Fee-for-Service	1215987672	1215987672	1	1	TAUSSIG, PEDRO MD	8/12/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	101 CIVIC CENTER LN LAKE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
156521	Fee-for-Service	1851775795	1851775795	1	1	THE CHILDRENS CLINIC SERVING	1/19/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CHILDREN AND THEIR FAMIL	1574 LINDEN AVE	None	LONG BEACH	CA	90813	2032	19	06037	33.786486	-118.1866335	Los Angeles County
156559	Fee-for-Service	1780710418	1780710418	1	1	TRAN, NAM D MD	10/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93756	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
156598	Fee-for-Service	1457472490	1457472490	1	1	TAN, FRANCIS R MD	4/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
156648	Fee-for-Service	1619283082	1619283082	1	1	TEAS, ANDREA L LCSW	1/2/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9565 BUSINESS CT DR	STE C	RANCHO CUCAMONGA	CA	91730	4560	36	06071	34.09805648	-117.595944	San Bernardino County
156677	Fee-for-Service	1679766281	1679766281	1	1	TREJO, JOSE E M LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	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
156691	Fee-for-Service	1518594266	1518594266	1	1	TRINITY HEARING AID INC	4/30/2020	332S00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	16575 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	2337	30	06059	33.7218603	-117.9547079	Orange County
156695	Fee-for-Service	1245316314	1245316314	1	1	THUMA, NATHAN H	12/19/1995	2084P0800X	NA	Psychiatry	026	PHYSICIANS	58451	36	Psychiatry	0	In state provider	None	1030 MAIN ST	STE 210	SAINT HELENA	CA	94574	2056	28	06055	38.50265028	-122.4659168	Napa County
156726	Fee-for-Service	1659484699	1659484699	1	1	TY CHUN, 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	9927 MICKELBERRY RD NW	STE 121	SILVERDALE	WA	98383	9195	00	None	47.65210996	-122.6823206	Kitsap County
156731	Fee-for-Service	1558466680	1558466680	1	1	TANABE, JENINE L MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	47810	07	Dermatology	0	In state provider	None	414 G ST	STE 204	MARYSVILLE	CA	95901	5669	58	06115	39.13913942	-121.5934649	Yuba County
156790	Fee-for-Service	1871987339	1871987339	1	1	THANG, CHRISTINE K MD	8/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146337	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
156794	Fee-for-Service	1639665516	1639665516	1	1	TRAINING CENTER EPHESIANS 4:	7/30/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	525 GRAND AVE	None	SPRING VALLEY	CA	91977	5933	37	06073	32.70681352	-116.9975147	San Diego County
156801	Fee-for-Service	1659344125	1659344125	1	1	TUCKER, RICK A	5/31/1993	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4910 VAN NUYS BLVD	STE 307	SHERMAN OAKS	CA	91403	1771	19	06037	34.15979697	-118.4486826	Los Angeles County
156832	Fee-for-Service	1154784544	1154784544	1	1	TYAN, ALEXANDER MD	10/6/2021	207R00000X	NA	Other	026	PHYSICIANS	150731	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
156865	Fee-for-Service	1861967622	1861967622	1	1	TEVES SIERRA, LILIANA NP	2/9/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
156873	Fee-for-Service	1447723879	1447723879	1	1	TRAN, HONG T	12/7/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
156901	Fee-for-Service	1336556505	1336556505	1	1	TURKOT, OLEG MD	10/11/2022	207L00000X	NA	Other	026	PHYSICIANS	178198	None	None	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
156921	Fee-for-Service	1063845998	1063845998	1	1	TARLOW, BRANDEN D MD	3/9/2022	207R00000X	NA	Other	026	PHYSICIANS	155604	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
157003	Fee-for-Service	1386030872	1386030872	1	1	TSANOTELIS, EMILY G MD	8/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148374	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
157050	Fee-for-Service	1447288345	1447288345	1	6	TEAM PHYSICIANS OF CALIFORNI	3/19/2020	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	A MEDICAL GROUP, INC	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
157071	Fee-for-Service	1013026392	1013026392	1	1	THRIFTY PAYLESS INC	12/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5548	18444 PLUMMER ST	None	NORTHRIDGE	CA	91325	2112	19	06037	34.24274252	-118.535067	Los Angeles County
157160	Fee-for-Service	1194959825	1194959825	1	1	TAT, SAN T MD	5/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107257	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2722	38	06075	37.76332993	-122.4582988	San Francisco County
157163	Fee-for-Service	1427108125	1427108125	1	1	TOMA, MAHA B MD	8/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	51245	None	None	0	In state provider	None	3466 MT DIABLO BLVD	C104	LAFAYETTE	CA	94549	3952	07	06013	37.89256947	-122.1150289	Contra Costa County
157226	Fee-for-Service	1841528346	1841528346	1	1	TABILA, EDGAR V MD	8/3/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18381	08	Family Practice	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
157236	Fee-for-Service	1417170267	1417170267	1	1	TAN, SHARON N MD	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102782	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
157292	Fee-for-Service	1407922107	1407922107	1	1	TORREBLANCA, JOSE M MD	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	41327	40	Pediatrics	0	In state provider	None	10001 CALIFORNIA AVE	None	SOUTH GATE	CA	90280	6005	19	06037	33.94353626	-118.207669	Los Angeles County
157298	Fee-for-Service	1083140594	1083140594	1	1	TICAS, DACIA J MD	1/1/2022	207P00000X	NA	Other	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
157305	Fee-for-Service	1073198222	1073198222	1	1	TETZLOFF, CLEO A LAC	4/9/2021	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	73255 EL PASEO	8	PALM DESERT	CA	92260	4249	33	06065	33.71965653	-116.386569	Riverside County
157337	Fee-for-Service	1679832802	1679832802	1	1	THOMAS, ANTONIO MD	12/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143098	05	Anesthesiology	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
157338	Fee-for-Service	1447288345	1447288345	1	6	TEAM PHYSICIANS OF CALIFORNI	3/19/2020	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	A MEDICAL GROUP, INC	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
157360	Fee-for-Service	1508122136	1508122136	1	1	TUN, ZIN M MD	8/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130533	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
157377	Fee-for-Service	1922033042	1922033042	1	1	TUNG, CHIU H MD	2/20/2008	207L00000X	NA	Other	026	PHYSICIANS	93842	05	Anesthesiology	0	In state provider	None	1441 FLORIDA AVENUE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
157380	Fee-for-Service	1780732776	1780732776	1	1	TANNER, STACY Y	2/25/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4700 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
157431	Fee-for-Service	1992774681	1992774681	1	1	TAHERI, DANIEL P MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	80445	07	Dermatology	0	In state provider	None	5600 CALIFORNIA AVE	STE 101	BAKERSFIELD	CA	93309	1614	15	06029	35.356203	-119.0612695	Kern County
157441	Fee-for-Service	1952321101	1952321101	1	1	TAYLOR, MIHAELA B MD	9/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76429	None	None	0	In state provider	None	200 MEDICAL PLAZA STE 36	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
157442	Fee-for-Service	1134556137	1134556137	1	1	TRAN, STANLY LCSW	5/25/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	955 W IMPERIAL HWY	SUITE 110	BREA	CA	92821	3812	30	06059	33.91745451	-117.9133065	Orange County
157474	Fee-for-Service	1174848295	1174848295	1	1	TENG, MARIA K NP	3/18/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
157537	Fee-for-Service	1285645531	1285645531	1	1	TCKACHENKO,DMITRIY 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	2901 NORTH CENTRAL AVE	STE 500	PHOENIX	AZ	85012	2738	00	None	33.480666	-112.0729905	Maricopa County
157540	Fee-for-Service	1528450459	1528450459	1	1	THOM, JENNIFER C PHD	3/18/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
157624	Fee-for-Service	1811905094	1811905094	1	1	TONG, DOUGLAS C MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73050	41	Internal Medicine	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
157669	Fee-for-Service	1831397603	1831397603	1	1	TASSONE, HEATHER M DO	1/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10476	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	STE A108	LOMA LINDA	CA	92354	3450	36	06071	34.049547	-117.264078	San Bernardino County
157687	Fee-for-Service	1396854766	1396854766	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5787	1159 E LOS ANGELES AVE	None	SIMI VALLEY	CA	93065	2846	56	06111	34.27181352	-118.7762625	Ventura County
157739	Fee-for-Service	1063706307	1063706307	1	1	TALSANIA, MITALI S MD	10/7/2019	207RE0101X	NA	Endocrinology	026	PHYSICIANS	163384	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
157760	Fee-for-Service	1710124417	1710124417	1	1	TIEN Q NGUYEN INC	1/1/1987	207N00000X	NA	Dermatology	026	PHYSICIANS	50454	07	Dermatology	0	In state provider	None	17271 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	3701	30	06059	33.71228787	-117.9545597	Orange County
157772	Fee-for-Service	1306010947	1306010947	1	1	TAN, EMILY J MD	9/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93419	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
157800	Fee-for-Service	1205497138	1205497138	1	1	TU, ELLEN MD	11/4/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
157851	Fee-for-Service	1659441533	1659441533	1	1	TORRES, NOEL JR MD	7/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93526	40	Pediatrics	0	In state provider	None	711 N ALVARADO ST	STE 106	LOS ANGELES	CA	90026	4016	19	06037	34.07424293	-118.2655575	Los Angeles County
157878	Fee-for-Service	1629029335	1629029335	1	1	TENA, ROWENA G MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69607	30	Radiology	0	In state provider	None	12620 MONTE VISTA RD	STE A	POWAY	CA	92064	2531	37	06073	32.99536145	-117.056826	San Diego County
157913	Fee-for-Service	1043361397	1043361397	1	1	TEMECULA VALLEY UNIF SD	11/17/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	31350 RANCHO VISTA RD	None	TEMECULA	CA	92592	6200	33	06065	33.50406869	-117.1134793	Riverside County
157952	Fee-for-Service	1295997096	1295997096	1	1	TURNER, JONATHAN W MD	2/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104031	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
158010	Fee-for-Service	1104250703	1104250703	1	1	TAYLOR, CORA L LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
158016	Fee-for-Service	1952411761	1952411761	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05891	200 FAIRMONT SHOPPING CT	None	PACIFICA	CA	94044	1240	41	06081	37.66090901	-122.4780698	San Mateo County
158027	Fee-for-Service	1063706307	1063706307	1	1	TALSANIA, MITALI S MD	10/7/2019	207RE0101X	NA	Endocrinology	026	PHYSICIANS	163384	67	Endocrinology	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
158032	Fee-for-Service	1295056018	1295056018	1	1	TULI,SANDEEP	6/13/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8268 164TH ST	None	JAMAICA	NY	11432	1121	00	None	40.717917	-73.804086	Queens County
158054	Fee-for-Service	1548349673	1548349673	1	1	TANNER, BRYCE J MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	62686	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
158099	Fee-for-Service	1366553240	1366553240	1	1	THUKRAL, NUPUR CCC-SLP	10/21/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	995 MONTAGUE EXPY	213	MILPITAS	CA	95035	6851	43	06085	37.41431261	-121.8844434	Santa Clara County
158132	Fee-for-Service	1992790232	1992790232	1	1	TANG, DAVID Y MD	7/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90990	05	Anesthesiology	0	In state provider	None	3939 J ST	STE 310	SACRAMENTO	CA	95819	3666	34	06067	38.570211	-121.45374	Sacramento County
158141	Fee-for-Service	1013368885	1013368885	1	1	THAN, SWE S MD	11/6/2019	207R00000X	NA	Other	026	PHYSICIANS	158060	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
158145	Fee-for-Service	1659441533	1659441533	1	1	TORRES, NOEL JR MD	7/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93526	01	General Practice	0	In state provider	None	711 N ALVARADO ST	STE 106	LOS ANGELES	CA	90026	4016	19	06037	34.07424293	-118.2655575	Los Angeles County
158164	Fee-for-Service	1215419601	1215419601	1	1	TURNER, TRANEAKA LMFT	1/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
158175	Fee-for-Service	1174710651	1174710651	1	1	THE FRESNO CENTER	8/5/2020	101YM0800X	NA	Other	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	4871 E. KINGS CANYON ROA	None	FRESNO	CA	93727	3811	10	06019	36.7360374	-119.7332482	Fresno County
158185	Fee-for-Service	1124051420	1124051420	1	1	TRAUNER, DORIS A MD	1/1/1979	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	25519	13	Neurology (M.D. only)	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
158219	Fee-for-Service	1538871637	1538871637	1	2	TARZANA TREATMENT CENTERS, I	5/17/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC.	1037 E PALMDALE BLVD	None	PALMDALE	CA	93550	4745	19	06037	34.57958348	-118.1104695	Los Angeles County
158262	Fee-for-Service	1003235607	1003235607	1	2	THOMAS, JULIAN	5/31/2019	2084N0402X	NA	Neurology	026	PHYSICIANS	137614	13	Neurology (M.D. only)	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
158375	Fee-for-Service	1528377975	1528377975	1	1	TSAI, DAVID C DO	11/2/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18067	None	None	0	In state provider	None	1038 E BROKAW ROAD	SUITE 30	SAN JOSE	CA	95131	2309	43	06085	37.3827822	-121.8982439	Santa Clara County
158389	Fee-for-Service	1255741765	1255741765	1	1	TENS UNLIMITED INC	8/16/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	5145 N ACADEMY BLVD	STE 210	COLORADO SPRINGS	CO	80918	4049	00	None	38.90544798	-104.7775997	El Paso County
158405	Fee-for-Service	1366862690	1366862690	1	1	TIDWELL, AUSTIN T DO	6/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14843	41	Internal Medicine	0	In state provider	None	275 HOSPITAL DRIVE	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
158428	Fee-for-Service	1538112826	1538112826	1	1	TAKAHASHI, JANEL T MD	9/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105516	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
158430	Fee-for-Service	1144361171	1144361171	1	1	TIGER VALLEY MEDICAL GRP	8/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	1711 W TEMPLE ST	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
158457	Fee-for-Service	1700560877	1700560877	1	1	TAFURI, SYDNEY	10/31/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2373 COLORADO BLVD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
158464	Fee-for-Service	1861537490	1861537490	2	1	TAK HEALTHCARE INC	12/24/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9126 VALLEY BLVD	STE A	ROSEMEAD	CA	91770	1987	19	06037	34.08089747	-118.0704869	Los Angeles County
158471	Fee-for-Service	1609370543	1609370543	1	1	TANTOCO, NICOLE K MD	10/13/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	167321	None	None	0	In state provider	None	20101 LAKE CHABOT RD	4TH FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
158472	Fee-for-Service	1437914009	1437914009	1	1	TWIN GEMINI INC	8/9/2024	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	Y	1426 W 6TH ST	STE 108	CORONA	CA	92882	3036	33	06065	33.87817542	-117.5926407	Riverside County
158529	Fee-for-Service	1255743712	1255743712	1	1	TSUI, EDMUND MD	6/11/2018	390200000X	NA	Other	026	PHYSICIANS	155023	18	Ophthalmology	0	In state provider	None	1001 POTRERO AVE	RM 4M31	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
158539	Fee-for-Service	1578763843	1578763843	1	1	TORRES, JENNIFER L LMFT	1/22/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
158553	Fee-for-Service	1003235607	1003235607	1	2	THOMAS, JULIAN	5/31/2019	2084N0402X	NA	Neurology	026	PHYSICIANS	137614	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
158555	Fee-for-Service	1568784098	1568784098	1	1	THINDA, SUMEER MD	6/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125632	None	None	0	In state provider	None	1360 E HERNDON AVE	SUITE 301	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
158561	Fee-for-Service	1316725088	1316725088	1	2	TAVAKALYAN PODIATRY PC	10/9/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1929 N. FAIRVIEW ST	None	SANTA ANA	CA	92706	2205	30	06059	33.763698	-117.902851	Orange County
158576	Fee-for-Service	1942581616	1942581616	1	1	TOIDZE, TAMARA MD	2/13/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	170808	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
158605	Fee-for-Service	1609832252	1609832252	1	1	TEEL, DONOVAN D MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30879	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	HILLSIDE OB & GYN MED GR	680 GUZZI LN	STE 101	SONORA	CA	95370	5288	55	06109	37.97611058	-120.3719921	Tuolumne County
158618	Fee-for-Service	1114242351	1114242351	1	1	TAN, SUSANNA K MD	7/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	117295	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
158632	Fee-for-Service	1609985050	1609985050	1	1	THRIFTY DRUG STORE 5459	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	6959 EASTERN AVE	None	BELL GARDENS	CA	90201	3926	19	06037	33.96943379	-118.1646562	Los Angeles County
158649	Fee-for-Service	1376652701	1376652701	1	1	THRIFTY PAYLESS INC	7/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	655 RUSSELL BLVD	None	DAVIS	CA	95616	3546	57	06113	38.54641761	-121.7582613	Yolo County
158652	Fee-for-Service	1841338555	1841338555	1	2	TUASON, NORBERTO M MD	8/13/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	53601	None	None	0	In state provider	None	705 W. LA VETA AVE	SUITE 111	ORANGE	CA	92868	4447	30	06059	33.78062272	-117.8600738	Orange County
158673	Fee-for-Service	1154598365	1154598365	1	1	TWITE LEHNEN, KRISTINE K CNM	5/17/2022	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
158675	Fee-for-Service	1073178539	1073178539	1	1	THE STEPHOUSE RECOVERY, INC.	5/24/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	17981 LOS TIEMPOS ST	None	FOUNTAIN VALLEY	CA	92708	6021	30	06059	33.70206742	-117.9407167	Orange County
158680	Fee-for-Service	1386740421	1386740421	1	1	THAYAPRAN, NALLATHAMBY MD	9/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	66422	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5945 TRUXTUN EXTENSION	None	BAKERSFIELD	CA	93309	0691	15	06029	35.36322921	-119.0706029	Kern County
158721	Fee-for-Service	1801282975	1801282975	1	1	TRAN, JACQUELINE DO	4/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15112	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
158736	Fee-for-Service	1255786406	1255786406	1	1	TABIBNIA, AMIR DO	12/7/2019	207P00000X	NA	Other	026	PHYSICIANS	17260	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
158738	Fee-for-Service	1053754333	1053754333	1	1	TOWNSEND, LAURIE MD	12/4/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	174538	None	None	0	In state provider	None	5525 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
158765	Fee-for-Service	1194776476	1194776476	1	1	TAMARIZ, VINCENT P MD	4/5/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80957	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
158863	Fee-for-Service	1942581616	1942581616	1	1	TOIDZE, TAMARA MD	2/13/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	170808	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
158897	Fee-for-Service	1376987818	1376987818	1	1	TRAN, LAC H MD	2/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131974	41	Internal Medicine	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
158903	Fee-for-Service	1629075734	1629075734	1	1	THE CHARLOTTE HUNTERFORD HOS	12/31/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	540 LITCHFIELD ST	None	TORRINGTON	CT	06790	6600	00	None	41.79088711	-73.13337473	Northwest Hills Planning Region
158907	Fee-for-Service	1427185610	1427185610	1	1	TAITZ, NANCY B	9/22/2000	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4293 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1313	38	06075	37.78513171	-122.4632195	San Francisco County
158925	Fee-for-Service	1356669287	1356669287	1	1	TRETTIN, LINDA J	3/12/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
158937	Fee-for-Service	1619424553	1619424553	1	1	THE REHABILITATION CENTER OF	11/1/2016	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ORANGE COUNTY, LLC	9021 KNOTT AVE	None	BUENA PARK	CA	90620	4138	30	06059	33.830712	-118.0109765	Orange County
158938	Fee-for-Service	1972892461	1972892461	1	1	THAN, PETER A MD	2/26/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	122991	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
158951	Fee-for-Service	1992394738	1992394738	1	2	THERAPEUTICALLY CONNECTED FA	6/8/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13800 HEACOCK ST	STE C234	MORENO VALLEY	CA	92553	3339	33	06065	33.91968997	-117.2437139	Riverside County
158970	Fee-for-Service	1386740421	1386740421	1	1	THAYAPRAN, NALLATHAMBY MD	9/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	66422	01	General Practice	0	In state provider	None	5945 TRUXTUN EXTENSION	None	BAKERSFIELD	CA	93309	0691	15	06029	35.36322921	-119.0706029	Kern County
158971	Fee-for-Service	1518026996	1518026996	1	1	TRUONG, SON N MD	2/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97261	01	General Practice	0	In state provider	None	9939 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.91571158	-117.4549231	Riverside County
159054	Fee-for-Service	1194776476	1194776476	1	1	TAMARIZ, VINCENT P MD	4/5/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80957	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
159057	Fee-for-Service	1710373303	1710373303	1	1	THOMAS, CHARLOTTE A CNP	7/8/2019	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
159064	Fee-for-Service	1396162574	1396162574	1	1	TUITE, JENNIFER M	11/17/2017	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
159155	Fee-for-Service	1124366109	1124366109	1	1	TRAN, ANNA NP	5/11/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
159192	Fee-for-Service	1629075734	1629075734	1	1	THE CHARLOTTE HUNTERFORD HOS	2/11/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	540 LITCHFIELD ST	None	TORRINGTON	CT	06790	6600	00	None	41.79088711	-73.13337473	Northwest Hills Planning Region
159193	Fee-for-Service	1376162321	1376162321	1	1	THOTA, JYOTSNA MD	4/28/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	184995	None	None	0	In state provider	None	1201 W LA VETA AVE	FLOOR 2	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
159196	Fee-for-Service	1235191396	1235191396	1	1	THOMPSON, JENNIFER M MD	8/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77596	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
159206	Fee-for-Service	1538615869	1538615869	1	1	TARIQ, SAAD MD	7/15/2022	207R00000X	NA	Other	026	PHYSICIANS	176097	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
159218	Fee-for-Service	1588923064	1588923064	1	1	TIPIRNENI, ANITA MD	5/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143038	13	Neurology (M.D. only)	0	In state provider	None	1328 16TH ST	SECOND FL	SANTA MONICA	CA	90404	1804	19	06037	34.02632404	-118.4846904	Los Angeles County
159227	Fee-for-Service	1083798060	1083798060	1	1	THORNTON, OPAL E MD	9/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	48065	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
159244	Fee-for-Service	1144339508	1144339508	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	VESSEY DRUG STORE 5965	80 RANCHO DEL MAR	None	APTOS	CA	95003	3901	44	06087	36.97708439	-121.9069072	Santa Cruz County
159254	Fee-for-Service	1205369899	1205369899	1	1	THOMPSON, AMANDA LMFT	12/28/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
159260	Fee-for-Service	1386740421	1386740421	1	1	THAYAPRAN, NALLATHAMBY MD	9/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	66422	41	Internal Medicine	0	In state provider	None	5945 TRUXTUN EXTENSION	None	BAKERSFIELD	CA	93309	0691	15	06029	35.36322921	-119.0706029	Kern County
159270	Fee-for-Service	1578715801	1578715801	1	1	THAM, ALLEN MD	12/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110804	20	Orthopedic Surgery	0	In state provider	None	2141 N HARBOR BLVD	SUITE 35000	FULLERTON	CA	92835	3616	30	06059	33.89443025	-117.9288328	Orange County
159333	Fee-for-Service	1780172031	1780172031	1	1	TRINGALE, KATHRYN R	8/30/2023	2085R0001X	NA	Other	026	PHYSICIANS	189312	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
159341	Fee-for-Service	1275718652	1275718652	1	1	TOCCHINI, TONYA M	7/2/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7551 MADISON AVE	None	CITRUS HEIGHTS	CA	95610	7449	34	06067	38.664333	-121.2879735	Sacramento County
159350	Fee-for-Service	1407199896	1407199896	1	1	TAGHADOSI, FARNOOSH MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143593	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1737	19	06037	34.07671715	-118.3799413	Los Angeles County
159379	Fee-for-Service	1497943914	1497943914	1	1	TABAN, MEHRAN MD	7/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108546	None	None	0	In state provider	None	4201 TORRANCE BLVD	STE 220	TORRANCE	CA	90503	4537	19	06037	33.8375955	-118.358748	Los Angeles County
159403	Fee-for-Service	1124223730	1124223730	1	2	THORPE, ELIZABETH N MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144218	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
159405	Fee-for-Service	1891293676	1891293676	1	1	TORRES, SARAH LPCC	12/28/2020	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SS	77564 COUNTRY CLUB DR.	BUILDING B, SUITE 404	PALM DESERT	CA	92211	0484	33	06065	33.75833451	-116.3114325	Riverside County
159594	Fee-for-Service	1386842631	1386842631	2	1	TUZNIK, NATASCHA M DO	9/17/2018	208M00000X	NA	Other	026	PHYSICIANS	16485	41	Internal Medicine	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
159598	Fee-for-Service	1710064654	1710064654	1	1	TRAN, GIAO MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61651	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
159694	Fee-for-Service	1134217730	1134217730	1	1	TRACEWELL, LAURA M OD	9/1/1995	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	39355 CALIFORNIA ST	STE 103	FREMONT	CA	94538	1447	01	06001	37.54733091	-121.9819574	Alameda County
159768	Fee-for-Service	1205190055	1205190055	1	1	TADROS, SHERINE O MD	3/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	143927	41	Internal Medicine	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
159786	Fee-for-Service	1942240213	1942240213	1	1	TAVARI, DANIEL B DO	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7214	08	Family Practice	0	In state provider	None	2230 LYNN RD	STE 200	THOUSAND OAKS	CA	91360	1900	56	06111	34.20894685	-118.885185	Ventura County
159836	Fee-for-Service	1184837098	1184837098	1	1	TESHIMA, KENNETH M DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	SUITE 201	23547 MOULTON PKWY	None	LAGUNA HILLS	CA	92653	1947	30	06059	33.62034959	-117.7316952	Orange County
159869	Fee-for-Service	1306298799	1306298799	1	1	TO, ELIZABETH L	6/30/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
159912	Fee-for-Service	1124002654	1124002654	1	1	TAN, DJERRICK C MD	12/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	73950	30	Radiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
159948	Fee-for-Service	1659597334	1659597334	1	1	TRIBE, JAMES B MD	9/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	104848	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
159982	Fee-for-Service	1093045700	1093045700	1	1	TORRES, ELISE C MD	7/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110243	08	Family Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
160017	Fee-for-Service	1720472012	1720472012	1	1	TSHIJIKA, NDONA M NP	5/18/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
160072	Fee-for-Service	1851755151	1851755151	1	1	TUMMALA, SIRISHA K MD	2/6/2020	208M00000X	NA	Other	026	PHYSICIANS	162966	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
160077	Fee-for-Service	1841267689	1841267689	1	7	TERRIO PHYSICAL THERAPY - FI	4/13/2020	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	7737 MEANY AVE	B5-7	BAKERSFIELD	CA	93308	5266	15	06029	35.39423549	-119.0882835	Kern County
160115	Fee-for-Service	1265518146	1265518146	1	1	TRAN, VICTORIA T MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	55367	24	Plastic Surgery	0	In state provider	None	14571 MAGNOLIA ST	STE 204	WESTMINSTER	CA	92683	5576	30	06059	33.75097286	-117.9723502	Orange County
160119	Fee-for-Service	1821081423	1821081423	1	1	TAM, KENNETH K MD	8/1/1993	207ZC0500X	NA	Other	026	PHYSICIANS	71122	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
160178	Fee-for-Service	1841267689	1841267689	1	10	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	815 TUCKER RD	B	TEHACHAPI	CA	93561	2513	15	06029	35.123004	-118.4678255	Kern County
160201	Fee-for-Service	1518199736	1518199736	1	1	TROTZKY-SIRR, REBECCA MD	7/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115986	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
160233	Fee-for-Service	1477603272	1477603272	1	1	TRUONG, PHU V MD	7/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86105	08	Family Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
160262	Fee-for-Service	1578672903	1578672903	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05491	2240 SEPULVEDA BLVD	None	TORRANCE	CA	90501	5301	19	06037	33.8203219	-118.3209025	Los Angeles County
160264	Fee-for-Service	1831660950	1831660950	1	1	TOLEDO, NAASON R RCP	8/15/2020	2279P1006X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
160328	Fee-for-Service	1780631788	1780631788	1	1	TAN, KENNETH I MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	60594	01	General Practice	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
160339	Fee-for-Service	1235217837	1235217837	1	1	TANG, RICHARD MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	63488	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
160344	Fee-for-Service	1972669141	1972669141	1	1	TEGAN, ARTEMIS 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
160348	Fee-for-Service	1851470900	1851470900	1	1	TENNER, LAURA MD	7/20/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	43208	07	Dermatology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
160364	Fee-for-Service	1841267689	1841267689	1	7	TERRIO PHYSICAL THERAPY - FI	4/13/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	7737 MEANY AVE	B5-7	BAKERSFIELD	CA	93308	5266	15	06029	35.39423549	-119.0882835	Kern County
160406	Fee-for-Service	1508865528	1508865528	1	2	TAHOE CARSON VALLEY	9/15/2021	174400000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	1	Border provider	MEDICAL GROUP, INC	1107 HIGHWAY 395	None	GARDNERVILLE	NV	89410	5304	00	None	38.76078609	-119.576046	Douglas County
160411	Fee-for-Service	1386783553	1386783553	1	1	THOMAS J KERN M.D.	8/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1120 S UTICA AVE	None	TULSA	OK	74104	4012	00	None	36.14680804	-95.96713336	Tulsa County
160468	Fee-for-Service	1841267689	1841267689	1	10	TERRIO PHYSICAL THERAPY - FI	8/3/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	815 TUCKER RD	B	TEHACHAPI	CA	93561	2513	15	06029	35.123004	-118.4678255	Kern County
160490	Fee-for-Service	1518199736	1518199736	1	1	TROTZKY-SIRR, REBECCA MD	7/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115986	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
160563	Fee-for-Service	1346663820	1346663820	1	3	THOMPSON, MICHELLE	8/9/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95013872	-	NOT APPLICABLE	0	In state provider	None	376 HARTNELL AVENUE	SUITE A	REDDING	CA	96002	1881	45	06089	40.56518339	-122.3683085	Shasta County
160594	Fee-for-Service	1245850775	1245850775	1	1	TSAO, RAY-YOUNG MD	6/22/2023	207P00000X	NA	Other	026	PHYSICIANS	184474	None	None	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
160610	Fee-for-Service	1881013902	1881013902	1	1	TOWNE, LAUREN R MD	7/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138398	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
160617	Fee-for-Service	1780631788	1780631788	1	1	TAN, KENNETH I MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	60594	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
160669	Fee-for-Service	1710124417	1710124417	1	2	TIEN Q NGUYEN INC	5/3/2022	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	17271 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	3701	30	06059	33.71228787	-117.9545597	Orange County
160670	Fee-for-Service	1235163163	1235163163	1	1	TECCA, DONALD P MD	8/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	45791	41	Internal Medicine	0	In state provider	None	4282 GENESEE AVE	STE 101	SAN DIEGO	CA	92117	4946	37	06073	32.82092667	-117.1828683	San Diego County
160678	Fee-for-Service	1851388748	1851388748	1	1	TANNER MEDICAL CENTER	6/8/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	601 DALLAS HWY	None	VILLA RICA	GA	30180	1202	00	None	33.74415769	-84.91868758	Carroll County
160694	Fee-for-Service	1508865528	1508865528	1	2	TAHOE CARSON VALLEY	9/28/2021	174400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	1	Border provider	MEDICAL GROUP, INC	1107 HIGHWAY 395	None	GARDNERVILLE	NV	89410	5304	00	None	38.76078609	-119.576046	Douglas County
160709	Fee-for-Service	1962805895	1962805895	1	1	TANG, JEANEEN CCC-SLP	7/13/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2836 W SUNSET BLVD	None	LOS ANGELES	CA	90026	9002	19	06037	34.08237374	-118.2726063	Los Angeles County
160757	Fee-for-Service	1295823854	1295823854	1	1	TAN, LUIS D MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	46580	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
160806	Fee-for-Service	1144389735	1144389735	1	1	TURNIER, JOCELYNE MD	6/25/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	52670	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
160844	Fee-for-Service	1427416841	1427416841	1	1	THACH, VIVIEN T NP	2/22/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
160866	Fee-for-Service	1427048545	1427048545	1	1	THEJOMURTHY, NIRMALA MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80473	05	Anesthesiology	0	In state provider	None	3530 WILSHIRE BLVD	STE 350	LOS ANGELES	CA	90010	2335	19	06037	34.06171652	-118.301427	Los Angeles County
160870	Fee-for-Service	1265063671	1265063671	1	1	TYNES, SARA LPCC	9/16/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
160872	Fee-for-Service	1538799077	1538799077	1	1	THATCHER, LAURA E OT	3/24/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5870 EL CAMINO REAL	100	CARLSBAD	CA	92008	8816	37	06073	33.13309467	-117.2697522	San Diego County
160900	Fee-for-Service	1992842801	1992842801	1	1	TSENG, TONY H MD	9/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101566	05	Anesthesiology	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
160903	Fee-for-Service	1164531604	1164531604	1	1	THRIFTY DRUG STORE 5432	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5490 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4113	19	06037	34.01922113	-118.1518608	Los Angeles County
160906	Fee-for-Service	1780631788	1780631788	1	1	TAN, KENNETH I MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	60594	40	Pediatrics	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
160943	Fee-for-Service	1598824153	1598824153	1	1	TANG, EMILY H MD	3/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71088	07	Dermatology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
160958	Fee-for-Service	1780042903	1780042903	1	1	TOTAL RENAL CARE INC	6/18/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	417 N MCDOWELL BLVD	None	PETALUMA	CA	94954	2339	49	06097	38.2542663	-122.6350565	Sonoma County
160980	Fee-for-Service	1508865528	1508865528	1	2	TAHOE CARSON VALLEY	6/22/2005	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	1	Border provider	MEDICAL GROUP, INC	1107 HIGHWAY 395	None	GARDNERVILLE	NV	89410	5304	00	None	38.76078609	-119.576046	Douglas County
161020	Fee-for-Service	1972091734	1972091734	1	1	TAVAKALYAN, KARINA G DPM	4/2/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	15225 VANOWEN ST	STE 108	VAN NUYS	CA	91405	3603	19	06037	34.19394549	-118.464777	Los Angeles County
161025	Fee-for-Service	1205923562	1205923562	1	1	THRIFTY PAYLESS INC	1/3/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6473	14515 MOJAVE DR	STE B	VICTORVILLE	CA	92394	6720	36	06071	34.5284025	-117.3457215	San Bernardino County
161044	Fee-for-Service	1295823854	1295823854	1	1	TAN, LUIS D MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	46580	41	Internal Medicine	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
161064	Fee-for-Service	1912386400	1912386400	1	1	THALER, NICHOLAS S PHD	11/2/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD BLVD	None	LOS ANGELES	CA	90095	8631	19	06037	34.07067	-118.4432445	Los Angeles County
161083	Fee-for-Service	1033891288	1033891288	1	1	TREJO, ANTHONY L CRNA	11/16/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
161172	Fee-for-Service	1750372140	1750372140	1	1	TAHOE FRACT & ORTH MED C	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	None	1139 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
161204	Fee-for-Service	1619087384	1619087384	1	1	THRIFTY DRUG STORE 5746	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1610 SAN MIGUEL DR	None	NEWPORT BEACH	CA	92660	7124	30	06059	33.61236594	-117.8640791	Orange County
161258	Fee-for-Service	1801830765	1801830765	1	1	TSUJIMOTO, CURT MD	9/18/1988	207L00000X	NA	Other	026	PHYSICIANS	55049	05	Anesthesiology	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
161330	Fee-for-Service	1831438522	1831438522	1	1	TAN, JEREMIAH S CRNA	3/11/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
161346	Fee-for-Service	1598179087	1598179087	1	1	TORNATORE-PILI, ANNE E CNM	10/26/2017	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
161376	Fee-for-Service	1043709116	1043709116	1	1	TSUNG, KAREN MD	10/1/2021	207R00000X	NA	Other	026	PHYSICIANS	165751	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
161377	Fee-for-Service	1033189568	1033189568	1	1	THOMPSON, DONNA MD	6/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	67144	08	Family Practice	0	In state provider	None	16655 FOOTHILL BLVD	None	FONTANA	CA	92335	8416	36	06071	34.10657805	-117.4415752	San Bernardino County
161430	Fee-for-Service	1437818499	1437818499	1	1	TARBOX, LIOUDMILA NP	1/16/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	108 GREEN VALLEY RD	None	FREEDOM	CA	95019	3110	44	06087	36.93669269	-121.7720262	Santa Cruz County
161441	Fee-for-Service	1609022730	1609022730	1	1	THOMSON, BRYON D DO	8/13/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	12704	30	Radiology	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
161489	Fee-for-Service	1952613515	1952613515	1	1	TALBOT, JOCELYN M MD	4/2/2019	207R00000X	NA	Other	026	PHYSICIANS	158726	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
161735	Fee-for-Service	1245715648	1245715648	1	1	TRANSPORT ASSIST	1/2/2019	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2693 E WASHINGTON BLVD	SUITE B	PASADENA	CA	91107	1412	19	06037	34.16895749	-118.0951839	Los Angeles County
161763	Fee-for-Service	1598781346	1598781346	1	1	TRAN,JAMES V MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	83026	41	Internal Medicine	0	In state provider	None	15623 BROOKHURST ST	STE 102	WESTMINSTER	CA	92683	7556	30	06059	33.73550115	-117.954801	Orange County
161781	Fee-for-Service	1629276332	1629276332	1	1	TSAI, SHUFANG PSYD	7/13/2021	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	405 KAINS AVE	SUITE 105	ALBANY	CA	94706	1271	01	06001	37.89775845	-122.3005042	Alameda County
161787	Fee-for-Service	1366478620	1366478620	1	1	TRACI L NIVENS MD	7/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
161796	Fee-for-Service	1902201841	1902201841	1	1	TRIGUEROS-THURSTON, MIRANDA	9/14/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	A LMFT	27851 BRADLEY RD	STE 110, 111	MENIFEE	CA	92586	2213	33	06065	33.71630969	-117.1904696	Riverside County
161800	Fee-for-Service	1689135220	1689135220	1	1	TOY, DANA	8/15/2023	208M00000X	NA	Other	026	PHYSICIANS	188015	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
161831	Fee-for-Service	1518541218	1518541218	1	1	TIET, DARREN C MD	9/25/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21428	08	Family Practice	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
161858	Fee-for-Service	1730666249	1730666249	1	1	TESFAYE, KEBREWORK RCP	10/8/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
161862	Fee-for-Service	1427692086	1427692086	1	1	TUSTIN URGENT CARE, APC	3/1/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	N BEACH	5888 EDINGER AVE	None	HUNTINGTON BEACH	CA	92649	1705	30	06059	33.72993249	-118.0255995	Orange County
161876	Fee-for-Service	1063832483	1063832483	1	1	TAO, LI MD	4/13/2018	207R00000X	NA	Other	026	PHYSICIANS	137555	41	Internal Medicine	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
161878	Fee-for-Service	1144337650	1144337650	1	1	TEEL, LISA A OD	10/12/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	19270 SONOMA HIGHWAY 12	None	SONOMA	CA	95476	5414	49	06097	38.29871411	-122.4751509	Sonoma County
161900	Fee-for-Service	1578512968	1578512968	1	1	TURNAGE, JIMMY W MD APMC	11/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79173	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7930 FROST ST	STE 103	SAN DIEGO	CA	92123	2738	37	06073	32.80027001	-117.1532893	San Diego County
161965	Fee-for-Service	1639767940	1639767940	1	1	TU, STELLA OD	8/30/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2619 E COLORADO BLVD	SUITE 150	PASADENA	CA	91107	3747	19	06037	34.14616014	-118.0964013	Los Angeles County
162001	Fee-for-Service	1063412195	1063412195	1	1	TSUCHIYOSE, MARC M MD	1/31/1988	174400000X	NA	Other	026	PHYSICIANS	53160	10	Gastroenterology (M.D. only)	0	In state provider	None	1850 SULLIVAN AVE	STE 502	DALY CITY	CA	94015	2221	41	06081	37.68085904	-122.4728842	San Mateo County
162124	Fee-for-Service	1992091243	1992091243	1	1	TRINH, LOAN X OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	44105 15TH ST WEST	None	LANCASTER	CA	93534	4088	19	06037	34.684218	-118.1568465	Los Angeles County
162135	Fee-for-Service	1235618356	1235618356	1	1	TIRADO, DENISE OD	12/16/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
162190	Fee-for-Service	1578512968	1578512968	1	1	TURNAGE, JIMMY W MD APMC	11/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79173	08	Family Practice	0	In state provider	None	7930 FROST ST	STE 103	SAN DIEGO	CA	92123	2738	37	06073	32.80027001	-117.1532893	San Diego County
162226	Fee-for-Service	1780997031	1780997031	1	1	THOMAS, PAUL W PHD	5/17/2018	No Taxonomy Provided	NA	None	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
162245	Fee-for-Service	1912016379	1912016379	1	1	THRIFTY PAYLESS INC	1/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6099	975 E CYPRESS AVE	None	REDDING	CA	96002	1001	45	06089	40.57101254	-122.353803	Shasta County
162257	Fee-for-Service	1962511378	1962511378	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5695	16910 FOOTHILL BLVD	None	FONTANA	CA	92335	3502	36	06071	34.10671782	-117.4344294	San Bernardino County
162266	Fee-for-Service	1326530411	1326530411	2	1	TRAN-NGUYEN, DOMINIC D DO	6/13/2023	207R00000X	NA	Other	026	PHYSICIANS	18940	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
162289	Fee-for-Service	1053421826	1053421826	1	1	THRIFTY DRUG STORE 6057	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	1220 BROADWAY	None	PLACERVILLE	CA	95667	5806	09	06017	38.73108579	-120.7869921	El Dorado County
162304	Fee-for-Service	1699594002	1699594002	1	1	TRAN, ERIC PT	11/12/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1855 E COCHRAN ST	#109	SIMI VALLEY	CA	93065	2265	56	06111	34.27906738	-118.7628635	Ventura County
162321	Fee-for-Service	1548872625	1548872625	1	1	TRAN, JACQUELINE V CRNA	3/31/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
162364	Fee-for-Service	1629030895	1629030895	2	1	TUQAN, SA'D K MD	2/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	37812	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2250 S MAIN ST	STE 201	CORONA	CA	92882	2536	33	06065	33.8550661	-117.5695499	Riverside County
162366	Fee-for-Service	1396835633	1396835633	1	1	TAN, TERESITA E MD	5/1/1984	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	40376	40	Pediatrics	0	In state provider	None	244 S OXFORD AVE	STE 9	LOS ANGELES	CA	90004	5126	19	06037	34.069851	-118.3078535	Los Angeles County
162386	Fee-for-Service	1114125796	1114125796	1	1	TAMAYO-SARVER JOSHUA H	12/5/2007	207P00000X	NA	Other	026	PHYSICIANS	97037	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
162398	Fee-for-Service	1134452980	1134452980	1	1	THIBAULT, SARAH D CSW	12/9/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	62703	-	NOT APPLICABLE	0	In state provider	None	1600 WEEOT WAY	None	ARCATA	CA	95521	4734	12	06023	40.89808837	-124.0923819	Humboldt County
162402	Fee-for-Service	1962172593	1962172593	1	1	TAN, ALISON G PHD	10/12/2021	103T00000X	NA	Mental Health Outpatient Services	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
162455	Fee-for-Service	1912199068	1912199068	1	1	TOMIHAMA, ROGER T MD	2/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115140	30	Radiology	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
162563	Fee-for-Service	1275089955	1275089955	1	1	THEMER, CHERI	9/27/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
162604	Fee-for-Service	1851417364	1851417364	1	1	TIMOTHY BEDIEN	5/23/2018	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
162639	Fee-for-Service	1316426554	1316426554	1	1	TRAN, MARIE T RCP	9/24/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
162661	Fee-for-Service	1396286316	1396286316	1	1	THAKKER, NIRALI NP	1/12/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
162682	Fee-for-Service	1801990239	1801990239	1	1	TABIB, MONA MD	10/31/1984	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	40287	01	General Practice	0	In state provider	None	16661 VENTURA BLVD	STE 211	ENCINO	CA	91436	1938	19	06037	34.15820737	-118.496492	Los Angeles County
162693	Fee-for-Service	1437183225	1437183225	1	1	TAHER, ABU T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	29357	40	Pediatrics	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
162726	Fee-for-Service	1386753671	1386753671	1	1	THRIFTY PAYLESS INC	10/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	RITE AID #5384	981 MEDFORD CTR	None	MEDFORD	OR	97504	6700	00	None	42.33337002	-122.8660024	Jackson County
162766	Fee-for-Service	1760568661	1760568661	1	1	TAY, THEAM L MD	10/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88981	08	Family Practice	0	In state provider	None	3000 Q ST	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
162788	Fee-for-Service	1881834919	1881834919	1	1	THOMAS, SMITHA NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4950 SUNSET BLVD	None	LOS ANGELES	CA	90027	5822	19	06037	34.09812092	-118.2980246	Los Angeles County
162810	Fee-for-Service	1851389696	1851389696	1	3	TIBURCIO VASQUEZ HLTH CT	8/26/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	33255 9TH ST	None	UNION CITY	CA	94587	2137	01	06001	37.60286569	-122.0260874	Alameda County
162843	Fee-for-Service	1083749725	1083749725	1	1	THE VILLAGE FAMILY SERVICES	5/10/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	6736 LAUREL CANYON BLVD	STE 200	NORTH HOLLYWOOD	CA	91606	1576	19	06037	34.193493	-118.3964925	Los Angeles County
162875	Fee-for-Service	1912094590	1912094590	1	1	TALEGON, ELIF T MD	4/20/2009	207R00000X	NA	Other	026	PHYSICIANS	63262	08	Family Practice	0	In state provider	INC	365 PEARSON DR	STE 5	PORTERVILLE	CA	93257	3360	54	06107	36.07254288	-119.0276371	Tulare County
162892	Fee-for-Service	1275236192	1275236192	1	1	TSAI, CINDY PT	2/20/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9850 GENESEE AVE	510	LA JOLLA	CA	92037	1224	37	06073	32.882913	-117.226341	San Diego County
162912	Fee-for-Service	1346786597	1346786597	2	1	TEHRANI, ELAZAR B PSYD	8/13/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	21621 NORDHOFF ST STE 30	None	CHATSWORTH	CA	91311	5825	19	06037	34.23550252	-118.6016209	Los Angeles County
162944	Fee-for-Service	1063570190	1063570190	1	1	TUJUNGA HEALTH CARE CORP	12/21/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TUJUNGA HEALTH CARE CORP	6653 FOOTHILL BLVD	None	TUJUNGA	CA	91042	2706	19	06037	34.24699663	-118.2775074	Los Angeles County
162972	Fee-for-Service	1477783884	1477783884	1	1	TURNER, ERIN L MD	1/9/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	2825 E BARNETT RD	None	MEDFORD	OR	97504	8332	00	None	42.31650147	-122.8306005	Jackson County
163024	Fee-for-Service	1598771883	1598771883	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05492	1237 W CARSON ST	None	TORRANCE	CA	90502	2009	19	06037	33.83159049	-118.2970485	Los Angeles County
163111	Fee-for-Service	1700816048	1700816048	1	1	THE TRUSTEES OF NOBLE	10/8/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	115 WEST SILVER ST	None	WESTFIELD	MA	01085	3628	00	None	42.118038	-72.759762	Hampden County
163143	Fee-for-Service	1568536878	1568536878	1	1	TANG, JEAN Y MD	1/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88243	07	Dermatology	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
163168	Fee-for-Service	1316981699	1316981699	1	1	TRAYNOR, JEFFREY D MD	6/1/1999	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	30478	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
163177	Fee-for-Service	1013310317	1013310317	1	1	TOMOSSIAN, NAZARET H CRNA	6/10/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	35-800 BOB HOPE DR	STE 100	RANCHO MIRAGE	CA	92270	1739	33	06065	33.78398109	-116.4059049	Riverside County
163186	Fee-for-Service	1194340232	1194340232	1	1	TAO, DEREK PT	4/12/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1085 W EL CAMINO REAL	None	SUNNYVALE	CA	94087	1030	43	06085	37.37270741	-122.0517412	Santa Clara County
163189	Fee-for-Service	1235253196	1235253196	1	1	TABAN, RYAN MD	8/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99816	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 STEIN PLAZA	#1-340	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
163229	Fee-for-Service	1568844017	1568844017	1	1	TRAN, QUOC-THIEU MD	8/8/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
163252	Fee-for-Service	1972586972	1972586972	1	1	TULE RIVER INDIAN HEALTH	9/1/2002	207Q00000X	NA	Adult Primary Care	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	0	In state provider	None	380 N RESERVATION RD	None	PORTERVILLE	CA	93257	9673	54	06107	36.02996779	-118.7882551	Tulare County
163327	Fee-for-Service	1467652727	1467652727	1	1	TRAN, MELISSA L LMFT	2/26/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
163342	Fee-for-Service	1437886595	1437886595	2	1	TRANSITIONS BUPRENORPHINE CL	9/18/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INIC OF SACRAMENTO	3647 40TH STREET	None	SACRAMENTO	CA	95817	3609	34	06067	38.541456	-121.4604765	Sacramento County
163399	Fee-for-Service	1700816048	1700816048	1	1	THE TRUSTEES OF NOBLE	10/8/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	115 WEST SILVER ST	None	WESTFIELD	MA	01085	3628	00	None	42.118038	-72.759762	Hampden County
163404	Fee-for-Service	1184814006	1184814006	1	1	THIERRY, ANDREW P MD	8/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112782	None	None	0	In state provider	None	1516 COTNER AVE	None	LOS ANGELES	CA	90025	3305	19	06037	34.04905416	-118.4477438	Los Angeles County
163438	Fee-for-Service	1447681333	1447681333	1	1	TEMPESTA, CHRISTINA M LMFT	5/7/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	49370 RD 426	SUITE B	OAKHURST	CA	93644	9052	20	06039	37.32775834	-119.647531	Madera County
163481	Fee-for-Service	1346828217	1346828217	1	1	TAYLOR, BRENNA S NP	4/5/2021	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
163517	Fee-for-Service	1669779708	1669779708	1	1	TRAN, HUNG N MD	5/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119593	68	Hematology	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
163538	Fee-for-Service	1972586972	1972586972	1	1	TULE RIVER INDIAN HEALTH	9/1/2002	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	380 N RESERVATION RD	None	PORTERVILLE	CA	93257	9673	54	06107	36.02996779	-118.7882551	Tulare County
163562	Fee-for-Service	1225147622	1225147622	1	1	THRIFTY DRUG STORE 6081	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	9133 KIEFER BLVD	None	SACRAMENTO	CA	95826	5105	34	06067	38.548188	-121.3607115	Sacramento County
163585	Fee-for-Service	1194753590	1194753590	1	1	THHBP MANAGEMENT COMPANY LLC	6/15/2021	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	RT HOSPITAL - DENTON	2801 S MAYHILL RD	None	DENTON	TX	76208	5910	00	None	33.1767639	-97.08816988	Denton County
163630	Fee-for-Service	1356591267	1356591267	1	1	TOMASIAN, ANDERANIK MD	6/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136782	30	Radiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
163638	Fee-for-Service	1346455672	1346455672	1	1	TANTIWONGKOSI, BUNDHIT	5/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103495	30	Radiology	0	In state provider	MD	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
163672	Fee-for-Service	1578182580	1578182580	1	1	TANG, CAROL MD	11/24/2023	390200000X	NA	Other	026	PHYSICIANS	185509	None	None	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
163712	Fee-for-Service	1922051739	1922051739	1	1	TRAN, CHARLES M DO	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	6999	07	Dermatology	0	In state provider	None	21580 YORBA LINDA BLVD	None	YORBA LINDA	CA	92887	3748	30	06059	33.877926	-117.750744	Orange County
163736	Fee-for-Service	1063442770	1063442770	1	1	TENET HIALEAH HEALTHSYST	2/7/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	651 E 25TH ST	None	HIALEAH	FL	33013	3814	00	None	25.8449845	-80.26837881	Miami-Dade County
163737	Fee-for-Service	1003171570	1003171570	1	1	TSENG, VICTORIA L MD	5/7/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	128499	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	#1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06482757	-118.4443441	Los Angeles County
163757	Fee-for-Service	1619753183	1619753183	1	1	THE GOLDEN DAYS CARE HOME	9/19/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	INC	8647 N RICHELLE AVENUE	None	FRESNO	CA	93720	5316	10	06019	36.86168574	-119.7317437	Fresno County
163766	Fee-for-Service	1326107038	1326107038	1	1	TO, CYNTHIA G NP	11/4/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	444 GLENOAKS BLVD	None	GLENDALE	CA	91202	2917	19	06037	34.1598361	-118.2632528	Los Angeles County
163792	Fee-for-Service	1417066879	1417066879	1	1	THRIFTY PAYLESS INC	5/10/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6400	3105 RANCHO VISTA BLVD	None	PALMDALE	CA	93551	4822	19	06037	34.60241498	-118.1862009	Los Angeles County
163805	Fee-for-Service	1669779708	1669779708	1	1	TRAN, HUNG N MD	5/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119593	78	Neoplastic Diseases/Oncology	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
163808	Fee-for-Service	1639189517	1639189517	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10823 ZELZAH AVE	BLDG D	GRANADA HILLS	CA	91344	4433	19	06037	34.266798	-118.5234555	Los Angeles County
163821	Fee-for-Service	1972259117	1972259117	1	1	THRU, INC	10/2/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1000 QUAIL ST	STE 188	NEWPORT BEACH	CA	92660	2735	30	06059	33.65915099	-117.8659973	Orange County
163828	Fee-for-Service	1972586972	1972586972	1	1	TULE RIVER INDIAN HEALTH	7/1/1994	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	380 N RESERVATION RD	None	PORTERVILLE	CA	93257	9673	54	06107	36.02996779	-118.7882551	Tulare County
163870	Fee-for-Service	1194753590	1194753590	1	1	THHBP MANAGEMENT COMPANY LLC	6/15/2021	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	RT HOSPITAL - DENTON	2801 S MAYHILL RD	None	DENTON	TX	76208	5910	00	None	33.1767639	-97.08816988	Denton County
163903	Fee-for-Service	1225168032	1225168032	1	1	TADROS, REDA M MD	7/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84889	22	Pathology (M.D. only)	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
163904	Fee-for-Service	1871022673	1871022673	1	1	TSANG, JESSY DO	3/1/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17109	None	None	0	In state provider	None	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
163964	Fee-for-Service	1659372241	1659372241	1	1	TURNER, ALAN T MD	7/27/2005	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	62013	30	Radiology	0	In state provider	None	9930 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166152	-117.955521	Orange County
164023	Fee-for-Service	1063442770	1063442770	1	1	TENET HIALEAH HEALTHSYST	2/7/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	651 E 25TH ST	None	HIALEAH	FL	33013	3814	00	None	25.8449845	-80.26837881	Miami-Dade County
164032	Fee-for-Service	1912981713	1912981713	1	1	TARASENKO, VALERY D	1/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	72444	None	None	0	In state provider	None	1101 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3700	48	06095	38.26103575	-122.0462501	Solano County
164047	Fee-for-Service	1225407596	1225407596	1	2	TUSTIN URGENT CARE APC	3/13/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	17612 E 17TH ST	None	TUSTIN	CA	92780	1937	30	06059	33.75968738	-117.8248408	Orange County
164066	Fee-for-Service	1740337161	1740337161	1	1	TALAVERA, GREGORY A MD	1/31/1984	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	40061	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
164067	Fee-for-Service	1346207289	1346207289	1	1	TAKATA, MARK C MD	4/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94975	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
164152	Fee-for-Service	1144004920	1144004920	1	1	TABIA, KRISTEN L PT	10/26/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	957 FAULKNERROAD	105	SANTA PAULA	CA	93060	9129	56	06111	34.33481551	-119.0867489	Ventura County
164156	Fee-for-Service	1154336246	1154336246	1	1	THOMAS, SEAN R MD INC	11/1/2001	207Q00000X	NA	Adult Primary Care	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	6186 ADOBE RD	None	TWENTYNINE PALMS	CA	92277	2652	36	06071	34.14141685	-116.0543152	San Bernardino County
164168	Fee-for-Service	1174976559	1174976559	1	1	TUASON, IVY NP	9/9/2020	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9942 BROADWAY	None	ANAHEIM	CA	92804	2308	30	06059	33.82885329	-117.9595736	Orange County
164203	Fee-for-Service	1336102433	1336102433	1	1	TOTAL RENAL CARE, INC	12/1/1998	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	SALINAS VALLEY DIALYSIS	955 BLANCO CIR	STE C	SALINAS	CA	93901	4452	27	06053	36.65564507	-121.6367659	Monterey County
164264	Fee-for-Service	1205149978	1205149978	1	1	TRONCALES, IMELINE H MD	8/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150188	40	Pediatrics	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
164280	Fee-for-Service	1952492605	1952492605	1	1	TOWNSEND, DENNIS C MD	2/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88856	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
164333	Fee-for-Service	1194865485	1194865485	1	1	TUBBS-RIVERO, MARIA V MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61715	41	Internal Medicine	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
164336	Fee-for-Service	1265458269	1265458269	1	1	TAYLOR, KENNETH S MD	10/18/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55037	08	Family Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
164340	Fee-for-Service	1043639248	1043639248	1	1	TERP, DIANNE M LCSW	6/8/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2200 LEAVENWORTH ST	STE 105	SAN FRANCISCO	CA	94133	2262	38	06075	37.80144941	-122.417812	San Francisco County
164351	Fee-for-Service	1144929324	1144929324	1	1	TERNER CARE	4/20/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	13800 WHEELER AVENUE	None	SYLMAR	CA	91342	1646	19	06037	34.32277459	-118.4410208	Los Angeles County
164398	Fee-for-Service	1851400220	1851400220	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05567	7239 WOODMAN AVE	None	VAN NUYS	CA	91405	2621	19	06037	34.202349	-118.431286	Los Angeles County
164435	Fee-for-Service	1235503533	1235503533	1	1	THOMPSON, BRIAN D LMFT	8/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28202 CABOT RD	STE 373	LAGUNA NIGUEL	CA	92677	1222	30	06059	33.55317111	-117.6788682	Orange County
164442	Fee-for-Service	1154336246	1154336246	1	1	THOMAS, SEAN R MD INC	11/1/2001	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	6186 ADOBE RD	None	TWENTYNINE PALMS	CA	92277	2652	36	06071	34.14141685	-116.0543152	San Bernardino County
164463	Fee-for-Service	1689772592	1689772592	1	1	THE REGENTS OF UNIV CA	7/1/2005	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	0296	38	06075	37.76344756	-122.4581992	San Francisco County
164464	Fee-for-Service	1689616690	1689616690	1	1	TRAN, XUANANH P MD	11/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66423	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2845 HOSPITAL DRIVE	SUITE 261	MOUNTAIN VIEW	CA	94040	4103	43	06085	37.36881011	-122.0817915	Santa Clara County
164487	Fee-for-Service	1891127312	1891127312	1	1	THORNTON, KIMBERLY A LCSW	4/15/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1443 N IVY ST	None	ESCONDIDO	CA	92026	2722	37	06073	33.14378677	-117.0871986	San Diego County
164489	Fee-for-Service	1811427347	1811427347	1	1	THOMAS, JESSICA M MD	10/8/2020	207P00000X	NA	Other	026	PHYSICIANS	169336	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
164507	Fee-for-Service	1043327737	1043327737	1	1	TANG, PAUL C MD	5/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	47811	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
164554	Fee-for-Service	1205103942	1205103942	1	2	TSAI, JACQUELINE MD	2/15/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	137638	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
164558	Fee-for-Service	1568487528	1568487528	1	1	TAI, LIANG-YU L DO	11/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	7444	08	Family Practice	0	In state provider	None	210 N GARFIELD AVE	STE 206	MONTEREY PARK	CA	91754	1746	19	06037	34.064181	-118.122834	Los Angeles County
164575	Fee-for-Service	1104960830	1104960830	1	1	THACKER, SWATI R MD	9/10/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	41122	36	Psychiatry	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
164581	Fee-for-Service	1043509136	1043509136	1	1	TITH, SOLINA MD	8/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139503	05	Anesthesiology	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
164589	Fee-for-Service	1821395740	1821395740	1	1	TOPIK, AMANDA L NP	6/30/2022	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
164607	Fee-for-Service	1164578787	1164578787	1	1	TRISTAN J HUIE 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	13199 E MONTVIEW BLVD	PO BOX 111719	AURORA	CO	80040	0876	00	None	39.748041	-104.834673	Adams County
164620	Fee-for-Service	1194865485	1194865485	1	1	TUBBS-RIVERO, MARIA V MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61715	38	Geriatrics	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
164633	Fee-for-Service	1013688175	1013688175	1	1	TAHIR, ILHAM LMFT	3/29/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	127 BROADWAY	SUITE 200	SANTA MONICA	CA	90401	2330	19	06037	34.01334753	-118.4957836	Los Angeles County
164656	Fee-for-Service	1245395680	1245395680	1	1	TARRAN, MATTHEW PHD	11/26/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3551 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
164667	Fee-for-Service	1306466826	1306466826	1	1	TRAK, JOSEPH MD	2/6/2025	207U00000X	NA	Other	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
164689	Fee-for-Service	1104065440	1104065440	1	1	TRAN, BAO G H MD	5/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106360	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
164699	Fee-for-Service	1689015901	1689015901	1	1	THEIS, JACQUELINE M OD	2/20/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1033 THIRD ST	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
164706	Fee-for-Service	1679077929	1679077929	1	1	TRAN, BENJAMIN V MD	10/19/2020	208600000X	NA	General Surgery	026	PHYSICIANS	166489	02	General Surgery	0	In state provider	None	888 S HILL ROAD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
164728	Fee-for-Service	1881645299	1881645299	1	1	TANAKA, ELAINE G MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73554	02	General Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
164733	Fee-for-Service	1982698684	1982698684	1	1	THOPU, ANURADHA R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	DOUGLAS HOSPITAL	8954 HOSPITAL DR,	STE 100-C	DOUGLASVILLE	GA	30134	0000	00	None	33.73923813	-84.73299495	Douglas County
164751	Fee-for-Service	1689772592	1689772592	1	1	THE REGENTS OF UNIV CA	7/1/2005	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	0296	38	06075	37.76344756	-122.4581992	San Francisco County
164756	Fee-for-Service	1043387954	1043387954	1	1	TREJO, EMMA B MD	10/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	56299	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
164805	Fee-for-Service	1588238513	1588238513	1	1	TAPIA RUIZ, SAUL MD	8/21/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
164812	Fee-for-Service	1801877170	1801877170	1	1	TRUONG, TRUNG H MD	8/1/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	79604	40	Pediatrics	0	In state provider	None	11420 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
164821	Fee-for-Service	1841453032	1841453032	1	1	TRAN, AARON K MD	4/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114153	41	Internal Medicine	0	In state provider	None	10362 BOLSA AVENUE	SUITE 110	WESTMINSTER	CA	92683	6763	30	06059	33.74488248	-117.94806	Orange County
164825	Fee-for-Service	1225047020	1225047020	1	1	TRI-COUNTIES EASTER SEAL	4/20/1995	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	SOCIETY	10730 HENDERSON RD	None	VENTURA	CA	93004	1832	56	06111	34.2869425	-119.1602281	Ventura County
164879	Fee-for-Service	1174976559	1174976559	1	2	TUASON, IVY NP	5/24/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	12932	-	NOT APPLICABLE	0	In state provider	None	3535 W COMMONWEALTH AVE	None	FULLERTON	CA	92833	2821	30	06059	33.8700505	-117.9749565	Orange County
164904	Fee-for-Service	1730411257	1730411257	1	1	TUNRU-DINH, VONNY W MD	10/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103524	22	Pathology (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
164923	Fee-for-Service	1104573633	1104573633	1	2	THE BEACON HOUSE ASSOCIATION	8/30/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	OF SAN PEDRO	411 W 10TH ST	None	SAN PEDRO	CA	90731	3213	19	06037	33.7351085	-118.2859605	Los Angeles County
164947	Fee-for-Service	1578586640	1578586640	1	1	TULADHAR, PREETI MD	12/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94944	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
164978	Fee-for-Service	1104065440	1104065440	1	1	TRAN, BAO G H MD	5/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106360	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
165000	Fee-for-Service	1659962454	1659962454	1	1	TAN, VIA G CRNA	5/13/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
165021	Fee-for-Service	1013026533	1013026533	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5711	949 KENDALL DR	None	SAN BERNARDINO	CA	92407	5801	36	06071	34.16345766	-117.303952	San Bernardino County
165033	Fee-for-Service	1780850016	1780850016	1	1	TRUONG, YEN N MD	6/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110548	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
165050	Fee-for-Service	1932545613	1932545613	1	1	TRIVEDI, TARAK K MD	9/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134755	None	None	0	In state provider	None	1800 N CALIFORNIA STREET	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
165065	Fee-for-Service	1376675942	1376675942	1	1	TURCHI, CLAIRE A MD	7/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101013	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
165095	Fee-for-Service	1144396383	1144396383	1	1	TAMAYO, BEATRIZ E MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74662	41	Internal Medicine	0	In state provider	None	2208 W 7TH ST	None	LOS ANGELES	CA	90057	4002	19	06037	34.05710805	-118.2782502	Los Angeles County
165097	Fee-for-Service	1437217767	1437217767	1	1	TAYLOR, JAMIE L MD	8/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86675	None	None	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
165175	Fee-for-Service	1366516676	1366516676	1	1	TZENG, YU-YEA M MD	5/7/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	68367	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	450 SUTTER ST	RM 916	SAN FRANCISCO	CA	94108	3911	38	06075	37.78934929	-122.4077786	San Francisco County
165244	Fee-for-Service	1023082591	1023082591	1	1	TODD SPENCER M D MEDICAL	1/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
165254	Fee-for-Service	1669867859	1669867859	1	1	TOTRI, CHRISTINE R MD	9/6/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	177907	None	None	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
165259	Fee-for-Service	1417938630	1417938630	1	1	THOMPSON, PATRICK S MD	8/11/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45100	08	Family Practice	0	In state provider	None	15 MAREBLU	STE 100	ALISO VIEJO	CA	92656	3015	30	06059	33.5729913	-117.703431	Orange County
165260	Fee-for-Service	1417910811	1417910811	1	1	TASNEEM K LALANI MD	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	908 10TH AVE SW	None	QUINCY	WA	98848	1376	00	None	47.23094665	-119.8691639	Grant County
165261	Fee-for-Service	1427007277	1427007277	1	1	TAEED, ELHAM M MD INC	10/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	54363	40	Pediatrics	0	In state provider	None	2301 NEWPORT BLVD	None	COSTA MESA	CA	92627	1516	30	06059	33.65438253	-117.9066754	Orange County
165262	Fee-for-Service	1801614474	1801614474	1	1	THE YOUNG PEOPLES FOUNDATION	11/4/2024	101YA0400X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC.	16316 WHITTIER BLVD STE	None	WHITTIER	CA	90603	2911	19	06037	33.94023498	-117.9826254	Los Angeles County
165283	Fee-for-Service	1881081404	1881081404	1	1	TANYA OPTOMETRY CORPORATION	3/29/2016	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27001 MOULTON PKWY	A100	ALISO VIEJO	CA	92656	3626	30	06059	33.57086878	-117.7000485	Orange County
165291	Fee-for-Service	1417394545	1417394545	1	1	TOOMEY, VANESSA MD	8/7/2020	2080P0203X	NA	Other	026	PHYSICIANS	168723	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
165333	Fee-for-Service	1174588891	1174588891	1	1	THOMPSON IV, WILLIAM M	5/22/2007	207R00000X	NA	Other	026	PHYSICIANS	98022	77	Infectious Disease	0	In state provider	MD	320 SUPERIOR AVE	STE 310	NEWPORT BEACH	CA	92663	2742	30	06059	33.62657138	-117.9330754	Orange County
165335	Fee-for-Service	1932342557	1932342557	1	1	TIMOTHY GREENE, MD	8/18/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 1ST AVE	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
165356	Fee-for-Service	1487998373	1487998373	1	1	TESSEL, PATRICIA A LMFT	2/20/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	30500 ARRASTRE CANYON RD	None	ACTON	CA	93510	2160	19	06037	34.449291	-118.1973465	Los Angeles County
165401	Fee-for-Service	1346689635	1346689635	1	1	TRAN, CAM T MD	8/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133561	01	General Practice	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
165411	Fee-for-Service	1326285198	1326285198	1	1	TAHA, NIMA MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106510	41	Internal Medicine	0	In state provider	None	3610 ATLANTIC AVENUE	None	LONG BEACH	CA	90807	3418	19	06037	33.822621	-118.185002	Los Angeles County
165438	Fee-for-Service	1891468849	1891468849	1	1	THIRD OPTOMETRIC CARE OF CAL	10/10/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7960 ORANGETHORPE AVE	None	BUENA PARK	CA	90621	3437	30	06059	33.85899466	-117.9941923	Orange County
165468	Fee-for-Service	1790860450	1790860450	1	1	TAMURA, EDDY MD	10/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	47809	18	Ophthalmology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
165476	Fee-for-Service	1245421254	1245421254	1	1	TAN, CHRISTINA E MD	10/31/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	73922	40	Pediatrics	0	In state provider	None	1800 SULLIVAN AVE	RM 202	DALY CITY	CA	94015	2222	41	06081	37.68077723	-122.4728941	San Mateo County
165502	Fee-for-Service	1841551124	1841551124	1	1	TSAI, ALBERT H MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140044	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
165507	Fee-for-Service	1063719722	1063719722	1	1	TABAS, ERIC MD INC	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	52667	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	450 SUTTER STREET	SUITE 1324	SAN FRANCISCO	CA	94108	4206	38	06075	37.78934929	-122.4077786	San Francisco County
165515	Fee-for-Service	1104434596	1104434596	1	1	TAYBIAN HOSPICE, INC	9/20/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1940 W ORANGEWOOD AVE	STE 110 9	ORANGE	CA	92868	5042	30	06059	33.79574869	-117.8734735	Orange County
165536	Fee-for-Service	1962818591	1962818591	1	1	TIRON, AIDA MD	12/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	500 SW RAMSEY AVE	None	GRANTS PASS	OR	97524	5554	00	None	42.4198785	-123.3432318	Josephine County
165563	Fee-for-Service	1447216510	1447216510	1	1	TANG, BILL W MD	5/30/1988	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	43358	None	None	0	In state provider	STE 206	1135 S SUNSET AVE	None	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
165564	Fee-for-Service	1831582253	1831582253	1	1	TAKEDA, NICOLE K MD	7/28/2022	208600000X	NA	General Surgery	026	PHYSICIANS	157327	None	None	0	In state provider	None	205 E RIVER PARK CIR	STE 460	FRESNO	CA	93720	1585	10	06019	36.85456375	-119.7863981	Fresno County
165608	Fee-for-Service	1285723361	1285723361	1	1	TIMOTHY E. MARNIE, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3288 MOANALUA RD	None	HONOLULU	HI	96819	1469	00	None	21.36247253	-157.900294	Honolulu County
165634	Fee-for-Service	1447307640	1447307640	1	1	TORRANCE UNIFIED SCH DIST	6/29/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	2335 PLAZA DEL AMO	None	TORRANCE	CA	90501	3420	19	06037	33.82819611	-118.3213536	Los Angeles County
165641	Fee-for-Service	1447756796	1447756796	1	1	TSUEI, JESSICA MD	5/13/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	166200	41	Internal Medicine	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
165707	Fee-for-Service	1366766099	1366766099	1	1	TRUAX, GREGORY F DO	10/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3001 ST ROSE PARKWAY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
165725	Fee-for-Service	1275194086	1275194086	1	1	TSAI, KEVIN MD	12/10/2024	207L00000X	NA	Other	026	PHYSICIANS	182120	05	Anesthesiology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
165800	Fee-for-Service	1427639376	1427639376	1	1	TURMAN, MAURICE LMFT	9/16/2024	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
165802	Fee-for-Service	1104434596	1104434596	1	1	TAYBIAN HOSPICE, INC	9/20/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1940 W ORANGEWOOD AVE	STE 110 9	ORANGE	CA	92868	5042	30	06059	33.79574869	-117.8734735	Orange County
165813	Fee-for-Service	1063807311	1063807311	1	1	TSAI, CINDY MD	1/2/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	139823	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
165825	Fee-for-Service	1508896259	1508896259	1	1	TAUS, STEPHEN D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	24011	41	Internal Medicine	0	In state provider	None	1366 W 7TH ST	None	SAN PEDRO	CA	90732	3500	19	06037	33.73796048	-118.3071105	Los Angeles County
165851	Fee-for-Service	1205927035	1205927035	1	1	TURAL, AHMET C MD	11/18/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	139542	None	None	0	In state provider	None	501 BUENA VISTA	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
165946	Fee-for-Service	1205305547	1205305547	1	1	TRUONG, QUYEN T OD	7/13/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8240 CALVINE RD	F	SACRAMENTO	CA	95828	9310	34	06067	38.455335	-121.4032545	Sacramento County
165981	Fee-for-Service	1124372347	1124372347	1	1	TANDON, PRIYA B MD	2/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123594	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
166012	Fee-for-Service	1417935933	1417935933	1	1	TSINANY, LYNDA MD	1/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72119	30	Radiology	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
166063	Fee-for-Service	1639214638	1639214638	1	1	TAYAG, JEFFREY J NP	7/29/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
166098	Fee-for-Service	1205811098	1205811098	1	1	THELEN, MICHAEL E MD	1/1/1979	207RR0500X	NA	Other	026	PHYSICIANS	27470	41	Internal Medicine	0	In state provider	None	4944 SUNRISE BLVD	STE A	FAIR OAKS	CA	95628	4941	34	06067	38.656107	-121.271931	Sacramento County
166126	Fee-for-Service	1386208569	1386208569	1	1	TRINH, THAOCHAU THUY PSYD	2/24/2025	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
166140	Fee-for-Service	1134211394	1134211394	1	1	TZENG, MIIN HSIUNG MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	33598	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25880 TOURNAMENT RD	STE 110	VALENCIA	CA	91355	2386	19	06037	34.39184204	-118.5626441	Los Angeles County
166176	Fee-for-Service	1093822363	1093822363	1	1	THOMAS, BRADLEY M MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72166	20	Orthopedic Surgery	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
166181	Fee-for-Service	1053321703	1053321703	1	1	TORGSYN DISCOUNT PHRMCY	8/28/1996	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	VARTANIAN, NARINE	5614 GEARY BLVD	None	SAN FRANCISCO	CA	94121	2215	38	06075	37.78039999	-122.4797631	San Francisco County
166186	Fee-for-Service	1942334123	1942334123	1	1	TORRES, VINCENT A MD	9/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99174	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
166211	Fee-for-Service	1093771578	1093771578	1	1	TEMPESTI, PAOLA MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71298	77	Infectious Disease	0	In state provider	None	435 ARDEN AVE	STE 540	GLENDALE	CA	91203	4025	19	06037	34.15848148	-118.2628845	Los Angeles County
166230	Fee-for-Service	1144207739	1144207739	1	1	THAKER, KARTIK MD	2/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	45557	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3650 SOUTH ST	STE 210	LAKEWOOD	CA	90712	1527	19	06037	33.86019847	-118.149255	Los Angeles County
166247	Fee-for-Service	1194850842	1194850842	1	1	TESSIE CLEVELAND COMMUNITY	7/7/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES CORPORATION	8019 S COMPTON AVENUE	None	LOS ANGELES	CA	90001	3409	19	06037	33.9664185	-118.2477481	Los Angeles County
166322	Fee-for-Service	1821444258	1821444258	1	1	TOTAL RENAL CARE INC	4/19/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4040 LONE TREE WAY	None	ANTIOCH	CA	94531	6209	07	06013	37.97744444	-121.8031019	Contra Costa County
166387	Fee-for-Service	1205811098	1205811098	1	1	THELEN, MICHAEL E MD	1/1/1979	207RR0500X	NA	Other	026	PHYSICIANS	27470	83	Rheumatology	0	In state provider	None	4944 SUNRISE BLVD	STE A	FAIR OAKS	CA	95628	4941	34	06067	38.656107	-121.271931	Sacramento County
166415	Fee-for-Service	1760846315	1760846315	1	1	TAHAI, MINA MD	7/22/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	168925	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
166464	Fee-for-Service	1730479239	1730479239	1	1	TOOSSI, SHAHED MD	6/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123300	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
166495	Fee-for-Service	1255351631	1255351631	1	1	TORTORICE, STEVEN T DO	9/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12227	08	Family Practice	0	In state provider	None	8110 LAGUNA BLVD	None	ELK GROVE	CA	95758	7904	34	06067	38.421306	-121.408173	Sacramento County
166522	Fee-for-Service	1144207739	1144207739	1	1	THAKER, KARTIK MD	2/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	45557	41	Internal Medicine	0	In state provider	None	3650 SOUTH ST	STE 210	LAKEWOOD	CA	90712	1527	19	06037	33.86019847	-118.149255	Los Angeles County
166527	Fee-for-Service	1821032129	1821032129	1	1	TCHEKMEDYIAN, NERSES S	11/30/1991	207RX0202X	NA	Oncology	026	PHYSICIANS	42410	78	Neoplastic Diseases/Oncology	0	In state provider	None	1043 ELM AVE	STE 104	LONG BEACH	CA	90813	3244	19	06037	33.779655	-118.1880065	Los Angeles County
166533	Fee-for-Service	1033822515	1033822515	1	1	TORRES, MIRIAM BIRTH DOULA	11/1/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
166558	Fee-for-Service	1275607384	1275607384	1	3	TONG, SENOCH P OD	10/23/2021	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	899 WASHINGTON ST	STE 6	SAN FRANCISCO	CA	94108	1214	38	06075	37.79495957	-122.4078614	San Francisco County
166563	Fee-for-Service	1215055918	1215055918	1	1	TAYLOR, HEATHER PHD	2/1/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
166571	Fee-for-Service	1043640741	1043640741	1	1	TASAKI, ANNE Y OD	2/20/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
166625	Fee-for-Service	1154077212	1154077212	1	1	TOUCHING HEARTS BOARDING	2/9/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	CARE	1010 LINDEN AVE	None	GLENDALE	CA	91201	3423	19	06037	34.17273026	-118.2964899	Los Angeles County
166696	Fee-for-Service	1285293969	1285293969	1	1	TATUM, KEVIN CRNA	4/15/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
166768	Fee-for-Service	1194402867	1194402867	1	1	TRINCA, ELIZABETH J POSTPART	2/12/2024	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	04	06007	0	0	None
166801	Fee-for-Service	1417154824	1417154824	1	1	TILMON, SHAWNIESE R PHD	1/28/2025	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
166803	Fee-for-Service	1699952820	1699952820	1	1	TAREEN, NAUREN MD	1/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	64054	41	Internal Medicine	0	In state provider	None	2785 PACIFIC AVENUE	SUITE A	LONG BEACH	CA	90806	2612	19	06037	33.807861	-118.193748	Los Angeles County
166810	Fee-for-Service	1144207739	1144207739	1	1	THAKER, KARTIK MD	2/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	45557	01	General Practice	0	In state provider	None	3650 SOUTH ST	STE 210	LAKEWOOD	CA	90712	1527	19	06037	33.86019847	-118.149255	Los Angeles County
166814	Fee-for-Service	1821032129	1821032129	1	1	TCHEKMEDYIAN, NERSES S	11/30/1991	207RX0202X	NA	Oncology	026	PHYSICIANS	42410	68	Hematology	0	In state provider	None	1043 ELM AVE	STE 104	LONG BEACH	CA	90813	3244	19	06037	33.779655	-118.1880065	Los Angeles County
166916	Fee-for-Service	1407388291	1407388291	1	1	THAI, RICHARD DO	5/14/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17017	08	Family Practice	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
166918	Fee-for-Service	1669139382	1669139382	1	1	TRIEU, MICHELLE PT	12/27/2022	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
166980	Fee-for-Service	1407225147	1407225147	1	1	TOOL, FRANK D NP	1/27/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	847518	-	NOT APPLICABLE	0	In state provider	None	1625 CARROLL STREET	2ND FLOOR	SAN FRANCISCO	CA	94124	3219	38	06075	37.72518613	-122.3938382	San Francisco County
167002	Fee-for-Service	1225562440	1225562440	1	1	THELIN, MARTIN MD	2/14/2024	2080P0205X	NA	Endocrinology	026	PHYSICIANS	172426	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
167016	Fee-for-Service	1871790261	1871790261	1	1	TAYLOR-WOODBURY, JEAN N NP	10/23/2024	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
167053	Fee-for-Service	1780084996	1780084996	1	1	TARIQ, AMBER MD	9/20/2024	208M00000X	NA	Other	026	PHYSICIANS	186225	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
167070	Fee-for-Service	1427362185	1427362185	1	1	TRIMBLE, JIMMY Z	12/24/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	16519 VICTOR ST	STE 201	VICTORVILLE	CA	92395	3966	36	06071	34.5212432	-117.3044617	San Bernardino County
167092	Fee-for-Service	1699952820	1699952820	1	1	TAREEN, NAUREN MD	1/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	64054	45	Nephrology (Renal-Kidney)	0	In state provider	None	2785 PACIFIC AVENUE	SUITE A	LONG BEACH	CA	90806	2612	19	06037	33.807861	-118.193748	Los Angeles County
167123	Fee-for-Service	1619272218	1619272218	1	1	TEKLEHAIMANOTE, CHRISTINE H	3/6/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	NP	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
167143	Fee-for-Service	1750319539	1750319539	1	1	TOM, MICHELLE L MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68130	66	Emergency Medicine (Urgent Care)	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
167150	Fee-for-Service	1578575791	1578575791	1	1	TSUI, TIMOTHY G MD	10/28/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71366	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	99 N LA CIENEGA BLVD	None	BEVERLY HILLS	CA	90211	2222	19	06037	34.06736471	-118.3763201	Los Angeles County
167239	Fee-for-Service	1215401583	1215401583	1	1	THAIBINH PHAN MD INC	7/15/2019	261QP2300X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	10691 WESTMINSTER AVE	100	GARDEN GROVE	CA	92843	4911	30	06059	33.75970546	-117.9429885	Orange County
167313	Fee-for-Service	1972559326	1972559326	1	1	THOMSON, SYDNEY I MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	62432	05	Anesthesiology	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
167323	Fee-for-Service	1821661398	1821661398	1	1	TAG HOSPICE, INC	2/8/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6412 MATILIJA AVE	SUITE 208	VAN NUYS	CA	91401	1576	19	06037	34.187184	-118.433434	Los Angeles County
167363	Fee-for-Service	1568539492	1568539492	1	1	TO, WILLIAM T MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	14183	41	Internal Medicine	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
167373	Fee-for-Service	1457302671	1457302671	1	1	TIERNEY, ANDREA M	8/13/2009	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11105 KNOTT AVE	STE B	CYPRESS	CA	90630	5137	30	06059	33.80083909	-118.0111199	Orange County
167383	Fee-for-Service	1346472453	1346472453	1	1	TRAN, KATHLEEN D MD	1/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127450	07	Dermatology	0	In state provider	None	276 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
167414	Fee-for-Service	1740225978	1740225978	1	1	TYERMAN, GAYLE H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43243	40	Pediatrics	0	In state provider	None	2400 S FLOWER ST	None	LOS ANGELES	CA	90007	2629	19	06037	34.02861627	-118.273964	Los Angeles County
167436	Fee-for-Service	1952819831	1952819831	1	1	TUCKER, DONNA P NP	3/7/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	847 W CHILDS AVE	None	MERCED	CA	95341	6805	24	06047	37.28825369	-120.4963159	Merced County
167446	Fee-for-Service	1013538982	1013538982	1	1	TIWANA, BARKHA MD	9/8/2023	390200000X	NA	Other	026	PHYSICIANS	188571	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
167450	Fee-for-Service	1700069630	1700069630	1	1	TANG, HENRY DO	11/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9024	13	Neurology (M.D. only)	0	In state provider	None	1195 ROADRUNNER WAY	None	SIMI VALLEY	CA	93065	1210	56	06111	34.26045263	-118.7955591	Ventura County
167464	Fee-for-Service	1831142223	1831142223	1	1	TELFER, JAMES G MD	12/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	87732	41	Internal Medicine	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
167467	Fee-for-Service	1245349737	1245349737	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1905 MONUMENT BLVD	None	CONCORD	CA	94520	3867	07	06013	37.95593313	-122.0397013	Contra Costa County
167518	Fee-for-Service	1821107251	1821107251	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5798	262 N HIGHWAY 65	None	LINDSAY	CA	93247	2702	54	06107	36.20191783	-119.1033246	Tulare County
167519	Fee-for-Service	1699309591	1699309591	1	1	TRUSTBRIDGE HOSPICE CARE LLC	6/9/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4605 LANKERSHIM BLVD	SUITE 311B	NORTH HOLLYWOOD	CA	91602	1875	19	06037	34.15389329	-118.3679999	Los Angeles County
167546	Fee-for-Service	1447526660	1447526660	1	1	TURAKHIA, RUCHI R MD	2/12/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	153407	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
167553	Fee-for-Service	1386855120	1386855120	1	1	TSANG, NICOLE L DO	7/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9479	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
167554	Fee-for-Service	1295296135	1295296135	1	1	TRAN, ANDREW B MD	3/30/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	188489	05	Anesthesiology	0	In state provider	None	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
167558	Fee-for-Service	1619086048	1619086048	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1701 AIRLINE HWY	None	HOLLISTER	CA	95023	5612	35	06069	36.83795703	-121.389955	San Benito County
167566	Fee-for-Service	1023329125	1023329125	1	1	TRUONG, KONG H MD	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131672	13	Neurology (M.D. only)	0	In state provider	None	9940 TALBERT AVE	SUITE 204	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166347	-117.955494	Orange County
167625	Fee-for-Service	1922274257	1922274257	1	1	TANCINCO, GLORY C MD INC	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50519	05	Anesthesiology	0	In state provider	None	2105 BEVERLY BLVD	#111	LOS ANGELES	CA	90057	2216	19	06037	34.06682861	-118.2706286	Los Angeles County
167639	Fee-for-Service	1841229820	1841229820	2	1	TAKSA, CHARLES R MD	3/12/2018	204C00000X	NA	Other	026	PHYSICIANS	36350	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	31180 ROAD 72	None	GOSHEN	CA	93227	9997	54	06107	36.35594779	-119.4124242	Tulare County
167806	Fee-for-Service	1699309591	1699309591	1	1	TRUSTBRIDGE HOSPICE CARE LLC	6/9/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4605 LANKERSHIM BLVD	SUITE 311B	NORTH HOLLYWOOD	CA	91602	1875	19	06037	34.15389329	-118.3679999	Los Angeles County
167810	Fee-for-Service	1174583033	1174583033	1	1	TRUONG, ANDY N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66251	01	General Practice	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
167867	Fee-for-Service	1497805790	1497805790	1	1	TIBURCIO VASQUEZ HEALTH	1/1/1997	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	1800 H STREET	ROOM 80	UNION CITY	CA	94587	3321	01	06001	37.59141753	-122.0265842	Alameda County
167885	Fee-for-Service	1215282785	1215282785	1	1	TOMLIN, MATTHEW L CNP	2/28/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
167906	Fee-for-Service	1811182397	1811182397	1	1	TAYLOR, BETH MD	9/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44477	36	Psychiatry	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
167934	Fee-for-Service	1174632368	1174632368	1	1	TIDEWATER MEDICAL INC	8/11/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	547 LONG POINT RD	#100	MT PLEASANT	SC	29464	8337	00	None	32.839443	-79.868817	Charleston County
167972	Fee-for-Service	1740574169	1740574169	1	1	TANG, NIKKI D MD	1/13/2021	207ND0101X	NA	Dermatology	026	PHYSICIANS	147609	None	None	0	In state provider	None	6605 NANCY RIDGE DR	None	SAN DIEGO	CA	92121	2253	37	06073	32.88682438	-117.1796133	San Diego County
167998	Fee-for-Service	1184737561	1184737561	1	1	TABIBIAN, BIALICK MD	6/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	47826	45	Nephrology (Renal-Kidney)	0	In state provider	None	8540 S SEPULVEDA BLVD	STE 1100	LOS ANGELES	CA	90045	3819	19	06037	33.96022076	-118.3961982	Los Angeles County
168100	Fee-for-Service	1174583033	1174583033	1	1	TRUONG, ANDY N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66251	41	Internal Medicine	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
168116	Fee-for-Service	1336820042	1336820042	1	1	THE LEISURE LIVING HOMES INC	3/27/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1738 FINECROFT DR	None	CLAREMONT	CA	91711	2411	19	06037	34.11529624	-117.7389643	Los Angeles County
168155	Fee-for-Service	1609815372	1609815372	1	1	TRAN, ANH N MD	11/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	105097	36	Psychiatry	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
168156	Fee-for-Service	1497805790	1497805790	1	1	TIBURCIO VASQUEZ HEALTH	1/1/1997	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	1800 H STREET	ROOM 80	UNION CITY	CA	94587	3321	01	06001	37.59141753	-122.0265842	Alameda County
168177	Fee-for-Service	1376705970	1376705970	1	1	TERP, SOPHIA M MD	10/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112157	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVENUE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
168301	Fee-for-Service	1265484588	1265484588	1	1	TAM, KA W MD	11/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88242	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
168362	Fee-for-Service	1609224609	1609224609	1	1	TANG, CHRISTINE DO	8/28/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	18852	None	None	0	In state provider	None	4150 REGENTS PARK ROW	STE 355	LA JOLLA	CA	92037	9102	37	06073	32.87272099	-117.2175656	San Diego County
168363	Fee-for-Service	1962803619	1962803619	1	1	TOUSET, VANESSA LMFT	1/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
168377	Fee-for-Service	1306112057	1306112057	1	1	TADROS, ANTHONY S MD	6/26/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	128627	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
168436	Fee-for-Service	1780855692	1780855692	1	1	TOTAL RENAL CARE, INC	6/8/2009	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	11611 BELLFLOWER BLVD	None	DOWNEY	CA	90241	5408	19	06037	33.93112986	-118.125527	Los Angeles County
168443	Fee-for-Service	1497805790	1497805790	1	1	TIBURCIO VASQUEZ HEALTH	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	1800 H STREET	ROOM 80	UNION CITY	CA	94587	3321	01	06001	37.59141753	-122.0265842	Alameda County
168450	Fee-for-Service	1316018369	1316018369	1	1	TSAI, TOWNSON MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66050	77	Infectious Disease	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
168516	Fee-for-Service	1427403187	1427403187	1	1	TRUONG, LINDA MD	7/1/2019	207P00000X	NA	Other	026	PHYSICIANS	161015	None	None	0	In state provider	None	75 NIELSON ST	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7937089	Santa Cruz County
168531	Fee-for-Service	1770689382	1770689382	1	1	TOULOUIE, ELAHE MD INC	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73141	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
168565	Fee-for-Service	1083898001	1083898001	1	1	TOATL RENAL CARE INC	12/1/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1759 W AVENUE J	STE 102	LANCASTER	CA	93534	2703	19	06037	34.68944351	-118.163124	Los Angeles County
168647	Fee-for-Service	1669715892	1669715892	1	1	TURNER, BRYCE D MD	7/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133525	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO STREET	STE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
168693	Fee-for-Service	1750768628	1750768628	1	1	TORIBIO, ANTONIO D MD	8/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	150054	41	Internal Medicine	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
168778	Fee-for-Service	1821322645	1821322645	1	1	TSUCHIMOTO, MIE LMFT	2/7/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	24977 WASHINGTON AVENUE	SUITES K & L	MURRIETA	CA	92562	6149	33	06065	33.55150034	-117.2118708	Riverside County
168817	Fee-for-Service	1770689382	1770689382	1	1	TOULOUIE, ELAHE MD INC	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73141	41	Internal Medicine	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
168869	Fee-for-Service	1710938394	1710938394	1	1	TSUKADA, GLENN H MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60235	30	Radiology	0	In state provider	None	25405 HANCOCK AVE	STE 107	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
168907	Fee-for-Service	1346778578	1346778578	1	1	THOMAS, KIMESHIA C MD	8/6/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	159929	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
168911	Fee-for-Service	1811064702	1811064702	1	1	TANIOS, NAYRA F MD	7/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49786	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
168938	Fee-for-Service	1548899420	1548899420	1	1	TRAN, ALEXANDER	4/5/2024	390200000X	NA	Other	026	PHYSICIANS	189467	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
168961	Fee-for-Service	1174929830	1174929830	1	1	TOTAL RENAL CARE, INC	10/17/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3933 COFFEE RD	SUITE A	BAKERSFIELD	CA	93308	5024	15	06029	35.395335	-119.092336	Kern County
169004	Fee-for-Service	1265528970	1265528970	1	1	TAYANI, RAMIN MD	8/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	69679	18	Ophthalmology	0	In state provider	None	653 CAMINO DE LOS MARES	STE 107	SAN CLEMENTE	CA	92673	2808	30	06059	33.45767098	-117.6495718	Orange County
169014	Fee-for-Service	1710109905	1710109905	1	1	TU, JOSEPH C MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112817	25	Physical Medicine and Rehabilitation	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
169015	Fee-for-Service	1215947981	1215947981	1	1	TIERNAN, CAROLYN MD	2/2/1982	207P00000X	NA	Other	026	PHYSICIANS	40571	None	None	0	In state provider	None	125 E BARSTOW AVE	STE 115	FRESNO	CA	93710	5023	10	06019	36.81570455	-119.787651	Fresno County
169054	Fee-for-Service	1003058348	1003058348	1	1	TSAY, ANNA TERESA NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
169124	Fee-for-Service	1245258524	1245258524	1	1	TRUONG, EMILIE D OD	1/1/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1916 ABORN RD	None	SAN JOSE	CA	95121	1581	43	06085	37.31070552	-121.8122395	Santa Clara County
169147	Fee-for-Service	1073974044	1073974044	1	1	TRAN, BRYANT DO	7/30/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17063	08	Family Practice	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
169177	Fee-for-Service	1134277569	1134277569	1	2	TAN, ANTONIO A MD APC	1/1/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45416	41	Internal Medicine	0	In state provider	None	24853 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	6102	33	06065	33.91718453	-117.228627	Riverside County
169187	Fee-for-Service	1851552996	1851552996	1	1	TAFRESHI-DARABI, NADEREH MD	2/13/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	127338	None	None	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
169200	Fee-for-Service	1811064702	1811064702	1	1	TANIOS, NAYRA F MD	7/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49786	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
169239	Fee-for-Service	1225052194	1225052194	1	1	TIGHE, THOMAS V DO	10/1/1991	207P00000X	NA	Other	026	PHYSICIANS	5921	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICUS MEDICAL GROUP	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
169259	Fee-for-Service	1972972578	1972972578	1	1	THIEME, JORDAN S PT	4/2/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
169310	Fee-for-Service	1912935701	1912935701	1	1	THUE, BRADFORD L MD	2/28/1995	207L00000X	NA	Other	026	PHYSICIANS	81949	05	Anesthesiology	0	In state provider	None	3857 BIRCH ST	STE 709	NEWPORT BEACH	CA	92660	2616	30	06059	33.66332364	-117.8712141	Orange County
169338	Fee-for-Service	1356381941	1356381941	1	1	THARP, PAUL S MD	8/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63390	05	Anesthesiology	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
169350	Fee-for-Service	1053641563	1053641563	1	1	TRAN, SHERI MD	7/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124071	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
169394	Fee-for-Service	1689190159	1689190159	1	1	THOMAS, SHEILA L PSYD	12/30/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	334 SHAW AVE	SUITE 100	CLOVIS	CA	93612	3839	10	06019	36.80839352	-119.7049776	Fresno County
169432	Fee-for-Service	1952400715	1952400715	1	2	TAMASHIRO, VICTOR G MD	1/23/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	46156	40	Pediatrics	0	In state provider	None	14901 RINALDI ST	STE 300	MISSION HILLS	CA	91345	1255	19	06037	34.27903452	-118.457433	Los Angeles County
169481	Fee-for-Service	1942588868	1942588868	1	1	TRAUMA & CRITICAL CARE SFV	6/5/2013	2086S0127X	NA	General Surgery	026	PHYSICIANS	84133	02	General Surgery	0	In state provider	GROUP INC	11550 INDIAN HILLS ROAD	STE 310	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
169482	Fee-for-Service	1699184184	1699184184	1	1	TALWAR, RISHI MD	4/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152341	41	Internal Medicine	0	In state provider	None	999 SAN BERNARDINO ROAD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
169514	Fee-for-Service	1790733111	1790733111	1	1	TURNER, JUDI A MD	5/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86025	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
169520	Fee-for-Service	1750490272	1750490272	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5776	1012 CASITAS PASS RD	None	CARPINTERIA	CA	93013	2109	42	06083	34.3958895	-119.5132603	Santa Barbara County
169528	Fee-for-Service	1669546263	1669546263	1	1	TAI, JUDY MD	11/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94519	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	220 E HACIENDA AVE	None	CAMPBELL	CA	95008	6617	43	06085	37.26914953	-121.9566285	Santa Clara County
169544	Fee-for-Service	1558536763	1558536763	1	1	TRUONG, MIREILLE D MD	10/30/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	163251	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8700 BEVERLY BLVD	# 3611	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
169545	Fee-for-Service	1437328689	1437328689	1	1	TOSTADO, ROBERTO MD	9/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	77858	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
169555	Fee-for-Service	1508086844	1508086844	1	1	TRAVIS R TORNGREN	8/25/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	360 E MAIN ST	None	REXBURG	ID	83440	2015	00	None	43.82596957	-111.7733381	Madison County
169562	Fee-for-Service	1598054942	1598054942	1	1	TANG, MELISSA P MD	7/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134260	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVENUE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
169569	Fee-for-Service	1225049646	1225049646	2	1	THRIFTY PAYLESS INC	2/21/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05724	260 NORTH SANDERSON AVE	None	HEMET	CA	92545	3614	33	06065	33.750414	-117.006531	Riverside County
169615	Fee-for-Service	1922219302	1922219302	2	1	TUPAZ HOMES LLC	6/6/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	4189 LEIGH AVE	None	SAN JOSE	CA	95124	3612	43	06085	37.25676	-121.921827	Santa Clara County
169618	Fee-for-Service	1407098551	1407098551	1	1	TWOGOOD, SARA B MD	3/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106607	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1300 N VERMONT AVE	STE 301	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
169645	Fee-for-Service	1174972673	1174972673	1	1	THAN, JUSTIN P DO	8/24/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	18692	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
169697	Fee-for-Service	1306006036	1306006036	1	1	TJEN-A-LOOI, ANGELIQUE MD	5/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116718	77	Infectious Disease	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
169767	Fee-for-Service	1942588868	1942588868	1	1	TRAUMA & CRITICAL CARE SFV	6/5/2013	2086S0127X	NA	General Surgery	026	PHYSICIANS	84133	66	Emergency Medicine (Urgent Care)	0	In state provider	GROUP INC	11550 INDIAN HILLS ROAD	STE 310	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
169769	Fee-for-Service	1073622429	1073622429	1	2	THRIFTY PAYLESS INC	11/13/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4120 PHELAN RD	None	PHELAN	CA	92371	3904	36	06071	34.42633752	-117.5720535	San Bernardino County
169770	Fee-for-Service	1952805574	1952805574	1	1	TSAI, KATHERINE Y MD	7/12/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	164780	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
169837	Fee-for-Service	1619058542	1619058542	1	1	TRAIL, MONICA J MD	4/19/2010	207N00000X	NA	Dermatology	026	PHYSICIANS	111384	07	Dermatology	0	In state provider	None	19950 RINALDI BLVD	STE 105	NORTHRIDGE	CA	91326	4141	19	06037	34.27560199	-118.5696701	Los Angeles County
169843	Fee-for-Service	1043438625	1043438625	1	1	THOMPSON, JAMES DO	8/27/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	23164	30	Radiology	0	In state provider	None	345 CONVENTION WAY	D-1	REDWOOD CITY	CA	94063	1444	41	06081	37.49391347	-122.2285705	San Mateo County
169872	Fee-for-Service	1376691246	1376691246	1	1	TAMURA, KIMI N MD	12/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67996	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
169941	Fee-for-Service	1801504691	1801504691	1	1	TUNG, VICTOR CRNA	4/15/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
169950	Fee-for-Service	1043764715	1043764715	1	1	THOMPSON, ROBBIE A LMFT	5/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10722 ARROW ROUTE	SUITE 712	RANCHO CUCAMONGA	CA	91730	4841	36	06071	34.09917725	-117.5708877	San Bernardino County
169972	Fee-for-Service	1104245414	1104245414	1	1	TONTHAT, VINH MD	3/6/2020	207P00000X	NA	Other	026	PHYSICIANS	161785	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16200 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.6617581	-117.7736362	Orange County
170037	Fee-for-Service	1134225683	1134225683	1	1	TRISAL, VIJAY MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78977	02	General Surgery	0	In state provider	None	50 BELLEFONTAINE ST	STE 104	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
170058	Fee-for-Service	1811185804	1811185804	1	1	TADROS, EHMAD MD APC	8/29/2014	2084P0800X	NA	Psychiatry	026	PHYSICIANS	49500	36	Psychiatry	0	In state provider	None	4060 FOURTH AVE	STE 102	SAN DIEGO	CA	92103	2120	37	06073	32.75053673	-117.1616539	San Diego County
170070	Fee-for-Service	1649086166	1649086166	1	1	THE WALL LAS MEMORIAS	2/12/2025	261QC1500X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	800 W 6TH ST	750	LOS ANGELES	CA	90017	2704	19	06037	34.05031885	-118.2577553	Los Angeles County
170089	Fee-for-Service	1740721679	1740721679	1	1	TAVANGARY, FARDIS DO	11/29/2022	207P00000X	NA	Other	026	PHYSICIANS	19378	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
170169	Fee-for-Service	1902281983	1902281983	1	1	TAYAG, DYLAN S LCSW	7/1/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
170220	Fee-for-Service	1609235613	1609235613	1	1	TRUONG, DANNY	1/14/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15272 SUMMIT AVE	None	FONTANA	CA	92336	0231	36	06071	34.152624	-117.4724415	San Bernardino County
170243	Fee-for-Service	1316103633	1316103633	1	1	THAN, CINDY Q OD	9/13/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2525 EL CAMINO REAL	SUITE 125	CARLSBAD	CA	92008	1261	37	06073	33.178248	-117.332028	San Diego County
170284	Fee-for-Service	1447235130	1447235130	1	1	TOMINAGA, JULIE A MD	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	55806	40	Pediatrics	0	In state provider	None	2660 W COVELL BLVD	None	DAVIS	CA	95616	5645	57	06113	38.56101005	-121.7821776	Yolo County
170364	Fee-for-Service	1104573633	1104573633	1	1	THE BEACON HOUSE ASSOCIATION	3/28/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	OF SAN PEDRO	103 W 11TH STREET	None	SAN PEDRO	CA	90731	4301	19	06037	33.73418683	-118.2807271	Los Angeles County
170395	Fee-for-Service	1689949257	1689949257	1	1	TSENG, IAN K MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129394	30	Radiology	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
170406	Fee-for-Service	1134367857	1134367857	1	1	TREVOR J TOWNSEND CPO	9/14/2010	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1524 21ST ST	None	BAKERSFIELD	CA	93301	4002	15	06029	35.3781555	-119.0195505	Kern County
170437	Fee-for-Service	1952385304	1952385304	1	1	TRACY ALAN POWELL M.D.	8/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5435 FELTL RD	None	MINNETONKA	MN	55343	7983	00	None	44.90402661	-93.4197671	Hennepin County
170446	Fee-for-Service	1518007848	1518007848	1	1	TAHMOORESZADEH, HOOMAN MD	10/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106868	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
170457	Fee-for-Service	1508098195	1508098195	1	2	TOP LINE HOME HEALTHCARE INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1100 E BROADWAY	STE 304	GLENDALE	CA	91205	4628	19	06037	34.14622171	-118.2415193	Los Angeles County
170478	Fee-for-Service	1093139552	1093139552	1	1	THIERS, SEAN T CRNA	8/4/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4001 J STREET	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
170575	Fee-for-Service	1972744001	1972744001	1	1	TOROUSSIAN, TALINE S MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109919	05	Anesthesiology	0	In state provider	None	501 S BUENA VISTA STREET	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
170662	Fee-for-Service	1649248782	1649248782	1	1	TREMAZI, JAFFAR A MD	9/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82895	None	None	0	In state provider	None	1866 N ORANGE GROVE AVE	STE 202	POMONA	CA	91767	3031	19	06037	34.07771682	-117.7485431	Los Angeles County
170753	Fee-for-Service	1407913775	1407913775	1	1	TULARE JOINT UNION HSD	12/4/1994	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	426 N BLACKSTONE ST	None	TULARE	CA	93274	4449	54	06107	36.21426196	-119.3310042	Tulare County
170760	Fee-for-Service	1598515900	1598515900	1	1	TESTAL CORPORATION	5/22/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	12832 VALLEY VIEW ST	105	GARDEN GROVE	CA	92845	2524	30	06059	33.77717962	-118.0346285	Orange County
170761	Fee-for-Service	1477524809	1477524809	1	1	TAYLOR, ROBERT M MD	4/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	50706	02	General Surgery	0	In state provider	None	2656 EDITH AVE	STE B	REDDING	CA	96001	3030	45	06089	40.57073094	-122.3974088	Shasta County
170776	Fee-for-Service	1902056609	1902056609	1	1	TRIEU, KHANH T MD	7/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103601	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
170811	Fee-for-Service	1114088184	1114088184	1	1	TANAKA, TARA R PHD	2/19/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
170847	Fee-for-Service	1780798496	1780798496	1	1	TAN, BUNTHAY C OD	5/22/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	220 W. VALLEY BLVD	SUITE 202	SAN GABRIEL	CA	91776	3738	19	06037	34.07955214	-118.1028758	Los Angeles County
170933	Fee-for-Service	1689672669	1689672669	1	1	THE PILL BOX PHARMACY	1/18/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1108 N LAKE ST	None	MADERA	CA	93638	2112	20	06039	36.97467681	-120.0564402	Madera County
170949	Fee-for-Service	1578908976	1578908976	1	1	TAKYAR, ANJALI A DO	9/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15333	41	Internal Medicine	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
171037	Fee-for-Service	1306265970	1306265970	1	1	TOLINS, MOLLY L MD	10/15/2018	207P00000X	NA	Other	026	PHYSICIANS	154012	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
171047	Fee-for-Service	1780624619	1780624619	1	2	TALIEH, YAHYA J MD	3/23/2024	208G00000X	NA	General Surgery	026	PHYSICIANS	73331	33	Thoracic Surgery	0	In state provider	None	1401 SPANOS CT	SUITE 203	MODESTO	CA	95355	2810	50	06099	37.66975543	-120.9724048	Stanislaus County
171125	Fee-for-Service	1447235858	1447235858	1	1	TURNER, MICHAEL H MD	8/15/2001	207R00000X	NA	Other	026	PHYSICIANS	44155	41	Internal Medicine	0	In state provider	None	1050 N STATE ST	None	UKIAH	CA	95482	3414	23	06045	39.1623719	-123.2098216	Mendocino County
171146	Fee-for-Service	1427249432	1427249432	1	1	TARASULA, INNA MD	9/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111840	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
171155	Fee-for-Service	1114368891	1114368891	1	1	TORIBIO, JANET S PHD	3/26/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ES	3097 WILLOW AVENUE	SUITE 5	CLOVIS	CA	93612	4715	10	06019	36.79616247	-119.7272892	Fresno County
171209	Fee-for-Service	1235297755	1235297755	1	1	TRAN, NAM L DO	12/31/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9875	05	Anesthesiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
171212	Fee-for-Service	1861845836	1861845836	1	1	TRESTLES HOLDINGS LLC	8/1/2016	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	450 HAYES LANE	None	PETALUMA	CA	94952	4010	49	06097	38.22242042	-122.6472785	Sonoma County
171232	Fee-for-Service	1861867715	1861867715	1	1	TINOCO, MARIA M G NP	9/26/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	12001 W WASHINGTON BLVD	None	LOS ANGELES	CA	90066	5801	19	06037	33.99760695	-118.4228296	Los Angeles County
171233	Fee-for-Service	1205981313	1205981313	1	1	TSAU, KANG MD	4/1/2001	207L00000X	NA	Other	026	PHYSICIANS	54695	05	Anesthesiology	0	In state provider	None	508 E HICKORY AVE	None	LOMPOC	CA	93436	7337	42	06083	34.63568383	-120.4522776	Santa Barbara County
171274	Fee-for-Service	1265437727	1265437727	1	1	TIEFENBRUN, JONATHAN MD	2/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85951	02	General Surgery	0	In state provider	None	5353 MISSION CENTER RD	STE 318	SAN DIEGO	CA	92108	1305	37	06073	32.77207362	-117.154699	San Diego County
171362	Fee-for-Service	1396121711	1396121711	1	2	TORRES, VICTORIA LCSW	6/24/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	88471	-	NOT APPLICABLE	0	In state provider	None	43807 10TH ST W	D	LANCASTER	CA	93534	4805	19	06037	34.6788	-118.1479295	Los Angeles County
171391	Fee-for-Service	1487725305	1487725305	1	1	TROPEA, BRADFORD MD	10/20/1992	208600000X	NA	General Surgery	026	PHYSICIANS	75421	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
171414	Fee-for-Service	1447235858	1447235858	1	1	TURNER, MICHAEL H MD	8/15/2001	207R00000X	NA	Other	026	PHYSICIANS	44155	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1050 N STATE ST	None	UKIAH	CA	95482	3414	23	06045	39.1623719	-123.2098216	Mendocino County
171445	Fee-for-Service	1619331923	1619331923	1	1	TELLEZ, RENE MD	10/17/2019	208600000X	NA	General Surgery	026	PHYSICIANS	151199	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
171466	Fee-for-Service	1669075370	1669075370	1	1	THE ANGELS OF HAVEN HOSPICE	5/26/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	13609 VICTORY BLVD	STE 133	VAN NUYS	CA	91401	6438	19	06037	34.18671049	-118.429353	Los Angeles County
171471	Fee-for-Service	1922117209	1922117209	1	1	THRIFTY PAYLESS INC	5/12/2003	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5606	8914 VALLEY BLVD	None	ROSEMEAD	CA	91770	1832	19	06037	34.08076988	-118.0744174	Los Angeles County
171518	Fee-for-Service	1780896563	1780896563	1	1	TABIT, HIND MD	8/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
171521	Fee-for-Service	1194803791	1194803791	1	1	TSAI, TA-MING MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74254	40	Pediatrics	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
171543	Fee-for-Service	1245462472	1245462472	1	1	TRIEU, NGOC OD	10/28/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
171568	Fee-for-Service	1518288083	1518288083	1	1	TAYLOR, JUSTIN B MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150056	10	Gastroenterology (M.D. only)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
171599	Fee-for-Service	1386958635	1386958635	1	1	TIMIRAOS, ERICA L MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124648	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 NORTH JACKSON AVENUE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
171603	Fee-for-Service	1972688299	1972688299	1	1	TOM, WYNNYEE L MD	8/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77626	40	Pediatrics	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
171639	Fee-for-Service	1558997940	1558997940	1	1	TIAMSON, PHILMARLON L PT	6/5/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2230 W SUNNYSIDE AVE STE	None	VISALIA	CA	93277	7269	54	06107	36.303912	-119.3156595	Tulare County
171738	Fee-for-Service	1700275468	1700275468	1	1	TRIMARCHI, KAITLYN OT	3/23/2021	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4000 CIVIC CENTER DRIVE	STE 100	SAN RAFAEL	CA	94903	4173	21	06041	38.0041783	-122.538861	Marin County
171746	Fee-for-Service	1992950703	1992950703	1	1	TOTAL CARE FAMILY MEDICAL CE	6/19/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NTER OF LAKE ELSINORE, I	425 DIAMOND DRIVE	SUITE 104-105	LAKE ELSINORE	CA	92530	4495	33	06065	33.65802263	-117.3002985	Riverside County
171753	Fee-for-Service	1669075370	1669075370	1	1	THE ANGELS OF HAVEN HOSPICE	5/26/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	13609 VICTORY BLVD	STE 133	VAN NUYS	CA	91401	6438	19	06037	34.18671049	-118.429353	Los Angeles County
171765	Fee-for-Service	1609417161	1609417161	1	1	TIENDA, MARISOL 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
171768	Fee-for-Service	1982850038	1982850038	1	1	TAMANAHA, NICOLE A DO	9/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10495	40	Pediatrics	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
171770	Fee-for-Service	1508044421	1508044421	1	1	TIMOTHY HIESTERMAN DO	3/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1901 CONNECTICUT AVE S	None	SARTELL	MN	56377	2554	00	None	45.59432076	-94.20160002	Stearns County
171780	Fee-for-Service	1144674003	1144674003	1	1	THANASUKARN, JOHN MD	7/1/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	156685	40	Pediatrics	0	In state provider	None	15922 WILLOW ST	None	HESPERIA	CA	92345	9154	36	06071	34.43374849	-117.3162448	San Bernardino County
171792	Fee-for-Service	1720890593	1720890593	1	1	TRAN, MELISSA N CRNA	3/13/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
171795	Fee-for-Service	1275678294	1275678294	1	1	TAN-KIM, JASMINE MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92871	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
171804	Fee-for-Service	1760038772	1760038772	1	1	TAHOE FOREST HOSPITAL DISTRI	1/30/2023	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	10121 PINE AVE	2ND FLOOR	TRUCKEE	CA	96161	4856	29	06057	39.3245308	-120.2013097	Nevada County
171823	Fee-for-Service	1265069041	1265069041	1	1	TAO, FRANCES MD MPH	11/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181532	08	Family Practice	0	In state provider	None	892 AEROVISTA PLACE	210	SAN LUIS OBISPO	CA	93401	8252	40	06079	35.24277125	-120.6405941	San Luis Obispo County
171859	Fee-for-Service	1831229632	1831229632	2	1	TONG, DENNIS C MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	108203	05	Anesthesiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
171870	Fee-for-Service	1609927151	1609927151	1	1	TOTSUBO, JAMIE MEGUMI OD	8/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1826 BUCHANAN ST	STE A	SAN FRANCISCO	CA	94115	3211	38	06075	37.78696345	-122.4300353	San Francisco County
171891	Fee-for-Service	1689184780	1689184780	1	1	THUY-TRANG NGUYEN OD INC	3/12/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	874C BLOSSOM HILL RD	None	SAN JOSE	CA	95123	2725	43	06085	37.2502227	-121.858389	Santa Clara County
171913	Fee-for-Service	1497003875	1497003875	1	1	TOTAL RENAL CARE INC	7/2/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3 ROSSI CIRCLE	UNIT B	SALINAS	CA	93907	2357	27	06053	36.68726296	-121.6712151	Monterey County
171984	Fee-for-Service	1235203910	1235203910	1	1	TSAU, PEI H MD	10/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55016	33	Thoracic Surgery	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
172016	Fee-for-Service	1699238147	1699238147	1	1	TURAY, ACHMED M MD	10/1/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
172026	Fee-for-Service	1508992496	1508992496	1	1	TERESA M BRAKE	10/20/2006	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	23 AMBER WAY	None	CHICO	CA	95926	1701	04	06007	39.75257804	-121.8103452	Butte County
172042	Fee-for-Service	1205595469	1205595469	1	1	TRAN, GARY J LAC	9/20/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	5265 UNIVERSITY AVE	None	SAN DIEGO	CA	92105	2202	37	06073	32.74906069	-117.0820977	San Diego County
172053	Fee-for-Service	1417453861	1417453861	1	1	TAI, ANDREA W MD	9/23/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	173417	None	None	0	In state provider	None	1433 W. MERCED AVE	SUITE 103	WEST COVINA	CA	91790	3402	19	06037	34.06252177	-117.9477117	Los Angeles County
172065	Fee-for-Service	1124472147	1124472147	1	1	TABARI, DANIEL MD	12/27/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	154292	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
172069	Fee-for-Service	1144674003	1144674003	1	1	THANASUKARN, JOHN MD	7/1/2023	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	15922 WILLOW ST	None	HESPERIA	CA	92345	9154	36	06071	34.43374849	-117.3162448	San Bernardino County
172077	Fee-for-Service	1497702195	1497702195	1	1	TIMPANOGOS REGIONAL MEDICAL	6/22/2011	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SERVICES INC	750 WEST 800 NORTH	None	OREM	UT	84057	3660	00	None	40.31373134	-111.7150045	Utah County
172093	Fee-for-Service	1760038772	1760038772	1	1	TAHOE FOREST HOSPITAL DISTRI	10/19/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	10121 PINE AVE	2ND FLOOR	TRUCKEE	CA	96161	4856	29	06057	39.3245308	-120.2013097	Nevada County
172108	Fee-for-Service	1992883763	1992883763	1	1	TAMBUNTING, FRANCIS G MD	8/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75453	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
172162	Fee-for-Service	1508942038	1508942038	1	1	TSANG, TIMOTHY H MD	12/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	61890	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
172221	Fee-for-Service	1275878233	1275878233	1	1	TRUSTY, JULISSA LMFT	2/2/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10653 RIVERSIDE DR	None	NORTH HOLLYWOOD	CA	91602	2341	19	06037	34.15226042	-118.3632608	Los Angeles County
172225	Fee-for-Service	1447287222	1447287222	1	1	TINAJERO-DECK, LYDIA A	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78528	40	Pediatrics	0	In state provider	None	1235 HARRISON ST	None	SAN LEANDRO	CA	94577	4515	01	06001	37.72577467	-122.1544541	Alameda County
172230	Fee-for-Service	1457948077	1457948077	1	1	THE SPACE BETWEEN COUNSELING	1/8/2021	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	SERVICES LICENSED CLINI	12139 MOUNT VERNON AVE	SUITE 200A	GRAND TERRACE	CA	92313	5547	36	06071	34.033185	-117.313583	San Bernardino County
172270	Fee-for-Service	1447288345	1447288345	1	8	TEAM PHYSICIANS OF CALIFORNI	1/12/2023	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	A MEDICAL GROUP, INC	525 WEST ACACIA STREET	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
172314	Fee-for-Service	1508992496	1508992496	1	1	TERESA M BRAKE	10/20/2006	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	23 AMBER WAY	None	CHICO	CA	95926	1701	04	06007	39.75257804	-121.8103452	Butte County
172330	Fee-for-Service	1124333828	1124333828	1	2	TRINH, LINDA	2/20/2020	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
172345	Fee-for-Service	1053698837	1053698837	1	1	TAYLOR, SHEILA E	12/11/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3450 MARICOPA STREET	# 24	TORRANCE	CA	90503	4935	19	06037	33.8394955	-118.346661	Los Angeles County
172365	Fee-for-Service	1497702195	1497702195	1	1	TIMPANOGOS REGIONAL MEDICAL	6/22/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SERVICES INC	750 WEST 800 NORTH	None	OREM	UT	84057	3660	00	None	40.31373134	-111.7150045	Utah County
172380	Fee-for-Service	1760038772	1760038772	1	1	TAHOE FOREST HOSPITAL DISTRI	10/19/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	10121 PINE AVE	2ND FLOOR	TRUCKEE	CA	96161	4856	29	06057	39.3245308	-120.2013097	Nevada County
172395	Fee-for-Service	1992883763	1992883763	1	1	TAMBUNTING, FRANCIS G MD	8/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75453	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
172420	Fee-for-Service	1487730974	1487730974	1	1	TU, LINH H OD	4/4/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3525 PACIFIC COAST HWY	STE E	TORRANCE	CA	90505	6656	19	06037	33.80337655	-118.3474795	Los Angeles County
172452	Fee-for-Service	1023512126	1023512126	1	1	THORNE, SOFIA L MD	10/18/2023	207ZP0102X	NA	Other	026	PHYSICIANS	165479	None	None	0	In state provider	None	3855 ALAMO ST	None	SIMI VALLEY	CA	93063	2104	56	06111	34.28644751	-118.721655	Ventura County
172468	Fee-for-Service	1841267689	1841267689	1	6	TERRIO PHYSICAL THERAPY - FI	12/3/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS INC	2838 OSWELL ST	None	BAKERSFIELD	CA	93306	2704	15	06029	35.39923633	-118.9499418	Kern County
172476	Fee-for-Service	1184854804	1184854804	1	1	TSAI, ERICA R MD	4/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139238	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
172488	Fee-for-Service	1811341837	1811341837	1	1	TANG, LUCY MD	6/23/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	153396	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25482 MARGUERITE PKWY	101	MISSION VIEJO	CA	92692	2911	30	06059	33.592473	-117.659872	Orange County
172496	Fee-for-Service	1588875421	1588875421	1	1	THRIFTY PAYLESS INC	6/28/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6560	446 ROSEVILLE SQ	None	ROSEVILLE	CA	95678	2808	31	06061	38.744316	-121.2761835	Placer County
172500	Fee-for-Service	1730259771	1730259771	1	1	TOVEY, WENDI LCSW	11/15/2023	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
172510	Fee-for-Service	1427022557	1427022557	1	1	THOMPSON, JILL B MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55829	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
172525	Fee-for-Service	1225062060	1225062060	2	1	TZENG, JOHN J MD	8/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53439	41	Internal Medicine	0	In state provider	None	736 S GARFIELD AVENUE	SUITE B	ALHAMBRA	CA	91801	4437	19	06037	34.087842	-118.1230415	Los Angeles County
172533	Fee-for-Service	1396906152	1396906152	1	1	TEJANI, ZARIN N MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110916	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
172534	Fee-for-Service	1386961985	1386961985	1	1	TRUONG, LOUISE M MD	5/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118950	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
172559	Fee-for-Service	1447288345	1447288345	1	8	TEAM PHYSICIANS OF CALIFORNI	1/12/2023	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	A MEDICAL GROUP, INC	525 WEST ACACIA STREET	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
172568	Fee-for-Service	1831108620	1831108620	1	1	TROY D. KRAMER M.D	12/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2240 SUTHERLAND AVE	STE 104	KNOXVILLE	TN	37919	2333	00	None	35.95707787	-83.95193291	Knox County
172592	Fee-for-Service	1114990512	1114990512	1	1	TSE, TOMMY H MD	11/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	103823	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
172614	Fee-for-Service	1093344707	1093344707	1	1	TARCHIONE, ASHLEY MD	8/25/2023	390200000X	NA	Other	026	PHYSICIANS	184943	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
172632	Fee-for-Service	1053698837	1053698837	1	1	TAYLOR, SHEILA E	12/11/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3450 MARICOPA STREET	# 24	TORRANCE	CA	90503	4935	19	06037	33.8394955	-118.346661	Los Angeles County
172692	Fee-for-Service	1942383088	1942383088	1	1	TABORI, ILDIKO L	8/3/2004	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1850 SAWTELLE BLVD	STE 400	LOS ANGELES	CA	90025	7083	19	06037	34.04279946	-118.4451959	Los Angeles County
172700	Fee-for-Service	1154943207	1154943207	1	1	TOY, GARRETT PT	6/15/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6759 SIERRA CT	SUITE A	DUBLIN	CA	94568	2670	01	06001	37.70825702	-121.9144925	Alameda County
172741	Fee-for-Service	1609092162	1609092162	1	1	TERESA MEDICAL CENTER	9/12/2001	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	INC	2675 W OLYMPIC BLVD	None	LOS ANGELES	CA	90026	2880	19	06037	34.05243942	-118.2907458	Los Angeles County
172744	Fee-for-Service	1528382801	1528382801	1	1	TORNABENE, STEPHEN V MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108440	84	Surgery-Head and Neck	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
172754	Fee-for-Service	1841267689	1841267689	1	6	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS INC	2838 OSWELL ST	None	BAKERSFIELD	CA	93306	2704	15	06029	35.39923633	-118.9499418	Kern County
172815	Fee-for-Service	1225062060	1225062060	2	1	TZENG, JOHN J MD	8/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53439	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	736 S GARFIELD AVENUE	SUITE B	ALHAMBRA	CA	91801	4437	19	06037	34.087842	-118.1230415	Los Angeles County
172861	Fee-for-Service	1285930396	1285930396	1	4	TARZANA TREATMENT CENTERS, I	10/20/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	320 EAST PALMDALE BLVD	None	PALMDALE	CA	93550	4598	19	06037	34.57983613	-118.1240079	Los Angeles County
172876	Fee-for-Service	1225643950	1225643950	1	1	TANA NOONAN, LICENSED MARRIA	9/29/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28924 OLD TOWN FRONT ST	203	TEMECULA	CA	92590	2857	33	06065	33.48624845	-117.1443751	Riverside County
172877	Fee-for-Service	1265853121	1265853121	1	2	TILLMAN, JONATHAN	8/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144918	40	Pediatrics	0	In state provider	None	2825 CAPITOL AVE	None	SACRAMENTO	CA	95816	5615	34	06067	38.570805	-121.4696385	Sacramento County
172929	Fee-for-Service	1730509134	1730509134	1	1	TUPY, DANIEL MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148671	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1000 GREENLEY ROAD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
172964	Fee-for-Service	1619086147	1619086147	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	616 E HOBSON WAY	None	BLYTHE	CA	92225	1800	33	06065	33.61044832	-114.5900045	Riverside County
173009	Fee-for-Service	1144435389	1144435389	1	1	TORANTO, JASON D MD	6/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120392	None	None	0	In state provider	None	3590 CAMINO DEL RIO	NORTH SUITE 103	SAN DIEGO	CA	92108	1707	37	06073	32.77890046	-117.1170088	San Diego County
173012	Fee-for-Service	1952575441	1952575441	1	1	TOLENTINO, ARMINDA S MD	6/21/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	54365	08	Family Practice	0	In state provider	INC	591 MCCRAY ST	STE 231	HOLLISTER	CA	95023	2224	35	06069	36.85020209	-121.397521	San Benito County
173013	Fee-for-Service	1851375521	1851375521	1	1	TEEHEE, KEVIN N MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69135	None	None	0	In state provider	None	12629 RIVERSIDE DR	None	NORTH HOLLYWOOD	CA	91607	3488	19	06037	34.15763646	-118.408473	Los Angeles County
173037	Fee-for-Service	1609092162	1609092162	1	1	TERESA MEDICAL CENTER	9/12/2001	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	2675 W OLYMPIC BLVD	None	LOS ANGELES	CA	90026	2880	19	06037	34.05243942	-118.2907458	Los Angeles County
173048	Fee-for-Service	1467436576	1467436576	1	1	TROST, STEPHANIE A MD	10/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89963	41	Internal Medicine	0	In state provider	None	909 BLANCO CIR	None	SALINAS	CA	93901	4401	27	06053	36.65354107	-121.6381985	Monterey County
173055	Fee-for-Service	1083825541	1083825541	2	1	TUPAZ HOMES LLC	6/6/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	888 CLARKSTON DRIVE	None	SAN JOSE	CA	95136	1503	43	06085	37.27129732	-121.8680267	Santa Clara County
173126	Fee-for-Service	1417156126	1417156126	1	1	TRAN, WAYNE H MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120522	None	None	0	In state provider	None	1205 E NORTH STREET	None	MANTECA	CA	95336	4932	39	06077	37.80110374	-121.1974853	San Joaquin County
173150	Fee-for-Service	1285930396	1285930396	1	4	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	320 EAST PALMDALE BLVD	None	PALMDALE	CA	93550	4598	19	06037	34.57983613	-118.1240079	Los Angeles County
173211	Fee-for-Service	1720007404	1720007404	1	1	TIMOTHY M GRONLIE 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	551 N HILLSIDE STE 320	None	WICHITA	KS	67214	0000	00	None	37.695978	-97.29908651	Sedgwick County
173230	Fee-for-Service	1447673645	1447673645	1	1	TEITZEL, KELLY P CRNA	1/31/2014	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
173255	Fee-for-Service	1194080168	1194080168	1	1	TRIPATHI, MOHAN S MD	11/1/2017	163WX0800X	NA	Other	026	PHYSICIANS	145097	20	Orthopedic Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
173313	Fee-for-Service	1003029646	1003029646	1	1	TENGGARDJAJA, CHRISTOPHER F	9/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	100721	34	Urology and Urological Surgery	0	In state provider	MD	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
173322	Fee-for-Service	1609092162	1609092162	1	1	TERESA MEDICAL CENTER	9/12/2001	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	INC	2675 W OLYMPIC BLVD	None	LOS ANGELES	CA	90026	2880	19	06037	34.05243942	-118.2907458	Los Angeles County
173378	Fee-for-Service	1750971784	1750971784	1	1	TRINIDAD, VLESS NP	10/8/2021	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
173380	Fee-for-Service	1619179504	1619179504	1	1	TANG, JEVON MD	7/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107806	41	Internal Medicine	0	In state provider	None	2557 MOWRY AVENUE	SUITE 12	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
173436	Fee-for-Service	1285930396	1285930396	1	4	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	320 EAST PALMDALE BLVD	None	PALMDALE	CA	93550	4598	19	06037	34.57983613	-118.1240079	Los Angeles County
173481	Fee-for-Service	1033152616	1033152616	1	1	TUCHMAN, LESLIE J MD	10/6/2020	207R00000X	NA	Other	026	PHYSICIANS	148437	41	Internal Medicine	0	In state provider	None	300 CORPORATE POINTE	STE 465	CULVER CITY	CA	90230	8706	19	06037	33.98867148	-118.3837334	Los Angeles County
173497	Fee-for-Service	1033236237	1033236237	1	1	TANARA, KARL MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	78249	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7117 BROCKTON AVENUE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
173500	Fee-for-Service	1831147180	1831147180	1	1	THOMAS, JAMES W MD	3/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	83177	30	Radiology	0	In state provider	None	995 GATEWAY CENTER WY	STE 207	SAN DIEGO	CA	92102	4500	37	06073	32.71405516	-117.1158459	San Diego County
173572	Fee-for-Service	1467575423	1467575423	1	1	TAYLOR, SIMON A	3/22/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
173626	Fee-for-Service	1619292588	1619292588	1	1	TAN, JAMES P MD	7/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117982	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
173725	Fee-for-Service	1285930396	1285930396	1	4	TARZANA TREATMENT CENTERS, I	12/1/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	320 EAST PALMDALE BLVD	None	PALMDALE	CA	93550	4598	19	06037	34.57983613	-118.1240079	Los Angeles County
173736	Fee-for-Service	1154409837	1154409837	1	1	TATIKUNTA, SAILAKSHMI MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55690	01	General Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
173781	Fee-for-Service	1952410383	1952410383	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	60 SOLANO SQ	None	BENICIA	CA	94510	2712	48	06095	38.05438587	-122.1553524	Solano County
173797	Fee-for-Service	1508373986	1508373986	1	1	TOP CHOICE HOME HEALTH INC	7/26/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5301 LAUREL CANYON BLVD	UNIT 244	VALLEY VILLAGE	CA	91607	2783	19	06037	34.166907	-118.396546	Los Angeles County
173801	Fee-for-Service	1053507822	1053507822	1	1	TRADITIONAL FAMILY PRACTICE	3/21/2005	193200000X	NA	Other	026	PHYSICIANS	81344	08	Family Practice	0	In state provider	INC	3655 LOMITA BLVD	STE 418	TORRANCE	CA	90505	1934	19	06037	33.81497113	-118.3489779	Los Angeles County
173827	Fee-for-Service	1689783037	1689783037	1	1	THRIFTY PAYLESS INC	2/24/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6395	1500 WHITLEY AVE	None	CORCORAN	CA	93212	2226	16	06031	36.09805441	-119.5667616	Kings County
173854	Fee-for-Service	1114733201	1114733201	1	1	TERRA, BOWEN PT	2/10/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	631 S HAM LN	STE B	LODI	CA	95242	3532	39	06077	38.12696729	-121.2882893	San Joaquin County
173858	Fee-for-Service	1558685149	1558685149	1	1	TAKEKAWA, SARAH R MD	10/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118177	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
173863	Fee-for-Service	1467862326	1467862326	1	1	TRAN, DANIEL V MD	10/17/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	136232	20	Orthopedic Surgery	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
173866	Fee-for-Service	1154393353	1154393353	1	1	THOMAS W EDHOLM MD	3/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	KONA COMMUNITY HOSPIAL	79-1019 HAUKAPILA ST	None	KEALAKEKU	HI	96750	0000	00	None	19.519965	-155.918154	Hawaii County
173871	Fee-for-Service	1669594040	1669594040	1	1	TSEPAS, DEMETRIOS J	6/13/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
173905	Fee-for-Service	1215042049	1215042049	1	1	TENG, HONGYU MD	1/6/2022	207L00000X	NA	Other	026	PHYSICIANS	174835	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
173911	Fee-for-Service	1629187166	1629187166	1	1	THRIFTY PAYLESS INC	5/18/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5687	21738 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	3916	36	06071	34.50078152	-117.1895895	San Bernardino County
173967	Fee-for-Service	1598816571	1598816571	2	1	THREE WISE MEN, INC.	5/16/2022	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 W GLENOAKS BLVD	SUITE E	GLENDALE	CA	91201	1730	19	06037	34.17124961	-118.2900542	Los Angeles County
173990	Fee-for-Service	1073167458	1073167458	1	1	TABARES, ROSARIO LMFT	3/22/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
174006	Fee-for-Service	1437549235	1437549235	1	1	TAKAGI, JENNIFER H NP	12/29/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
174009	Fee-for-Service	1578023792	1578023792	1	1	THAI LAN N TRAN MD INC	7/3/2019	2086S0127X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
174013	Fee-for-Service	1740429612	1740429612	1	1	TAGORDA, TERENCE J CRNA	4/5/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
174043	Fee-for-Service	1396040713	1396040713	2	1	TROTTER, ZOLA N MD	12/10/2019	207PP0204X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
174049	Fee-for-Service	1518145499	1518145499	1	1	THINN, MIE MIE MD	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98081	41	Internal Medicine	0	In state provider	None	11370 ANDERSON STREET	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
174069	Fee-for-Service	1447218086	1447218086	1	1	THE REGENTS OF THE UNIVERSIT	12/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CENTER	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
174089	Fee-for-Service	1053507822	1053507822	1	1	TRADITIONAL FAMILY PRACTICE	3/21/2005	193200000X	NA	Other	026	PHYSICIANS	81344	01	General Practice	0	In state provider	INC	3655 LOMITA BLVD	STE 418	TORRANCE	CA	90505	1934	19	06037	33.81497113	-118.3489779	Los Angeles County
174116	Fee-for-Service	1841267689	1841267689	1	8	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	13019 STOCKDALE HWY	500	BAKERSFIELD	CA	93314	9570	15	06029	35.35418947	-119.147103	Kern County
174124	Fee-for-Service	1427085810	1427085810	1	1	TIRAKITSOONTORN, PORNCHA	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64929	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	# 1165W	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
174152	Fee-for-Service	1437183043	1437183043	1	1	TERRA LINDA PEDIATRICS INC	2/16/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	76970	40	Pediatrics	0	In state provider	TERRA LINDA PEDIATRICS I	4000 CIVIC CENTER DR	STE 201	SAN RAFAEL	CA	94903	5232	21	06041	38.0041783	-122.538861	Marin County
174160	Fee-for-Service	1407057391	1407057391	1	1	TEKAWA, ESTHER N OD	4/7/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
174161	Fee-for-Service	1679179352	1679179352	1	1	TUSCANO, TOTI CRNA	4/5/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
174195	Fee-for-Service	1710913876	1710913876	1	1	TSAI, HENRY C MD	11/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76710	22	Pathology (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
174250	Fee-for-Service	1942906391	1942906391	1	1	TOPANGA BEACH HOLDINGS LLC	3/1/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	831 SOUTH LAKE STREET	None	LOS ANGELES	CA	90057	4013	19	06037	34.05455067	-118.2794864	Los Angeles County
174259	Fee-for-Service	1740377928	1740377928	1	1	TASCOE, RAMONA M MD	6/17/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	36430	01	General Practice	0	In state provider	None	426 17TH ST	STE 420	OAKLAND	CA	94612	2820	01	06001	37.80642889	-122.269093	Alameda County
174285	Fee-for-Service	1295319960	1295319960	1	1	THE TRUSTED TRANSPORT TEAM	3/16/2023	347C00000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2901 34TH AVENUE	None	SACRAMENTO	CA	95824	1035	34	06067	38.521863	-121.475232	Sacramento County
174290	Fee-for-Service	1912401332	1912401332	1	1	TRAORE, FATIMA MD	10/13/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	165324	None	None	0	In state provider	None	100 MED PLAZA	100, 755	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
174340	Fee-for-Service	1487324463	1487324463	1	1	THE MINDFUL LEMON MARRIAGE A	4/22/2023	261QM0801X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	ND FAMILY THERAPY, INC	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
174341	Fee-for-Service	1447218086	1447218086	1	1	THE REGENTS OF THE UNIVERSIT	7/6/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	CENTER	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
174347	Fee-for-Service	1699177733	1699177733	2	1	TYRREL, BURGUNDY R MD	3/8/2022	207R00000X	NA	Other	026	PHYSICIANS	134784	None	None	0	In state provider	None	400 WEST PUEBLO STREET	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
174404	Fee-for-Service	1841267689	1841267689	1	8	TERRIO PHYSICAL THERAPY - FI	8/4/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	13019 STOCKDALE HWY	500	BAKERSFIELD	CA	93314	9570	15	06029	35.35418947	-119.147103	Kern County
174407	Fee-for-Service	1346501533	1346501533	1	1	TAYLOR, CORRDERO A LCSW	7/19/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	32362 FERNLEAF DRIVE	None	LAKE ELSINORE	CA	92532	2551	33	06065	33.66161452	-117.2528227	Riverside County
174412	Fee-for-Service	1427085810	1427085810	1	1	TIRAKITSOONTORN, PORNCHA	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64929	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	# 1165W	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
174435	Fee-for-Service	1164606554	1164606554	1	1	THOMAS, PIIA E MD	1/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	101389	13	Neurology (M.D. only)	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
174444	Fee-for-Service	1154344091	1154344091	1	1	TRAN, HOANG V MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71916	05	Anesthesiology	0	In state provider	None	3931 MACARTHUR BLVD	STE 105	NEWPORT BEACH	CA	92660	3012	30	06059	33.65770891	-117.8628645	Orange County
174446	Fee-for-Service	1710587639	1710587639	1	1	THOMPSON, STEVEN W K	11/20/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	10960 POPPY FIELD CIRCLE	None	MORENO VALLEY	CA	92557	3912	33	06065	33.96171604	-117.2511154	Riverside County
174449	Fee-for-Service	1134302409	1134302409	1	1	TANG, SUJIE MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107300	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
174464	Fee-for-Service	1467582486	1467582486	1	1	TOM, PETER H MD	8/31/1983	207P00000X	NA	Other	026	PHYSICIANS	34760	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
174486	Fee-for-Service	1457310211	1457310211	1	1	TRAN, BAO CONG MD	10/12/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	41661	41	Internal Medicine	0	In state provider	None	175 W LA VERNE AVE	STE D	POMONA	CA	91767	2347	19	06037	34.08615354	-117.7522473	Los Angeles County
174507	Fee-for-Service	1124361464	1124361464	1	1	TSE, AUDREY MD	7/12/2022	207P00000X	NA	Other	026	PHYSICIANS	175178	None	None	0	In state provider	None	2540 EAST ST	None	CONCORD	CA	94520	1906	07	06013	37.98292379	-122.0341876	Contra Costa County
174563	Fee-for-Service	1841268240	1841268240	1	1	THUMATI, RAMA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	36557	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
174601	Fee-for-Service	1770633588	1770633588	1	1	THOMAS, ABRAHAM P JR MD	7/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	78168	01	General Practice	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
174612	Fee-for-Service	1508914532	1508914532	1	1	TAN, LORELEI D MD	9/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92817	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
174630	Fee-for-Service	1487324463	1487324463	1	1	THE MINDFUL LEMON MARRIAGE A	4/22/2023	261QM0801X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ND FAMILY THERAPY, INC	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
174642	Fee-for-Service	1063521474	1063521474	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1830 MITCHELL RD	None	CERES	CA	95307	2824	50	06099	37.602738	-120.938691	Stanislaus County
174675	Fee-for-Service	1700219821	1700219821	1	1	TLC CONGREGATE LIVING I INC	12/1/2017	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	11905 RIVERSIDE DR	None	VALLEY VILLAGE	CA	91607	3724	19	06037	34.15764652	-118.3923495	Los Angeles County
174689	Fee-for-Service	1073879904	1073879904	1	1	TENG, ANNABELLE H MD	6/13/2020	2086X0206X	NA	General Surgery	026	PHYSICIANS	148706	02	General Surgery	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
174690	Fee-for-Service	1619531548	1619531548	1	1	TRIGUEROS, STUARDO DPM	10/18/2023	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
174695	Fee-for-Service	1124834551	1124834551	1	1	THOMAS, BRIANA Y BIRTH DOULA	12/19/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
174701	Fee-for-Service	1538228218	1538228218	1	1	TENDER LOVING CARE HEALTH	1/16/2010	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE SERVICES WESTERN	1700 S WINCHESTER BLVD	SUITE 102	CAMPBELL	CA	95008	1163	43	06085	37.29252967	-121.9498242	Santa Clara County
174704	Fee-for-Service	1518940303	1518940303	1	1	TU, JYEPING MD	4/30/1993	207R00000X	NA	Other	026	PHYSICIANS	73188	41	Internal Medicine	0	In state provider	None	1095 MARSHALL WAY	None	PLACERVILLE	CA	95667	5722	09	06017	38.7257686	-120.7910663	El Dorado County
174737	Fee-for-Service	1710587639	1710587639	1	1	THOMPSON, STEVEN W K	11/20/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	10960 POPPY FIELD CIRCLE	None	MORENO VALLEY	CA	92557	3912	33	06065	33.96171604	-117.2511154	Riverside County
174743	Fee-for-Service	1427454255	1427454255	1	1	TAN, IRMA NP	11/4/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
174768	Fee-for-Service	1497887830	1497887830	1	1	TANNER, KATHY A LMFT	6/22/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10603 EAST RIVER STREET	None	TRUCKEE	CA	96161	0339	29	06057	39.33020293	-120.1728277	Nevada County
174769	Fee-for-Service	1679990550	1679990550	1	1	TAMBORSKI, MARIA E MD	9/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	141856	66	Emergency Medicine (Urgent Care)	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1947	56	06111	34.2064445	-118.8824085	Ventura County
174771	Fee-for-Service	1255859328	1255859328	1	1	THOMPSON, TIA Y CNM	1/22/2018	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
174796	Fee-for-Service	1538296322	1538296322	1	1	TRUONG, CHRISTINE H OD	10/10/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4405 VANDEVER AVE	None	SAN DIEGO	CA	92120	3315	37	06073	32.78765609	-117.09908	San Diego County
174863	Fee-for-Service	1073583266	1073583266	1	1	TAYS,RENAE 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	2901 NORTH CENTRAL AVE	STE 500	PHOENIX	AZ	85012	2738	00	None	33.480666	-112.0729905	Maricopa County
174897	Fee-for-Service	1922074533	1922074533	1	1	TERRILL, STEPHEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2210 CANTERBURY DR	None	HAYS	KS	67601	2370	00	None	38.87856402	-99.29924822	Ellis County
174906	Fee-for-Service	1427405315	1427405315	1	1	TINKHAM, LEAH LAC	8/13/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
174909	Fee-for-Service	1598269854	1598269854	1	1	TERASHIMA, KEVIN MD	11/16/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	165920	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
174920	Fee-for-Service	1487324463	1487324463	1	1	THE MINDFUL LEMON MARRIAGE A	4/22/2023	261QM0801X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ND FAMILY THERAPY, INC	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
174941	Fee-for-Service	1871847608	1871847608	1	1	THAMBUNDIT, APISADAPORN MD	5/22/2020	2080P0205X	NA	Endocrinology	026	PHYSICIANS	150514	40	Pediatrics	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
175005	Fee-for-Service	1538587258	1538587258	1	1	TRAVIS THOMPSON MD	4/11/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
175027	Fee-for-Service	1295291680	1295291680	1	1	THE CROSSROADS HOSPICE, INC	2/26/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7108 DE SOTO AVE	STE 204C	CANOGA PARK	CA	91303	3230	19	06037	34.1994564	-118.5884133	Los Angeles County
175035	Fee-for-Service	1437340015	1437340015	1	1	TUMUSOK, MARIE N MD	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98755	41	Internal Medicine	0	In state provider	None	2580 SR MARY COLUMBA DR	None	RED BLUFF	CA	96080	4327	52	06103	40.14842672	-122.2180085	Tehama County
175041	Fee-for-Service	1902004534	1902004534	1	1	TERRY, DAVID S PHD	8/21/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE ROAD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
175093	Fee-for-Service	1023196656	1023196656	1	1	TYLER, CHRISTOPHER L MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	66173	01	General Practice	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
175113	Fee-for-Service	1508865528	1508865528	1	3	TAHOE CARSON VALLEY	9/28/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	1	Border provider	MEDICAL GROUP INC	1516 VIRGINIA RANCH RD	None	GARDNERVILLE	NV	89410	5730	00	None	38.91947242	-119.7199658	Douglas County
175115	Fee-for-Service	1417619669	1417619669	1	1	TRAN, CRYSTAL OD	2/7/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2746 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5747	19	06037	33.97375784	-118.2212008	Los Angeles County
175129	Fee-for-Service	1790836211	1790836211	1	1	THIET, MARI-PAULE MD	8/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50917	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
175186	Fee-for-Service	1336961697	1336961697	1	1	TUPPER, LACIE BIRTH DOULA	11/6/2024	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	44	06087	0	0	None
175209	Fee-for-Service	1487324463	1487324463	1	1	THE MINDFUL LEMON MARRIAGE A	4/22/2023	261QM0801X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ND FAMILY THERAPY, INC	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
175243	Fee-for-Service	1962573857	1962573857	1	1	TU, ELAINE M OD	4/10/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
175267	Fee-for-Service	1104862689	1104862689	1	1	TATOMER, WILLIAM R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	35537	36	Psychiatry	0	In state provider	None	101 S SAN MATEO DR	STE 300	SAN MATEO	CA	94401	3844	41	06081	37.56590481	-122.325549	San Mateo County
175282	Fee-for-Service	1245298942	1245298942	1	1	THREE RIVERS EMS	9/23/2009	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	31 7TH ST W	None	COLUMBIA FLS	MT	59912	3711	00	None	48.372678	-114.182028	Flathead County
175306	Fee-for-Service	1871675744	1871675744	1	1	TSAI, ZONG LANG MD	4/30/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	35282	41	Internal Medicine	0	In state provider	None	3011 ARTESIA BLVD	None	TORRANCE	CA	90504	2613	19	06037	33.87295149	-118.3258485	Los Angeles County
175315	Fee-for-Service	1295291680	1295291680	1	1	THE CROSSROADS HOSPICE, INC	2/26/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7108 DE SOTO AVE	STE 204C	CANOGA PARK	CA	91303	3230	19	06037	34.1994564	-118.5884133	Los Angeles County
175353	Fee-for-Service	1861451445	1861451445	1	1	TRI-CITY ORTHOPAEDIC SURGERY	1/3/2019	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL GROUP INC	3905 WARING RD	None	OCEANSIDE	CA	92056	4405	37	06073	33.18781249	-117.2923383	San Diego County
175378	Fee-for-Service	1861501249	1861501249	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05445	4322 S FIGUEROA ST	None	LOS ANGELES	CA	90037	2642	19	06037	34.00493783	-118.2827097	Los Angeles County
175396	Fee-for-Service	1508865528	1508865528	1	3	TAHOE CARSON VALLEY	12/5/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	1	Border provider	MEDICAL GROUP INC	1516 VIRGINIA RANCH RD	None	GARDNERVILLE	NV	89410	5730	00	None	38.91947242	-119.7199658	Douglas County
175417	Fee-for-Service	1255440707	1255440707	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12491 VALLEY VIEW ST	None	GARDEN GROVE	CA	92845	2032	30	06059	33.78026945	-118.0313622	Orange County
175429	Fee-for-Service	1285930396	1285930396	1	2	TARZANA TREATMENT CENTERS, I	9/24/2018	261QM2500X	NA	Other	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	320 E PALMDALE BLVD	None	PALMDALE	CA	93550	4598	19	06037	34.57983613	-118.1240079	Los Angeles County
175437	Fee-for-Service	1083398838	1083398838	1	1	THOMAS, AMBER M CRNA	1/16/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
175440	Fee-for-Service	1598821084	1598821084	1	1	TUCKER, PAULA L LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
175490	Fee-for-Service	1861602559	1861602559	1	1	TONIA TUNG YEE, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
175492	Fee-for-Service	1235376443	1235376443	1	1	TO, BRITTANY A OD APC	7/18/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15622 BROOKHURST ST	None	WESTMINSTER	CA	92683	7573	30	06059	33.73592833	-117.954678	Orange County
175524	Fee-for-Service	1447321179	1447321179	1	1	TZEVAN POON	3/4/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1035 116TH AVE NE	None	BELLEVUE	WA	98004	4604	00	None	47.620296	-122.1856955	King County
175549	Fee-for-Service	1780134221	1780134221	1	1	TSE, HOLLY LMFT	3/11/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5750 TRAFFIC WAY	UNIT A	ATASCADERO	CA	93422	7205	40	06079	35.49169627	-120.668855	San Luis Obispo County
175595	Fee-for-Service	1487369146	1487369146	1	1	THORPE, ERIKKA G BIRTH DOULA	3/29/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	37	06073	0	0	None
175600	Fee-for-Service	1417229501	1417229501	1	1	TRAN, TIFFANY K MD	12/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123648	41	Internal Medicine	0	In state provider	None	220 E HACIENDA AVENUE	None	CAMPBELL	CA	95008	6617	43	06085	37.26914953	-121.9566285	Santa Clara County
175611	Fee-for-Service	1851955058	1851955058	1	1	TREADWELL, MARSHA J PHD	12/12/2019	103TH0100X	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
175640	Fee-for-Service	1861451445	1861451445	1	1	TRI-CITY ORTHOPAEDIC SURGERY	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	3905 WARING RD	None	OCEANSIDE	CA	92056	4405	37	06073	33.18781249	-117.2923383	San Diego County
175660	Fee-for-Service	1407223217	1407223217	1	1	THIRUGNANASAMBANDAM, POORNA	3/16/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	149414	08	Family Practice	0	In state provider	MD	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
175666	Fee-for-Service	1558451112	1558451112	1	1	TAN, SUSAN R MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68769	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	309 E MOUNTAIN VIEW ST	STE 110	BARSTOW	CA	92311	2814	36	06071	34.89352417	-117.0239099	San Bernardino County
175687	Fee-for-Service	1508865528	1508865528	1	3	TAHOE CARSON VALLEY	9/15/2021	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	1	Border provider	MEDICAL GROUP INC	1516 VIRGINIA RANCH RD	None	GARDNERVILLE	NV	89410	5730	00	None	38.91947242	-119.7199658	Douglas County
175715	Fee-for-Service	1285930396	1285930396	1	2	TARZANA TREATMENT CENTERS, I	8/3/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	320 E PALMDALE BLVD	None	PALMDALE	CA	93550	4598	19	06037	34.57983613	-118.1240079	Los Angeles County
175719	Fee-for-Service	1225121981	1225121981	1	1	TSFIRA, ALETE PHD	5/8/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1125 S BEVERLY DR	STE 401	LOS ANGELES	CA	90035	1152	19	06037	34.05696658	-118.3966613	Los Angeles County
175728	Fee-for-Service	1801400957	1801400957	1	1	TOUCHING HEARTS HOSPICE, LLC	11/18/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	813 N LA CADENA DRIVE	None	COLTON	CA	92324	2747	36	06071	34.07372869	-117.3229585	San Bernardino County
175803	Fee-for-Service	1710058441	1710058441	1	1	TLC OF THE BAY AREA INC	10/1/1994	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	991 CLYDE AVE	None	SANTA CLARA	CA	95054	1905	43	06085	37.38957265	-121.9511234	Santa Clara County
175805	Fee-for-Service	1578588331	1578588331	1	1	TIMOTHY J NAGEL MD	9/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1316 S MAIN ST	None	CLARION	IA	50525	2019	00	None	42.72125987	-93.7326632	Wright County
175810	Fee-for-Service	1225173537	1225173537	1	3	TIU-TORRES, LALAINE L MD	5/12/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	63191	-	NOT APPLICABLE	0	In state provider	None	1310 M ST	None	FRESNO	CA	93721	1808	10	06019	36.73926478	-119.7905188	Fresno County
175842	Fee-for-Service	1245729466	1245729466	1	1	TOROSYAN, NARE MD	9/29/2021	207R00000X	NA	Other	026	PHYSICIANS	164395	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
175859	Fee-for-Service	1043483431	1043483431	1	2	TSAI, TIFFANY Y MD	1/14/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	106162	-	NOT APPLICABLE	0	In state provider	None	3150 EAST LOS ANGELES	None	SIMI VALLEY	CA	93065	3940	56	06111	34.2716367	-118.7360247	Ventura County
175862	Fee-for-Service	1124082144	1124082144	1	1	TONG, ELISA K MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77136	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
175877	Fee-for-Service	1992032239	1992032239	1	1	TANG, JIN MD	5/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109699	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
175889	Fee-for-Service	1366625451	1366625451	1	2	TANAKA, GEORGE H MD INC	8/31/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78526	None	None	0	In state provider	None	491 30TH ST	STE 103	OAKLAND	CA	94609	3235	01	06001	37.81935528	-122.2667902	Alameda County
175911	Fee-for-Service	1730812926	1730812926	1	1	TABARANZA, KRESTA RIA A OD	8/1/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
175917	Fee-for-Service	1326225368	1326225368	1	1	TAMAS, VANESSA L MD	7/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101991	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
175936	Fee-for-Service	1588608749	1588608749	1	1	THOMAS, ROGER H MD	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	21525	30	Radiology	0	In state provider	None	355 PLACENTIA AVE	None	NEWPORT BEACH	CA	92663	3311	30	06059	33.62672719	-117.9312941	Orange County
175949	Fee-for-Service	1073031993	1073031993	1	1	THRASHER, JULIA NP	10/11/2017	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
175957	Fee-for-Service	1184851578	1184851578	1	1	THRIFTY PAYLESS INC	8/10/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06510	4774 WEST LANE	None	STOCKTON	CA	95210	3552	39	06077	37.99723489	-121.2886388	San Joaquin County
175971	Fee-for-Service	1376959395	1376959395	1	1	TRAN, THIEN T OD	2/29/2016	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1092 N STATE COLLEGE	BLVD	ANAHEIM	CA	92806	2701	30	06059	33.848622	-117.889122	Orange County
176017	Fee-for-Service	1801400957	1801400957	1	1	TOUCHING HEARTS HOSPICE, LLC	11/18/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	813 N LA CADENA DRIVE	None	COLTON	CA	92324	2747	36	06071	34.07372869	-117.3229585	San Bernardino County
176025	Fee-for-Service	1336536291	1336536291	1	1	TERESA D FREY	10/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5225 23RD AVE S	None	FARGO	ND	58104	7927	00	None	46.845468	-96.8753655	Cass County
176057	Fee-for-Service	1730315557	1730315557	1	1	TREFRY, DAVID A	6/23/2009	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	740 LOMAS SANTA FE DR	STE 110	SOLANA BEACH	CA	92075	1441	37	06073	32.9960581	-117.2579748	San Diego County
176130	Fee-for-Service	1699765305	1699765305	1	1	TAM, JOHN W DPM	7/11/1977	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	222 E ALOSTA AVE	None	GLENDORA	CA	91740	6241	19	06037	34.1286357	-117.8617319	Los Angeles County
176146	Fee-for-Service	1740575950	1740575950	1	1	TSAI, MICHELLE C MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134754	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	136 NORTH SAN MATEO DR	101	SAN MATEO	CA	94401	2779	41	06081	37.56923131	-122.3291888	San Mateo County
176156	Fee-for-Service	1104605617	1104605617	1	1	TOPIWALA, DAVE PT	6/13/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6125 KING ROAD	102	LOOMIS	CA	95650	8809	31	06061	38.82513051	-121.189707	Placer County
176166	Fee-for-Service	1730112558	1730112558	1	1	TERRY BOULWARE	10/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 S TELSHOR BLVD B14	STE 102	LAS CRUCES	NM	88011	9148	00	None	32.2910181	-106.7345861	Doña Ana County
176187	Fee-for-Service	1902292204	1902292204	1	1	TURNER, GRANT MD	4/8/2021	207RP1001X	NA	Pulmonology	026	PHYSICIANS	171935	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
176192	Fee-for-Service	1225052483	1225052483	1	1	THOMSON, SCOTT C MD	1/31/1986	207P00000X	NA	Other	026	PHYSICIANS	53658	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
176204	Fee-for-Service	1326225368	1326225368	1	1	TAMAS, VANESSA L MD	7/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101991	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
176238	Fee-for-Service	1538174123	1538174123	1	1	TAHOE FOREST PHARMACY	1/30/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS RD	STE 101	TRUCKEE	CA	96161	4861	29	06057	39.32625521	-120.2012059	Nevada County
176242	Fee-for-Service	1740733708	1740733708	1	1	TEMPUS AI, INC.	3/1/2020	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	600 W CHICAGO AVE	STE 510	CHICAGO	IL	60654	2526	00	None	41.896484	-87.64363924	Cook County
176245	Fee-for-Service	1679766745	1679766745	1	1	TAHERI, HAMED MD	8/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138318	02	General Surgery	0	In state provider	None	1040 ELM AVE	STE 100	LONG BEACH	CA	90813	3265	19	06037	33.779799	-118.1879535	Los Angeles County
176247	Fee-for-Service	1366570103	1366570103	1	1	TANG, LISA W MD	2/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93754	08	Family Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
176267	Fee-for-Service	1851488100	1851488100	1	1	TAUBER, EVA S LSCW	10/24/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	11765	-	NOT APPLICABLE	0	In state provider	None	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
176311	Fee-for-Service	1497252522	1497252522	1	1	TSAI, JONATHAN	10/20/2023	207R00000X	NA	Other	026	PHYSICIANS	180276	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
176336	Fee-for-Service	1225154461	1225154461	1	1	TELLERS-SCHULTZ, JENNIFER R	11/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	NP	3830 MARTIN LUTHER KING	None	LYNWOOD	CA	90262	3625	19	06037	33.92753236	-118.1975459	Los Angeles County
176377	Fee-for-Service	1356899231	1356899231	1	1	TEHRANI FOOT AND ANKLE INC	2/19/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2514 S CENTRAL AVE	None	LOS ANGELES	CA	90011	1635	19	06037	34.01945961	-118.2546333	Los Angeles County
176463	Fee-for-Service	1679979553	1679979553	1	1	TIBURCIO VASQUEZ HEALTH	5/13/2015	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	MOBILE	22331 MISSION BLVD	None	HAYWARD	CA	94541	3911	01	06001	37.67442187	-122.0867356	Alameda County
176465	Fee-for-Service	1124455316	1124455316	1	2	TRACY, MICHELLE LMFT	3/10/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	206 SACRAMENTO STREET	SUITE 204	NEVADA CITY	CA	95959	2633	29	06057	39.26103141	-121.0166729	Nevada County
176530	Fee-for-Service	1205450210	1205450210	1	1	TRAN, TRACIE MD	3/21/2024	207L00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
176534	Fee-for-Service	1649809971	1649809971	1	1	TODD HARSHBARGER MD, A MEDIC	11/7/2020	174400000X	NA	Other	026	PHYSICIANS	None	14	Neurological Surgery	0	In state provider	AL CORPORATION	191 BUENA VISTA	STE 370	BURBANK	CA	91505	4554	19	06037	34.15872557	-118.3283863	Los Angeles County
176539	Fee-for-Service	1659498830	1659498830	1	1	TAYLOR, FRANCESCA M MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70649	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
176571	Fee-for-Service	1174689376	1174689376	1	1	TANG, MOLLY	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
176593	Fee-for-Service	1013322320	1013322320	1	1	TOUBI, KAREN DO	9/24/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	16028	15	Obstetrics (D.O. only)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
176667	Fee-for-Service	1952726143	1952726143	1	1	TAM, JASON H MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135233	20	Orthopedic Surgery	0	In state provider	None	315 N 3RD AVE	SUITE 302	COVINA	CA	91723	1916	19	06037	34.08873786	-117.8923869	Los Angeles County
176702	Fee-for-Service	1750458659	1750458659	1	1	TABEL, GHASAN M MD	1/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88852	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
176770	Fee-for-Service	1043246036	1043246036	1	1	TAMMY PARK MD	1/4/2016	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
176790	Fee-for-Service	1568947802	1568947802	1	1	THOMPSON, CHELSEA LMFT	1/14/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	510 FIRECREST CT	None	NEWBURY PARK	CA	91320	5022	56	06111	34.16869042	-118.9471108	Ventura County
176795	Fee-for-Service	1548986235	1548986235	1	1	TODD, SPENCER	5/23/2023	2251X0800X	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
176824	Fee-for-Service	1942424106	1942424106	1	1	TRI-CITY HEALTH CENTER	12/24/1999	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	LIBERTY	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
176961	Fee-for-Service	1952530313	1952530313	1	1	TOBLER, TINA L MD	10/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
177034	Fee-for-Service	1083631659	1083631659	1	1	TAYLOR JERALD B. MD	10/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	48 W 1500 N	None	NEPHI	UT	84648	8900	00	None	39.7306275	-111.83724	Juab County
177056	Fee-for-Service	1891145322	1891145322	1	1	TORIGOE-LAI, TIFFANY K PHD	5/18/2021	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
177063	Fee-for-Service	1235576638	1235576638	1	1	TILSTRA, MATTHEW L MD	5/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148079	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1552 COFFEE ROAD	1ST FLOOR	MODESTO	CA	95355	3122	50	06099	37.666872	-120.975684	Stanislaus County
177068	Fee-for-Service	1487742003	1487742003	1	1	TSANG, NALLY L MD	1/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76823	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
177100	Fee-for-Service	1174556518	1174556518	1	1	TECOMA, EVELYN S MD	10/31/1989	2084N0400X	NA	Neurology	026	PHYSICIANS	58138	13	Neurology (M.D. only)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
177103	Fee-for-Service	1063428514	1063428514	2	2	TROXELL, MEGAN L MD	11/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78593	22	Pathology (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
177203	Fee-for-Service	1659031193	1659031193	1	1	TANATHA HOADLEY, NP	8/14/2023	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1717 ARLINGTON AVE	None	CALDWELL	ID	83605	4802	00	None	43.654374	-116.694738	Canyon County
177206	Fee-for-Service	1366842668	1366842668	1	1	TANG, MINH C O D INC	12/12/2014	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5475 E LA PALMA AVE	SUITE 209	ANAHEIM	CA	92807	2075	30	06059	33.85997926	-117.7958236	Orange County
177209	Fee-for-Service	1831126952	1831126952	1	1	TRAN, CHRISTOPHER D MD	10/31/1992	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	75609	30	Radiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
177225	Fee-for-Service	1285798504	1285798504	1	1	TARANTO, JEFFREY L OD	3/29/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12214 VENTURA BLVD	None	STUDIO CITY	CA	91604	2518	19	06037	34.14320212	-118.3990216	Los Angeles County
177247	Fee-for-Service	1952530313	1952530313	1	1	TOBLER, TINA L MD	10/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
177261	Fee-for-Service	1003994682	1003994682	1	1	TRAUM, AMY E MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61695	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
177272	Fee-for-Service	1841444049	1841444049	1	1	THRIFTY PAYLESS INC.	2/10/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06557	5075 OLIVEHURST AVE.	None	OLIVEHURST	CA	95961	4023	58	06115	39.10100242	-121.5512317	Yuba County
177283	Fee-for-Service	1548244965	1548244965	1	1	THIO, DAVID MD	11/30/1996	207R00000X	NA	Other	026	PHYSICIANS	80273	41	Internal Medicine	0	In state provider	None	28125 BRADLEY RD	None	SUN CITY	CA	92586	2248	33	06065	33.71309746	-117.1898349	Riverside County
177289	Fee-for-Service	1699906164	1699906164	1	1	TSE, RAYMOND W.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	4500 SAND POINT WAY NE	STE 100	SEATTLE	WA	98105	3954	00	None	47.66165594	-122.2864502	King County
177320	Fee-for-Service	1699822239	1699822239	1	2	TERENCE T Z TAN MD INC.	12/13/2020	2251P0200X	NA	Physical Therapist	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3301 BEECHWOOD AVE	None	LYNWOOD	CA	90262	3301	19	06037	33.92961073	-118.2111703	Los Angeles County
177352	Fee-for-Service	1972082949	1972082949	1	1	THOMAS, SARAH D LMFT	12/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1513 E CHAPMAN AVE	None	FULLERTON	CA	92831	4013	30	06059	33.8741613	-117.9005017	Orange County
177357	Fee-for-Service	1487742003	1487742003	1	1	TSANG, NALLY L MD	1/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76823	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
177401	Fee-for-Service	1619764347	1619764347	1	1	TORREY PINES BIRTH COLLECTIV	4/25/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	37	06073	0	0	None
177523	Fee-for-Service	1114634185	1114634185	1	1	TUNG, JESSE CNP	1/5/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10 BAYHILL SHOPPING CTR	None	SAN BRUNO	CA	94066	0000	41	06081	37.62675744	-122.4250498	San Mateo County
177534	Fee-for-Service	1629573688	1629573688	1	1	THOMAS-URIBE, MONIKA MD	10/1/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	173383	None	None	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
177538	Fee-for-Service	1689741571	1689741571	1	1	TRAN, HOA D MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	45603	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
177571	Fee-for-Service	1881780849	1881780849	1	1	TEFERA, LEMENEH	2/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145299	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
177602	Fee-for-Service	1669556353	1669556353	1	1	TORRE, PAUL 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 GARTH RD	None	BAYTOWN	TX	77521	2122	00	None	29.76910842	-94.97759843	Harris County
177619	Fee-for-Service	1396700175	1396700175	1	1	TERZO, TODD L MD	1/15/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	69959	None	None	0	In state provider	None	1444 FLORIDA AVE	STE 103	MODESTO	CA	95350	4400	50	06099	37.66487562	-120.9961927	Stanislaus County
177674	Fee-for-Service	1851352983	1851352983	1	1	TOM, RICHARD	12/31/1993	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	874C BLOSSOM HILL RD	None	SAN JOSE	CA	95123	2725	43	06085	37.2502227	-121.858389	Santa Clara County
177692	Fee-for-Service	1285413286	1285413286	1	1	THOMAS, BELINDA DEMETRIA	1/16/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1474 SALEM CT	None	FAIRFIELD	CA	94534	3339	48	06095	38.25800528	-122.0757609	Solano County
177712	Fee-for-Service	1982900015	1982900015	1	1	TRENTACOSTA, NATASHA E MD	8/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	135772	20	Orthopedic Surgery	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.069509	-118.383743	Los Angeles County
177738	Fee-for-Service	1912963232	1912963232	1	1	THE REGENTS OF THE UNIVERSIT	12/1/1995	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ASSOCIATES	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
177788	Fee-for-Service	1568598860	1568598860	1	1	TELFORD, BYRON B NP	9/14/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	555 BLACK OAK DR	STE 300	MEDFORD	OR	97504	8491	00	None	42.318873	-122.835653	Jackson County
177821	Fee-for-Service	1205843323	1205843323	1	1	TRAN, QUYEN N CRNA	2/29/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
177823	Fee-for-Service	1124454962	1124454962	1	1	TWIN TOWN CORPORATION	12/17/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	8739 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90069	4507	19	06037	34.08687562	-118.3813577	Los Angeles County
177826	Fee-for-Service	1689741571	1689741571	1	1	TRAN, HOA D MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	45603	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
177874	Fee-for-Service	1588278592	1588278592	1	1	TRINH, ANDREW PT	10/15/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	41990 COOK ST	BLDG G STE 602	PALM DESERT	CA	92211	6103	33	06065	33.748371	-116.356173	Riverside County
177901	Fee-for-Service	1831720069	1831720069	1	1	TAPANG, RHEA NP	10/27/2023	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
177903	Fee-for-Service	1356450894	1356450894	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5969	1988 FREEDOM BLVD	None	FREEDOM	CA	95019	2837	44	06087	36.93771137	-121.7766815	Santa Cruz County
177934	Fee-for-Service	1831847862	1831847862	1	1	THOMAS, AMBER LCSW	7/17/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	690 E GREEN ST	202	PASADENA	CA	91101	2197	19	06037	34.14449605	-118.1361004	Los Angeles County
177940	Fee-for-Service	1306955778	1306955778	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05551	14727 RINALDI ST	None	SAN FERNANDO	CA	91340	4189	19	06037	34.28094049	-118.4531117	Los Angeles County
177972	Fee-for-Service	1528731619	1528731619	1	1	TUPOU FAMILY INC	5/12/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	3839 STRONG STREET	None	RIVERSIDE	CA	92501	1843	33	06065	34.00121235	-117.3652526	Riverside County
177974	Fee-for-Service	1184017477	1184017477	1	1	TRAN, HANG M DO MD	8/22/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15828	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
177981	Fee-for-Service	1285413286	1285413286	1	1	THOMAS, BELINDA DEMETRIA	1/16/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1474 SALEM CT	None	FAIRFIELD	CA	94534	3339	48	06095	38.25800528	-122.0757609	Solano County
178025	Fee-for-Service	1679056014	1679056014	1	1	THRIFTY PAYLESS INC	9/9/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6420 RIO LINDA BLVD	None	RIO LINDA	CA	95673	3332	34	06067	38.684322	-121.456395	Sacramento County
178033	Fee-for-Service	1447624200	1447624200	1	1	TOTAL RENAL CARE INC	12/20/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	21608 S VERMONT AVE	None	TORRANCE	CA	90502	1940	19	06037	33.832161	-118.2902545	Los Angeles County
178047	Fee-for-Service	1093921447	1093921447	1	1	TRAN, CAM MD	5/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89336	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
178051	Fee-for-Service	1720237050	1720237050	1	1	TRIFILETTI, CHRISTINA M OD	4/2/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3772 HOWE STREET	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
178054	Fee-for-Service	1548276835	1548276835	1	1	THRIFTY PAYLESS INC	11/23/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6448	2751 DEL PASO RD	None	SACRAMENTO	CA	95835	2303	34	06067	38.657529	-121.5233235	Sacramento County
178067	Fee-for-Service	1508865528	1508865528	1	6	TAHOE CARSON VALLEY	12/26/2007	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	1	Border provider	None	3919 CARTER DR	None	WELLINGTON	NV	89444	9995	00	None	38.73144685	-119.5064055	Douglas County
178068	Fee-for-Service	1811154727	1811154727	1	1	TSANG, DORCAS OD	12/13/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E SECOND ST	STE 2	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
178084	Fee-for-Service	1417005448	1417005448	1	1	TSAI, CAMMY DO	12/31/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	9466	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
178096	Fee-for-Service	1265541700	1265541700	1	1	THRIFTY DRUG STORE 5942	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	31836 ALVARADO BLVD	None	UNION CITY	CA	94587	3913	01	06001	37.59048544	-122.0708927	Alameda County
178124	Fee-for-Service	1336281179	1336281179	1	1	THE LOS ANGELES FREE CLINIC	2/4/2011	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HOLLYWOOD WILSHIRE HLTH	5205 MELROSE AVE	None	LOS ANGELES	CA	90038	3144	19	06037	34.08354051	-118.314009	Los Angeles County
178191	Fee-for-Service	1235101502	1235101502	1	1	TRACY, HEATHER MD	9/4/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	95980	70	Clinic (mixed specialty)	0	In state provider	None	3075 HEALTH CENTER DR	STE 102	SAN DIEGO	CA	92123	2773	37	06073	32.79963065	-117.1556197	San Diego County
178200	Fee-for-Service	1639610264	1639610264	1	1	THE WRIGHT HOME CARE INC	6/30/2017	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	6060 W MANCHESTER AVE	SUITE 113	LOS ANGELES	CA	90045	4266	19	06037	33.95976851	-118.390734	Los Angeles County
178235	Fee-for-Service	1003964933	1003964933	1	1	TOMAN, RACHEL M NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	250 TRAVELODGE DR	None	EL CAJON	CA	92020	4126	37	06073	32.79312432	-116.980275	San Diego County
178256	Fee-for-Service	1922137272	1922137272	1	1	TROMPETA, BELLAFLOR V MD	5/11/2017	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	A MEDICAL CORP	18433 ROSCOE BLVD	STE 104	NORTHRIDGE	CA	91325	4127	19	06037	34.22076747	-118.534725	Los Angeles County
178271	Fee-for-Service	1952590382	1952590382	1	1	TSCHIDA, ROBERT CO & P	5/1/1995	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	214 S ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	2811	19	06037	34.06440553	-118.3835984	Los Angeles County
178294	Fee-for-Service	1013095751	1013095751	1	1	TILLMAN, JENNIFER S MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84646	08	Family Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
178313	Fee-for-Service	1821509654	1821509654	1	1	THOM, RYAN C LMFT	1/10/2025	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
178333	Fee-for-Service	1053182709	1053182709	1	1	THE QUEEN RX INC	2/4/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1233 N TUSTIN ST	None	ORANGE	CA	92867	5147	30	06059	33.807861	-117.8356835	Orange County
178356	Fee-for-Service	1508865528	1508865528	1	6	TAHOE CARSON VALLEY	9/28/2021	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	1	Border provider	None	3919 CARTER DR	None	WELLINGTON	NV	89444	9995	00	None	38.73144685	-119.5064055	Douglas County
178412	Fee-for-Service	1336281179	1336281179	1	1	THE LOS ANGELES FREE CLINIC	2/4/2011	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	HOLLYWOOD WILSHIRE HLTH	5205 MELROSE AVE	None	LOS ANGELES	CA	90038	3144	19	06037	34.08354051	-118.314009	Los Angeles County
178444	Fee-for-Service	1023077401	1023077401	1	1	TASA, LAURA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4343 N JOSEY LN	None	CARROLLTON	TX	75010	4603	00	None	33.02809675	-96.88453535	Denton County
178448	Fee-for-Service	1346714722	1346714722	1	1	TANIOS, RANA PSYD	11/13/2024	101YM0800X	NA	Other	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
178490	Fee-for-Service	1053040188	1053040188	1	1	TPIRC MEDICAL FOUNDATION INC	10/26/2022	2080P0201X	NA	Neurology	022	PHYSICIANS GROUP	-	43	Pediatric Allergy	0	In state provider	None	2704 E WILLOW ST	None	SIGNAL HILL	CA	90755	2217	19	06037	33.80432955	-118.1594295	Los Angeles County
178536	Fee-for-Service	1447555123	1447555123	1	1	TUCKER, TIFFANY N LMFT	3/7/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
178583	Fee-for-Service	1902278203	1902278203	1	1	TAPIA, JOCELYN C LMFT	10/18/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
178584	Fee-for-Service	1306112677	1306112677	1	1	TRAY, NANCY J MD	9/3/2019	207R00000X	NA	Other	026	PHYSICIANS	161012	41	Internal Medicine	0	In state provider	None	23625 HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
178590	Fee-for-Service	1285714006	1285714006	1	1	THOMPSON, STEVEN P MD	1/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	48670	41	Internal Medicine	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
178643	Fee-for-Service	1508865528	1508865528	1	6	TAHOE CARSON VALLEY	9/15/2021	207Q00000X	NA	Adult Primary Care	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	1	Border provider	None	3919 CARTER DR	None	WELLINGTON	NV	89444	9995	00	None	38.73144685	-119.5064055	Douglas County
178672	Fee-for-Service	1699822239	1699822239	1	1	TERENCE T Z TAN MD INC.	11/30/1991	261QP2300X	NA	Other	026	PHYSICIANS	47880	None	None	0	In state provider	None	3301 BEECHWOOD AVE	None	LYNWOOD	CA	90262	3301	19	06037	33.92961073	-118.2111703	Los Angeles County
178679	Fee-for-Service	1013946367	1013946367	1	1	TALAN, DAVID A MD	7/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	48932	66	Emergency Medicine (Urgent Care)	0	In state provider	None	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	19	06037	34.32450186	-118.4456317	Los Angeles County
178682	Fee-for-Service	1578700597	1578700597	1	1	TSUJIMOTO, CURT N MD INC	11/12/2009	207L00000X	NA	Other	026	PHYSICIANS	55049	05	Anesthesiology	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
178699	Fee-for-Service	1336281179	1336281179	1	1	THE LOS ANGELES FREE CLINIC	2/4/2011	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HOLLYWOOD WILSHIRE HLTH	5205 MELROSE AVE	None	LOS ANGELES	CA	90038	3144	19	06037	34.08354051	-118.314009	Los Angeles County
178716	Fee-for-Service	1427629724	1427629724	1	1	TRINITY LIFE SUPPORT COMMUNI	7/1/2021	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TY SERVICE DISTRICT	610 WASHINGTON STREET	None	WEAVERVILLE	CA	96093	2907	53	06105	40.73383971	-122.9329237	Trinity County
178765	Fee-for-Service	1568502979	1568502979	1	1	TUTTLE, DAVID MD	8/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120172	30	Radiology	0	In state provider	None	2320 BATH STREET	STE 208	SANTA BARBARA	CA	93105	3805	42	06083	34.43082689	-119.7223032	Santa Barbara County
178770	Fee-for-Service	1760591119	1760591119	1	2	THRIFTY PAYLESS INC	9/8/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4920 LA SIERRA AVE	None	RIVERSIDE	CA	92505	2726	33	06065	33.91972174	-117.4891571	Riverside County
178777	Fee-for-Service	1053040188	1053040188	1	1	TPIRC MEDICAL FOUNDATION INC	1/12/2023	2080P0201X	NA	Neurology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2704 E WILLOW ST	None	SIGNAL HILL	CA	90755	2217	19	06037	33.80432955	-118.1594295	Los Angeles County
178829	Fee-for-Service	1720408305	1720408305	1	1	TU, JOEY MD	5/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141469	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
178861	Fee-for-Service	1578902540	1578902540	1	1	TRIVEDI, HIRSH D MD	7/26/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	138036	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
178870	Fee-for-Service	1508865528	1508865528	1	1	TAHOE CARSON VALLEY	9/15/2021	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP, INC	2155 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7038	09	06017	38.91235187	-119.9983501	El Dorado County
178968	Fee-for-Service	1013918911	1013918911	1	1	TOMLIN, LUELINDA OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4409 E LOS COYOTES DIAGO	None	LONG BEACH	CA	90815	2820	19	06037	33.79080918	-118.1413013	Los Angeles County
178987	Fee-for-Service	1336281179	1336281179	1	1	THE LOS ANGELES FREE CLINIC	2/4/2011	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HOLLYWOOD WILSHIRE HLTH	5205 MELROSE AVE	None	LOS ANGELES	CA	90038	3144	19	06037	34.08354051	-118.314009	Los Angeles County
178996	Fee-for-Service	1255845525	1255845525	1	1	TAMAYO, JANICE LYNN V CNP	12/6/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	921 PACIFIC COAST HWY	None	SEAL BEACH	CA	90740	6244	30	06059	33.74418902	-118.1018883	Orange County
179105	Fee-for-Service	1861613481	1861613481	1	1	TAFF, WARREN R MD	3/15/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	29577	None	None	0	In state provider	None	17601 17TH ST	120	TUSTIN	CA	92780	1946	30	06059	33.75990351	-117.8253082	Orange County
179135	Fee-for-Service	1992153266	1992153266	1	1	TOOR, HARJYOT DO	7/6/2023	208200000X	NA	General Surgery	026	PHYSICIANS	16138	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
179156	Fee-for-Service	1508865528	1508865528	1	1	TAHOE CARSON VALLEY	9/28/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP, INC	2155 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7038	09	06017	38.91235187	-119.9983501	El Dorado County
179161	Fee-for-Service	1497842017	1497842017	1	1	TOLO, VERNON T MD	7/1/2004	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	315 NORTH PASADENA AVE	None	PASADENA	CA	91103	3567	19	06037	34.15118357	-118.1572237	Los Angeles County
179204	Fee-for-Service	1669669289	1669669289	1	1	TIN, JOHN K MD	5/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91777	25	Physical Medicine and Rehabilitation	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
179228	Fee-for-Service	1528051604	1528051604	1	1	TULI, SUHAS W MD	10/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	79304	18	Ophthalmology	0	In state provider	None	2625 W ALAMEDA AVE	STE 208	BURBANK	CA	91505	4823	19	06037	34.1577056	-118.329779	Los Angeles County
179321	Fee-for-Service	1215977517	1215977517	1	1	THOMAS, RICHARD M MD	2/8/2015	208600000X	NA	General Surgery	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	UTAH COUNTY SURG ASSOC	3550 N UNIVERSITY AVE	#250	PROVO	UT	84604	6685	00	None	40.28087789	-111.6581666	Utah County
179332	Fee-for-Service	1164046843	1164046843	1	1	THOMAS, SNEHA E MD	8/12/2024	207R00000X	NA	Other	026	PHYSICIANS	None	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
179357	Fee-for-Service	1518904903	1518904903	2	1	THOENE, JENNIFER MD	12/30/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	66547	08	Family Practice	0	In state provider	None	7800 NILES ST	None	BAKERSFIELD	CA	93306	4922	15	06029	35.37628052	-118.9179	Kern County
179369	Fee-for-Service	1992087126	1992087126	1	1	TRIPLETT, CAROL I	12/2/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	80418	-	NOT APPLICABLE	0	In state provider	None	5 MAREBLU	STE 100, 200, 250	ALISO VIEJO	CA	92656	3014	30	06059	33.57250566	-117.7027366	Orange County
179374	Fee-for-Service	1316578990	1316578990	1	1	TRAN, JENNIFER LCSW	4/12/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
179379	Fee-for-Service	1275611204	1275611204	1	1	TIMOTHY AHU, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	98-1079 MOANALUA RD	None	AIEA,	HI	96701	0000	00	None	21.38373524	-157.937629	Honolulu County
179444	Fee-for-Service	1508865528	1508865528	1	1	TAHOE CARSON VALLEY	6/17/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP, INC	2155 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7038	09	06017	38.91235187	-119.9983501	El Dorado County
179449	Fee-for-Service	1497842017	1497842017	1	1	TOLO, VERNON T MD	10/22/1997	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	60380	20	Orthopedic Surgery	0	In state provider	None	315 NORTH PASADENA AVE	None	PASADENA	CA	91103	3567	19	06037	34.15118357	-118.1572237	Los Angeles County
179457	Fee-for-Service	1023185238	1023185238	1	1	TRAN, HUNG D MD	2/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	55366	30	Radiology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
179503	Fee-for-Service	1487898623	1487898623	1	1	TREBINO, CHRISTOPHER R MD	11/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114689	30	Radiology	0	In state provider	None	121 SOTOYOME STREET	None	SANTA ROSA	CA	95405	4871	49	06097	38.44224	-122.70195	Sonoma County
179506	Fee-for-Service	1235106188	1235106188	1	1	TAMAYO, JOANA J R MD	3/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79900	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1808 VERDUGO BLVD	STE 208	GLENDALE	CA	91208	1415	19	06037	34.2056211	-118.2154553	Los Angeles County
179527	Fee-for-Service	1861953697	1861953697	1	1	TSENG, FARN-HSUAN MD	1/13/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	176794	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
179598	Fee-for-Service	1942233978	1942233978	1	1	TITAPIWATANAKUN, SUPAKIT	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103574	41	Internal Medicine	0	In state provider	MD	7373 WEST LAND	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
179609	Fee-for-Service	1942223508	1942223508	1	1	TREIMAN, STEPHEN B MD	7/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67434	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
179620	Fee-for-Service	1346508843	1346508843	1	1	TONE, RYAN C MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148233	05	Anesthesiology	0	In state provider	None	11370 ANDERSON STREET	SUITE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
179709	Fee-for-Service	1285855288	1285855288	1	1	TOWFIGH, SHIRIN MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64128	02	General Surgery	0	In state provider	None	1510 SAN PABLO ST	STE 514	LOS ANGELES	CA	90033	5324	19	06037	34.06287152	-118.2029433	Los Angeles County
179725	Fee-for-Service	1841384336	1841384336	1	1	TAHOE VALLEY PHARMACY	4/22/1982	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2074 LAKE TAHOE BLVD	STE 1	SOUTH LAKE TAHOE	CA	96150	6408	09	06017	38.91488542	-120.0019087	El Dorado County
179735	Fee-for-Service	1497842017	1497842017	1	1	TOLO, VERNON T MD	10/22/1997	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	60380	40	Pediatrics	0	In state provider	None	315 NORTH PASADENA AVE	None	PASADENA	CA	91103	3567	19	06037	34.15118357	-118.1572237	Los Angeles County
179794	Fee-for-Service	1992336036	1992336036	1	1	TONG, LINDSEY LCSW	11/6/2024	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
179797	Fee-for-Service	1407090574	1407090574	1	1	TRAUBE, LAURA E MD	3/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115032	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
179800	Fee-for-Service	1528555646	1528555646	1	1	TAN, YONGTIAN T MD	10/14/2024	207PP0204X	NA	Other	026	PHYSICIANS	165395	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
179834	Fee-for-Service	1164035101	1164035101	1	1	TURLOCK WOUND CARE INC	9/14/2021	163WW0000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	2150 COLORADO AVE	None	TURLOCK	CA	95382	2003	50	06099	37.51248365	-120.8352587	Stanislaus County
179850	Fee-for-Service	1255353793	1255353793	1	1	THAUBERGER, GERALD	10/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1095 STAFFORD WAY STE E	None	YUBA CITY	CA	95991	3333	51	06101	39.14336078	-121.6277128	Sutter County
179853	Fee-for-Service	1366840878	1366840878	1	1	TFC PHARMACY INC	7/16/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4914 1/2 W SLAUSON AVE	None	LOS ANGELES	CA	90056	1639	19	06037	33.98751404	-118.3632457	Los Angeles County
179867	Fee-for-Service	1598880007	1598880007	1	1	TRIEU, THI OD	2/3/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4510 VIEWRIDGE AVE	None	SAN DIEGO	CA	92123	1637	37	06073	32.82283469	-117.1248707	San Diego County
179872	Fee-for-Service	1881623676	1881623676	1	1	TUSO, NICHOLAS J MD	5/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73520	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25775 MCBEAN PKWY	None	VALENCIA	CA	91355	3708	19	06037	34.40042013	-118.5511416	Los Angeles County
179902	Fee-for-Service	1831109735	1831109735	1	1	TREATMENT ASSOCIATES INC	3/16/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CLINIC	7225 E SOUTHGATE DR	STE D	SACRAMENTO	CA	95823	2620	34	06067	38.49489	-121.435704	Sacramento County
179905	Fee-for-Service	1881756492	1881756492	1	1	TAMBOLI, KAUSHAL R MD INC	7/1/1994	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	CARDIOVASCULAR MED ASSOC	8317 DAVIS ST	STE A	DOWNEY	CA	90241	4918	19	06037	33.93657096	-118.1345206	Los Angeles County
179967	Fee-for-Service	1942782032	1942782032	1	1	TARLANI CORP	5/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2351 HONOLULU AVE	None	MONTROSE	CA	91020	1821	19	06037	34.20628699	-118.2301418	Los Angeles County
180020	Fee-for-Service	1417016445	1417016445	1	1	TRI VALLEY CARDIOLOGY	1/1/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	MEDICAL OFFICE	5565 W LAS POSITAS BLVD	STE 300	PLEASANTON	CA	94588	5808	01	06001	37.69215143	-121.8800337	Alameda County
180031	Fee-for-Service	1679665392	1679665392	1	1	TRAN, JOHN T MD	12/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89168	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
180050	Fee-for-Service	1669670758	1669670758	1	1	TSONG, CHERIE J MD	6/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106433	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
180094	Fee-for-Service	1881378834	1881378834	1	1	TONG, MELANIE H PT	9/8/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39650 LIBERTY ST	SUITE 140	FREMONT	CA	94538	2225	01	06001	37.54662058	-121.9736002	Alameda County
180100	Fee-for-Service	1033386487	1033386487	1	1	TSUI, JANET Y MD	10/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116062	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
180121	Fee-for-Service	1164035101	1164035101	1	1	TURLOCK WOUND CARE INC	9/14/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2150 COLORADO AVE	None	TURLOCK	CA	95382	2003	50	06099	37.51248365	-120.8352587	Stanislaus County
180135	Fee-for-Service	1467607127	1467607127	1	2	TRILLIUM MED SPA COSMETIC SU	1/12/2024	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1240 S WESTLAKE BLVD	STE 137	WESTLAKE VILLAGE	CA	91361	1988	56	06111	34.14966879	-118.8378084	Ventura County
180167	Fee-for-Service	1932218393	1932218393	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3515 DEL MAR HEIGHTS RD	None	SAN DIEGO	CA	92130	2122	37	06073	32.953338	-117.2306655	San Diego County
180191	Fee-for-Service	1831109735	1831109735	1	1	TREATMENT ASSOCIATES INC	2/6/2003	261QM2800X	NA	Other	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	CLINIC	7225 E SOUTHGATE DR	STE D	SACRAMENTO	CA	95823	2620	34	06067	38.49489	-121.435704	Sacramento County
180197	Fee-for-Service	1881756492	1881756492	1	1	TAMBOLI, KAUSHAL R MD INC	7/1/1994	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	CARDIOVASCULAR MED ASSOC	8317 DAVIS ST	STE A	DOWNEY	CA	90241	4918	19	06037	33.93657096	-118.1345206	Los Angeles County
180222	Fee-for-Service	1700505674	1700505674	1	1	THE YOUNG PEOPLES FOUNDATION	8/27/2024	251S00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	INC.	16316 WHITTIER BLVD	A & B	WHITTIER	CA	90603	1301	19	06037	33.94023498	-117.9826254	Los Angeles County
180253	Fee-for-Service	1942782032	1942782032	1	1	TARLANI CORP	5/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2351 HONOLULU AVE	None	MONTROSE	CA	91020	1821	19	06037	34.20628699	-118.2301418	Los Angeles County
180265	Fee-for-Service	1356727275	1356727275	1	1	TOMOOKA, LEE BEREN H MD	10/19/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	15075	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
180282	Fee-for-Service	1861675878	1861675878	1	1	TUCKER, JAMES P	5/25/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
180302	Fee-for-Service	1417016445	1417016445	1	1	TRI VALLEY CARDIOLOGY	1/1/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL OFFICE	5565 W LAS POSITAS BLVD	STE 300	PLEASANTON	CA	94588	5808	01	06001	37.69215143	-121.8800337	Alameda County
180358	Fee-for-Service	1861606188	1861606188	1	1	TOLAND, KATHLEEN K LMFT	6/25/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	217 COMMERCIAL ST	None	ROSEVILLE	CA	96122	2186	32	06063	39.80627458	-120.4694072	Plumas County
180423	Fee-for-Service	1962476960	1962476960	1	1	THAKORE, DEVANSHU H MD	5/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128303	01	General Practice	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
180424	Fee-for-Service	1467607127	1467607127	1	2	TRILLIUM MED SPA COSMETIC SU	1/12/2024	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1240 S WESTLAKE BLVD	STE 137	WESTLAKE VILLAGE	CA	91361	1988	56	06111	34.14966879	-118.8378084	Ventura County
180434	Fee-for-Service	1891798146	1891798146	1	1	TEPPER, ERIC G MD	7/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77012	08	Family Practice	0	In state provider	None	5030 J ST	STE 201	SACRAMENTO	CA	95819	3800	34	06067	38.566359	-121.442094	Sacramento County
180448	Fee-for-Service	1902289515	1902289515	1	1	TABEK BAKIR, MOHAMMAD A MD	8/26/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	153458	40	Pediatrics	0	In state provider	None	136 N 3RD ST	None	LOMPOC	CA	93436	7002	42	06083	34.64013944	-120.4451768	Santa Barbara County
180482	Fee-for-Service	1881756492	1881756492	1	1	TAMBOLI, KAUSHAL R MD INC	7/1/1994	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CARDIOVASCULAR MED ASSOC	8317 DAVIS ST	STE A	DOWNEY	CA	90241	4918	19	06037	33.93657096	-118.1345206	Los Angeles County
180494	Fee-for-Service	1801955463	1801955463	1	1	TJOA, WALTER S MD	12/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	42142	07	Dermatology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
180540	Fee-for-Service	1952897423	1952897423	1	1	TABLADA, DERLYN T CNP	8/21/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	100A SAN PABLO TOWNE CTR	None	SAN PABLO	CA	94806	0000	07	06013	37.95446487	-122.3326626	Contra Costa County
180544	Fee-for-Service	1366083198	1366083198	1	1	TYDUS GROUP	12/3/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	Y	431 N TUSTIN AVE	STE 431-C	SANTA ANA	CA	92705	3821	30	06059	33.74883544	-117.8340691	Orange County
180559	Fee-for-Service	1750931606	1750931606	1	1	THOMPSON, GABRIELLE NP	1/14/2022	363LF0000X	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
180607	Fee-for-Service	1902819477	1902819477	1	1	TAHERNIA, AMIR D MD	10/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85201	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
180623	Fee-for-Service	1417170242	1417170242	1	1	THOMPSON, NAILAH A DO	10/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9511	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
180667	Fee-for-Service	1356409312	1356409312	1	1	TAYAG, EMILIO C MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	54615	13	Neurology (M.D. only)	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
180704	Fee-for-Service	1871818906	1871818906	1	2	TRINH, KHANHPHONG D MD MPH	1/16/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	126690	-	NOT APPLICABLE	0	In state provider	None	1670 E 120TH ST	STE 1003, 1E04, 2E07, 21	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
180707	Fee-for-Service	1386805760	1386805760	1	1	TSUCHITANI,SARA N MD	8/6/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	736 N BATTLEFIELD AVE	None	CHESAPEAKE	VA	23320	4941	00	None	36.74619744	-76.24489616	Chesapeake city
180718	Fee-for-Service	1770127334	1770127334	1	1	THOMPSON, ANDREW L NP	1/1/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
180751	Fee-for-Service	1508896333	1508896333	1	1	TOVAR, JUAN M MD	7/13/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72609	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15615 POMERADO RD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
180780	Fee-for-Service	1801955463	1801955463	1	1	TJOA, WALTER S MD	12/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	42142	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
180782	Fee-for-Service	1336209428	1336209428	1	1	TIMPE, BETH K	1/16/2004	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
180783	Fee-for-Service	1760463780	1760463780	1	1	THIO, WARREN W MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	76462	05	Anesthesiology	0	In state provider	None	1301 20TH STREET	None	SANTA MONICA	CA	90404	2050	19	06037	34.02976782	-118.4812493	Los Angeles County
180893	Fee-for-Service	1902819477	1902819477	1	1	TAHERNIA, AMIR D MD	10/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85201	20	Orthopedic Surgery	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
180908	Fee-for-Service	1093475303	1093475303	1	1	TRISTYN ST THOMAS-ACHOJA, M.	2/7/2024	207L00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	D., INC., A PROFESSIONAL	7901 WALKER ST	None	LA PALMA	CA	90623	1722	30	06059	33.84755382	-118.0373024	Orange County
180917	Fee-for-Service	1316725088	1316725088	1	1	TAVAKALYAN PODIATRY PC	10/9/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1145 W. REDONDO BEACH BL	None	GARDENA	CA	90247	3511	19	06037	33.89242734	-118.2947128	Los Angeles County
180928	Fee-for-Service	1477923233	1477923233	1	1	THOMPSON, JESSICA L CCC-SLP	10/18/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	556 N 1ST ST	SUITE 201	SAN JOSE	CA	95112	5300	43	06085	37.34591974	-121.8977166	Santa Clara County
180933	Fee-for-Service	1548468069	1548468069	1	1	TAMPOYA, JEREMIAH M OD	4/26/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
180946	Fee-for-Service	1306921929	1306921929	1	1	THC-ORANGE COUNTY, LLC	6/13/2002	282E00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2800 BENEDICT DR	None	SAN LEANDRO	CA	94577	6840	01	06001	37.71593435	-122.131151	Alameda County
180981	Fee-for-Service	1609192426	1609192426	1	1	TABIBIAN, BENJAMIN DO	5/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12185	41	Internal Medicine	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92552	3927	33	06065	33.912117	-117.195849	Riverside County
180988	Fee-for-Service	1912927401	1912927401	1	1	TIEGS, VERNA G MD	1/20/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	21531	30	Radiology	0	In state provider	None	293 S MAIN ST	STE 100	ORANGE	CA	92868	3806	30	06059	33.7842	-117.8672725	Orange County
180992	Fee-for-Service	1427885052	1427885052	1	1	TISHANGI KUMAR AGRAWAL MD	2/8/2025	207RA0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1202 E GREEN ST	None	PASADENA	CA	91106	3112	19	06037	34.14455265	-118.1256206	Los Angeles County
180996	Fee-for-Service	1932191673	1932191673	1	1	THAKER, SUDEVI P MD	5/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52147	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	999 S FAIRMONT AVE	STE 230	LODI	CA	95240	5142	39	06077	38.1206163	-121.2858323	San Joaquin County
181005	Fee-for-Service	1306979208	1306979208	1	1	TUTELA, ROCCO MD	6/10/2021	208600000X	NA	General Surgery	026	PHYSICIANS	168048	None	None	0	In state provider	None	11100 WARNER AVE.	258	FOUNTAIN VALLEY	CA	92708	7512	30	06059	33.716291	-117.9355051	Orange County
181015	Fee-for-Service	1417343716	1417343716	1	1	TESFALIDET, FEVEN MD	4/29/2024	207LC0200X	NA	Other	026	PHYSICIANS	172413	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
181062	Fee-for-Service	1962737205	1962737205	1	1	TALBOT, ANNIE MD	10/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53116	08	Family Practice	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
181127	Fee-for-Service	1851325468	1851325468	1	1	TERRY, GISELE LMFT	7/1/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1531 PURDUE AVE	None	LOS ANGELES	CA	90025	3104	19	06037	34.04643848	-118.4513015	Los Angeles County
181136	Fee-for-Service	1619917747	1619917747	1	1	TODD, LOVELACE, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9205 SW BARNES RD	None	PORTLAND	OR	97225	0000	00	None	45.51093	-122.771907	Washington County
181180	Fee-for-Service	1821860453	1821860453	1	1	TRAVIS, FRANKIE	12/6/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	49	06097	0	0	None
181187	Fee-for-Service	1376787432	1376787432	1	1	TABARAEE, SULTANA L MD	9/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115722	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7601 STONERIDGE DRIVE	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
181215	Fee-for-Service	1629487285	1629487285	1	1	THOMPSON, COURTNEY J NP	11/9/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
181234	Fee-for-Service	1184079139	1184079139	1	1	TIAN, JULIA MD	9/5/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	163821	None	None	0	In state provider	None	9394 BIG HORN BLVD	None	ELK GROVE	CA	95758	7977	34	06067	38.420028	-121.40712	Sacramento County
181237	Fee-for-Service	1114952629	1114952629	1	1	THIBODEAU, PETER DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3121 PARK AVE	None	SOQUEL	CA	95073	2920	44	06087	36.9896384	-121.9356617	Santa Cruz County
181292	Fee-for-Service	1316364714	1316364714	1	1	THIERS, KATHERINE M B CRNA	5/9/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
181304	Fee-for-Service	1457967259	1457967259	1	1	TARLANI CORP.	12/18/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2349 HONOLULU AVE	None	MONTROSE	CA	91020	2512	19	06037	34.20621211	-118.2299668	Los Angeles County
181357	Fee-for-Service	1588608921	1588608921	1	1	TSAI, WUN-YI MD	2/28/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	34858	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	619 BOLTON CT	None	SAN JOSE	CA	95129	2059	43	06085	37.31511329	-121.9798434	Santa Clara County
181369	Fee-for-Service	1316922198	1316922198	3	1	TVO PHARMACY INC	10/24/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10963 WESTMINSTER AVE	None	GARDEN GROVE	CA	92843	4929	30	06059	33.75971458	-117.938808	Orange County
181388	Fee-for-Service	1528114204	1528114204	1	1	TURAKHIA, MINANG P MD	2/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	83028	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	MC:5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
181442	Fee-for-Service	1114154754	1114154754	1	1	TSAVALER, ALEXANDER MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	116061	None	None	0	In state provider	None	75 NIELSON STREET	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7937089	Santa Cruz County
181452	Fee-for-Service	1588757918	1588757918	1	1	THU VAN PHARMACY	4/6/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10362 BOLSA AVE	STE 108	WESTMINSTER	CA	92683	6763	30	06059	33.74488248	-117.94806	Orange County
181561	Fee-for-Service	1730744129	1730744129	1	1	TOPCHIY, ALINA	10/26/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1860 HOWE AVE	SUITE 250	SACRAMENTO	CA	95825	1098	34	06067	38.59947	-121.4142525	Sacramento County
181563	Fee-for-Service	1144270620	1144270620	1	1	TYNER, JOHN J MD	2/19/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	70821	01	General Practice	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
181575	Fee-for-Service	1124115506	1124115506	1	1	THOMAS KENNETH LO	1/1/1979	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1372 W ROBINHOOD DR	None	STOCKTON	CA	95207	5513	39	06077	37.99813401	-121.3250794	San Joaquin County
181587	Fee-for-Service	1427392539	1427392539	1	1	TOTAL RENAL CARE INC	1/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	464 E YOSEMITE AVE	SUITE B	MERCED	CA	95340	8489	24	06047	37.33210949	-120.4612425	Merced County
181630	Fee-for-Service	1568162352	1568162352	1	1	TAKIJIRI, AKANE LMFT	5/15/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2932 FAIRMOUNT AVENUE	APT 3	LA CRESCENTA	CA	91214	2807	19	06037	34.22796764	-118.2432247	Los Angeles County
181642	Fee-for-Service	1831396720	1831396720	2	1	TOBIS, SCOTT B MD	10/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123266	34	Urology and Urological Surgery	0	In state provider	None	4151 FOOTHILL BLVD	None	SANTA BARBARA	CA	93110	1110	42	06083	34.45144647	-119.7604485	Santa Barbara County
181656	Fee-for-Service	1609196310	1609196310	1	1	TRINH, AARON L PHD	7/27/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
181683	Fee-for-Service	1487017810	1487017810	1	1	TROY, MICHAEL P MD	6/14/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	156542	None	None	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
181685	Fee-for-Service	1831377860	1831377860	1	1	TUQAN, ALIA T MD	7/13/2010	207R00000X	NA	Other	026	PHYSICIANS	103407	38	Geriatrics	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
181696	Fee-for-Service	1053407593	1053407593	2	1	TRUJILLO, JENNIFER C	7/7/2021	174400000X	NA	Other	026	PHYSICIANS	8204	None	None	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
181725	Fee-for-Service	1255690624	1255690624	1	1	TRAPPEY, DOMINIQUE A MD	1/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144670	05	Anesthesiology	0	In state provider	None	3939 J ST	STE 310	SACRAMENTO	CA	95819	3666	34	06067	38.570211	-121.45374	Sacramento County
181730	Fee-for-Service	1487659116	1487659116	1	1	TORKAN, BRUCE MD INC	2/28/1986	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CLINICA MEDICA FATIMA	820 S ALVARADO ST	None	LOS ANGELES	CA	90057	4010	19	06037	34.05440348	-118.2781085	Los Angeles County
181832	Fee-for-Service	1437831799	1437831799	1	2	THE ENDZONE, A MARRIAGE AND	1/27/2025	101YM0800X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	700 N CENTRAL AVE	STE 340	GLENDALE	CA	91203	4238	19	06037	34.15708991	-118.2579615	Los Angeles County
181850	Fee-for-Service	1144270620	1144270620	1	1	TYNER, JOHN J MD	2/19/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	70821	66	Emergency Medicine (Urgent Care)	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
181937	Fee-for-Service	1578988994	1578988994	1	1	THU, EI E MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142454	41	Internal Medicine	0	In state provider	None	600 N HIGHLAND SPRINGS	None	BANNING	CA	92220	3046	33	06065	33.9316595	-116.9468639	Riverside County
181949	Fee-for-Service	1316056716	1316056716	1	1	THRIFTY PAYLESS INC	1/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6010	1032 OAKDALE RD	None	MODESTO	CA	95355	4513	50	06099	37.657215	-120.9574735	Stanislaus County
181961	Fee-for-Service	1598722555	1598722555	1	1	TULAGAN, JOSEPH C	6/5/2014	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	98025	40	Pediatrics	0	In state provider	None	3400 EAST 8TH STREET	SUITE 105	NATIONAL CITY	CA	91950	3134	37	06073	32.68571247	-117.0716254	San Diego County
181970	Fee-for-Service	1831377860	1831377860	1	1	TUQAN, ALIA T MD	7/13/2010	207R00000X	NA	Other	026	PHYSICIANS	103407	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
182018	Fee-for-Service	1891058962	1891058962	1	1	TOMKINS, DAVID L MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136310	01	General Practice	0	In state provider	None	2030 SUTTER PL	SUITE 2000	DAVIS	CA	95616	6201	57	06113	38.56292466	-121.7715423	Yolo County
182028	Fee-for-Service	1821361700	1821361700	1	1	TRAYNOR, COLIN J DPM	5/2/2017	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
182038	Fee-for-Service	1487752374	1487752374	1	1	TANGCHITNOB, DUMRONG MD	5/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	42027	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1135 S SUNSET AVE	STE 401	WEST COVINA	CA	91790	3921	19	06037	34.06215064	-117.9453997	Los Angeles County
182050	Fee-for-Service	1265759807	1265759807	1	1	TSENG, JILL MD	7/10/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	156171	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
182061	Fee-for-Service	1720055478	1720055478	1	1	TACHE, VERONIQUE MD	7/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88468	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
182094	Fee-for-Service	1780159426	1780159426	1	1	TATARU, LORI LAC	1/22/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1453 DOWNER ST	SUITE A	OROVILLE	CA	95965	4966	04	06007	39.5130958	-121.553668	Butte County
182095	Fee-for-Service	1477622835	1477622835	1	1	TENEMBAUM, GABRIEL MD	12/22/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	53157	09	Gynecology (D.O. only)	0	In state provider	None	215 JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
182100	Fee-for-Service	1497099188	1497099188	1	1	THOMPSON, AMY D LPCC	10/16/2020	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	256 CAJON ST	SUITE E	REDLANDS	CA	92373	5278	36	06071	34.05204454	-117.1802319	San Bernardino County
182114	Fee-for-Service	1407221021	1407221021	1	1	TER KUILE, SONIA	4/30/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	139452	08	Family Practice	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
182118	Fee-for-Service	1437831799	1437831799	1	2	THE ENDZONE, A MARRIAGE AND	9/12/2024	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	700 N CENTRAL AVE	STE 340	GLENDALE	CA	91203	4238	19	06037	34.15708991	-118.2579615	Los Angeles County
182182	Fee-for-Service	1689069403	1689069403	1	1	TECKCHANDANI, PRIYANKA H MD	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146886	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
182186	Fee-for-Service	1205250263	1205250263	1	1	THE CHILDRENS CLINIC SERVING	3/3/2014	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CHILDREN AND FAMILIES	2125 SANTA FE AVENUE	None	LONG BEACH	CA	90810	3547	19	06037	33.795585	-118.215548	Los Angeles County
182233	Fee-for-Service	1124090659	1124090659	1	2	TOOELE HOSPITAL CORPORATION	4/9/2023	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2055 N MAIN ST	None	TOOELE	UT	84074	9819	00	None	40.56668579	-112.2959013	Tooele County
182275	Fee-for-Service	1508824368	1508824368	1	1	TRUONG, NHU V MD	7/1/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	52253	08	Family Practice	0	In state provider	None	10402 WESTMINSTER AVE	STE 100	GARDEN GROVE	CA	92843	4862	30	06059	33.75951204	-117.9478527	Orange County
182326	Fee-for-Service	1033605522	1033605522	1	1	TANG, ZHAOYI MD	7/17/2023	207L00000X	NA	Other	026	PHYSICIANS	166274	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
182334	Fee-for-Service	1700473204	1700473204	1	1	TLC ASSISTANT LIVING SVCS CO	8/2/2023	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	20915 O'BRIEN CT	None	SONORA	CA	95370	8633	55	06109	38.00220631	-120.331649	Tuolumne County
182368	Fee-for-Service	1255465894	1255465894	1	1	TM AND HANA MEDICAL CORP	9/12/2007	207RE0101X	NA	Endocrinology	026	PHYSICIANS	55960	41	Internal Medicine	0	In state provider	TM AND HANA MEDICAL CORP	12780 HESPERIA RD	None	VICTORVILLE	CA	92395	5806	36	06071	34.4833646	-117.2904386	San Bernardino County
182379	Fee-for-Service	1255467916	1255467916	1	1	TAYLOR, KIMBERLY J LAC	7/20/2017	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
182382	Fee-for-Service	1477622835	1477622835	1	1	TENEMBAUM, GABRIEL MD	12/22/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	53157	15	Obstetrics (D.O. only)	0	In state provider	None	215 JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
182409	Fee-for-Service	1437831799	1437831799	1	2	THE ENDZONE, A MARRIAGE AND	9/12/2024	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	700 N CENTRAL AVE	STE 340	GLENDALE	CA	91203	4238	19	06037	34.15708991	-118.2579615	Los Angeles County
182428	Fee-for-Service	1760822191	1760822191	1	1	TEYMOORIAN, ARIAN MD	8/16/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	152257	None	None	0	In state provider	None	40404 CALIFORNIA OAKS RD	STE C	MURRIETA	CA	92562	5786	33	06065	33.57857707	-117.1998797	Riverside County
182435	Fee-for-Service	1619133600	1619133600	1	1	TAM, JONATHAN S MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125923	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
182474	Fee-for-Service	1205250263	1205250263	1	1	THE CHILDRENS CLINIC SERVING	3/3/2014	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CHILDREN AND FAMILIES	2125 SANTA FE AVENUE	None	LONG BEACH	CA	90810	3547	19	06037	33.795585	-118.215548	Los Angeles County
182479	Fee-for-Service	1871947697	1871947697	1	1	THIRUVENGADAM, SUSHRUT S MD	4/27/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	151339	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
182522	Fee-for-Service	1124090659	1124090659	1	2	TOOELE HOSPITAL CORPORATION	4/9/2023	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2055 N MAIN ST	None	TOOELE	UT	84074	9819	00	None	40.56668579	-112.2959013	Tooele County
182541	Fee-for-Service	1396083440	1396083440	1	1	TAFT, TIFFANI LMFT	12/2/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95784	-	NOT APPLICABLE	0	In state provider	None	2743 ORANGE STREET	None	RIVERSIDE	CA	92501	2538	33	06065	33.99108079	-117.3667042	Riverside County
182543	Fee-for-Service	1568907475	1568907475	1	1	THRIVE PHARMACY CARE INC	4/3/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	114 S PARK VICTORIA DR	None	MILPITAS	CA	95035	5724	43	06085	37.43384159	-121.8836388	Santa Clara County
182550	Fee-for-Service	1477756344	1477756344	1	1	TORK, MICHAELA E LMFT	7/13/2018	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3808 RIVERSIDE DR	None	BURBANK	CA	91505	4339	19	06037	34.15252315	-118.3412174	Los Angeles County
182551	Fee-for-Service	1033476916	1033476916	1	1	THEIN, KAITLIN L MD	12/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131879	40	Pediatrics	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
182589	Fee-for-Service	1316649429	1316649429	1	1	THARON SAN DIEGO LLC	10/26/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	655 S MOLLISON AVENUE	None	EL CAJON	CA	92020	6609	37	06073	32.788413	-116.9508998	San Diego County
182598	Fee-for-Service	1629250394	1629250394	1	1	TSAI, TSUNG-TSO MD	4/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114112	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
182624	Fee-for-Service	1720556723	1720556723	1	1	THOMAS, CHRISTOPHER J LMFT	9/20/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2516 A ST	None	SAN DIEGO	CA	92102	2111	37	06073	32.71895346	-117.1397471	San Diego County
182657	Fee-for-Service	1255465894	1255465894	1	1	TM AND HANA MEDICAL CORP	9/12/2007	207RE0101X	NA	Endocrinology	026	PHYSICIANS	55960	67	Endocrinology	0	In state provider	TM AND HANA MEDICAL CORP	12780 HESPERIA RD	None	VICTORVILLE	CA	92395	5806	36	06071	34.4833646	-117.2904386	San Bernardino County
182696	Fee-for-Service	1568424398	1568424398	1	1	TOVIA AARON LENT, 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	900 FRANKLIN AVE	None	VALLEY STREAM	NY	11580	2145	00	None	40.681296	-73.686483	Nassau County
182762	Fee-for-Service	1205250263	1205250263	1	1	THE CHILDRENS CLINIC SERVING	3/3/2014	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CHILDREN AND FAMILIES	2125 SANTA FE AVENUE	None	LONG BEACH	CA	90810	3547	19	06037	33.795585	-118.215548	Los Angeles County
182787	Fee-for-Service	1861811812	1861811812	1	1	TIMPANE, COLLEEN P LCSW	1/31/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
182799	Fee-for-Service	1801929773	1801929773	1	1	TALAKOUB, LILY MD	10/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97076	07	Dermatology	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
182850	Fee-for-Service	1982746657	1982746657	1	1	TRAN, TONNIA TO DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	7662	08	Family Practice	0	In state provider	None	3177 OCEAN VIEW BLVD	None	SAN DIEGO	CA	92113	1432	37	06073	32.7011883	-117.1261025	San Diego County
182921	Fee-for-Service	1053674770	1053674770	1	1	TRANDEM, KATHRYN R MD	6/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155864	34	Urology and Urological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
182922	Fee-for-Service	1407430689	1407430689	1	1	TASTAD, JOHN LPCC	1/3/2025	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
182980	Fee-for-Service	1982701918	1982701918	1	1	TU, RICHARD MD	2/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	54032	41	Internal Medicine	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
182986	Fee-for-Service	1639493430	1639493430	1	1	THOMAS, JAMES A MD	2/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123299	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	4121	43	06085	37.43920432	-122.162109	Santa Clara County
182994	Fee-for-Service	1043296957	1043296957	1	1	THOMPSON, GREGORY L MD	3/10/2022	207L00000X	NA	Other	026	PHYSICIANS	167386	None	None	0	In state provider	None	75 NIELSON	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7937089	Santa Cruz County
182996	Fee-for-Service	1609278225	1609278225	1	1	TOTAL CARE PLUS LLC	4/7/2015	111N00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2620 MISSION ST	None	SAN FRANCISCO	CA	94110	3102	38	06075	37.75507345	-122.4187403	San Francisco County
183002	Fee-for-Service	1235690827	1235690827	1	1	THOMPSON, RYAN MD	10/18/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182467	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
183010	Fee-for-Service	1952569600	1952569600	1	1	TOOFAN, MARC P MD	4/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 SOUTH AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
183014	Fee-for-Service	1003925736	1003925736	1	1	TRIMMER, ROBERT M MD	11/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	83471	36	Psychiatry	0	In state provider	None	2081 ARENA BLVD	SUITE 160	SACRAMENTO	CA	95834	2309	34	06067	38.647737	-121.510467	Sacramento County
183043	Fee-for-Service	1275575557	1275575557	1	1	TEHRANZADEH, ARASH D MD	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77858	None	None	0	In state provider	None	330 LEWIS ST	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
183046	Fee-for-Service	1043279938	1043279938	1	1	TANVEER, ASRA MD	4/9/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	178355	40	Pediatrics	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
183047	Fee-for-Service	1538108717	1538108717	1	1	TRAN, NHAN MD	6/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90134	None	None	0	In state provider	None	14850 ROSCOE BLVD	None	PANORAMA CITY	CA	91402	4618	19	06037	34.22145548	-118.4566005	Los Angeles County
183067	Fee-for-Service	1407299787	1407299787	1	1	TODD, SARAH C MD	8/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154043	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
183096	Fee-for-Service	1932495496	1932495496	1	1	TONG, ELIZABETH MD	7/8/2016	2085N0700X	NA	MRI Provider	026	PHYSICIANS	142867	None	None	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
183171	Fee-for-Service	1982775953	1982775953	1	1	TSAI, EUGENIA I MD	12/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70115	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
183184	Fee-for-Service	1407084551	1407084551	1	1	TAHMASEBI, NEDA MD	7/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122452	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
183203	Fee-for-Service	1710112883	1710112883	1	1	TSANG, MERISSA LAC	12/29/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	801 TRAEGER AVE	STE 209	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
183217	Fee-for-Service	1285741413	1285741413	1	1	TOWLER, CAROLYN R MD	5/24/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	58971	30	Radiology	0	In state provider	None	309 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
183232	Fee-for-Service	1639376189	1639376189	1	1	TALISMAN, JENNIFER L LMFT	12/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
183269	Fee-for-Service	1447092903	1447092903	1	1	THE DIVINE BIRTH ACADEMY	7/31/2024	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	39	06077	0	0	None
183293	Fee-for-Service	1043483431	1043483431	1	1	TSAI, TIFFANY Y MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106162	36	Psychiatry	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
183312	Fee-for-Service	1164899027	1164899027	1	1	THE HOANG&SONS PHARMACEUTICA	1/29/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11033 ACACIA PARKWAY	None	GARDEN GROVE	CA	92840	5126	30	06059	33.77607046	-117.940311	Orange County
183336	Fee-for-Service	1992394738	1992394738	1	1	THERAPEUTICALLY CONNECTED FA	6/8/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MILY COUNSELING INC	12712 HEACOCK ST	STE 3	MORENO VALLEY	CA	92553	3037	33	06065	33.936165	-117.2437645	Riverside County
183348	Fee-for-Service	1790828754	1790828754	1	1	TORCHINSKY, CYRUS MD	11/10/2008	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	88768	04	Otology, Laryngology, Rhinology	0	In state provider	None	4060 4TH AVE	SUITE 410	SAN DIEGO	CA	92103	2121	37	06073	32.75053673	-117.1616539	San Diego County
183380	Fee-for-Service	1649618406	1649618406	1	1	TRUONG, KEVIN K MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150000	66	Emergency Medicine (Urgent Care)	0	In state provider	None	12601 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	1908	30	06059	33.77450951	-117.913014	Orange County
183399	Fee-for-Service	1083658363	1083658363	1	1	THUMAN, BRUCE D MD	3/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	61341	05	Anesthesiology	0	In state provider	None	301 VICTORIA ST	None	COSTA MESA	CA	92627	1995	30	06059	33.65258952	-117.9121545	Orange County
183464	Fee-for-Service	1033296066	1033296066	1	1	TUKENMEZ, DENISE S MD	10/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71825	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
183480	Fee-for-Service	1972091429	1972091429	1	1	THOMAS, MAXWELL S MD	7/26/2022	208M00000X	NA	Other	026	PHYSICIANS	164898	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
183496	Fee-for-Service	1114211141	1114211141	1	1	TZVETKOVA, EKATERINA I MD	4/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122798	66	Emergency Medicine (Urgent Care)	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
183568	Fee-for-Service	1699767061	1699767061	2	1	TIN PHAT PHARMACY INC	3/24/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9081 BOLSA AVE	STE 108	WESTMINSTER	CA	92683	5590	30	06059	33.7449813	-117.9708224	Orange County
183601	Fee-for-Service	1639339203	1639339203	1	1	TRUONG, HUU TAM D MD	4/6/2010	390200000X	NA	Other	026	PHYSICIANS	106627	41	Internal Medicine	0	In state provider	None	4020 5TH AVE	None	SAN DIEGO	CA	92103	2180	37	06073	32.75032457	-117.1610686	San Diego County
183608	Fee-for-Service	1396779948	1396779948	1	1	TEXAS HEALTH PRESBYTERIAN	1/11/2016	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL DALLAS	8200 WALNUT HILL LN	None	DALLAS	TX	75231	4426	00	None	32.87916	-96.763959	Dallas County
183633	Fee-for-Service	1639839418	1639839418	1	1	TA, KIMBERLY NP	1/10/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4950 BARRANCA PARKWAY	SUITE 104	IRVINE	CA	92604	4630	30	06059	33.67620851	-117.7948348	Orange County
183649	Fee-for-Service	1922198274	1922198274	1	1	TRUONG, HA MD FAAP	3/13/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7124	00	None	32.683167	-114.633459	Yuma County
183684	Fee-for-Service	1801413638	1801413638	1	1	TU, CHENG YANG PT	7/9/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3925 ROSEMEAD BLVD	#102	ROSEMEAD	CA	91770	1933	19	06037	34.07930385	-118.0732531	Los Angeles County
183704	Fee-for-Service	1053594184	1053594184	1	1	THRIFTY PAYLESS INC	2/21/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	19035 BEAR VALLEY RD	None	APPLE VALLEY	CA	92308	2712	36	06071	34.47094653	-117.248481	San Bernardino County
183724	Fee-for-Service	1194933713	1194933713	1	1	TARAVATI, PARISA MD	8/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	18	Ophthalmology	2	Out of state provider	None	501 EASTLAKE AVE E	SUITE 400	SEATTLE	WA	98109	4456	00	None	47.62349268	-122.3292138	King County
183762	Fee-for-Service	1598874950	1598874950	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5629	1825 S CENTRE CITY PKWY	None	ESCONDIDO	CA	92025	6525	37	06073	33.10180862	-117.0746307	San Diego County
183784	Fee-for-Service	1699963678	1699963678	1	1	TESHOME, MEDIGET MD	11/9/2023	208600000X	NA	General Surgery	026	PHYSICIANS	101388	None	None	0	In state provider	None	100 MED PLAZA	100, 755	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
183826	Fee-for-Service	1982687307	1982687307	1	1	THOMAS FREDERICK KOEHLER, MD	11/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1460 NE MEDICAL CTR DR	None	BEND	OR	79901	6061	00	None	44.064765	-121.2666635	Deschutes County
183850	Fee-for-Service	1841936812	1841936812	1	1	TWINS BAY INC.	6/6/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2460 MAIN ST	None	MORRO BAY	CA	93442	1552	40	06079	35.3868704	-120.8576894	San Luis Obispo County
183878	Fee-for-Service	1235145525	1235145525	1	1	THRIFTY PAYLESS INC	1/4/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06225	1665 ALPINE BLVD	None	ALPINE	CA	91901	3859	37	06073	32.8377424	-116.7789574	San Diego County
183896	Fee-for-Service	1396779948	1396779948	1	1	TEXAS HEALTH PRESBYTERIAN	1/11/2016	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL DALLAS	8200 WALNUT HILL LN	None	DALLAS	TX	75231	4426	00	None	32.87916	-96.763959	Dallas County
183924	Fee-for-Service	1518069608	1518069608	1	1	TU, MARINDA L MD	2/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85036	40	Pediatrics	0	In state provider	None	2400 S FLOWER STREET	None	LOS ANGELES	CA	90007	2629	19	06037	34.02861627	-118.273964	Los Angeles County
183927	Fee-for-Service	1114036498	1114036498	1	1	THRIFTY PAYLESS INC	11/12/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5811	1425 S H ST	None	BAKERSFIELD	CA	93304	4512	15	06029	35.339841	-119.0213365	Kern County
183946	Fee-for-Service	1376613703	1376613703	1	1	TRANSYLVANIA COMMUNITY	4/13/2015	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	260 HOSPITAL DRIVE	None	BREVARD	NC	28712	1116	00	None	35.256213	-82.712448	Transylvania County
183967	Fee-for-Service	1548341050	1548341050	1	1	TALARICO, MATTHEW T MD	11/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54186	01	General Practice	0	In state provider	None	265 POSADA LANE	SUITE B	TEMPLETON	CA	93465	4056	40	06079	35.55354235	-120.7214149	San Luis Obispo County
183981	Fee-for-Service	1871783241	1871783241	1	1	TRAN, MARIANNE Y OD	10/8/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	790 S ATLANTIC BLVD	STE 105	MONTEREY PARK	CA	91754	3848	19	06037	34.05275683	-118.1369259	Los Angeles County
184006	Fee-for-Service	1144548785	1144548785	1	1	TIMOTHY MISSEY D.O.	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1003 WILLOW CREEK RD	None	PRESCOTT	AZ	86301	1641	00	None	34.558992	-112.481901	Yavapai County
184059	Fee-for-Service	1891781217	1891781217	1	1	THOMAS, JAMES C MD INC	3/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	24677	30	Radiology	0	In state provider	None	1122 N IRWIN ST	None	HANFORD	CA	93230	2928	16	06031	36.336348	-119.647699	Kings County
184065	Fee-for-Service	1124135512	1124135512	1	1	TRAN, LOUIS PHI MD	12/1/1999	207P00000X	NA	Other	026	PHYSICIANS	66660	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	33	06065	33.89552551	-117.186021	Riverside County
184102	Fee-for-Service	1275703605	1275703605	1	1	TRAN, LINDA DO	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	10298	08	Family Practice	0	In state provider	None	1400 N MAIN ST	None	SANTA ANA	CA	92701	2304	30	06059	33.75688822	-117.8676134	Orange County
184111	Fee-for-Service	1598856106	1598856106	1	1	TIGHE, THOMAS LMFT	4/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
184147	Fee-for-Service	1578907903	1578907903	1	1	TRAN, HOANG D DO	9/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13649	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
184161	Fee-for-Service	1134889652	1134889652	1	1	TUSTIN URGENT CARE, APC	7/19/2022	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	11741 VALLEY VIEW ST	A	CYPRESS	CA	90630	5500	30	06059	33.79210447	-118.0287769	Orange County
184168	Fee-for-Service	1497021109	1497021109	1	1	TRI CITY HEALTH CENTER	4/17/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	3607 MAIN STREET	SUITE B	FREMONT	CA	94538	4390	01	06001	37.53389511	-121.9553706	Alameda County
184223	Fee-for-Service	1538602420	1538602420	1	1	TWU, PAMELA	8/7/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152627	08	Family Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
184239	Fee-for-Service	1376613703	1376613703	1	1	TRANSYLVANIA COMMUNITY	4/13/2015	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	260 HOSPITAL DRIVE	None	BREVARD	NC	28712	1116	00	None	35.256213	-82.712448	Transylvania County
184245	Fee-for-Service	1992880512	1992880512	1	1	THC-ORANGE COUNTY INC	9/1/2001	282E00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1940 EL CAJON BLVD	None	SAN DIEGO	CA	92104	1005	37	06073	32.75537745	-117.1446525	San Diego County
184256	Fee-for-Service	1821076258	1821076258	1	1	THOMPSON, TRACY MD	8/2/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	52019	41	Internal Medicine	0	In state provider	None	1258 CONCANNON BLVD	None	LIVERMORE	CA	94550	6002	01	06001	37.6609605	-121.7789055	Alameda County
184269	Fee-for-Service	1104272509	1104272509	1	1	TAHERIAN, RANA MD	7/10/2023	207R00000X	NA	Other	026	PHYSICIANS	183891	None	None	0	In state provider	None	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	19	06037	34.2214515	-118.4573205	Los Angeles County
184338	Fee-for-Service	1790935948	1790935948	1	1	TIWARI, VIJAY P MD	12/30/2008	207R00000X	NA	Other	026	PHYSICIANS	105441	41	Internal Medicine	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9989	39	06077	37.88652418	-121.2820956	San Joaquin County
184353	Fee-for-Service	1407845092	1407845092	1	1	TEMECULA VALLEY EMERGENCY	7/27/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL ASSOCIATES	28062 BAXTER RD	None	MURRIETA	CA	92563	1401	33	06065	33.61350847	-117.1691225	Riverside County
184362	Fee-for-Service	1720314560	1720314560	1	1	TERRY, ANN C OT	11/14/2022	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
184376	Fee-for-Service	1962682179	1962682179	1	1	TANG, LILY E MD	2/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85784	30	Radiology	0	In state provider	None	8933 ACTIVITY RD	None	SAN DIEGO	CA	92126	4427	37	06073	32.89637448	-117.133497	San Diego County
184382	Fee-for-Service	1366804312	1366804312	1	1	TSAKOS, DREW MD	7/13/2020	207L00000X	NA	Other	026	PHYSICIANS	168322	05	Anesthesiology	0	In state provider	None	1328 22ND ST	None	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
184402	Fee-for-Service	1225126311	1225126311	1	1	TSI, CHUNG HENG MD	5/18/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	35803	40	Pediatrics	0	In state provider	None	1025 ATLANTIC AVE	None	LONG BEACH	CA	90813	3402	19	06037	33.779403	-118.1850775	Los Angeles County
184405	Fee-for-Service	1619279205	1619279205	1	1	TENG, AMY H DO	9/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12105	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2490 HOSPITAL DR	STE 300	MOUNTAIN VIEW	CA	94040	4124	43	06085	37.369827	-122.0818185	Santa Clara County
184455	Fee-for-Service	1497021109	1497021109	1	1	TRI CITY HEALTH CENTER	4/17/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	3607 MAIN STREET	SUITE B	FREMONT	CA	94538	4390	01	06001	37.53389511	-121.9553706	Alameda County
184460	Fee-for-Service	1467032599	1467032599	1	2	TARZANA TREATMENT CENTERS, I	2/11/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC	6005 YOLANDA AVE	None	TARZANA	CA	91356	1421	19	06037	34.17908685	-118.5407845	Los Angeles County
184490	Fee-for-Service	1659708436	1659708436	1	1	TUCKER, JENNIFER L MD	4/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	66144	40	Pediatrics	0	In state provider	None	17822 BEACH BLVD	SUITE 278	HUNTINGTON BEACH	CA	92647	7180	30	06059	33.70331388	-117.9890471	Orange County
184505	Fee-for-Service	1699487215	1699487215	1	1	TAVAF, MISHA DPM	6/27/2024	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	400 CARLTON AVE	SUITE 200	LOS GATOS	CA	95032	2629	43	06085	37.24728836	-121.9514527	Santa Clara County
184535	Fee-for-Service	1194712083	1194712083	1	1	TANNER MEDICAL CENTER	6/8/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 ALLEN MEMORIAL DR	None	BREMEN	GA	30110	2012	00	None	33.71622808	-85.14494791	Haralson County
184589	Fee-for-Service	1447644497	1447644497	1	1	TATE, MALLORY S MD	10/8/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	144255	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
184632	Fee-for-Service	1184048712	1184048712	2	1	TORRANCE EMERGENCY PHYSICIAN	7/14/2014	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	S INC	3330 LOMITA	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
184636	Fee-for-Service	1508865528	1508865528	1	11	TAHOE CARSON VALLEY	9/15/2021	174400000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2169 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	7059	09	06017	38.91235146	-119.9974905	El Dorado County
184642	Fee-for-Service	1891843868	1891843868	1	1	TONG, CHRISTINE C MD	11/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87151	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
184665	Fee-for-Service	1104019132	1104019132	1	1	THEISEN, RENEE L MD	8/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104246	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4897	49	06097	38.443806	-122.701374	Sonoma County
184687	Fee-for-Service	1225411788	1225411788	1	1	TSENG, TIFFANY OD	8/19/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	477 E COLORADO BLVD	None	PASADENA	CA	91101	2024	19	06037	34.14587948	-118.140561	Los Angeles County
184725	Fee-for-Service	1033323746	1033323746	1	1	TEMECULA VALLEY FAMILY PHYSI	8/1/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CIANS INC.	31720 TEMECULA PKWY	203	TEMECULA	CA	92592	5895	33	06065	33.4799323	-117.1033702	Riverside County
184742	Fee-for-Service	1497021109	1497021109	1	1	TRI CITY HEALTH CENTER	12/12/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	3607 MAIN STREET	SUITE B	FREMONT	CA	94538	4390	01	06001	37.53389511	-121.9553706	Alameda County
184744	Fee-for-Service	1336347293	1336347293	1	1	TAYLOR, DUSTIN A MD	6/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	94821	01	General Practice	0	In state provider	None	2720 S BRISTOL ST	STE 110	SANTA ANA	CA	92704	6207	30	06059	33.710463	-117.8854565	Orange County
184757	Fee-for-Service	1366084360	1366084360	1	1	THERAVILLE COUNSELING SERVIC	8/14/2020	1041C0700X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	ES, A LICENSED CLINICAL	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
184791	Fee-for-Service	1639121981	1639121981	1	1	TER-ZAKARIAN, HOVANES J	2/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	45597	22	Pathology (M.D. only)	0	In state provider	None	5250 SANTA MONICA BLVD	STE 310	LOS ANGELES	CA	90029	1255	19	06037	34.09077051	-118.3046976	Los Angeles County
184836	Fee-for-Service	1467983742	1467983742	1	1	TSENG, MIKE MD	11/26/2024	207P00000X	NA	Other	026	PHYSICIANS	175471	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
184851	Fee-for-Service	1811997646	1811997646	1	1	TAN, FANG MD INC	2/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81026	18	Ophthalmology	0	In state provider	None	1895 MOWRY AVE	STE 101	FREMONT	CA	94538	1700	01	06001	37.55909066	-121.9799265	Alameda County
184867	Fee-for-Service	1164461455	1164461455	1	1	TOPPENISH COMMUNITY HOSP	1/1/2003	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	502 W 4TH AVE	None	TOPPENISH	WA	98948	1616	00	None	46.37133652	-120.3169635	Yakima County
184909	Fee-for-Service	1265965271	1265965271	1	1	TRAN-RX LLC	8/25/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1106 E 17TH ST	UNIT B	SANTA ANA	CA	92701	2603	30	06059	33.75982249	-117.8556318	Orange County
184923	Fee-for-Service	1508865528	1508865528	1	11	TAHOE CARSON VALLEY	9/28/2021	174400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2169 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	7059	09	06017	38.91235146	-119.9974905	El Dorado County
184941	Fee-for-Service	1063635001	1063635001	1	1	TEIXERA, LISA D LCSW	4/6/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1320 STANDIFORD AVE	None	MODESTO	CA	95350	0726	50	06099	37.68934252	-121.0140405	Stanislaus County
184963	Fee-for-Service	1982645602	1982645602	1	1	TEITELBAUM, GEORGE P MD	5/31/1990	2085R0204X	NA	Other	026	PHYSICIANS	45097	30	Radiology	0	In state provider	None	505 PARNASSUS AVE	# L352	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
185000	Fee-for-Service	1518272038	1518272038	1	1	TARANEH MOSTAGHASI	8/18/2023	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3108 WILLOW PASS RD	None	CONCORD	CA	94519	2325	07	06013	37.98123305	-122.0199965	Contra Costa County
185002	Fee-for-Service	1932929940	1932929940	1	1	TOMASKO, SYDNEY	10/18/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
185043	Fee-for-Service	1366084360	1366084360	1	1	THERAVILLE COUNSELING SERVIC	12/5/2019	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ES, A LICENSED CLINICAL	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
185073	Fee-for-Service	1154419505	1154419505	1	1	TANENBAUM, JACK LCSW	7/19/2012	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1209 WEST TOKAY STREET	None	LODI	CA	95240	3845	39	06077	38.12635934	-121.2874011	San Joaquin County
185079	Fee-for-Service	1639121981	1639121981	1	1	TER-ZAKARIAN, HOVANES J	2/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	45597	01	General Practice	0	In state provider	None	5250 SANTA MONICA BLVD	STE 310	LOS ANGELES	CA	90029	1255	19	06037	34.09077051	-118.3046976	Los Angeles County
185091	Fee-for-Service	1477680866	1477680866	1	1	TRAN, QUY V MD	9/11/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	50649	36	Psychiatry	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
185121	Fee-for-Service	1326508854	1326508854	1	1	TINGLE, RANDOLPH K DO	3/10/2023	207R00000X	NA	Other	026	PHYSICIANS	19676	None	None	0	In state provider	None	465 W PUTNAM AVENUE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
185195	Fee-for-Service	1497802003	1497802003	1	1	TRAN, KHAI QUANG	5/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	7325	01	General Practice	0	In state provider	None	15955 PARAMOUNT BLVD	None	PARAMOUNT	CA	90723	5113	19	06037	33.8880387	-118.1602095	Los Angeles County
185213	Fee-for-Service	1508865528	1508865528	1	11	TAHOE CARSON VALLEY	4/1/2012	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2169 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	7059	09	06017	38.91235146	-119.9974905	El Dorado County
185218	Fee-for-Service	1285096602	1285096602	1	1	TADOKORO, KENT S MD	10/18/2022	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	179429	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
185229	Fee-for-Service	1699357988	1699357988	1	1	TAPADIA EYE CARE	6/14/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	None	None	0	In state provider	None	1075 YORBA PL	SUITE 205	PLACENTIA	CA	92870	3152	30	06059	33.88941645	-117.844866	Orange County
185252	Fee-for-Service	1447510003	1447510003	1	1	TIEU, MEGHAN M H MD	5/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122642	05	Anesthesiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
185272	Fee-for-Service	1538338942	1538338942	1	1	TRUONG, THUY N DO	9/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10326	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
185307	Fee-for-Service	1275911364	1275911364	1	1	TSAY, ERIC T MD	7/16/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	145318	None	None	0	In state provider	None	250 E CAROLINE ST	STE J	SAN BERNARDINO	CA	92408	3758	36	06071	34.0615203	-117.2793274	San Bernardino County
185332	Fee-for-Service	1366084360	1366084360	1	1	THERAVILLE COUNSELING SERVIC	12/5/2019	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ES, A LICENSED CLINICAL	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
185369	Fee-for-Service	1639121981	1639121981	1	1	TER-ZAKARIAN, HOVANES J	2/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	45597	08	Family Practice	0	In state provider	None	5250 SANTA MONICA BLVD	STE 310	LOS ANGELES	CA	90029	1255	19	06037	34.09077051	-118.3046976	Los Angeles County
185390	Fee-for-Service	1669453262	1669453262	1	2	TUCKER, LAWRENCE MD	6/5/2019	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	84067	-	NOT APPLICABLE	0	In state provider	None	2060 CHICAGO AVE	A-9	RIVERSIDE	CA	92507	2081	33	06065	33.992568	-117.3483325	Riverside County
185405	Fee-for-Service	1255526067	1255526067	1	1	TOMPKINS PETTIGREW,	4/11/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	KIMBERLEY R PSY	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
185416	Fee-for-Service	1306023973	1306023973	1	1	TSUI, IRENA MD	6/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103523	18	Ophthalmology	0	In state provider	None	100 STEIN PLAZA	STE I-340	LOS ANGELES	CA	90095	7001	19	06037	34.06489065	-118.4443287	Los Angeles County
185439	Fee-for-Service	1225120454	1225120454	1	1	THDORSON, JOHN A MD	2/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	82079	22	Pathology (M.D. only)	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
185448	Fee-for-Service	1235273327	1235273327	1	1	TAM, DANIEL T MD INC	7/6/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	34833	01	General Practice	0	In state provider	None	665 CAMINO DE LOS MARES	SUITE 305	SAN CLEMENTE	CA	92673	2841	30	06059	33.45730192	-117.6483252	Orange County
185491	Fee-for-Service	1710249883	1710249883	1	1	TRONCALES, ALFRED D MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148917	40	Pediatrics	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
185499	Fee-for-Service	1356620736	1356620736	1	1	TIRADO, DIANE LMFT	11/24/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
185500	Fee-for-Service	1508865528	1508865528	1	11	TAHOE CARSON VALLEY	4/1/2012	174400000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2169 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	7059	09	06017	38.91235146	-119.9974905	El Dorado County
185581	Fee-for-Service	1184641888	1184641888	1	1	TORABIAN, SIMA Z MD	9/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	93997	07	Dermatology	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
185601	Fee-for-Service	1558442384	1558442384	1	1	TURKAT, TEVIAH J MD	10/1/1983	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	7882	30	Radiology	0	In state provider	SPLIT BILLING	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
185672	Fee-for-Service	1003122680	1003122680	1	1	TWEETEN, YVONNE J	2/26/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
185690	Fee-for-Service	1164680708	1164680708	1	1	TABRIZI, MARYAM B MD	2/2/2021	2086S0102X	NA	General Surgery	026	PHYSICIANS	124582	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
185768	Fee-for-Service	1093248601	1093248601	1	1	TALIAFERRO, ANDREW S MD	6/8/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	160016	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
185794	Fee-for-Service	1285165613	1285165613	1	1	TANAKIT, ALISA MD	8/22/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	187934	None	None	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
185821	Fee-for-Service	1568631901	1568631901	1	1	TYE, KENNETH MD INC	12/1/1998	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	32035	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1250 S SUNSET AVE	STE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
185899	Fee-for-Service	1457841090	1457841090	1	1	TIU, STEVE H CNP	5/26/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2895 N TOWNE AVE	None	POMONA	CA	91767	2009	19	06037	34.098525	-117.7368955	Los Angeles County
185958	Fee-for-Service	1902827835	1902827835	1	1	TEWARI, DEVANSU MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68445	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
185977	Fee-for-Service	1881756096	1881756096	1	1	TSADOK, YACOV M MD	12/1/1997	207R00000X	NA	Other	026	PHYSICIANS	61419	41	Internal Medicine	0	In state provider	None	2080 CENTURY PARK E	STE 1208	LOS ANGELES	CA	90067	2015	19	06037	34.05887194	-118.4122914	Los Angeles County
186031	Fee-for-Service	1326825860	1326825860	1	1	TSAI, LUKE	4/25/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
186034	Fee-for-Service	1093919946	1093919946	1	1	TSIMPAS, ASTERIOS MD FACS	12/9/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	121207	None	None	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 541	MISSION VIEJO	CA	92691	6376	30	06059	33.56347704	-117.66546	Orange County
186095	Fee-for-Service	1699152397	1699152397	1	1	TRAN, KIM V MD	9/16/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	154561	40	Pediatrics	0	In state provider	None	2240 MERCURY WAY	None	SANTA ROSA	CA	95407	5413	49	06097	38.421135	-122.752008	Sonoma County
186110	Fee-for-Service	1427029529	1427029529	1	1	TAKACS,MICHAEL E	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	0000	00	None	41.659929	-91.548099	Johnson County
186113	Fee-for-Service	1568631901	1568631901	1	1	TYE, KENNETH MD INC	12/1/1998	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	32035	41	Internal Medicine	0	In state provider	None	1250 S SUNSET AVE	STE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
186131	Fee-for-Service	1104434125	1104434125	1	1	T'SOUVAS, NICOLE LMFT	12/8/2023	171M00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
186150	Fee-for-Service	1144222803	1144222803	1	1	TORNO, JR. MAURO S MD	6/1/1995	207R00000X	NA	Other	026	PHYSICIANS	52189	41	Internal Medicine	0	In state provider	None	1723 W BALL RD	None	ANAHEIM	CA	92804	5502	30	06059	33.8193	-117.942588	Orange County
186166	Fee-for-Service	1285801241	1285801241	2	1	TERRA BELLA COMMUNITIES	10/19/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1010 SAN MIGUEL ST	None	GILROY	CA	95020	5402	43	06085	37.00611924	-121.5872614	Santa Clara County
186179	Fee-for-Service	1114163201	1114163201	1	1	TORRES, LISA M LMFT	6/13/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
186259	Fee-for-Service	1982049839	1982049839	1	1	THOMPSON, SHEENA C LMFT	5/1/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1030 NEVADA ST.	SUITE 103	REDLANDS	CA	92374	2957	36	06071	34.064172	-117.217431	San Bernardino County
186290	Fee-for-Service	1780364224	1780364224	1	1	THE HOLLYWOOD & VINE RECOVER	6/5/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	Y CENTER	20933 DEVONSHIRE ST	STE 102	CHATSWORTH	CA	91311	2369	19	06037	34.25727951	-118.589886	Los Angeles County
186323	Fee-for-Service	1376657130	1376657130	1	1	TRACY LOPER M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6655 S YALE AVE	None	TULSA	OK	74136	3326	00	None	36.06542494	-95.92006491	Tulsa County
186335	Fee-for-Service	1902915432	1902915432	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	170 SAN MATEO RD	None	HALF MOON BAY	CA	94019	1706	41	06081	37.46785388	-122.4311995	San Mateo County
186346	Fee-for-Service	1669453262	1669453262	1	1	TUCKER, LAWRENCE V	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84067	36	Psychiatry	0	In state provider	None	3382 COLONIAL AVE	None	LOS ANGELES	CA	90066	1508	19	06037	34.01250142	-118.441032	Los Angeles County
186347	Fee-for-Service	1881270387	1881270387	1	1	TANG, JENNIFER J MD	3/13/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
186357	Fee-for-Service	1649700592	1649700592	1	1	TSIKITAS, LUCAS A MD	7/8/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175907	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
186358	Fee-for-Service	1225559446	1225559446	1	1	TABESH, PARNIAN	7/9/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1620 E ROSEVILLE PKWY	110	ROSEVILLE	CA	95661	3995	31	06061	38.74929858	-121.2417037	Placer County
186389	Fee-for-Service	1154598290	1154598290	1	1	TAGHIZADEH, POUNEH MD	1/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108394	05	Anesthesiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
186402	Fee-for-Service	1568631901	1568631901	1	1	TYE, KENNETH MD INC	12/1/1998	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	32035	30	Radiology	0	In state provider	None	1250 S SUNSET AVE	STE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
186404	Fee-for-Service	1023240546	1023240546	1	1	THAKRAR, DARSHIT J MD	9/1/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	167220	30	Radiology	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
186421	Fee-for-Service	1417066903	1417066903	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	153 E GLADSTONE ST	None	AZUSA	CA	91702	4926	19	06037	34.11426525	-117.9049294	Los Angeles County
186438	Fee-for-Service	1871541961	1871541961	1	1	THAKER, NIMISH	5/31/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74757	34	Urology and Urological Surgery	0	In state provider	None	489 E 21ST ST	None	SAN BERNARDINO	CA	92404	4816	36	06071	34.13403455	-117.2756115	San Bernardino County
186464	Fee-for-Service	1821607771	1821607771	1	1	TONYA OCTAVE, LCSW, PROF COR	10/4/2020	261QM0855X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CORP.	237 S LAKEVIEW AVE	SUITE A	PLACENTIA	CA	92870	6756	30	06059	33.86855096	-117.8182453	Orange County
186489	Fee-for-Service	1932502440	1932502440	1	1	TURNER, DARRYL J NP	1/19/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
186495	Fee-for-Service	1104247329	1104247329	1	1	TORREBLANCA, JOSE MD INC	12/23/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	7128 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	4906	19	06037	33.9746878	-118.2224195	Los Angeles County
186515	Fee-for-Service	1225488075	1225488075	1	1	TODD, CHRISTINE MD	8/18/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	169226	15	Obstetrics (D.O. only)	0	In state provider	None	25495 MEDICAL CENTER DR	STE 300	MURRIETA	CA	92562	4902	33	06065	33.55804188	-117.1834064	Riverside County
186536	Fee-for-Service	1588639314	1588639314	1	1	TAO, SUE HONG MD	11/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	17073 MAIN ST	None	HESPERIA	CA	92345	6004	36	06071	34.41987484	-117.2906045	San Bernardino County
186670	Fee-for-Service	1790869774	1790869774	1	1	TEPPER, ERIC F MD	9/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	44047	01	General Practice	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
186678	Fee-for-Service	1225736440	1225736440	1	1	TASH MANOR INC	3/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	22040 COVELLO STREET	None	CANOGA PARK	CA	91303	1127	19	06037	34.20734976	-118.6074755	Los Angeles County
186723	Fee-for-Service	1225004021	1225004021	1	1	TABACK, STEVEN M MD	12/30/1991	207RP1001X	NA	Pulmonology	026	PHYSICIANS	62972	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3808 W RIVERSIDE DR	STE 403	BURBANK	CA	91505	5301	19	06037	34.15252315	-118.3412174	Los Angeles County
186748	Fee-for-Service	1619520665	1619520665	1	1	TUNGOL, RACHEL M NP	11/25/2024	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
186783	Fee-for-Service	1104247329	1104247329	1	1	TORREBLANCA, JOSE MD INC	12/23/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	7128 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	4906	19	06037	33.9746878	-118.2224195	Los Angeles County
186784	Fee-for-Service	1710663125	1710663125	1	1	TRUONG, JEFFREY OT	7/5/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 W GLENOAKS BLVD	None	GLENDALE	CA	91202	2813	19	06037	34.15937082	-118.2644042	Los Angeles County
186796	Fee-for-Service	1770622466	1770622466	1	1	TZADIK, MOR Z MD	4/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86756	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1425 SOUTH MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
186806	Fee-for-Service	1225488075	1225488075	1	1	TODD, CHRISTINE MD	8/18/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	169226	09	Gynecology (D.O. only)	0	In state provider	None	25495 MEDICAL CENTER DR	STE 300	MURRIETA	CA	92562	4902	33	06065	33.55804188	-117.1834064	Riverside County
186825	Fee-for-Service	1265561641	1265561641	1	1	TRENT, DAVID C DDS MD	8/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118083	02	General Surgery	0	In state provider	None	1174 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4802	49	06097	38.44314	-122.6996775	Sonoma County
186932	Fee-for-Service	1770515454	1770515454	1	1	TRIMBLE, I RIDGEWAY MD	3/31/1989	207P00000X	NA	Other	026	PHYSICIANS	27897	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
187008	Fee-for-Service	1225004021	1225004021	1	1	TABACK, STEVEN M MD	12/30/1991	207RP1001X	NA	Pulmonology	026	PHYSICIANS	62972	41	Internal Medicine	0	In state provider	None	3808 W RIVERSIDE DR	STE 403	BURBANK	CA	91505	5301	19	06037	34.15252315	-118.3412174	Los Angeles County
187028	Fee-for-Service	1679783161	1679783161	1	1	THERAPEUTIC LIVING CENTERS	9/3/1992	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR THE BLIND INC	7937 LINDLEY AVE	None	RESEDA	CA	91335	2122	19	06037	34.2149632	-118.5273746	Los Angeles County
187071	Fee-for-Service	1104247329	1104247329	1	1	TORREBLANCA, JOSE MD INC	12/23/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	7128 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	4906	19	06037	33.9746878	-118.2224195	Los Angeles County
187081	Fee-for-Service	1932273604	1932273604	1	1	THE ORION MED GRP	3/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3325 CHANATE RD	None	SANTA ROSA	CA	95404	1707	49	06097	38.469537	-122.707314	Sonoma County
187090	Fee-for-Service	1033857578	1033857578	1	1	TALYA MD CORP	4/28/2023	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	None	None	None	0	In state provider	None	9288 MADISON AVE	None	ORANGEVALE	CA	95662	5857	34	06067	38.669427	-121.207896	Sacramento County
187108	Fee-for-Service	1518657394	1518657394	1	1	TRAN, THAO NP	12/6/2023	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
187110	Fee-for-Service	1306816277	1306816277	1	1	TODD, MARILYN MD	11/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	84691	08	Family Practice	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
187164	Fee-for-Service	1487691606	1487691606	1	2	TAY, JAFAR MD	6/8/2021	2086S0129X	NA	General Surgery	026	PHYSICIANS	69558	None	None	0	In state provider	None	175 N JACKSON AVE	201	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
187172	Fee-for-Service	1043244437	1043244437	1	1	TING, TUOW D MD	4/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87240	18	Ophthalmology	0	In state provider	None	122 LA CASA VIA	STE 223	WALNUT CREEK	CA	94598	3014	07	06013	37.91198028	-122.041845	Contra Costa County
187179	Fee-for-Service	1477206084	1477206084	1	1	TEAGARDEN, GARRETT J OT	4/11/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
187194	Fee-for-Service	1669886644	1669886644	1	1	TOTAH-MCCARTY, LAUREN LMFT	12/7/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
187267	Fee-for-Service	1972193290	1972193290	1	1	TRU HOSPICE, INC	4/6/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1145 E LOS ANGELES	STE 301S	SIMI VALLEY	CA	93065	2846	56	06111	34.2718593	-118.7777078	Ventura County
187393	Fee-for-Service	1427756493	1427756493	1	1	THE LIVING WATER CARE HOME	3/16/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7800 CLAYPOOL WAY	None	CITRUS HEIGHTS	CA	95610	2707	34	06067	38.707875	-121.2494715	Sacramento County
187421	Fee-for-Service	1770018947	1770018947	1	1	TUNG, CHRISTINE MD	10/23/2020	208600000X	NA	General Surgery	026	PHYSICIANS	158080	02	General Surgery	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
187430	Fee-for-Service	1346359890	1346359890	1	1	THRIFTY DRUG STORE 5597	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	2150 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	6839	19	06037	34.03875147	-118.1444233	Los Angeles County
187471	Fee-for-Service	1104875160	1104875160	1	1	TOMASIC, NICKOLAS A MD	3/31/1993	208800000X	NA	Other	026	PHYSICIANS	66614	34	Urology and Urological Surgery	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
187483	Fee-for-Service	1649613407	1649613407	1	1	TOMLINSON, STARR NP	8/18/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2200 OFARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
187485	Fee-for-Service	1194826909	1194826909	1	1	TABRIZI, FARZANEH	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64717	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
187510	Fee-for-Service	1942822572	1942822572	1	1	TOTAL CARE HOSPICE	1/18/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	& PALLIATIVE	625 FAIR OAKS AVE	STE 377	S PASADENA	CA	91030	5814	19	06037	34.117947	-118.1503575	Los Angeles County
187529	Fee-for-Service	1669528089	1669528089	1	1	TRUONG, THANH K OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	LOW VISION OPTOMETRIC	3443 B BALBOA ST	None	SAN FRANCISCO	CA	94121	2701	38	06075	37.7757571	-122.4958904	San Francisco County
187539	Fee-for-Service	1205923844	1205923844	1	1	TURKEL, SUSAN B MD	7/1/1996	2084P0804X	NA	Psychiatry	026	PHYSICIANS	23504	36	Psychiatry	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
187552	Fee-for-Service	1740551407	1740551407	1	1	THOMASON, EMMETT L LMFT	3/22/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	51786	-	NOT APPLICABLE	0	In state provider	None	340 RANCHEROS DR	SUITE 166	SAN MARCOS	CA	92069	2980	37	06073	33.1388667	-117.1563523	San Diego County
187558	Fee-for-Service	1972193290	1972193290	1	1	TRU HOSPICE, INC	4/6/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1145 E LOS ANGELES	STE 301S	SIMI VALLEY	CA	93065	2846	56	06111	34.2718593	-118.7777078	Ventura County
187589	Fee-for-Service	1902803216	1902803216	1	1	THOMSON, CHRIS P MD	12/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	66058	41	Internal Medicine	0	In state provider	None	758 E BULLARD AVE	STE 100	FRESNO	CA	93710	5472	10	06019	36.82313646	-119.7733995	Fresno County
187593	Fee-for-Service	1144245929	1144245929	1	1	THE PRESCRIPTION SHOPPE	7/1/2003	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 S 2ND AVE	STE 101	BARSTOW	CA	92311	2805	36	06071	34.894656	-117.0262295	San Bernardino County
187602	Fee-for-Service	1952920803	1952920803	1	1	TRAN, CHINH L MD	3/13/2024	207L00000X	NA	Other	026	PHYSICIANS	186422	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
187610	Fee-for-Service	1053940890	1053940890	1	1	TUBBS, TAJAH C MD	5/16/2024	207P00000X	NA	Other	026	PHYSICIANS	189284	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
187640	Fee-for-Service	1740276518	1740276518	1	1	THE VILLAGES TRI COUNTY	5/19/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER INC	1451 EL CAMINO REAL	None	THE VILLAGES	FL	32159	0041	00	None	28.94945411	-81.95850467	Sumter County
187641	Fee-for-Service	1376091264	1376091264	1	1	TRAN, HELEN P OD	1/27/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	17801 PIONEER BLVD	STE F	ARTESIA	CA	90701	4124	19	06037	33.8693187	-118.0823685	Los Angeles County
187663	Fee-for-Service	1972981405	1972981405	1	1	TOMPKINS, JODY M LMFT	12/18/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	260 MAPLE COURT	SUITE 103	VENTURA	CA	93003	3553	56	06111	34.27027545	-119.24562	Ventura County
187687	Fee-for-Service	1457970998	1457970998	1	1	TORBELA, ADRIAN MD	11/6/2023	207R00000X	NA	Other	026	PHYSICIANS	183399	None	None	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
187692	Fee-for-Service	1912079880	1912079880	2	1	TRAVELWORLD US INCORPORATED	3/29/2024	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	214 WEST E ST	None	ONTARIO	CA	91762	3420	36	06071	34.068312	-117.6529545	San Bernardino County
187723	Fee-for-Service	1326272915	1326272915	1	1	TE, TAM T MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118332	41	Internal Medicine	0	In state provider	None	11211 SUPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
187773	Fee-for-Service	1194826909	1194826909	1	1	TABRIZI, FARZANEH	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64717	08	Family Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
187775	Fee-for-Service	1912951898	1912951898	1	1	TAGGART, JAMES R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	82893	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 N MCDOWELL BLVD	None	PETALUMA	CA	94954	2339	49	06097	38.25477	-122.63175	Sonoma County
187778	Fee-for-Service	1376787416	1376787416	1	1	THOMAS, CASSANDRA L MD	5/17/2023	207RX0202X	NA	Oncology	026	PHYSICIANS	184675	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
187796	Fee-for-Service	1942822572	1942822572	1	1	TOTAL CARE HOSPICE	1/18/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	& PALLIATIVE	625 FAIR OAKS AVE	STE 377	S PASADENA	CA	91030	5814	19	06037	34.117947	-118.1503575	Los Angeles County
187807	Fee-for-Service	1336109149	1336109149	1	1	TRUONG, HUY MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80704	41	Internal Medicine	0	In state provider	None	1851 N RIVERSIDE AVE	None	RIALTO	CA	92376	8069	36	06071	34.133238	-117.3704145	San Bernardino County
187828	Fee-for-Service	1205923844	1205923844	1	1	TURKEL, SUSAN B MD	7/1/1996	2084P0804X	NA	Psychiatry	026	PHYSICIANS	23504	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
187845	Fee-for-Service	1477643690	1477643690	1	1	TEXAS CHILDRENS HOSP	8/31/2001	282NC2000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	6621 FANNIN ST	None	HOUSTON	TX	77030	2399	00	None	29.70724683	-95.4026169	Harris County
187846	Fee-for-Service	1487676656	1487676656	1	1	THIEL, GLENN W DO	9/20/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	6997	None	None	0	In state provider	None	1900 DRESDEN	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
187866	Fee-for-Service	1982124947	1982124947	1	1	THOMAS, MOLLY A	8/14/2017	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
187918	Fee-for-Service	1437369147	1437369147	1	1	TSAO, LILIAN L MD	2/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	92416	08	Family Practice	0	In state provider	None	2433 CENTRAL AVE	STE A	ALAMEDA	CA	94501	4564	01	06001	37.76358675	-122.2413153	Alameda County
187962	Fee-for-Service	1952416190	1952416190	1	1	TINGUS, KATHLEEN D	10/6/2004	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.06680182	-118.4450804	Los Angeles County
187998	Fee-for-Service	1821076316	1821076316	1	1	TRAN, KHOI M MD	9/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54763	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
188002	Fee-for-Service	1700226289	1700226289	1	1	TURNER, NATHAN K PSYD	1/13/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
188134	Fee-for-Service	1477643690	1477643690	1	1	TEXAS CHILDRENS HOSP	8/31/2001	282NC2000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	6621 FANNIN ST	None	HOUSTON	TX	77030	2399	00	None	29.70724683	-95.4026169	Harris County
188174	Fee-for-Service	1841424728	1841424728	1	1	TERRY, JONATHAN DO	3/27/2024	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	12657	-	NOT APPLICABLE	0	In state provider	None	215 4TH ST	None	CHOWCHILLA	CA	93610	2818	20	06039	37.12051777	-120.2606405	Madera County
188178	Fee-for-Service	1255440640	1255440640	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05424	226 N LARCHMONT BLVD	None	LOS ANGELES	CA	90004	3707	19	06037	34.075197	-118.323604	Los Angeles County
188231	Fee-for-Service	1679500193	1679500193	1	1	TOBIAS, SERGE M MD	9/30/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	39355	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1045 ATLANTIC AVE	STE 912	LONG BEACH	CA	90813	3410	19	06037	33.780267	-118.1850795	Los Angeles County
188236	Fee-for-Service	1639247190	1639247190	1	1	TAKEMOTO, KIMBERLY	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
188307	Fee-for-Service	1679141709	1679141709	1	1	TRUSTFUL HOME HEALTH INC	12/14/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6356 VAN NUYS BLVD	SUITE 200	VAN NUYS	CA	91401	2747	19	06037	34.185861	-118.4487045	Los Angeles County
188344	Fee-for-Service	1235339656	1235339656	1	1	TOTOIU, MINODORA O MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	98106	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
188382	Fee-for-Service	1720773443	1720773443	1	1	TRAN, NGHI Y OT	7/21/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
188432	Fee-for-Service	1053381335	1053381335	1	1	THOMAS MICHAEL HILLS JR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	ST EDWARD MERCY CLINIC	7301 ROGERS AVE	None	FORT SMITH	AR	72903	0000	00	None	35.35551	-94.35276	Sebastian County
188438	Fee-for-Service	1801154463	1801154463	1	1	TOTAL CARE MEDICAL CLINIC	3/27/2014	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INC	1110 W ANAHEIM ST	STE 6	WILMINGTON	CA	90744	4131	19	06037	33.77921216	-118.2759309	Los Angeles County
188454	Fee-for-Service	1316096688	1316096688	1	1	TRAN, NEIL Q MD	11/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84603	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
188466	Fee-for-Service	1740377928	1740377928	1	2	TASCOE, RAMONA M MD	10/5/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	36430	-	NOT APPLICABLE	0	In state provider	None	795 FLETCHER LANE	None	HAYWARD	CA	94544	1008	01	06001	37.66549609	-122.080513	Alameda County
188480	Fee-for-Service	1316947781	1316947781	1	1	TARR,CHRISTOPHER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 N WILMOT	None	TUCSON	AZ	85732	0000	00	None	32.227209	-110.8556595	Pima County
188499	Fee-for-Service	1093766933	1093766933	1	1	TURNER, RODERICK R MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	43344	22	Pathology (M.D. only)	0	In state provider	None	1328 22ND ST	None	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
188548	Fee-for-Service	1730462714	1730462714	1	1	TERZULLI, CAITLIN M LCSW	4/25/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39650 LIBERTY STREET	SUITE 310	FREMONT	CA	94538	2227	01	06001	37.54662058	-121.9736002	Alameda County
188560	Fee-for-Service	1821613670	1821613670	1	1	TERIAN, VICKTORIA OD	9/23/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
188574	Fee-for-Service	1841636123	1841636123	1	1	TENG, RACHEL MD	9/14/2018	208600000X	NA	General Surgery	026	PHYSICIANS	154014	02	General Surgery	0	In state provider	None	1541 FLORIDA AVE	STE 200	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
188590	Fee-for-Service	1396775847	1396775847	1	1	TIWARI, RATAN L MD INC	9/27/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	35113	06	Cardiovascular Disease (M.D. only)	0	In state provider	JOLENE S DIEHL	949 CALHOUN PL	STE D	HEMET	CA	92543	4403	33	06065	33.7502744	-116.9618423	Riverside County
188623	Fee-for-Service	1639240609	1639240609	1	1	TONG, GARRISON M MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70113	67	Endocrinology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
188677	Fee-for-Service	1114541729	1114541729	1	1	TRI MEADOWS HEALTHCARE LLC	12/18/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8622 RESEDA BLVD	STE 204	NORTHRIDGE	CA	91324	4094	19	06037	34.22719786	-118.5360442	Los Angeles County
188762	Fee-for-Service	1013185131	1013185131	1	1	TRIBBLE, MELISSA S AU	11/27/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
188781	Fee-for-Service	1538125844	1538125844	1	2	THE REGENTS OF THE UNIVERSIT	9/26/2019	207T00000X	NA	General Surgery	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 STEIN PLAZA	STE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
188801	Fee-for-Service	1366625451	1366625451	1	1	TANAKA, GEORGE H MD INC	7/3/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	78526	18	Ophthalmology	0	In state provider	None	1515 SCOTT ST	STE 2	SAN FRANCISCO	CA	94115	3511	38	06075	37.78406999	-122.4379366	San Francisco County
188803	Fee-for-Service	1306997143	1306997143	1	2	TO, BRITTANY A OD	9/4/2024	152WC0802X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1950 SUNNY CREST DR	3200	FULLERTON	CA	92856	3517	30	06059	33.89240507	-117.9313904	Orange County
188805	Fee-for-Service	1104089606	1104089606	1	1	TANNER, DAWN T MD	6/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110702	30	Radiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
188825	Fee-for-Service	1902818131	1902818131	1	1	TRUONG, MY-LE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	63412	05	Anesthesiology	0	In state provider	None	1025 S ANAHEIM BLVD	None	ANAHEIM	CA	92805	5806	30	06059	33.81994338	-117.9087416	Orange County
188892	Fee-for-Service	1619659505	1619659505	1	1	TARMANI, BRONIKA LMFT	5/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1461 FORD ST	202	REDLANDS	CA	92373	3909	36	06071	34.03913285	-117.1563139	San Bernardino County
188900	Fee-for-Service	1194723874	1194723874	1	1	TYSON, KEVIN B MD	8/21/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69141	41	Internal Medicine	0	In state provider	None	1542 E FLORENCE AVE	None	LOS ANGELES	CA	90001	2536	19	06037	33.97472354	-118.246122	Los Angeles County
188966	Fee-for-Service	1114541729	1114541729	1	1	TRI MEADOWS HEALTHCARE LLC	12/18/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8622 RESEDA BLVD	STE 204	NORTHRIDGE	CA	91324	4094	19	06037	34.22719786	-118.5360442	Los Angeles County
189024	Fee-for-Service	1235715160	1235715160	1	1	TRAN-VU, KHANHPHI MD	7/1/2024	390200000X	NA	Other	026	PHYSICIANS	187893	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
189053	Fee-for-Service	1154740389	1154740389	1	1	TOBOLOWSKY, FARRELL DO	4/1/2025	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	23182	77	Infectious Disease	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	9411	38	06075	37.78610439	-122.421569	San Francisco County
189069	Fee-for-Service	1538125844	1538125844	1	2	THE REGENTS OF THE UNIVERSIT	10/23/2015	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	300 STEIN PLAZA	STE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
189078	Fee-for-Service	1326002700	1326002700	1	1	TAGORE, KULDEEP S MD	6/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81456	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
189103	Fee-for-Service	1194724617	1194724617	1	1	TRUONG, HIEU T MD	11/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75688	30	Radiology	0	In state provider	None	705 W LA VETA AVE	STE 107	ORANGE	CA	92868	4447	30	06059	33.78062272	-117.8600738	Orange County
189124	Fee-for-Service	1982185336	1982185336	1	1	TORRES, CLAUDIA M LMFT	1/13/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5122 KATELLA AVE	SUITE # 305	LOS ALAMITOS	CA	90720	2831	30	06059	33.80290311	-118.0433422	Orange County
189147	Fee-for-Service	1508963398	1508963398	1	1	TRAN, LOANNE B MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63084	40	Pediatrics	0	In state provider	None	624 W DUARTE RD	STE 205	ARCADIA	CA	91007	9260	19	06037	34.12637452	-118.0527313	Los Angeles County
189214	Fee-for-Service	1578651584	1578651584	1	1	TORRES, RODRIGO J MD	6/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	83341	18	Ophthalmology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
189263	Fee-for-Service	1619338456	1619338456	1	1	TRIVEDI, KRUPA U	12/19/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
189300	Fee-for-Service	1518230176	1518230176	1	1	TAHER, REZA MD	11/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149605	25	Physical Medicine and Rehabilitation	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
189301	Fee-for-Service	1245437581	1245437581	2	1	TRAN, TUAN A MD FACS	8/3/2022	208200000X	NA	General Surgery	026	PHYSICIANS	104823	46	Hand Surgery	0	In state provider	None	10301 BOLSA AVE	101	WESTMINSTER	CA	92683	4950	30	06059	33.74508782	-117.9495976	Orange County
189328	Fee-for-Service	1053373134	1053373134	1	1	THOMAS WARFEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4805 NE GLISAN STREET	None	PORTLAND	OR	97213	0000	00	None	45.52655191	-122.6121355	Multnomah County
189352	Fee-for-Service	1659953180	1659953180	1	1	TU, JENNIFER DO	10/7/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	21869	40	Pediatrics	0	In state provider	None	27303 SLEEPY HOLLOW	None	HAYWARD	CA	94545	4203	01	06001	37.63208871	-122.0939191	Alameda County
189359	Fee-for-Service	1306260799	1306260799	1	1	TREBACH, JOSHUA MD	5/7/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
189373	Fee-for-Service	1538125844	1538125844	1	1	THE REGENTS OF THE UNIVERSIT	10/2/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	UCLA NEUROSURGERY ASSOC	300 UCLA MEDICAL PLZ	STE 200	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
189412	Fee-for-Service	1285789834	1285789834	1	1	THOMPSON, LAURALEE A MD	8/31/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	39399	30	Radiology	0	In state provider	None	9808 VENICE BLVD	STE 200	CULVER CITY	CA	90232	6809	19	06037	34.0236396	-118.3980847	Los Angeles County
189427	Fee-for-Service	1841309366	1841309366	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5621	955 TAMARACK AVE	None	CARLSBAD	CA	92008	3414	37	06073	33.15262682	-117.3353055	San Diego County
189434	Fee-for-Service	1952880197	1952880197	1	1	TUMANUT, MARCIAL F RCP	8/31/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
189438	Fee-for-Service	1508963398	1508963398	1	1	TRAN, LOANNE B MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63084	41	Internal Medicine	0	In state provider	None	624 W DUARTE RD	STE 205	ARCADIA	CA	91007	9260	19	06037	34.12637452	-118.0527313	Los Angeles County
189448	Fee-for-Service	1992768329	1992768329	1	1	TOTAL RENAL CARE, INC	5/1/1998	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	9142 MONTE VISTA AVE	None	MONTCLAIR	CA	91763	1723	36	06071	34.08850692	-117.6983358	San Bernardino County
189476	Fee-for-Service	1720282262	1720282262	2	1	TATENCO-LAGUNA, PATRICIA LM	3/22/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3200 E GUASTI RD.	SUITE 100	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
189492	Fee-for-Service	1326253279	1326253279	1	1	TEJURA, TAPAS K MD	7/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110917	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
189509	Fee-for-Service	1871104687	1871104687	1	1	THOMSON, RACHEL PT	4/17/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	24331 EL TORO ROAD	SUITE 200	LAGUNA WOODS	CA	92637	3116	30	06059	33.60928782	-117.7295058	Orange County
189521	Fee-for-Service	1912106634	1912106634	1	1	TZENG, JULIA W MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106697	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
189536	Fee-for-Service	1487604401	1487604401	1	1	TSAI, YEH-KUANG MD	6/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82398	05	Anesthesiology	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
189543	Fee-for-Service	1770680159	1770680159	1	1	TRAN, KEVIN S OD	7/5/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	C & K VISION OPTOMETRY	9131 BOLSA AVE	STE 202	WESTMINSTER	CA	92683	1301	30	06059	33.74495045	-117.969201	Orange County
189568	Fee-for-Service	1942503958	1942503958	1	1	TMOGI INC	2/23/2011	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
189587	Fee-for-Service	1245437581	1245437581	2	1	TRAN, TUAN A MD FACS	8/3/2022	208200000X	NA	General Surgery	026	PHYSICIANS	104823	02	General Surgery	0	In state provider	None	10301 BOLSA AVE	101	WESTMINSTER	CA	92683	4950	30	06059	33.74508782	-117.9495976	Orange County
189599	Fee-for-Service	1376317032	1376317032	1	1	THOMAS CHIROPRACTIC, INC.	4/3/2025	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1390 W H ST	STE C	OAKDALE	CA	95361	3529	50	06099	37.75817442	-120.8617244	Stanislaus County
189626	Fee-for-Service	1962115626	1962115626	1	1	THOMAS, AMOREENA LCSW	12/13/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8300 UTICA AVE	STE 245	RANCHO CUCAMONGA	CA	91730	3852	36	06071	34.10227306	-117.5715643	San Bernardino County
189665	Fee-for-Service	1710356886	1710356886	1	1	THOMPSON, LISA M PT	7/26/2020	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
189678	Fee-for-Service	1972008282	1972008282	1	1	TRAN, JOSEPH T MD	4/29/2022	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
189703	Fee-for-Service	1962580571	1962580571	1	1	TOMKIEWICZ, WILLIAM R MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	43022	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
189705	Fee-for-Service	1487691606	1487691606	1	1	TAY, JAFAR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	69558	None	None	0	In state provider	None	455 OCONNOR DR	STE 390	SAN JOSE	CA	95128	1600	43	06085	37.326654	-121.939897	Santa Clara County
189722	Fee-for-Service	1821329830	1821329830	1	1	TOTAL RENAL CARE INC	12/17/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1150 E LELAND ROAD	None	PITTSBURG	CA	94565	5319	07	06013	38.0086381	-121.8730133	Contra Costa County
189754	Fee-for-Service	1174620553	1174620553	3	1	TOP PHARMACY, INC.	8/14/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3650 E. SOUTH ST.	STE. 100	LAKEWOOD	CA	90712	1535	19	06037	33.8601747	-118.1494013	Los Angeles County
189781	Fee-for-Service	1225166606	1225166606	1	1	TRAN, FRANCES T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	82497	08	Family Practice	0	In state provider	None	14571 MAGNOLIA ST	STE 106	WESTMINSTER	CA	92683	5575	30	06059	33.75097286	-117.9723502	Orange County
189782	Fee-for-Service	1952325169	1952325169	1	1	THOMAS, TERESA E PHD	10/10/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
189817	Fee-for-Service	1053739805	1053739805	1	1	TAM, ERIC L MD	8/6/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	139987	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
189826	Fee-for-Service	1700814886	1700814886	1	1	TIAN, QING MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72446	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
189860	Fee-for-Service	1992212278	1992212278	1	1	TALEBIZADEH-MASHEKI, MARJAN	3/23/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	16800 ASTON	STE 175	IRVINE	CA	92606	4820	30	06059	33.70035445	-117.8435881	Orange County
189869	Fee-for-Service	1922201631	1922201631	1	1	TOROK-MANGASARIAN, JULIE M L	7/4/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1847 ROBINSON STREET	None	OROVILLE	CA	95965	4860	04	06007	39.51175105	-121.5562188	Butte County
189875	Fee-for-Service	1245437581	1245437581	2	1	TRAN, TUAN A MD FACS	8/3/2022	208200000X	NA	General Surgery	026	PHYSICIANS	104823	24	Plastic Surgery	0	In state provider	None	10301 BOLSA AVE	101	WESTMINSTER	CA	92683	4950	30	06059	33.74508782	-117.9495976	Orange County
189908	Fee-for-Service	1750901278	1750901278	1	1	TORRES, ANGELA N MD	7/3/2023	207P00000X	NA	Other	026	PHYSICIANS	184219	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
189916	Fee-for-Service	1679875942	1679875942	1	1	THE CENTER FOR COMPREHENSIVE	3/28/2012	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CARE OF BL0OD DISORDERS	701 SOUTH PARKER STREET	SUITE 1000, 1100	ORANGE	CA	92868	4720	30	06059	33.77647082	-117.8595932	Orange County
189943	Fee-for-Service	1285238048	1285238048	1	1	TEJEDA, JULIA A NP	1/11/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
190004	Fee-for-Service	1730926643	1730926643	1	1	TEMESGEN, MULUGETA CRNA	12/5/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	207 W LEGION	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
190042	Fee-for-Service	1679687776	1679687776	1	1	TAN, LINDA G MD	7/1/1976	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	26940	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
190047	Fee-for-Service	1033178975	1033178975	1	1	TORRES, ALFREDO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3421 MEDICAL PARK DR	None	MONROE	LA	71203	2355	00	None	32.57793846	-92.07056949	Ouachita Parish
190131	Fee-for-Service	1134170830	1134170830	1	1	TOTAL RENAL CARE, INC	8/23/2006	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	MADERA DIALYSIS CLINIC	501 E ALMOND AVENUE	None	MADERA	CA	93637	5661	20	06039	36.94552586	-120.0513574	Madera County
190174	Fee-for-Service	1447202528	1447202528	1	1	TYRRELL, JAMES B MD	9/23/1970	No Taxonomy Provided	NA	None	026	PHYSICIANS	23986	67	Endocrinology	0	In state provider	None	350 PARNASSUS AVE	STE 908	SAN FRANCISCO	CA	94117	3612	38	06075	37.76403932	-122.4561371	San Francisco County
190185	Fee-for-Service	1063699023	1063699023	1	1	TAYLOR, MERY M PHD	10/20/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1201 W ORANGE AVE	None	ORANGE	CA	92868	4203	30	06059	33.7963083	-117.8928546	Orange
190288	Fee-for-Service	1407847684	1407847684	1	1	THOMAN, DAVID S MD	7/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	72445	02	General Surgery	0	In state provider	None	536 E ARRELLAGA ST	STE 201	SANTA BARBARA	CA	93103	2255	42	06083	34.43335006	-119.702891	Santa Barbara County
190311	Fee-for-Service	1427555804	1427555804	1	1	TAYLOR, ADAM MD	9/1/2024	207XS0114X	NA	Orthopedic Surgery	026	PHYSICIANS	165508	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
190346	Fee-for-Service	1790304988	1790304988	1	1	TAM, TATIANA DO	9/8/2023	207R00000X	NA	Other	026	PHYSICIANS	21019	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
190382	Fee-for-Service	1285051177	1285051177	1	1	TSAI, MATTHEW MD	12/13/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	138084	10	Gastroenterology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
190402	Fee-for-Service	1053641290	1053641290	1	1	TOOR, DAVID M MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110510	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHLEY AVE	None	BERKELEY	CA	94705	2067	01	06001	0	0	None
190475	Fee-for-Service	1982261046	1982261046	1	1	TIMOTHY H CHEN MD INC	5/7/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	None	None	0	In state provider	None	1700 CALIFORNIA ST	100	SAN FRANCISCO	CA	94109	4587	38	06075	37.79030099	-122.4230289	San Francisco County
190515	Fee-for-Service	1508547811	1508547811	1	1	TLT CARE ENDEAVOR, LLC	3/10/2025	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	19208 SHERYL AVE	None	CERRITOS	CA	90703	6622	19	06037	33.85630319	-118.0878227	Los Angeles County
190540	Fee-for-Service	1952410359	1952410359	1	1	THRIFTY PAYLESS INC	2/21/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4300 ELVERTA RD	None	SACRAMENTO	CA	95843	6700	34	06067	38.713032	-121.3635555	Sacramento
190616	Fee-for-Service	1417242389	1417242389	1	1	TOCHIKURA, KEIKO MD	2/12/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	81118	08	Family Practice	0	In state provider	None	4323 W RIVERSIDE DRIVE	None	BURBANK	CA	91505	4044	19	06037	34.15223748	-118.347426	Los Angeles County
190646	Fee-for-Service	1922027077	1922027077	1	1	TALKOWSKI, THOMAS S MD	7/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86062	08	Family Practice	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
190695	Fee-for-Service	1891997078	1891997078	1	1	TRAN, HAO A MD	8/10/2010	207R00000X	NA	Other	026	PHYSICIANS	112846	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
190743	Fee-for-Service	1760668156	1760668156	1	1	TAHVILDARI, ALI M MD	7/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119698	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
190749	Fee-for-Service	1932334158	1932334158	1	1	THOM, DOUGLAS H MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124286	05	Anesthesiology	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
190810	Fee-for-Service	1902229685	1902229685	1	1	TIHIN, MELISSA L LMFT	5/2/2016	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 E SHAW AVE	STE 103	FRESNO	CA	93710	7706	10	06019	36.80886739	-119.7731624	Fresno County
190815	Fee-for-Service	1730619867	1730619867	1	1	TRUONG, HONG MATTA T OD	6/16/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8120 TIMBERLAKE WAY	STE 211	SACRAMENTO	CA	95823	5414	34	06067	38.461023	-121.41414	Sacramento County
190848	Fee-for-Service	1760435648	1760435648	1	1	TATINENY, ASHALATHA MD	11/19/2024	207P00000X	NA	Other	026	PHYSICIANS	-	70	Clinic (mixed specialty)	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
190889	Fee-for-Service	1962555789	1962555789	1	1	TRINH, MINDY D OD	1/25/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3257 S WHITE ROAD	None	SAN JOSE	CA	95148	4056	43	06085	37.314396	-121.794084	Santa Clara County
190924	Fee-for-Service	1124073663	1124073663	1	1	THOMPSON, ALONDRA L LCSW	2/2/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3356 ADELINE STREET	None	BERKELEY	CA	94703	2737	01	06001	37.84739513	-122.2721066	Alameda County
190927	Fee-for-Service	1932856382	1932856382	1	1	TOTAL SPINE INSTITUTE INC	1/17/2023	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4849 VAN NUYS BLVD	STE 203	SHERMAN OAKS	CA	91403	2122	19	06037	34.159113	-118.4487465	Los Angeles County
190931	Fee-for-Service	1578088324	1578088324	1	1	THURLOW, MARY K LMFT	6/8/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15336 DEVONSHIRE	UNIT 6	MISSION HILLS	CA	91345	3205	19	06037	34.25726849	-118.4664285	Los Angeles County
190950	Fee-for-Service	1629137344	1629137344	1	1	TUCKER, JUDY C OD	2/7/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1843 1/2 S LA CIENEGA BL	None	LOS ANGELES	CA	90035	4603	19	06037	34.04410366	-118.3768223	Los Angeles County
190954	Fee-for-Service	1366836397	1366836397	1	1	TOCCO, JESSICA L	3/4/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
190955	Fee-for-Service	1407250160	1407250160	1	1	THIELEN, HEATHER R	5/8/2015	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12139 MOUNT VERNON AVE	SUITE 110	GRAND TERRACE	CA	92313	5500	36	06071	34.033185	-117.313583	San Bernardino County
190984	Fee-for-Service	1891997078	1891997078	1	1	TRAN, HAO A MD	8/10/2010	207R00000X	NA	Other	026	PHYSICIANS	112846	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
191053	Fee-for-Service	1124156120	1124156120	1	1	TRI-COUNTY EYE INSTITUTE INC	7/21/1991	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	1124 S MAIN ST	STE 101	CORONA	CA	92882	4449	33	06065	33.86931623	-117.5673487	Riverside County
191081	Fee-for-Service	1104856152	1104856152	1	1	TAKEMOTO, RONALD K MD	3/8/2011	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	4490	25	Physical Medicine and Rehabilitation	0	In state provider	None	2840 LONG BEACH BLVD	STE 130	LONG BEACH	CA	90806	1593	19	06037	33.808743	-118.189341	Los Angeles County
191084	Fee-for-Service	1821445339	1821445339	1	1	THE SALVATION ARMY	11/2/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	3107 SOUTH GRAND AVENUE	None	LOS ANGELES	CA	90007	3816	19	06037	34.02221271	-118.2750172	Los Angeles County
191086	Fee-for-Service	1548436397	1548436397	1	1	TARSIN, ASAD M MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122026	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
191105	Fee-for-Service	1053371369	1053371369	1	1	TAMAYO, RAOUL I MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	5400 S RAINBOW BLVD	None	LAS VEGAS	NV	89118	1859	00	None	36.090072	-115.2405585	Clark County
191129	Fee-for-Service	1760435648	1760435648	1	1	TATINENY, ASHALATHA MD	11/19/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
191138	Fee-for-Service	1124040191	1124040191	1	1	THRIFTY PAYLESS INC	4/16/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6356	4100 LONE TREE WAY	None	ANTIOCH	CA	94531	6201	07	06013	37.9710851	-121.7955967	Contra Costa County
191182	Fee-for-Service	1346388626	1346388626	1	1	TERRY, CRYSTAL MD	3/28/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	2070 CLINTON AVE	None	ALAMEDA	CA	94501	4399	01	06001	37.76333626	-122.253868	Alameda County
191245	Fee-for-Service	1477809812	1477809812	1	1	TOTAL RENAL CARE INC	12/10/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1493 WEBSTER ST	None	SAN FRANCISCO	CA	94115	3705	38	06075	37.78408269	-122.4311967	San Francisco County
191261	Fee-for-Service	1649809385	1649809385	1	1	TZENG, WILLIAM MD	3/14/2024	207R00000X	NA	Other	026	PHYSICIANS	187692	None	None	0	In state provider	None	17170 COLIMA RD	G	HACIENDA HEIGHTS	CA	91745	6771	19	06037	33.9907128	-117.9325812	Los Angeles County
191264	Fee-for-Service	1558592782	1558592782	1	1	TIRSBECK, SHELLEY A LMFT	4/8/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2131 CAPITOL AVE	SUITE 206	SACRAMENTO	CA	95816	5755	34	06067	38.573073	-121.4788005	Sacramento County
191292	Fee-for-Service	1841541984	1841541984	1	1	THIESSEN, BRUCE L PHD	7/23/2021	103TC0700X	NA	Mental Health Outpatient Services	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
191308	Fee-for-Service	1891989612	1891989612	1	1	THAMES, APRIL D PHD	8/21/2012	No Taxonomy Provided	NA	None	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
191334	Fee-for-Service	1831552082	1831552082	1	1	TANG, AI-SHAN C MD	8/17/2020	207L00000X	NA	Other	026	PHYSICIANS	155783	05	Anesthesiology	0	In state provider	None	PUEBLO AT BATH STREETS	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
191341	Fee-for-Service	1124156120	1124156120	1	1	TRI-COUNTY EYE INSTITUTE INC	7/21/1991	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	1124 S MAIN ST	STE 101	CORONA	CA	92882	4449	33	06065	33.86931623	-117.5673487	Riverside County
191350	Fee-for-Service	1902414790	1902414790	1	1	TRAN, ALEXANDER H OD	1/25/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7910 FROST ST	None	SAN DIEGO	CA	92123	2771	37	06073	32.80027449	-117.153846	San Diego County
191352	Fee-for-Service	1205899812	1205899812	1	1	TONLEY, JASON C	4/14/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
191397	Fee-for-Service	1891892253	1891892253	1	1	THOMPSON, MICHELLE A MD	1/1/2000	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	62329	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
191444	Fee-for-Service	1992124978	1992124978	1	1	TRENKLE, GEOFFREY DO APC	10/5/2015	193400000X	NA	Other	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	None	1700 E CESAR E CHAVEZ AV	SUITE 2500	LOS ANGELES	CA	90033	2434	19	06037	34.05101259	-118.217259	Los Angeles County
191446	Fee-for-Service	1679637615	1679637615	1	1	THOMPSON, KRISTINE A	1/24/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
191452	Fee-for-Service	1396299814	1396299814	1	1	TOWN HOSPICE & PALLIATIVE	8/4/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE LLC	6465 SYCAMORE CANYON BLV	STE 150	RIVERSIDE	CA	92507	0705	33	06065	33.93351602	-117.2976013	Riverside County
191473	Fee-for-Service	1831441054	1831441054	1	1	TOTAL CARE PHYSICAL THERAPY	1/23/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	12139 MT VERNON AVE	STE 110	GRAND TERRACE	CA	92313	5500	36	06071	34.033185	-117.313583	San Bernardino County
191523	Fee-for-Service	1861580565	1861580565	1	1	TER, ROLAND B C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	STRAUB CLINIC & HOSPITAL	888 SOUTH KING ST	None	HONOLULU	HI	96813	0000	00	None	21.30218603	-157.8505732	Honolulu County
191549	Fee-for-Service	1093824518	1093824518	1	1	THRIFTY PAYLESS INC	10/4/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6338	2059 S GAREY AVE	None	POMONA	CA	91766	5727	19	06037	34.03401989	-117.7493786	Los Angeles County
191567	Fee-for-Service	1861588626	1861588626	1	1	TANAKA, DIANE MD	9/30/1994	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	73061	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	# 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
191575	Fee-for-Service	1760502280	1760502280	1	1	TANNER, KEVIN G LCSW	8/22/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	225 30TH ST	STE 306	SACRAMENTO	CA	95816	3359	34	06067	38.58102	-121.4628165	Sacramento County
191592	Fee-for-Service	1336629229	1336629229	1	1	TRIGO, MATINA LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	420 DOWNEY AVE	None	MODESTO	CA	95354	1301	50	06099	37.64547549	-120.987999	Stanislaus County
191614	Fee-for-Service	1033241773	1033241773	1	2	THE HOME CARE GROUP INC	3/9/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	20620 LEAPWOOD AVE	SUITE L	CARSON	CA	90746	3668	19	06037	33.8435724	-118.2588172	Los Angeles County
191615	Fee-for-Service	1679716252	1679716252	1	1	TAWFIK, VIVIANNE L MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113563	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
191628	Fee-for-Service	1568979417	1568979417	1	1	TJOA, REX F NP	1/23/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3828 SCHAUFELE AVE	STE 340	LONG BEACH	CA	90808	1793	19	06037	33.8283	-118.1479725	Los Angeles County
191633	Fee-for-Service	1124156120	1124156120	1	1	TRI-COUNTY EYE INSTITUTE INC	7/19/2019	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1124 S MAIN ST	STE 101	CORONA	CA	92882	4449	33	06065	33.86931623	-117.5673487	Riverside County
191636	Fee-for-Service	1386883494	1386883494	1	2	TRATHEN, ANGELA M LMFT	6/18/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	412 EAST MAIN STREET	SUITE D	GRASS VALLEY	CA	95945	6533	29	06057	39.2215704	-121.0543391	Nevada County
191666	Fee-for-Service	1083705628	1083705628	1	1	THOMAS, DAVID A MD	2/1/1994	207P00000X	NA	Other	026	PHYSICIANS	72902	66	Emergency Medicine (Urgent Care)	0	In state provider	None	17772 BEACH BLVD	None	HUNTINGTON BEACH	CA	92647	6819	30	06059	33.703677	-117.9865035	Orange County
191672	Fee-for-Service	1477658797	1477658797	2	1	THREE RIVERS PHARMACY INC	9/30/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	40893 SIERRA DRIVE	None	THREE RIVERS	CA	93271	0415	54	06107	36.42915129	-118.9126964	Tulare County
191699	Fee-for-Service	1306493051	1306493051	1	1	TAGLE, MAYRA AU	1/10/2025	106S00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
191722	Fee-for-Service	1972679496	1972679496	1	1	TORIBIO, GERARDO S	1/7/2019	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	74390	-	NOT APPLICABLE	0	In state provider	None	162 E CARSON ST	None	COLUSA	CA	95932	2866	06	06011	39.20587882	-122.0061518	Colusa County
191734	Fee-for-Service	1386890481	1386890481	1	1	TAMEEM S KAKA	1/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	929 JASONWAY AVE	None	COLUMBUS	OH	43214	2464	00	None	40.06233915	-83.04369682	Franklin County
191738	Fee-for-Service	1396299814	1396299814	1	1	TOWN HOSPICE & PALLIATIVE	8/4/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE LLC	6465 SYCAMORE CANYON BLV	STE 150	RIVERSIDE	CA	92507	0705	33	06065	33.93351602	-117.2976013	Riverside County
191796	Fee-for-Service	1811956618	1811956618	1	1	TIM, LESLIE S MD	2/28/1996	207R00000X	NA	Other	026	PHYSICIANS	57485	41	Internal Medicine	0	In state provider	None	350 30TH ST	STE 320	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
191801	Fee-for-Service	1578882569	1578882569	1	1	TUMBLIN, ASHAUNTA R MD	11/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116905	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
191804	Fee-for-Service	1598093304	1598093304	1	1	THUILLIER, DANIEL U MD	7/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108153	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
191873	Fee-for-Service	1619317450	1619317450	1	1	TRUONG, LOAN T MD	3/21/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	139072	08	Family Practice	0	In state provider	None	855 E ANAHEIM ST	None	LONG BEACH	CA	90813	3550	19	06037	33.78263447	-118.1827035	Los Angeles County
191893	Fee-for-Service	1912456971	1912456971	1	1	THE HOME HEALTH GROUP INC	4/19/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1110 N BRAND BLVD	STE 302	GLENDALE	CA	91202	2567	19	06037	34.161876	-118.255033	Los Angeles County
191968	Fee-for-Service	1306955729	1306955729	1	1	THRIFTY PAYLESS INC	7/3/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05679	12900 PALM DR	None	DESERT HOT SPRING	CA	92240	4567	33	06065	33.954687	-116.501281	Riverside County
191969	Fee-for-Service	1730290214	1730290214	1	1	TERESA CHAPMAN MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4800 SAND POINT WAY NE	None	SEATTLE	WA	98105	3901	00	None	47.662389	-122.281857	King County
191971	Fee-for-Service	1770646812	1770646812	1	1	TANAKA, THOMAS J DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	17400 IRVINE BLVD	STE H	TUSTIN	CA	92780	3030	30	06059	33.74814651	-117.828558	Orange County
192035	Fee-for-Service	1891965430	1891965430	1	1	TRINH, THUAN-HAU T MD	10/26/2010	207L00000X	NA	Other	026	PHYSICIANS	101195	05	Anesthesiology	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
192043	Fee-for-Service	1881762847	1881762847	1	1	TRAN, DE H MD	12/1/1995	207R00000X	NA	Other	026	PHYSICIANS	75664	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
192055	Fee-for-Service	1346894409	1346894409	1	1	TYLER DAVIS	3/17/2024	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1380 E MEDICAL CENTER DR	None	ST GEORGE	UT	84790	2123	00	None	37.097622	-113.553828	Washington County
192060	Fee-for-Service	1881610707	1881610707	1	1	TIEN HWANG, ANNETTE W MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	53259	40	Pediatrics	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
192087	Fee-for-Service	1417066838	1417066838	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05697	15510 MAIN ST	None	HESPERIA	CA	92345	3410	36	06071	34.42498219	-117.3245336	San Bernardino County
192111	Fee-for-Service	1396731436	1396731436	1	1	TANEN, DAVID MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	75158	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
192135	Fee-for-Service	1528889888	1528889888	1	1	TOLES, JOSEPH PT	12/11/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	16008 KAMANA RD.,	SUITE 200	APPLE VALLEY	CA	92307	0000	36	06071	34.54191149	-117.2725046	San Bernardino County
192205	Fee-for-Service	1841267689	1841267689	1	11	TERRIO PHYSICAL THERAPY - FI	9/26/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ESS, INC.	1430 HIGH ST	None	DELANO	CA	93215	1715	15	06029	35.77510842	-119.2483794	Kern County
192209	Fee-for-Service	1346532405	1346532405	1	2	TORNAI, CATHERINE A LMFT	6/2/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5871 PINE AVE	SUITE 230	CHINO HILLS	CA	91709	6545	36	06071	33.94767013	-117.6754339	San Bernardino County
192215	Fee-for-Service	1396347324	1396347324	1	1	TRUONG TRAN, CINDY C NP	1/5/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3300 E SOUTH ST	STE 308	LONG BEACH	CA	90805	4598	19	06037	33.86018093	-118.1537163	Los Angeles County
192217	Fee-for-Service	1447414727	1447414727	1	1	TOGASHI, KEI MD	3/18/2020	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
192236	Fee-for-Service	1669707840	1669707840	1	1	TODD, NATALIE M PHD	6/4/2014	No Taxonomy Provided	NA	None	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
192302	Fee-for-Service	1770806770	1770806770	1	1	TANG, NORA C	4/13/2015	No Taxonomy Provided	NA	None	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
192315	Fee-for-Service	1700383718	1700383718	1	1	THE WHOLE SOUL COUNSELING, A	2/5/2024	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	8005 SACRAMENTO ST	None	FAIR OAKS	CA	95628	7526	34	06067	38.643669	-121.2675435	Sacramento County
192325	Fee-for-Service	1134161854	1134161854	1	1	TRIVEDI, NAYANA M MD	4/1/2013	207R00000X	NA	Other	026	PHYSICIANS	43349	66	Emergency Medicine (Urgent Care)	0	In state provider	None	351 SANTA FE DR	STE 220	ENCINITAS	CA	92024	5137	37	06073	33.03617853	-117.2843775	San Diego County
192332	Fee-for-Service	1700195856	1700195856	1	1	TUN, MYA T MD	12/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124856	38	Geriatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
192347	Fee-for-Service	1063574150	1063574150	1	1	TRAN, DANIEL T MD	1/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	77436	01	General Practice	0	In state provider	None	4618 FOUNTAIN AVE	STE 102	LOS ANGELES	CA	90029	1963	19	06037	34.095582	-118.290195	Los Angeles County
192367	Fee-for-Service	1902088735	1902088735	1	1	THE ARC OF SAN DIEGO	1/7/1983	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2930 HELIX ST	None	SPRING VALLEY	CA	91977	2727	37	06073	32.73689454	-117.0001922	San Diego County
192397	Fee-for-Service	1215004361	1215004361	1	1	TRAN, TAN D MD	3/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75459	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
192443	Fee-for-Service	1952451015	1952451015	1	1	TAN, TIENG M OD INC	2/6/2007	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	220 W VALLEY BLVD	STE 202	SAN GABRIEL	CA	91776	3738	19	06037	34.07955214	-118.1028758	Los Angeles County
192465	Fee-for-Service	1134112626	1134112626	1	1	TOMAN, JEFFREY R MD	7/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	83995	None	None	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
192495	Fee-for-Service	1841267689	1841267689	1	11	TERRIO PHYSICAL THERAPY - FI	8/3/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ESS, INC.	1430 HIGH ST	None	DELANO	CA	93215	1715	15	06029	35.77510842	-119.2483794	Kern County
192528	Fee-for-Service	1467149195	1467149195	1	1	TOY, KELLY N	5/1/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
192590	Fee-for-Service	1295820835	1295820835	1	1	TWIN TOWN CORPORATION	7/17/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4281 KATELLA AVE.	117	LOS ALAMITOS	CA	90720	3565	30	06059	33.80315853	-118.058328	Orange County
192593	Fee-for-Service	1275683070	1275683070	1	1	TANNEBAUM, JESSE A MD	1/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	63018	40	Pediatrics	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
192604	Fee-for-Service	1700383718	1700383718	1	1	THE WHOLE SOUL COUNSELING, A	2/5/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8005 SACRAMENTO ST	None	FAIR OAKS	CA	95628	7526	34	06067	38.643669	-121.2675435	Sacramento County
192613	Fee-for-Service	1134161854	1134161854	1	1	TRIVEDI, NAYANA M MD	4/1/2013	207R00000X	NA	Other	026	PHYSICIANS	43349	41	Internal Medicine	0	In state provider	None	351 SANTA FE DR	STE 220	ENCINITAS	CA	92024	5137	37	06073	33.03617853	-117.2843775	San Diego County
192615	Fee-for-Service	1679009989	1679009989	1	1	TORNBERG, IAN M MD	8/1/2020	207P00000X	NA	Other	026	PHYSICIANS	169298	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1214	36	06071	34.131303	-117.3225325	San Bernardino County
192644	Fee-for-Service	1750579330	1750579330	1	1	TURNER, TRACI LCSW	3/27/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
192682	Fee-for-Service	1346493491	1346493491	1	1	TEICHEIRA, DAVID MD PC	11/13/2008	208VP0014X	NA	Other	026	PHYSICIANS	60747	05	Anesthesiology	0	In state provider	None	83 SCRIPPS DR	STE 310	SACRAMENTO	CA	95825	6383	34	06067	38.572488	-121.4097975	Sacramento County
192686	Fee-for-Service	1215004361	1215004361	1	1	TRAN, TAN D MD	3/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75459	38	Geriatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
192696	Fee-for-Service	1639214711	1639214711	1	1	TUCKER, NANCI D MD	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74461	40	Pediatrics	0	In state provider	None	595 BUCKINGHAM WAY	STE 515	SAN FRANCISCO	CA	94132	1913	38	06075	37.73012679	-122.4767395	San Francisco County
192732	Fee-for-Service	1144282351	1144282351	1	1	TEST, VICTOR J MD	12/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73492	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
192738	Fee-for-Service	1952558561	1952558561	1	1	THAWAIT, SHREY MD	3/28/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175611	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
192789	Fee-for-Service	1023637410	1023637410	1	1	TAN, ELLIE R MD	9/1/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180706	None	None	0	In state provider	None	555 TACHEVAH DR	SUITE 2E-107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
192803	Fee-for-Service	1942319306	1942319306	1	1	THRIFTY PAYLESS INC	4/20/2000	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5869	3795 W SHIELDS AVE	None	FRESNO	CA	93722	5247	10	06019	36.77901131	-119.8617042	Fresno County
192827	Fee-for-Service	1598233306	1598233306	1	1	TORRES, NINA B CNM	8/19/2019	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1353 OLD TEMESCAL ROAD	None	CORONA	CA	92881	7262	33	06065	33.85386752	-117.537732	Riverside County
192839	Fee-for-Service	1992209134	1992209134	1	1	TOM, WESTIN R MD	6/8/2022	207L00000X	NA	Other	026	PHYSICIANS	166502	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
192851	Fee-for-Service	1629194170	1629194170	1	1	TEICHER, STACEY L NP	2/22/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
192886	Fee-for-Service	1407210875	1407210875	1	1	TURNER, ANDIA MD	1/20/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	153995	36	Psychiatry	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
192927	Fee-for-Service	1255427050	1255427050	1	1	TOMPKINS, GEOFFREY S.	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	76351	20	Orthopedic Surgery	0	In state provider	None	990 SONOMA AVE	STE 8	SANTA ROSA	CA	95404	4813	49	06097	38.439729	-122.701545	Sonoma County
192968	Fee-for-Service	1346493491	1346493491	1	1	TEICHEIRA, DAVID MD PC	11/13/2008	208VP0014X	NA	Other	026	PHYSICIANS	60747	41	Internal Medicine	0	In state provider	None	83 SCRIPPS DR	STE 310	SACRAMENTO	CA	95825	6383	34	06067	38.572488	-121.4097975	Sacramento County
193021	Fee-for-Service	1447280318	1447280318	1	1	THOMPSON, MATTHEW D MD	1/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	842 E MAIN STREET	None	MEDFORD	OR	95704	7155	00	None	42.32787853	-122.863311	Jackson County
193039	Fee-for-Service	1376756833	1376756833	1	1	TOBALINA, GINA MD	9/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93320	08	Family Practice	0	In state provider	None	8170 LAGUNA BLVD	STE 304	ELK GROVE	CA	95758	7903	34	06067	38.421054	-121.405365	Sacramento County
193066	Fee-for-Service	1710537139	1710537139	1	1	TONG, JANICE KIT YING LMFT	2/24/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	905 MAPLE ST	None	REDWOOD CITY	CA	94063	0000	41	06081	37.48767797	-122.223049	San Mateo County
193129	Fee-for-Service	1265510341	1265510341	1	1	TUCKER, DALE C MD	7/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	46377	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
193133	Fee-for-Service	1427167881	1427167881	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05441	9864 NATIONAL BLVD	None	LOS ANGELES	CA	90034	2713	19	06037	34.0311756	-118.4011213	Los Angeles County
193141	Fee-for-Service	1639387954	1639387954	1	1	TUCKER, BETHANY J MD	4/8/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	73695	36	Psychiatry	0	In state provider	None	30423 CANWOOD ST	SUITE 138	AGOURA HILLS	CA	91301	4315	19	06037	34.14710182	-118.7842501	Los Angeles County
193193	Fee-for-Service	1710058987	1710058987	1	1	TEOPHILOV, NICKOLAY T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55038	01	General Practice	0	In state provider	None	222 W EULALIA ST	STE 301	GLENDALE	CA	91204	2851	19	06037	34.12653215	-118.257121	Los Angeles County
193248	Fee-for-Service	1083818116	1083818116	1	1	TAITANO, MARIA T MD	7/8/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55303	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
193251	Fee-for-Service	1780948125	1780948125	1	1	TAN, GISELLE D R	2/26/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
193261	Fee-for-Service	1194965608	1194965608	1	1	TENOFSKY, MICHAEL A MD	4/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	100329	41	Internal Medicine	0	In state provider	None	1245 WILSHIRE BLVD	STE 407	LOS ANGELES	CA	90017	4804	19	06037	34.05362775	-118.2661889	Los Angeles County
193292	Fee-for-Service	1023079118	1023079118	1	1	THUKRAL, MAMTA MD	4/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89962	05	Anesthesiology	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
193297	Fee-for-Service	1952656084	1952656084	1	1	TRAN, CHAU M DO	2/26/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	16808	40	Pediatrics	0	In state provider	None	15785 LAGUNA CANYON RD	SUITE 120	IRVINE	CA	92618	3165	30	06059	33.66542536	-117.7615537	Orange County
193299	Fee-for-Service	1558599050	1558599050	1	1	TRANCHELL, NATHAN L DO	9/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	9300 W SUNSET ROAD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
193315	Fee-for-Service	1588284251	1588284251	1	1	TAKANG, KEMERICK NP	3/17/2021	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	5493 STONEVIEW RD	None	RANCHO CUCAMONGA	CA	91739	8933	36	06071	34.15424712	-117.5318491	San Bernardino County
193337	Fee-for-Service	1841556099	1841556099	1	1	TREJO, BROCK T MD	2/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	1905 MAIN ST	None	KLAMATH FALLS	OR	97601	2638	00	None	42.22838442	-121.7691707	Klamath County
193341	Fee-for-Service	1508327446	1508327446	1	1	THOUSAND OAKS POST ACUTE LLC	5/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	93 W AVENIDA DE LOS ARBO	None	THOUSAND OAKS	CA	91360	2939	56	06111	34.21853234	-118.8774826	Ventura County
193379	Fee-for-Service	1164471884	1164471884	1	1	THOMAS OLIVER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2901 SQUALICUM PKWY	None	BELLINGHAM	WA	98225	1851	00	None	48.77211992	-122.473101	Whatcom County
193460	Fee-for-Service	1659508455	1659508455	1	1	TRINH, TAN N MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143641	05	Anesthesiology	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4378	43	06085	37.36893518	-122.0779448	Santa Clara County
193482	Fee-for-Service	1255667770	1255667770	1	1	THOMAS, HEATHER E LMFT	3/29/2019	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
193504	Fee-for-Service	1548385867	1548385867	1	1	TASHMAN, DAVID A MD	8/1/1995	207P00000X	NA	Other	026	PHYSICIANS	55499	41	Internal Medicine	0	In state provider	None	17821 PIONEER BLVD	None	ARTESIA	CA	90701	3901	19	06037	33.8691791	-118.0823685	Los Angeles County
193524	Fee-for-Service	1154783009	1154783009	1	1	TONDRE, JULIANNE M MD	9/29/2019	207R00000X	NA	Other	026	PHYSICIANS	153522	41	Internal Medicine	0	In state provider	None	1020 29TH ST	STE 120	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
193526	Fee-for-Service	1205906229	1205906229	1	14	THE NEPHROLOGY GROUP, INC.	6/9/2020	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	432 LEXINGTON ST	STE. A	DELANO	CA	93215	3697	15	06029	35.762706	-119.2407725	Kern County
193532	Fee-for-Service	1760622104	1760622104	1	1	THRIFTY PAYLESS INC.	5/14/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06547	10570 TWIN CITIES RD	None	GALT	CA	95632	8874	34	06067	38.290653	-121.2985755	Sacramento County
193534	Fee-for-Service	1083818116	1083818116	1	1	TAITANO, MARIA T MD	7/8/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55303	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
193549	Fee-for-Service	1194965608	1194965608	1	1	TENOFSKY, MICHAEL A MD	4/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	100329	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1245 WILSHIRE BLVD	STE 407	LOS ANGELES	CA	90017	4804	19	06037	34.05362775	-118.2661889	Los Angeles County
193597	Fee-for-Service	1023009693	1023009693	1	1	TON, LIEU T OD	6/1/1996	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	358 N LEMON AVE	None	WALNUT	CA	91789	2345	19	06037	34.01951358	-117.865383	Los Angeles County
193604	Fee-for-Service	1588284251	1588284251	1	1	TAKANG, KEMERICK NP	3/17/2021	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	5493 STONEVIEW RD	None	RANCHO CUCAMONGA	CA	91739	8933	36	06071	34.15424712	-117.5318491	San Bernardino County
193612	Fee-for-Service	1801802103	1801802103	1	1	THRIFTY DRUG STORE 5613	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	4348 BONITA RD	None	BONITA	CA	91902	1421	37	06073	32.66058914	-117.0333927	San Diego County
193631	Fee-for-Service	1700608122	1700608122	1	1	TALARO, EVANGELINA A	1/3/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1317 OAKDALE ROAD	SUITE 100	MODESTO	CA	95355	3362	50	06099	37.662489	-120.957588	Stanislaus County
193698	Fee-for-Service	1811140486	1811140486	1	1	THOMAS, TERRI M LMFT	1/12/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46018	-	NOT APPLICABLE	0	In state provider	None	3707 E SHIELDS AVE	None	FRESNO	CA	93726	7029	10	06019	36.77969052	-119.7632025	Fresno County
193700	Fee-for-Service	1124648183	1124648183	1	1	TOPETE, ISIS M OD	9/3/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
193774	Fee-for-Service	1649251158	1649251158	1	1	TINT, DAISY M MD	3/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	41437	08	Family Practice	0	In state provider	None	2445 MCCABE WAY	None	IRVINE	CA	92614	4293	30	06059	33.67952503	-117.8479012	Orange County
193795	Fee-for-Service	1548385867	1548385867	1	1	TASHMAN, DAVID A MD	8/1/1995	207P00000X	NA	Other	026	PHYSICIANS	55499	66	Emergency Medicine (Urgent Care)	0	In state provider	None	17821 PIONEER BLVD	None	ARTESIA	CA	90701	3901	19	06037	33.8691791	-118.0823685	Los Angeles County
193812	Fee-for-Service	1477867869	1477867869	1	1	TIMILSINA, SURAJ MD	8/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	127568	83	Rheumatology	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
193854	Fee-for-Service	1386678340	1386678340	1	1	TOGETHER WE GROW	1/1/2002	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2120 THIBODO RD	None	VISTA	CA	92081	7901	37	06073	33.16745345	-117.2180381	San Diego County
193893	Fee-for-Service	1588284251	1588284251	1	2	TAKANG, KEMERICK NP	8/23/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5493 STONEVIEW RD	None	RANCHO CUCAMONGA	CA	91739	8933	36	06071	34.15424712	-117.5318491	San Bernardino County
193894	Fee-for-Service	1376523134	1376523134	1	1	TODD, NINA S DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	RICHMOND DIST POD GRP	1511 CLEMENT ST	None	SAN FRANCISCO	CA	94118	1031	38	06075	37.7823969	-122.475506	San Francisco County
193939	Fee-for-Service	1306126974	1306126974	1	1	TOMBALL TEXAS HOSPITAL	3/14/2016	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COMPANY LLC	605 HOLDERRIETH BLVD	None	DALLAS	TX	77375	6445	00	None	30.08796297	-95.62422168	Harris County
193954	Fee-for-Service	1093225419	1093225419	1	1	TAN, VANESSA LMFT	11/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4645 NORTH AVE	None	SAN DIEGO	CA	92116	2621	37	06073	32.76184735	-117.1475046	San Diego County
193982	Fee-for-Service	1528201514	1528201514	1	1	THOMAS L ASHCOM MD PHD PA	5/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9350 E 35TH ST N	STE 101	WICHITA	KS	67226	2022	00	None	37.74931103	-97.2293063	Sedgwick County
194014	Fee-for-Service	1699746396	1699746396	1	1	THE KIDNEY CENTER OF	7/24/1996	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	NORTH VALLEY INC	16907 DEVONSHIRE ST	None	GRANADA HILLS	CA	91344	7407	19	06037	34.25754015	-118.5004161	Los Angeles County
194021	Fee-for-Service	1669538187	1669538187	1	1	THRELFALL, ALEXANDER W MD	11/6/2020	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	113086	-	NOT APPLICABLE	0	In state provider	None	1400 EMELINE AVENUE	BUILDING K	SANTA CRUZ	CA	95060	1976	44	06087	36.99276804	-122.0178271	Santa Cruz County
194026	Fee-for-Service	1366678484	1366678484	1	1	TANG, NAI Y MD	3/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110803	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
194052	Fee-for-Service	1518381045	1518381045	1	1	TA HOPKINS, TRANG T. OD	7/22/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4029 43RD STREET	SUITE 300	SAN DIEGO	CA	92105	8537	37	06073	32.75012697	-117.1019424	San Diego County
194059	Fee-for-Service	1285772566	1285772566	1	1	THOMAS, JAMES J MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	29943	66	Emergency Medicine (Urgent Care)	0	In state provider	None	PUEBLO AT BATH	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
194077	Fee-for-Service	1215358924	1215358924	1	1	THE DAVIS STREET COMMUNITY	8/1/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER INCORPORATED	3081 TEAGARDEN STREET	None	SAN LEANDRO	CA	94577	5720	01	06001	37.70519163	-122.1536391	Alameda County
194078	Fee-for-Service	1316014426	1316014426	1	1	THOMPSON, PATRICIA A NP	10/19/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
194149	Fee-for-Service	1457105256	1457105256	1	1	TSOY, OLGA NP	8/6/2024	363LP0808X	NA	Nurse Practitioner	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	P	13323 W WASHINGTON BLVD	STE 202	LOS ANGELES	CA	90066	5163	19	06037	33.99291637	-118.4429405	Los Angeles County
194170	Fee-for-Service	1841615606	1841615606	1	1	TOMA, MARISSA D MD	9/28/2018	2086S0129X	NA	General Surgery	026	PHYSICIANS	154805	70	Clinic (mixed specialty)	0	In state provider	None	1320 EL CAPITAN DR	120	DANVILLE	CA	94526	6260	07	06013	37.78476866	-121.9658691	Contra Costa County
194181	Fee-for-Service	1154999209	1154999209	2	1	TARZANA TREATMENT CENTERS, I	5/17/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC.	5178 ATLANTIC AVE	None	LONG BEACH	CA	90805	6510	19	06037	33.850449	-118.1848215	Los Angeles County
194195	Fee-for-Service	1447232731	1447232731	1	1	TRAMO, MARK J MD	11/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	88591	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
194207	Fee-for-Service	1679307797	1679307797	1	1	TELLEZ RODRIGUEZ, RAUL NP	10/24/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	451 E ALMOND AVE	STE 103	MADERA	CA	93637	5562	20	06039	36.94554615	-120.0523936	Madera County
194221	Fee-for-Service	1306126974	1306126974	1	1	TOMBALL TEXAS HOSPITAL	3/14/2016	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COMPANY LLC	605 HOLDERRIETH BLVD	None	DALLAS	TX	77375	6445	00	None	30.08796297	-95.62422168	Harris County
194228	Fee-for-Service	1962665786	1962665786	1	1	TRAN, DIANE D MD	7/1/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	135647	None	None	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
194238	Fee-for-Service	1477642585	1477642585	1	1	TRAN, THAO H MD	1/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80749	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
194253	Fee-for-Service	1225296429	1225296429	1	1	TIMOTHY A VANHOOSE	3/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1120 KANAWHA BLVD E	None	CHARLESTON	WV	25301	2400	00	None	38.34470937	-81.63296112	Kanawha County
194276	Fee-for-Service	1891790630	1891790630	1	1	TEAFORD, SUSAN H MD	9/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	79922	40	Pediatrics	0	In state provider	ARROYO GRANDE PEDIATRIC	138 W BRANCH ST	STE A	ARROYO GRANDE	CA	93420	3310	40	06079	35.122941	-120.58074	San Luis Obispo County
194310	Fee-for-Service	1366678484	1366678484	1	1	TANG, NAI Y MD	3/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110803	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
194352	Fee-for-Service	1710096342	1710096342	1	1	TAYLOR, NANCY J MFT	3/18/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	45605	-	NOT APPLICABLE	0	In state provider	None	12183 LOCKSLEY LANE	None	AUBURN	CA	95602	2050	31	06061	38.9503293	-121.0966898	Placer County
194366	Fee-for-Service	1215358924	1215358924	1	1	THE DAVIS STREET COMMUNITY	8/1/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER INCORPORATED	3081 TEAGARDEN STREET	None	SAN LEANDRO	CA	94577	5720	01	06001	37.70519163	-122.1536391	Alameda County
194393	Fee-for-Service	1225086283	1225086283	1	1	TERRAULT, NORAH A MD	12/31/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	60147	10	Gastroenterology (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
194400	Fee-for-Service	1629119920	1629119920	1	1	TE, SEANGLONG MD	5/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106386	None	None	0	In state provider	None	420 WEST ROWLAND STREET	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
194424	Fee-for-Service	1164860458	1164860458	1	1	TAKHER, ELLEN S MD	10/13/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	167681	None	None	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
194505	Fee-for-Service	1619052933	1619052933	1	1	TRAN, KHAI VU MD	12/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84412	41	Internal Medicine	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
194516	Fee-for-Service	1619111564	1619111564	1	1	TOY, ANDREW W MD	2/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123020	25	Physical Medicine and Rehabilitation	0	In state provider	None	1635 DIVISADERO STREET	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
194569	Fee-for-Service	1225284359	1225284359	1	1	THEETHIRA, THIMMAIAH G MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135528	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LN	SUITE 450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
194581	Fee-for-Service	1992905723	1992905723	1	2	TAYLOR, BRIAN S MD	6/26/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	75540	-	NOT APPLICABLE	0	In state provider	None	1911 WILLIAMS DRIVE	None	OXNARD	CA	93036	2612	56	06111	34.219566	-119.1539365	Ventura County
194652	Fee-for-Service	1215358924	1215358924	1	1	THE DAVIS STREET COMMUNITY	4/7/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER INCORPORATED	3081 TEAGARDEN STREET	None	SAN LEANDRO	CA	94577	5720	01	06001	37.70519163	-122.1536391	Alameda County
194661	Fee-for-Service	1649203175	1649203175	1	1	TOLLEY, DOUGLAS G JR MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	22256	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1007 LIVE OAK BLVD	STE B2	YUBA CITY	CA	95991	3454	51	06101	39.14368281	-121.6207923	Sutter County
194686	Fee-for-Service	1598979593	1598979593	1	1	THANGARAJAH, HARIHARAN	3/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94137	02	General Surgery	0	In state provider	MD	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
194742	Fee-for-Service	1578632980	1578632980	1	1	TUAN, BERTRAND Y MD	2/2/1994	174400000X	NA	Other	026	PHYSICIANS	78339	68	Hematology	0	In state provider	None	2100 WEBSTER ST	STE 225	SAN FRANCISCO	CA	94115	2376	38	06075	37.7904826	-122.4324477	San Francisco County
194764	Fee-for-Service	1548371354	1548371354	1	1	TSAI, KATHERINE M MD	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80446	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
194795	Fee-for-Service	1144036286	1144036286	1	1	TWISTED ROOTS MARRIAGE AND F	2/23/2025	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	AMILY THERAPY CORPORAT	1280 S VICTORIA AVE	SUITE 130	VENTURA	CA	93003	6550	56	06111	34.26344767	-119.2119344	Ventura County
194796	Fee-for-Service	1477977114	1477977114	1	1	TALWAR, NEEL MD	6/9/2020	207RX0202X	NA	Oncology	026	PHYSICIANS	168727	41	Internal Medicine	0	In state provider	None	1100 SAN BERNARDINO RD	1100	UPLAND	CA	91786	4923	36	06071	34.10129201	-117.636283	San Bernardino County
194802	Fee-for-Service	1295266484	1295266484	1	1	TREKI, YOUSEF MD	1/16/2025	208M00000X	NA	Other	026	PHYSICIANS	175504	41	Internal Medicine	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
194858	Fee-for-Service	1952613606	1952613606	1	1	TRAN, THUY THI XUAN DO	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12822	41	Internal Medicine	0	In state provider	None	3687 MT DIABLO BLVD	#200	LAFAYETTE	CA	94549	3746	07	06013	37.8898926	-122.1304235	Contra Costa County
194903	Fee-for-Service	1457575722	1457575722	1	1	TANG, PAIGE OD	9/11/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	701 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.3345743	-121.9954769	Santa Clara County
194906	Fee-for-Service	1275643942	1275643942	1	1	THRIFTY PAYLESS INC	9/20/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5734	2300 HARBOR BLVD	STE G	COSTA MESA	CA	92626	6200	30	06059	33.656967	-117.9190235	Orange County
194941	Fee-for-Service	1215358924	1215358924	1	1	THE DAVIS STREET COMMUNITY	6/15/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CENTER INCORPORATED	3081 TEAGARDEN STREET	None	SAN LEANDRO	CA	94577	5720	01	06001	37.70519163	-122.1536391	Alameda County
194972	Fee-for-Service	1598979593	1598979593	1	1	THANGARAJAH, HARIHARAN	3/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94137	85	Surgery-Pediatric	0	In state provider	MD	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
195031	Fee-for-Service	1578632980	1578632980	1	1	TUAN, BERTRAND Y MD	2/2/1994	174400000X	NA	Other	026	PHYSICIANS	78339	78	Neoplastic Diseases/Oncology	0	In state provider	None	2100 WEBSTER ST	STE 225	SAN FRANCISCO	CA	94115	2376	38	06075	37.7904826	-122.4324477	San Francisco County
195085	Fee-for-Service	1386822641	1386822641	1	1	TOKUHARA, KEITH G MD	7/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97863	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
195106	Fee-for-Service	1689625618	1689625618	1	1	TAPE, THOMAS D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
195126	Fee-for-Service	1013494921	1013494921	2	1	TOWER PHARMACY	6/14/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	501 E OLIVE AVE	None	TURLOCK	CA	95380	4012	50	06099	37.49764561	-120.8438573	Stanislaus County
195170	Fee-for-Service	1164963666	1164963666	1	1	THE ALDER CORPORATION	3/27/2017	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	24300 EL TORO ROAD	None	LAGUNA WOODS	CA	92637	2737	30	06059	33.60891487	-117.7335187	Orange County
195182	Fee-for-Service	1841274198	1841274198	1	1	TROPPMANN, CHRISTOPH MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	50366	02	General Surgery	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
195257	Fee-for-Service	1598781635	1598781635	1	1	TENET SOUTH FULTON INC	11/21/2005	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1170 CLEVELAND AVE	None	EAST POINT	GA	30344	3615	00	None	33.68127228	-84.42742435	Fulton County
195269	Fee-for-Service	1225095730	1225095730	1	1	TEMPERO, MARGARET A MD	8/31/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85868	78	Neoplastic Diseases/Oncology	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
195329	Fee-for-Service	1841258050	1841258050	1	1	TERKELTAUB, ROBERT MD	1/31/1984	207RR0500X	NA	Other	026	PHYSICIANS	47014	83	Rheumatology	0	In state provider	None	225 DICKINSON ST	# H201	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
195359	Fee-for-Service	1881985182	1881985182	1	1	THOMAS P KENNEDY M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 BROADWAY N	None	FARGO	ND	58102	3641	00	None	46.885068	-96.7872375	Cass County
195363	Fee-for-Service	1659505493	1659505493	1	1	TERRY, ERINN M LAC	10/25/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	800 SERENO DR	None	VALLEJO	CA	94589	2411	48	06095	38.12792924	-122.2506587	Solano County
195392	Fee-for-Service	1992073415	1992073415	1	1	TRINH, VAN D MD	5/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113456	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
195398	Fee-for-Service	1619944360	1619944360	1	1	TOSCANO, JOSEPH DANIEL	7/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	48734	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
195534	Fee-for-Service	1679129407	1679129407	1	1	TRINH, COURTNEY J CCC-SLP	10/28/2024	390200000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 S INDIAN HILL BLVD S	None	CLAREMONT	CA	91711	5461	19	06037	34.084494	-117.7191945	Los Angeles County
195546	Fee-for-Service	1598781635	1598781635	1	1	TENET SOUTH FULTON INC	11/21/2005	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1170 CLEVELAND AVE	None	EAST POINT	GA	30344	3615	00	None	33.68127228	-84.42742435	Fulton County
195556	Fee-for-Service	1225095730	1225095730	1	1	TEMPERO, MARGARET A MD	8/31/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85868	68	Hematology	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
195587	Fee-for-Service	1548255698	1548255698	1	1	TAMMAN, RICHARD J MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	73580	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
195599	Fee-for-Service	1477789162	1477789162	1	1	THWIN, MIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1003 WILLOW CREEK RD	None	PRESCOTT	AZ	86301	1641	00	None	34.558992	-112.481901	Yavapai County
195619	Fee-for-Service	1104917780	1104917780	1	1	THE HEALTH CARE AUTHORITY	1/13/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FOR BAPTIST HEALTH	400 TAYLOR ROAD	None	MONTGOMERY	AL	36117	3512	00	None	32.376087	-86.1748695	Montgomery County
195772	Fee-for-Service	1457433633	1457433633	1	1	TRAKTMAN, ALICIA R	10/17/2002	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 THE CITY DRIVE	PAVILLION II	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
195811	Fee-for-Service	1891862736	1891862736	1	1	TOVAR, DIANA L MD	11/30/1993	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	74072	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
195825	Fee-for-Service	1619466448	1619466448	1	1	TRINH, KRISTINA N DO	11/19/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	19005	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
195889	Fee-for-Service	1538278064	1538278064	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5779	11496 N VENTURA AVE	None	OJAI	CA	93023	4195	56	06111	34.42532114	-119.2889784	Ventura County
195898	Fee-for-Service	1124197736	1124197736	1	1	TARVER, STEVE M PHD	2/17/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8939 S SEPULVEDA BLVD	SUITE #200	LOS ANGELES	CA	90045	3631	19	06037	33.95485856	-118.3962461	Los Angeles County
195909	Fee-for-Service	1104917780	1104917780	1	1	THE HEALTH CARE AUTHORITY	1/13/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FOR BAPTIST HEALTH	400 TAYLOR ROAD	None	MONTGOMERY	AL	36117	3512	00	None	32.376087	-86.1748695	Montgomery County
195923	Fee-for-Service	1942369574	1942369574	1	1	TRUONG, HIEN T MD	9/30/1995	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	77808	77	Infectious Disease	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
195925	Fee-for-Service	1528201266	1528201266	1	1	TSENG, PHILIP H MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115141	13	Neurology (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
195951	Fee-for-Service	1396121711	1396121711	1	1	TORRES, VICTORIA LCSW	5/30/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1335 N WATERMAN AVENUE	None	SAN BERNARDINO	CA	92404	5385	36	06071	34.124274	-117.2787625	San Bernardino County
195962	Fee-for-Service	1366520884	1366520884	1	2	TRANSITIONAL HOSPITALS CORPO	6/30/2021	282E00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	1	Border provider	(SAHARA CAMPUS)	5110 W SAHARA AVE	None	LAS VEGAS	NV	89146	3406	00	None	36.14458087	-115.2117863	Clark County
195963	Fee-for-Service	1174672356	1174672356	1	1	THOMAS,JAMES E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1000 HWY 35 N	STE 5	BENTON	AR	72819	0000	00	None	34.57348492	-92.59175534	Saline County
196069	Fee-for-Service	1407997737	1407997737	1	1	TIRUVILUAMALA, PARVATHI	5/23/2006	193400000X	NA	Other	026	PHYSICIANS	79302	29	Pulmonary Diseases (M.D. only)	0	In state provider	MD APC	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
196106	Fee-for-Service	1609345743	1609345743	1	1	THE TEEN PROJECT, INC	6/1/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	20301 FLANAGAN ROAD	20331 & 20371	TRABUCO CANYON	CA	92679	0975	30	06059	33.66754509	-117.5843188	Orange County
196124	Fee-for-Service	1942293394	1942293394	1	1	TIMPLE, FELURYNE NP	5/25/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
196200	Fee-for-Service	1881637791	1881637791	1	1	TRIGEIRO, CHRISTINE L PHD	11/6/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8775 AERO DRIVE	STE 238	SAN DIEGO	CA	92123	1756	37	06073	32.80965551	-117.1391563	San Diego County
196212	Fee-for-Service	1942369574	1942369574	1	1	TRUONG, HIEN T MD	9/30/1995	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	77808	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
196249	Fee-for-Service	1366520884	1366520884	1	2	TRANSITIONAL HOSPITALS CORPO	6/30/2021	282E00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	1	Border provider	(SAHARA CAMPUS)	5110 W SAHARA AVE	None	LAS VEGAS	NV	89146	3406	00	None	36.14458087	-115.2117863	Clark County
196261	Fee-for-Service	1588773949	1588773949	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05847	811 TUCKER RD	None	TEHACHAPI	CA	93561	2510	15	06029	35.12367	-118.4678195	Kern County
196306	Fee-for-Service	1881772796	1881772796	1	1	TRUONG, THUHONG T MD	11/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	88296	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
196337	Fee-for-Service	1013587286	1013587286	1	1	THOMAS, SHANE	1/7/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
196347	Fee-for-Service	1376646778	1376646778	1	1	TRAN, LONG D OD	9/30/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3971 IRVINE BLVD	SUITE 110	IRVINE	CA	92602	2483	30	06059	33.72261953	-117.7725183	Orange County
196352	Fee-for-Service	1518948678	1518948678	1	1	TAM, HELEN B MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	72782	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1111 E STANLEY BLVD	None	LIVERMORE	CA	94550	4115	01	06001	37.67881307	-121.7823992	Alameda County
196358	Fee-for-Service	1407997737	1407997737	1	1	TIRUVILUAMALA, PARVATHI	5/23/2006	193400000X	NA	Other	026	PHYSICIANS	79302	66	Emergency Medicine (Urgent Care)	0	In state provider	MD APC	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
196362	Fee-for-Service	1871912493	1871912493	1	1	TULLY, JEFFREY MD	5/28/2020	207L00000X	NA	Other	026	PHYSICIANS	147704	40	Pediatrics	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
196371	Fee-for-Service	1578627337	1578627337	1	1	TAUBMAN, MARTIN R DPM	4/24/2007	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3330 3RD AVE	STE 402	SAN DIEGO	CA	92103	5639	37	06073	32.74053588	-117.1622264	San Diego County
196421	Fee-for-Service	1336810860	1336810860	1	1	TOY, JAIME A PT	1/7/2022	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
196452	Fee-for-Service	1801597968	1801597968	1	1	THE SPRINGS HEALTHCARE	4/1/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER AT THE CARLOTTA	41505 CARLOTTA DR	None	PALM DESERT	CA	92211	3279	33	06065	33.745986	-116.344298	Riverside County
196458	Fee-for-Service	1023391166	1023391166	1	1	TARIQ, SOHAIB MD	1/1/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	148260	None	None	0	In state provider	None	1590 S IMPERIAL AVE	None	EL CENTRO	CA	92243	4241	13	06025	32.77950118	-115.5697279	Imperial County
196464	Fee-for-Service	1407206055	1407206055	1	1	TOWNSEND, DAHLIA N MD	10/27/2023	207L00000X	NA	Other	026	PHYSICIANS	188488	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
196474	Fee-for-Service	1265595870	1265595870	1	1	TOWNER-CARO, KARIN D LMFT	10/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2505 VALHALLA PL	STE 100	CHICO	CA	95973	8276	04	06007	39.761604	-121.8180955	Butte County
196483	Fee-for-Service	1366459679	1366459679	1	1	THORUP, STEVEN J MD	8/26/1993	207L00000X	NA	Other	026	PHYSICIANS	75791	05	Anesthesiology	0	In state provider	None	2540 EAST ST	None	CONCORD	CA	94520	1906	07	06013	37.98292379	-122.0341876	Contra Costa County
196510	Fee-for-Service	1770642415	1770642415	1	1	TRELATSKY, MELISSA CRNA	7/12/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
196523	Fee-for-Service	1649591454	1649591454	1	1	TRAN, MICHAEL N MD	7/25/2017	208600000X	NA	General Surgery	026	PHYSICIANS	148475	02	General Surgery	0	In state provider	None	101 CITY DR S	# B10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
196575	Fee-for-Service	1861112765	1861112765	1	1	TERRELL, ALYSHA PT	1/30/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
196577	Fee-for-Service	1982364766	1982364766	1	1	TUFFOUR, OHENEBA K	9/15/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	319 BELFONT CIRCLE	None	SACRAMENTO	CA	95835	1530	34	06067	38.675529	-121.51548	Sacramento County
196601	Fee-for-Service	1972090280	1972090280	1	1	TATE, STEVEN D MD	4/22/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	173657	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
196612	Fee-for-Service	1508065145	1508065145	1	1	TAECHARVONGPHAIROJ, VEERAVAT	4/8/2021	208M00000X	NA	Other	026	PHYSICIANS	115763	None	None	0	In state provider	MD	1525 W FLORIDA AVE	STE D	HEMET	CA	92543	3869	33	06065	33.7473507	-116.9878543	Riverside County
196627	Fee-for-Service	1689640211	1689640211	1	1	TEUTEBERG, WINIFRED G MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148438	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
196640	Fee-for-Service	1518948678	1518948678	1	1	TAM, HELEN B MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	72782	05	Anesthesiology	0	In state provider	None	1111 E STANLEY BLVD	None	LIVERMORE	CA	94550	4115	01	06001	37.67881307	-121.7823992	Alameda County
196646	Fee-for-Service	1407997737	1407997737	1	1	TIRUVILUAMALA, PARVATHI	5/23/2006	193400000X	NA	Other	026	PHYSICIANS	79302	41	Internal Medicine	0	In state provider	MD APC	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
196648	Fee-for-Service	1871912493	1871912493	1	1	TULLY, JEFFREY MD	5/28/2020	207L00000X	NA	Other	026	PHYSICIANS	147704	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
196652	Fee-for-Service	1205809357	1205809357	1	1	TYSON DARWIN HALE, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4402	00	None	29.508012	-98.578683	Bexar County
196692	Fee-for-Service	1316983885	1316983885	1	1	TOUKHLADJIAN, NEKTAR H PT	11/14/2023	208100000X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13637 BURBANK BLVD	None	VAN NUYS	CA	91401	1735	19	06037	34.17215452	-118.4303475	Los Angeles County
196718	Fee-for-Service	1750956561	1750956561	1	1	TANAKA, KARA MD	7/30/2024	207ZP0101X	NA	Other	026	PHYSICIANS	None	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
196751	Fee-for-Service	1033755301	1033755301	1	1	TAM, GLENDA H CNP	11/15/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
196767	Fee-for-Service	1508230145	1508230145	1	1	TRAN, JOHN LMFT	5/16/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
196771	Fee-for-Service	1184747024	1184747024	1	1	TRAN, DAVID D MD	4/21/2023	207RX0202X	NA	Oncology	026	PHYSICIANS	184582	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
196779	Fee-for-Service	1376886655	1376886655	1	1	TAYLOR, BRYNN J MD	10/10/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	154041	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
196782	Fee-for-Service	1902190226	1902190226	1	1	TIU, BRIAN P MD	9/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155522	02	General Surgery	0	In state provider	None	36320 INLAND VALLEY DR	STE 101	WILDOMAR	CA	92595	7512	33	06065	33.592158	-117.2367705	Riverside County
196795	Fee-for-Service	1003522483	1003522483	1	1	TEAM 4 YOU INC	10/18/2024	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	715 N ARROWHEAD AVE	STE 101	SAN BERNARDINO	CA	92401	1150	36	06071	34.112394	-117.289624	San Bernardino County
196822	Fee-for-Service	1558083915	1558083915	1	1	TINGEY, JAMIE L PHD	10/24/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
196865	Fee-for-Service	1982364766	1982364766	1	1	TUFFOUR, OHENEBA K	9/15/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	319 BELFONT CIRCLE	None	SACRAMENTO	CA	95835	1530	34	06067	38.675529	-121.51548	Sacramento County
196866	Fee-for-Service	1427033646	1427033646	1	1	THOMPSON, RONALD W MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	12376	30	Radiology	0	In state provider	None	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
196972	Fee-for-Service	1184732901	1184732901	1	1	TSE, PHILLIP FOON MD	1/25/1995	207RN0300X	NA	Nephrology	026	PHYSICIANS	53900	45	Nephrology (Renal-Kidney)	0	In state provider	None	373 S REDWOOD AVE	None	SAN JOSE	CA	95128	5109	43	06085	37.32168382	-121.9468458	Santa Clara County
196975	Fee-for-Service	1548335128	1548335128	1	1	TAMINAYA, NELIA N LMFT	5/16/2020	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
196989	Fee-for-Service	1114098167	1114098167	1	1	TSUCHIYA, ARLINE MD	6/29/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	43062	07	Dermatology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
196995	Fee-for-Service	1245688027	1245688027	1	1	TORRES, NICOLAE ANDREY V MD	8/7/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	167972	08	Family Practice	0	In state provider	None	1011 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72827776	-121.2904066	Placer County
197014	Fee-for-Service	1285197327	1285197327	1	1	TEN HOPE, MERRITT DO	1/1/2025	208M00000X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
197030	Fee-for-Service	1316614506	1316614506	1	1	TRAN, HENRY H PT	10/22/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
197051	Fee-for-Service	1538125844	1538125844	1	3	THE REGENTS OF THE UNIVERSIT	6/1/2016	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1131 WILSHIRE BLVD	STE 100	SANTA MONICA	CA	90401	2072	19	06037	34.02509887	-118.4909994	Los Angeles County
197071	Fee-for-Service	1457936569	1457936569	1	1	THOMPSON, KELSEY MA OTR	6/3/2022	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
197072	Fee-for-Service	1477846095	1477846095	1	1	TOLOUBEYDOKHTI, TANNAZ MD	6/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134477	67	Endocrinology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
197086	Fee-for-Service	1578192928	1578192928	1	1	TRAN, JESSICA MD	12/1/2023	207R00000X	NA	Other	026	PHYSICIANS	189310	None	None	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	9411	38	06075	37.78610439	-122.421569	San Francisco County
197089	Fee-for-Service	1508217159	1508217159	1	2	TRAN, NGUYENVY C DO	9/25/2024	208M00000X	NA	Other	026	PHYSICIANS	17638	41	Internal Medicine	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
197098	Fee-for-Service	1073680880	1073680880	1	1	TAIRA, MARK T MD	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80956	22	Pathology (M.D. only)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
197116	Fee-for-Service	1396927836	1396927836	1	1	TRUAX, CASEY M OT	11/12/2008	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1340 LAKE BLVD	None	DAVIS	CA	95616	2619	57	06113	38.55491538	-121.7876886	Yolo County
197117	Fee-for-Service	1528262672	1528262672	1	1	TORDAI, HILARY A CNM	11/1/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	18081 BEACH BLVD	None	HUNTINGTON BEACH	CA	92648	1304	30	06059	33.69987737	-117.9892394	Orange County
197122	Fee-for-Service	1659473726	1659473726	1	1	THORBURN, CHRISTINE M MD	11/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73049	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
197153	Fee-for-Service	1427033646	1427033646	1	1	THOMPSON, RONALD W MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	12376	78	Neoplastic Diseases/Oncology	0	In state provider	None	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
197162	Fee-for-Service	1669767976	1669767976	1	1	TEODORO, ALVIN P MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142009	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
197238	Fee-for-Service	1912003542	1912003542	1	1	TAFUR, JOSEPH R MD	12/13/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	91233	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
197241	Fee-for-Service	1043388663	1043388663	1	1	TICHENOR, CAROL JO C	2/26/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
197264	Fee-for-Service	1184732901	1184732901	1	1	TSE, PHILLIP FOON MD	1/25/1995	207RN0300X	NA	Nephrology	026	PHYSICIANS	53900	41	Internal Medicine	0	In state provider	None	373 S REDWOOD AVE	None	SAN JOSE	CA	95128	5109	43	06085	37.32168382	-121.9468458	Santa Clara County
197267	Fee-for-Service	1548265036	1548265036	1	3	TRUXTUN RADIOLOGY	12/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	42	Nuclear Medicine	0	In state provider	MEDICAL GROUP, LP	901 OLIVE DR	None	BAKERSFIELD	CA	93308	4137	15	06029	35.41225153	-119.0396655	Kern County
197279	Fee-for-Service	1114098167	1114098167	1	1	TSUCHIYA, ARLINE MD	6/29/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	43062	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
197288	Fee-for-Service	1154554228	1154554228	1	1	TRAN, HANH T DO	9/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13408	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	969 PLUMAS BLVD	SUITE 205	YUBA CITY	CA	95991	4011	51	06101	39.14263634	-121.6176593	Sutter County
197324	Fee-for-Service	1720208424	1720208424	1	1	TAYLOR, TIMOTHY MD	3/21/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	66724	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	549 OLD MAMMOTH RD.	SUITE 204	MAMMOTH LAKES	CA	93546	3813	26	06051	37.63801502	-118.9665687	Mono County
197329	Fee-for-Service	1053349621	1053349621	1	1	TANIA STEVENS OPTOMETRIST PC	3/1/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12925 EL CAMINO REAL	STE 203	SAN DIEGO	CA	92130	2229	37	06073	32.9521702	-117.2338715	San Diego County
197352	Fee-for-Service	1609118157	1609118157	1	1	TAN, JESSIE A MD	10/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143614	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
197354	Fee-for-Service	1538689583	1538689583	1	1	TAHOE FOREST HOSPITAL DISTRI	10/10/2017	207V00000X	NA	Obstetrics & Gynecology	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10175 LEVON AVENUE	None	TRUCKEE	CA	96161	4821	29	06057	39.32449955	-120.1999296	Nevada County
197355	Fee-for-Service	1518263748	1518263748	1	1	TORTOSA, ANNA	6/1/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	420 B ST	None	YUBA CITY	CA	95991	5070	51	06101	39.13415904	-121.6121453	Sutter County
197362	Fee-for-Service	1043672579	1043672579	1	1	TEISCH, LAURA F MD	3/14/2020	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
197411	Fee-for-Service	1659473726	1659473726	1	1	THORBURN, CHRISTINE M MD	11/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73049	83	Rheumatology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
197441	Fee-for-Service	1417342734	1417342734	1	1	TSENG, GLORY Y MD	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11472	45	Nephrology (Renal-Kidney)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
197442	Fee-for-Service	1487963658	1487963658	1	1	THOMAS, MYISHA L LCSW	3/21/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3711 LONG BEACH BLVD	400	LONG BEACH	CA	90807	3315	19	06037	33.824583	-118.1893785	Los Angeles County
197468	Fee-for-Service	1306197066	1306197066	1	1	THEUS, CHAKA KAHN D LCSW	3/28/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1652 WEST AVE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1602957	Los Angeles County
197493	Fee-for-Service	1790760064	1790760064	1	1	TURNER, JAMES H MD	12/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87352	30	Radiology	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
197554	Fee-for-Service	1871514729	1871514729	1	1	TEACHER, THEODORE M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45898	13	Neurology (M.D. only)	0	In state provider	None	27800 MEDICAL CENTER RD	STE 226	MISSION VIEJO	CA	92691	6460	30	06059	33.55952733	-117.6645199	Orange County
197559	Fee-for-Service	1548265036	1548265036	1	3	TRUXTUN RADIOLOGY	12/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP, LP	901 OLIVE DR	None	BAKERSFIELD	CA	93308	4137	15	06029	35.41225153	-119.0396655	Kern County
197562	Fee-for-Service	1376108456	1376108456	1	1	THOMAS, ALEXANDER MD	9/27/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	177664	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
197597	Fee-for-Service	1043774987	1043774987	1	1	TOTTEN, HEATHER LMFT	2/7/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
197604	Fee-for-Service	1366839474	1366839474	1	1	TOOLEY, JAMES MD	8/21/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	144729	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	38	06075	37.78594176	-122.421322	San Francisco County
197620	Fee-for-Service	1497411326	1497411326	1	1	TRUSTWORTHY HOME CARE INC	9/28/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR STREET	SUITE 208	VAN NUYS	CA	91411	2398	19	06037	34.18570347	-118.450386	Los Angeles County
197639	Fee-for-Service	1437285624	1437285624	1	1	THARANI, SHABEEN C MD	3/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97955	05	Anesthesiology	0	In state provider	None	260 INTERNATIONAL CIRCLE	None	SANTA CLARA	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara
197654	Fee-for-Service	1356343149	1356343149	1	1	TOE, FELICIA T MD	2/14/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	79172	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
197679	Fee-for-Service	1457622177	1457622177	1	1	TOMY, JALEEN LCSW	1/8/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	400 BOYD ST	None	VACAVILLE	CA	95688	4522	48	06095	38.35472873	-121.9887138	Solano County
197697	Fee-for-Service	1831198431	1831198431	1	1	THOMAS SEWARD MD	1/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10500 MONTGOMERY RD	None	CINCINNATI	OH	45242	4402	00	None	39.252267	-84.3413535	Hamilton County
197710	Fee-for-Service	1386830222	1386830222	1	1	TYE, GRACE A MD	5/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92646	30	Radiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
197730	Fee-for-Service	1598701864	1598701864	1	1	TONG, JONATHAN L MD CORP	2/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	62923	05	Anesthesiology	0	In state provider	None	9920 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.7016655	-117.955521	Orange County
197759	Fee-for-Service	1568780138	1568780138	1	1	TERTEROV, SERGEI MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	118706	14	Neurological Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
197798	Fee-for-Service	1568581296	1568581296	1	1	TORRINGTON, MATTHEW A MD	9/21/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	77468	-	NOT APPLICABLE	0	In state provider	None	4439, 4445, 4455 BURNS A	None	LOS ANGELES	CA	90029	2702	19	06037	34.0877373	-118.2910045	Los Angeles County
197837	Fee-for-Service	1205906229	1205906229	1	4	THE NEPHROLOGY GROUP, INC.	3/2/2012	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	1205 EVERGREEN ST	None	SELMA	CA	93662	3808	10	06019	36.56701154	-119.599857	Fresno County
197861	Fee-for-Service	1285990283	1285990283	1	1	THORNBLADE, LUCAS W MD	9/23/2021	2086X0206X	NA	General Surgery	026	PHYSICIANS	161336	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
197874	Fee-for-Service	1851771158	1851771158	1	1	TEHRANI, DAVID M MD DO	4/21/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	160798	None	None	0	In state provider	None	798 S WINCHESTER BLVD	None	SAN JOSE	CA	95128	2928	43	06085	37.313361	-121.9499825	Santa Clara County
197891	Fee-for-Service	1477141760	1477141760	1	1	TUBIG, DONNA CHEN G OT	6/19/2023	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 S INDIAN HILL BLVD S	None	CLAREMONT	CA	91711	5461	19	06037	34.084494	-117.7191945	Los Angeles County
197929	Fee-for-Service	1265473730	1265473730	1	2	TRIVEDI, DIVYANG N MD	3/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	42411	03	Allergy	0	In state provider	None	11832 E ROSECRANS AVE	SUITE 200	NORWALK	CA	90650	4107	19	06037	33.90211977	-118.0813129	Los Angeles County
197937	Fee-for-Service	1396083440	1396083440	1	2	TAFT, TIFFANI LMFT	7/8/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27412 ENTERPRISE CIR W	STE. 205	TEMECULA	CA	92590	4875	33	06065	33.51594134	-117.1669025	Riverside County
197983	Fee-for-Service	1851681308	1851681308	1	1	TECHASITH, TUST MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	126248	30	Radiology	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
197986	Fee-for-Service	1992757694	1992757694	1	1	TON, DUY K MD	9/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83996	05	Anesthesiology	0	In state provider	None	725 E SANTA CLARA ST	STE 101	SAN JOSE	CA	95112	1936	43	06085	37.34328626	-121.8756374	Santa Clara County
197995	Fee-for-Service	1912277492	1912277492	1	1	TOWNS HEALTH SERVICES INC	3/24/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	750 SPAANS DRIVE	SUITES C,D AND F	GALT	CA	95632	8609	34	06067	38.265354	-121.302423	Sacramento County
198002	Fee-for-Service	1487132288	1487132288	1	1	TIMMONS SUND, LAUREN K CCC-S	12/16/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	LP	1450 SAN PABLO STREET	SUITE 5901	LOS ANGELES	CA	90033	5313	19	06037	34.06189518	-118.203256	Los Angeles County
198056	Fee-for-Service	1447472212	1447472212	1	2	THIRUNAGARI, HARRSHA MD FAA	1/16/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	64928	40	Pediatrics	0	In state provider	P	1590 SOUTH IMPERIAL AVE	None	EL CENTRO	CA	92243	4241	13	06025	32.77950118	-115.5697279	Imperial County
198085	Fee-for-Service	1982695375	1982695375	1	1	TODD K HOLTZ MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4230 BAY CITY RD	None	MIDLAND	MI	48642	0000	00	None	43.60494952	-84.175551	Midland County
198122	Fee-for-Service	1609402221	1609402221	1	1	TUN, SWE L NP	7/1/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
198130	Fee-for-Service	1205906229	1205906229	1	4	THE NEPHROLOGY GROUP, INC.	10/13/2017	207RN0300X	NA	Nephrology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1205 EVERGREEN ST	None	SELMA	CA	93662	3808	10	06019	36.56701154	-119.599857	Fresno County
198164	Fee-for-Service	1427103910	1427103910	1	1	TRINITY HOSPITALS	7/8/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1 BURDICK EXPRESSWAY WES	None	MINOT	ND	58701	4406	00	None	48.2325845	-101.2938165	Ward County
198172	Fee-for-Service	1740274257	1740274257	1	1	THOMPSON, SUSAN 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	3390 N CAMPBELL AVE	STE 110	TUCSON	AZ	85719	2380	00	None	32.26833	-110.94327	Pima County
198173	Fee-for-Service	1063557049	1063557049	1	1	TAYLOR, KENYA L LMFT	3/10/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
198176	Fee-for-Service	1346889565	1346889565	1	1	TEDJA, BRIGITTA LCSW	8/17/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18672 FLORIDA ST	#100	HUNTINGTON BEACH	CA	92648	1917	30	06059	33.691185	-117.9910425	Orange County
198194	Fee-for-Service	1477626422	1477626422	1	1	TULARE COUNTY CCS	5/28/2004	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	RIVERBEND MTU	1800 N LOVERS LN	None	VISALIA	CA	93292	3102	54	06107	36.344637	-119.260359	Tulare County
198233	Fee-for-Service	1063123925	1063123925	1	1	TRIPPEL, MARIA NP	7/21/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	301 VICTORIA STREET	None	COSTA MESA	CA	92627	1995	30	06059	33.65258952	-117.9121545	Orange County
198256	Fee-for-Service	1114036639	1114036639	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05672	806 W RAMSEY ST	None	BANNING	CA	92220	4478	33	06065	33.92539448	-116.886312	Riverside County
198337	Fee-for-Service	1558447607	1558447607	1	1	TEKKELIAN, TSOVINAR MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52251	41	Internal Medicine	0	In state provider	INC	540 N CENTRAL AVE	STE 207	GLENDALE	CA	91203	3366	19	06037	34.15437	-118.257912	Los Angeles County
198342	Fee-for-Service	1700899564	1700899564	1	1	TRAN, NGOC MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	35031	05	Anesthesiology	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
198368	Fee-for-Service	1346355161	1346355161	1	1	TAUB, PAM R MD	8/2/2010	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	89612	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 W ARBOR DR	STE 8201	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
198377	Fee-for-Service	1396779450	1396779450	1	1	TIN, SANSAN M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	93869	41	Internal Medicine	0	In state provider	None	1800 31ST AVE	None	SAN FRANCISCO	CA	94122	4229	38	06075	37.75345413	-122.4892859	San Francisco County
198393	Fee-for-Service	1659625002	1659625002	1	1	THRIVE COMPREHENSIVE MEDICAL	1/26/2018	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	38	Geriatrics	0	In state provider	GROUP, INC.	18607 VENTURA BLVD	102	TARZANA	CA	91356	4159	19	06037	34.16995274	-118.5388841	Los Angeles County
198451	Fee-for-Service	1427103910	1427103910	1	1	TRINITY HOSPITALS	7/8/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1 BURDICK EXPRESSWAY WES	None	MINOT	ND	58701	4406	00	None	48.2325845	-101.2938165	Ward County
198459	Fee-for-Service	1518250653	1518250653	1	1	TSAI, HALLEY MD	7/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	126277	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
198460	Fee-for-Service	1447288345	1447288345	1	7	TEAM PHYSICIANS OF CALIFORNI	3/19/2020	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	A MEDICAL GROUP, INC	1401 GARCES HWY	None	DELANO	CA	93215	3660	15	06029	35.76144847	-119.238912	Kern County
198462	Fee-for-Service	1770780165	1770780165	1	2	THAO, LONG E. DO	11/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11766	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
198501	Fee-for-Service	1790949618	1790949618	1	1	TOKH, MOHAMMED M MD	1/8/2018	208M00000X	NA	Other	026	PHYSICIANS	147078	41	Internal Medicine	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
198523	Fee-for-Service	1710475777	1710475777	1	1	TAI, NGUYEN D MD	5/15/2024	207R00000X	NA	Other	026	PHYSICIANS	163882	41	Internal Medicine	0	In state provider	None	13355 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5802	19	06037	33.91091877	-118.3527745	Los Angeles County
198569	Fee-for-Service	1346772530	1346772530	1	1	TA, VIET-THI DO	2/22/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18059	None	None	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
198607	Fee-for-Service	1104095942	1104095942	1	1	TABATABAI, MEHER F MD	11/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	38282	77	Infectious Disease	0	In state provider	INC	3621 MARTIN LUTHER KING	STE 6	LYNWOOD	CA	90262	3512	19	06037	33.93082719	-118.2024698	Los Angeles County
198646	Fee-for-Service	1346400785	1346400785	1	1	TYER, NICOLE M MD	10/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107790	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
198655	Fee-for-Service	1346355161	1346355161	1	1	TAUB, PAM R MD	8/2/2010	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	89612	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	STE 8201	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
198678	Fee-for-Service	1346350014	1346350014	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5523	6400 E SPRING ST	None	LONG BEACH	CA	90815	1553	19	06037	33.81039155	-118.1069595	Los Angeles County
198681	Fee-for-Service	1659625002	1659625002	1	1	THRIVE COMPREHENSIVE MEDICAL	1/26/2018	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GROUP, INC.	18607 VENTURA BLVD	102	TARZANA	CA	91356	4159	19	06037	34.16995274	-118.5388841	Los Angeles County
198747	Fee-for-Service	1518250653	1518250653	1	1	TSAI, HALLEY MD	7/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	126277	29	Pulmonary Diseases (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
198748	Fee-for-Service	1447288345	1447288345	1	7	TEAM PHYSICIANS OF CALIFORNI	3/19/2020	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	A MEDICAL GROUP, INC	1401 GARCES HWY	None	DELANO	CA	93215	3660	15	06029	35.76144847	-119.238912	Kern County
198796	Fee-for-Service	1902011851	1902011851	1	1	TAYLOR, JENNIFER MD	5/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102837	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2721	38	06075	37.76386986	-122.4568084	San Francisco County
198890	Fee-for-Service	1073795027	1073795027	1	1	TSAI, IRENE S MD	2/14/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	64461	40	Pediatrics	0	In state provider	None	17577 ARROW BLVD	None	FONTANA	CA	92335	4011	36	06071	34.09938951	-117.421272	San Bernardino County
198914	Fee-for-Service	1528069176	1528069176	1	1	TALBERT MEDICAL GROUP	3/31/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	INC	9930 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166152	-117.955521	Orange County
198939	Fee-for-Service	1306913207	1306913207	1	1	THIO, EDWARD H MD	1/31/1994	207L00000X	NA	Other	026	PHYSICIANS	73825	05	Anesthesiology	0	In state provider	None	841 MOHAWK ST	STE 270	BAKERSFIELD	CA	93309	1547	15	06029	35.36193277	-119.0628694	Kern County
198965	Fee-for-Service	1215027396	1215027396	1	1	TELIAN, SIMON H MD	6/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99605	02	General Surgery	0	In state provider	None	1328 22ND ST	FL 3	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
198969	Fee-for-Service	1659625002	1659625002	1	1	THRIVE COMPREHENSIVE MEDICAL	1/26/2018	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	GROUP, INC.	18607 VENTURA BLVD	102	TARZANA	CA	91356	4159	19	06037	34.16995274	-118.5388841	Los Angeles County
198981	Fee-for-Service	1376562173	1376562173	1	1	TRAN, MICHAEL P H MD	11/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95299	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	1688 WILLOW ST	STE C	SAN JOSE	CA	95125	5109	43	06085	37.30345662	-121.9161453	Santa Clara County
199094	Fee-for-Service	1508953936	1508953936	1	1	TONG, ANHTUAN MD	4/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	67846	41	Internal Medicine	0	In state provider	None	3584 REDONDO BEACH BLVD	None	TORRANCE	CA	90504	1404	19	06037	33.88027435	-118.3345809	Los Angeles County
199111	Fee-for-Service	1740354331	1740354331	1	1	TOMITA, MEGUMI MD	4/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85397	41	Internal Medicine	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
199174	Fee-for-Service	1376502831	1376502831	1	1	TOTAL RENAL CARE INC	1/1/1995	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	KIDNEY DIALYSIS CARE	3600 MARTIN LUTHER KING	None	LYNWOOD	CA	90262	2607	19	06037	33.93232915	-118.2038066	Los Angeles County
199189	Fee-for-Service	1649730680	1649730680	1	1	THOMAS, ANDREA M DO	12/16/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19422	None	None	0	In state provider	None	8110 LAGUNA BLVD	None	ELK GROVE	CA	95758	7904	34	06067	38.421306	-121.408173	Sacramento County
199226	Fee-for-Service	1225312614	1225312614	1	1	TRINITY MEDICAL, LLC	12/20/2012	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	6611 CENTRAL	SUITE D	WICHITA	KS	67206	1921	00	None	37.69378147	-97.2597105	Sedgwick County
199252	Fee-for-Service	1245386358	1245386358	1	1	THERIOT, LOUIS P MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35533	40	Pediatrics	0	In state provider	None	2921 REDONDO AVE	None	LONG BEACH	CA	90806	2415	19	06037	33.808185	-118.1513675	Los Angeles County
199258	Fee-for-Service	1659625002	1659625002	1	1	THRIVE COMPREHENSIVE MEDICAL	5/24/2021	208D00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	GROUP, INC.	18607 VENTURA BLVD	102	TARZANA	CA	91356	4159	19	06037	34.16995274	-118.5388841	Los Angeles County
199263	Fee-for-Service	1003879685	1003879685	1	1	TRAN, TINH V MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	64367	41	Internal Medicine	0	In state provider	None	9039 BOLSA AVE	STE 207	WESTMINSTER	CA	92683	5595	30	06059	33.7449633	-117.9717088	Orange County
199293	Fee-for-Service	1053301200	1053301200	1	1	TSAI, EUGENE W MD	12/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70444	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
199302	Fee-for-Service	1740796051	1740796051	1	1	TERPCARE	3/13/2024	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	735 SUNRISE AVE	STE 160	ROSEVILLE	CA	95661	4504	31	06061	38.73334248	-121.2720172	Placer County
199324	Fee-for-Service	1053466326	1053466326	1	1	TAPAWAN-SERRANO, MARY MD	4/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82865	08	Family Practice	0	In state provider	None	480 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13286634	-121.6142652	Sutter County
199353	Fee-for-Service	1164837894	1164837894	1	1	TRAN, HIEU N OD	12/11/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	375 LAGUNA HONDA BLVD	None	SAN FRANCISCO	CA	94116	1411	38	06075	37.74791027	-122.4587116	San Francisco County
199428	Fee-for-Service	1093824526	1093824526	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6215 SANTA TERESA BLVD	None	SAN JOSE	CA	95119	1436	43	06085	37.23690453	-121.8028344	Santa Clara County
199464	Fee-for-Service	1568497998	1568497998	1	1	TABRIZI, PELMA R MD	10/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82936	41	Internal Medicine	0	In state provider	None	1303 N EUCLID ST	None	ANAHEIM	CA	92801	1956	30	06059	33.85215173	-117.9418188	Orange County
199521	Fee-for-Service	1760536254	1760536254	1	1	TRISTAN, LUZ ELVA P MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64252	40	Pediatrics	0	In state provider	None	408 E 3RD ST	STE D	CALEXICO	CA	92231	2854	13	06025	32.66770975	-115.4931181	Imperial County
199538	Fee-for-Service	1770798589	1770798589	1	1	THOMAS, CALAH S PHD	8/1/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
199562	Fee-for-Service	1457525388	1457525388	1	1	TAFTI, SANAZ A MD	8/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106082	15	Obstetrics (D.O. only)	0	In state provider	None	529 EAST 10TH STREET	None	LONG BEACH	CA	90813	4508	19	06037	33.77901046	-118.186047	Los Angeles County
199564	Fee-for-Service	1669039202	1669039202	1	1	TRIVEDI, NEIL	9/12/2023	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
199576	Fee-for-Service	1053301200	1053301200	1	1	TSAI, EUGENE W MD	12/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70444	03	Allergy	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
199603	Fee-for-Service	1801047931	1801047931	1	1	TRI VALLEY MEDICAL ASSOC INC	9/17/2009	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1133 EAST STANLEY BLVD	SUITE 117	LIVERMORE	CA	94550	4243	01	06001	37.67914693	-121.7810206	Alameda County
199624	Fee-for-Service	1710134226	1710134226	1	1	TRAN, THAI LAN N MD	10/27/2017	2086S0127X	NA	General Surgery	026	PHYSICIANS	111671	66	Emergency Medicine (Urgent Care)	0	In state provider	None	160 E. ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
199677	Fee-for-Service	1588773964	1588773964	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	501 S BROADWAY	None	LOS ANGELES	CA	90013	2301	19	06037	34.04784376	-118.2509494	Los Angeles County
199694	Fee-for-Service	1659581148	1659581148	1	1	THERAPEUTIC LIVING CNTRS	6/26/1995	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOR THE BLIND	18640 ELKWOOD ST	None	RESEDA	CA	91335	1848	19	06037	34.21290715	-118.5397578	Los Angeles County
199698	Fee-for-Service	1356325104	1356325104	1	1	TSE, GLENN MD	8/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75460	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
199712	Fee-for-Service	1275651515	1275651515	1	25	THE ONCOLOGY INSTITUTE CA, A	10/17/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	450 4TH AVENUE	SUITE 311	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
199761	Fee-for-Service	1922079110	1922079110	1	1	THOMAS, MATHEW M MD	8/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	76430	None	None	0	In state provider	None	354 SANTA FE DRIVE	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
199775	Fee-for-Service	1093281990	1093281990	1	1	THROUGH THE SEA MARRIAGE AND	1/17/2020	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	FAMILY COUNSELING INC	2155 E GARVEY AVE N	B2	WEST COVINA	CA	91791	1544	19	06037	34.07280989	-117.8995249	Los Angeles County
199823	Fee-for-Service	1205906229	1205906229	1	12	THE NEPHROLOGY GROUP, INC.	11/16/2018	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	3933 COFFEE RD	STE A	BAKERSFIELD	CA	93308	5024	15	06029	35.395335	-119.092336	Kern County
199873	Fee-for-Service	1275651515	1275651515	1	55	THE ONCOLOGY INSTITUTE CA, A	12/13/2023	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	INNOVATION	1555 N ORANGE GROVE AVE	None	POMONA	CA	91767	3811	19	06037	34.07316011	-117.7510577	Los Angeles County
199890	Fee-for-Service	1801047931	1801047931	1	1	TRI VALLEY MEDICAL ASSOC INC	9/17/2009	193200000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1133 EAST STANLEY BLVD	SUITE 117	LIVERMORE	CA	94550	4243	01	06001	37.67914693	-121.7810206	Alameda County
199913	Fee-for-Service	1710134226	1710134226	1	1	TRAN, THAI LAN N MD	10/27/2017	2086S0127X	NA	General Surgery	026	PHYSICIANS	111671	89	Surgery-Traumatic	0	In state provider	None	160 E. ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
199920	Fee-for-Service	1033749270	1033749270	1	1	TAN, BERNICE Z NP	8/16/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15030 7TH ST.	None	VICTORVILLE	CA	92395	3811	36	06071	34.52471945	-117.3042336	San Bernardino County
199941	Fee-for-Service	1205355567	1205355567	1	1	TISCARENO, VALERIE M AU	6/26/2020	237600000X	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
199953	Fee-for-Service	1609082312	1609082312	1	1	TIONGSON, JAY E MD	2/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	91234	41	Internal Medicine	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 151	MISSION VIEJO	CA	92691	6337	30	06059	33.56347704	-117.66546	Orange County
199970	Fee-for-Service	1780626333	1780626333	1	1	THREE RIVERS MEDICAL GP	11/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
200000	Fee-for-Service	1275651515	1275651515	1	25	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	450 4TH AVENUE	SUITE 311	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
200001	Fee-for-Service	1518386937	1518386937	1	1	TUCKER, RYAN C DO	8/7/2017	390200000X	NA	Other	026	PHYSICIANS	14752	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	STE 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
200018	Fee-for-Service	1275651515	1275651515	1	47	THE ONCOLOGY INSTITUTE CA, A	12/2/2022	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1127 WILSHIRE BLVD	900	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
200074	Fee-for-Service	1558363028	1558363028	1	1	TOWN CENTER PHARMACY INC	11/1/2001	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	TOWN CENTER PHARMACY	535 W ACEQUIA AVE	None	VISALIA	CA	93291	6131	54	06107	36.329112	-119.2975515	Tulare County
200103	Fee-for-Service	1902198286	1902198286	1	1	TRAN, JAMES T MD CORP	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	60960	14	Neurological Surgery	0	In state provider	None	13031 KERRY ST	None	GARDEN GROVE	CA	92844	1638	30	06059	33.773265	-117.958877	Orange County
200157	Fee-for-Service	1518981307	1518981307	1	1	TAM, MICHELLE S MD	9/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	62269	41	Internal Medicine	0	In state provider	None	4600 FAIRFAX AVE	None	OAKLAND	CA	94601	4808	01	06001	37.78004707	-122.2049953	Alameda County
200163	Fee-for-Service	1275651515	1275651515	1	55	THE ONCOLOGY INSTITUTE CA, A	8/23/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	INNOVATION	1555 N ORANGE GROVE AVE	None	POMONA	CA	91767	3811	19	06037	34.07316011	-117.7510577	Los Angeles County
200169	Fee-for-Service	1710009683	1710009683	1	1	TAYLOR, JOE R LMFT	6/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1600 HUMBOLT RD	SUITE 3	CHICO	CA	95928	9196	04	06007	39.73660489	-121.8115227	Butte County
200179	Fee-for-Service	1801047931	1801047931	1	1	TRI VALLEY MEDICAL ASSOC INC	9/17/2009	193200000X	NA	Other	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1133 EAST STANLEY BLVD	SUITE 117	LIVERMORE	CA	94550	4243	01	06001	37.67914693	-121.7810206	Alameda County
200201	Fee-for-Service	1710134226	1710134226	1	1	TRAN, THAI LAN N MD	10/27/2017	2086S0127X	NA	General Surgery	026	PHYSICIANS	111671	02	General Surgery	0	In state provider	None	160 E. ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
200205	Fee-for-Service	1881753598	1881753598	1	1	TSE, WILLIAM OD	12/24/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1188 N EUCLID ST	None	ANAHEIM	CA	92801	1900	30	06059	33.850314	-117.9416115	Orange County
200237	Fee-for-Service	1205906229	1205906229	1	19	THE NEPHROLOGY GROUP, INC.	1/5/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	568 E HERNDON AVE	SUITE 104	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
200249	Fee-for-Service	1487187290	1487187290	1	1	TRAN, TAN Q MD	11/14/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	158843	None	None	0	In state provider	None	905 MAPLE ST	None	REDWOOD CITY	CA	94063	0000	41	06081	37.48767797	-122.223049	San Mateo County
200252	Fee-for-Service	1528524691	1528524691	1	1	TELFAIR HOME HEALTH CARE	10/5/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1545 N VERDUGO RD	STE 101B	GLENDALE	CA	91208	2857	19	06037	34.16921698	-118.2280083	Los Angeles County
200255	Fee-for-Service	1780626333	1780626333	1	1	THREE RIVERS MEDICAL GP	11/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
200258	Fee-for-Service	1184154726	1184154726	1	1	THORNDYKE, EARL C III PSY	9/19/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
200260	Fee-for-Service	1831143858	1831143858	1	1	TAYLOR, DONALD S MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	35628	05	Anesthesiology	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
200287	Fee-for-Service	1275651515	1275651515	1	25	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	450 4TH AVENUE	SUITE 311	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
200288	Fee-for-Service	1407815996	1407815996	2	1	TURPIN, IVAN M MD	3/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	22754	24	Plastic Surgery	0	In state provider	None	1310 W STEWART DRIVE	SUITE 610	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
200296	Fee-for-Service	1790956381	1790956381	1	1	TAHER, HEATHER F MD	7/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104149	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
200308	Fee-for-Service	1275651515	1275651515	1	47	THE ONCOLOGY INSTITUTE CA, A	5/3/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	1127 WILSHIRE BLVD	900	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
200320	Fee-for-Service	1497955421	1497955421	1	1	TIBBLE, ADAM R MD	7/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103760	05	Anesthesiology	0	In state provider	None	1801 HANOVER DRIVE	STE F	DAVIS	CA	95616	1067	57	06113	38.55895232	-121.7567316	Yolo County
200340	Fee-for-Service	1558460394	1558460394	1	1	TRAUNER, MICHAEL A MD	9/13/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54693	01	General Practice	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
200385	Fee-for-Service	1134253693	1134253693	1	1	TERZIAN, MICHAEL V OD	1/17/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12000 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	3319	19	06037	34.18665451	-118.394541	Los Angeles County
200405	Fee-for-Service	1033406566	1033406566	1	1	TRIVEDI, KOVID MD	1/21/2025	207R00000X	NA	Other	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	2850 TELEGRAPH AVE	120	BERKELEY	CA	94705	1159	01	06001	37.85808554	-122.2594469	Alameda County
200449	Fee-for-Service	1184800302	1184800302	1	1	THRIFTY PAYLESS INC.	5/19/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06532	47985 MONROE ST.	BLDG A	INDIO	CA	92203	6752	33	06065	33.700572	-116.2338855	Riverside County
200451	Fee-for-Service	1275651515	1275651515	1	55	THE ONCOLOGY INSTITUTE CA, A	8/23/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INNOVATION	1555 N ORANGE GROVE AVE	None	POMONA	CA	91767	3811	19	06037	34.07316011	-117.7510577	Los Angeles County
200536	Fee-for-Service	1336258748	1336258748	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7025 EL CAMINO REAL	None	ATASCADERO	CA	93422	4523	40	06079	35.48601298	-120.6645521	San Luis Obispo County
200565	Fee-for-Service	1063804755	1063804755	1	1	TRUONG, KEVIN MD	7/27/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	158018	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
200576	Fee-for-Service	1275651515	1275651515	1	25	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	450 4TH AVENUE	SUITE 311	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
200595	Fee-for-Service	1275651515	1275651515	1	47	THE ONCOLOGY INSTITUTE CA, A	5/3/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1127 WILSHIRE BLVD	900	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
200606	Fee-for-Service	1710157631	1710157631	1	1	THOMAS M. SKRYPEK M.D.	10/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 CHICAGO AVE	None	MINNEAPOLIS	MN	55404	4518	00	None	44.95666589	-93.26255996	Hennepin County
200619	Fee-for-Service	1649725821	1649725821	1	1	TALAMANTES, SARAH M MD	6/19/2023	207R00000X	NA	Other	026	PHYSICIANS	185608	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
200635	Fee-for-Service	1558347377	1558347377	1	1	TERRELL, CALVIN B MD	12/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	36679	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1117 E DEVONSHIRE AVENUE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
200673	Fee-for-Service	1548254295	1548254295	1	1	TAFF, LON J MD	4/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54503	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9989	39	06077	37.88652418	-121.2820956	San Joaquin County
200691	Fee-for-Service	1033406566	1033406566	1	1	TRIVEDI, KOVID MD	1/21/2025	207R00000X	NA	Other	026	PHYSICIANS	None	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2850 TELEGRAPH AVE	120	BERKELEY	CA	94705	1159	01	06001	37.85808554	-122.2594469	Alameda County
200755	Fee-for-Service	1972923068	1972923068	1	1	TRUECARE SURGERY CENTER	4/7/2017	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	4511 CHINO HILLS PKWY	STE C	CHINO HILLS	CA	91709	5852	36	06071	33.9826287	-117.7061708	San Bernardino County
200792	Fee-for-Service	1568542314	1568542314	1	1	TURRILL, MARK MD	2/28/1993	207RH0003X	NA	Oncology	026	PHYSICIANS	66868	78	Neoplastic Diseases/Oncology	0	In state provider	None	5150 HILL RD E	None	LAKEPORT	CA	95453	5100	17	06033	39.10437349	-122.9088331	Lake County
200825	Fee-for-Service	1467984880	1467984880	1	1	TRAN, DAISY H MD	11/12/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	167593	None	None	0	In state provider	None	43112 N 15TH WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
200863	Fee-for-Service	1275651515	1275651515	1	25	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	450 4TH AVENUE	SUITE 311	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
200864	Fee-for-Service	1164950663	1164950663	1	1	TRIGEROUS, NOELLE M LMFT	11/15/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4310 ORANGE ST	None	RIVERSIDE	CA	92501	3829	33	06065	33.97629981	-117.3766255	Riverside County
200870	Fee-for-Service	1689835738	1689835738	1	1	THONG, ALAN E MD	9/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	109039	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
200872	Fee-for-Service	1437160868	1437160868	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05733	211 E 17TH ST	None	COSTA MESA	CA	92627	3831	30	06059	33.63508541	-117.9183173	Orange County
200873	Fee-for-Service	1639344963	1639344963	1	1	TEDJA, RUDY DO	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13497	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
200882	Fee-for-Service	1275651515	1275651515	1	47	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1127 WILSHIRE BLVD	900	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
200888	Fee-for-Service	1386321214	1386321214	1	1	TOY, NICHOLAS S PT	10/26/2023	208100000X	NA	Physical Medicine and Rehabilitation	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
200906	Fee-for-Service	1770573222	1770573222	1	1	THE WOMANS CHRISTIAN	9/4/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ASSOCIATION OF JAMESTOWN	207 FOOTE AVE	None	JAMESTOWN	NY	14701	7077	00	None	42.091227	-79.2320445	Chautauqua County
200952	Fee-for-Service	1669444543	1669444543	2	1	TENENBERG, DAVID MD	3/24/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	23451	30	Radiology	0	In state provider	None	150 W. WASHINGTON STREET	None	SAN DIEGO	CA	92103	2005	37	06073	32.74999225	-117.1647027	San Diego County
200981	Fee-for-Service	1033406566	1033406566	1	1	TRIVEDI, KOVID MD	1/21/2025	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2850 TELEGRAPH AVE	120	BERKELEY	CA	94705	1159	01	06001	37.85808554	-122.2594469	Alameda County
201008	Fee-for-Service	1427066869	1427066869	1	1	TRAN, KHANH P MD	5/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83982	22	Pathology (M.D. only)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
201021	Fee-for-Service	1477061083	1477061083	1	1	TRUONG, KATHALINE OT	1/28/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W ARROW HWY	130	SAN DIMAS	CA	91773	2330	19	06037	34.10677054	-117.8331379	Los Angeles County
201083	Fee-for-Service	1568542314	1568542314	1	1	TURRILL, MARK MD	2/28/1993	207RH0003X	NA	Oncology	026	PHYSICIANS	66868	41	Internal Medicine	0	In state provider	None	5150 HILL RD E	None	LAKEPORT	CA	95453	5100	17	06033	39.10437349	-122.9088331	Lake County
201096	Fee-for-Service	1699111443	1699111443	1	1	TANG, SCHIRIN MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146079	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
201195	Fee-for-Service	1770573222	1770573222	1	1	THE WOMANS CHRISTIAN	9/4/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ASSOCIATION OF JAMESTOWN	207 FOOTE AVE	None	JAMESTOWN	NY	14701	7077	00	None	42.091227	-79.2320445	Chautauqua County
201205	Fee-for-Service	1083053821	1083053821	1	1	TAYLOR, KATHRINE C MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149246	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 MED PLAZA	STE 430	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
201242	Fee-for-Service	1730615014	1730615014	1	1	TOLANI, ALISHA T MD	7/23/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162164	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
201259	Fee-for-Service	1275920092	1275920092	1	1	TSIN, CATHY M MD	7/28/2023	2080P0216X	NA	Other	026	PHYSICIANS	168568	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
201284	Fee-for-Service	1740379759	1740379759	1	1	THOMANDER, DARRYL PHD	2/25/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
201358	Fee-for-Service	1295197473	1295197473	1	1	TRAN, HENRY L DO	9/23/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15818	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
201363	Fee-for-Service	1831121649	1831121649	1	1	TURBAN, JOSEPH W MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	86-260 FARRINGTON HWY	None	WAIANAE	HI	96792	3128	00	None	21.42944095	-158.1807437	Honolulu County
201372	Fee-for-Service	1568542314	1568542314	1	1	TURRILL, MARK MD	2/28/1993	207RH0003X	NA	Oncology	026	PHYSICIANS	66868	68	Hematology	0	In state provider	None	5150 HILL RD E	None	LAKEPORT	CA	95453	5100	17	06033	39.10437349	-122.9088331	Lake County
201377	Fee-for-Service	1477049187	1477049187	1	1	TANGALOS, LISA L LCSW	2/8/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10 MILLWOOD ST	#6	MILL VALLEY	CA	94941	2066	21	06041	37.90348247	-122.5431493	Marin County
201392	Fee-for-Service	1023036415	1023036415	1	1	TONG, LY T MD	8/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85786	18	Ophthalmology	0	In state provider	None	1821 DAILY DR	None	CAMARILLO	CA	93010	6201	56	06111	34.21782879	-119.0452962	Ventura County
201412	Fee-for-Service	1871956359	1871956359	1	1	TONG, GREGORY E MD	1/4/2019	207P00000X	NA	Other	026	PHYSICIANS	152777	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
201414	Fee-for-Service	1689091852	1689091852	1	1	TSAI, JUSTIN D MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149035	None	None	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5179	39	06077	38.12188356	-121.285872	San Joaquin County
201470	Fee-for-Service	1205030897	1205030897	1	1	TANOUS, THOMAS L MD	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107723	20	Orthopedic Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
201474	Fee-for-Service	1366779373	1366779373	1	1	TOBAY, CHYNARA MD	2/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106562	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
201536	Fee-for-Service	1033101829	1033101829	1	1	TIMOTHY L. HUGGINS MD.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1212 CLEAR LAKE ROAD	SUITE 100	WEATHERFORD	TX	76086	0000	00	None	32.74422696	-97.77991528	Parker County
201580	Fee-for-Service	1114389616	1114389616	1	1	TENG, SOPHIE X MD	3/1/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	170631	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
201596	Fee-for-Service	1306955695	1306955695	1	1	THRIFTY PAYLESS INC	10/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	RITE AID #5386	915 NE D ST	None	GRANTS PASS	OR	97526	2320	00	None	42.44012371	-123.3124845	Josephine County
201606	Fee-for-Service	1083723522	1083723522	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05545	10120 MASON AVE	None	CHATSWORTH	CA	91311	3301	19	06037	34.254549	-118.579811	Los Angeles County
201675	Fee-for-Service	1417535857	1417535857	1	1	TRAN, DAN VY DIEM DO	7/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22182	08	Family Practice	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
201744	Fee-for-Service	1548816473	1548816473	1	1	TOUCH OF ANGELS HOME HEALTH	6/18/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14545 FRIAR ST	STE 156	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
201750	Fee-for-Service	1740354356	1740354356	1	1	TOCH, PHYLLIS E MD	6/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	83726	36	Psychiatry	0	In state provider	None	710 S BROADWAY STREET	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
201809	Fee-for-Service	1629090451	1629090451	1	1	THRIFTY DRUG STORE 5763	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	17904 MAGNOLIA ST	None	FOUNTAIN VALLEY	CA	92708	5039	30	06059	33.702381	-117.9715905	Orange County
201829	Fee-for-Service	1144813221	1144813221	1	1	THV CONSULTANT INC	9/28/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	622 34TH STREET	None	BAKERSFIELD	CA	93301	2208	15	06029	35.39051453	-119.009079	Kern County
201848	Fee-for-Service	1902172000	1902172000	1	1	TEODORA TOPALOVSKI	11/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	640 ULUKAHIKI ST	None	KAILUA	HI	96734	4454	00	None	21.38090913	-157.758388	Honolulu County
201864	Fee-for-Service	1184706616	1184706616	1	2	THAKRAN, PURNIMA MD INC	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52465	13	Neurology (M.D. only)	0	In state provider	None	705 E VIRGINIA WAY	STE C	BARSTOW	CA	92311	3955	36	06071	34.88815781	-117.018543	San Bernardino County
201913	Fee-for-Service	1366895831	1366895831	1	1	TURNER, ANDREW E DO	7/31/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16417	08	Family Practice	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
201917	Fee-for-Service	1275175481	1275175481	1	1	TORRES, MARISSA LMFT	2/10/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	565 CASTRO STREET	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38903016	-122.0819046	Santa Clara County
201922	Fee-for-Service	1114161635	1114161635	1	1	TEICHEIRA, LORY M PT	5/25/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
201934	Fee-for-Service	1982790077	1982790077	1	1	THOMAS, WILLIAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	317 MARTIN LUTHER KING J	None	TACOMA	WA	98405	4234	00	None	47.25960844	-122.4534238	Pierce County
201967	Fee-for-Service	1245520386	1245520386	1	1	THE NEMOURS FOUNDATION	11/18/2019	282NC2000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	F THE NEMOURS FOUNDATION	13535 NEMOURS PKWY	None	ORLANDO	FL	32827	7402	00	None	28.37499835	-81.27311315	Orange County
202042	Fee-for-Service	1568996262	1568996262	1	1	TAKANO, HIROMI DO	6/4/2019	390200000X	NA	Other	026	PHYSICIANS	16639	08	Family Practice	0	In state provider	None	9461 DESCHUTES RD	UNIT 4	PALO CEDRO	CA	96073	9761	45	06089	40.562523	-122.238633	Shasta County
202053	Fee-for-Service	1457791899	1457791899	1	1	TAYLOR, ZACHARY A DO	6/3/2021	208600000X	NA	General Surgery	026	PHYSICIANS	17558	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
202068	Fee-for-Service	1346286663	1346286663	1	1	TABAIE, HAROLD A DO	5/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	4475	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1801 COLORADO AVE	STE 250	TURLOCK	CA	95382	2710	50	06099	37.50941613	-120.8353105	Stanislaus County
202087	Fee-for-Service	1154467181	1154467181	1	5	THE HUNTINGTON MEDICAL FOUND	4/13/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	FOUNDATION	800 S FAIRMONT ST	STE 310	PASADENA	CA	91105	3153	19	06037	34.13193177	-118.1517805	Los Angeles County
202094	Fee-for-Service	1114036589	1114036589	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5538	2647 FOOTHILL BLVD	None	LA CRESCENTA	CA	91214	3511	19	06037	34.22226927	-118.2368419	Los Angeles County
202122	Fee-for-Service	1740675222	1740675222	1	1	TRONTIS, ANDREW J MD	8/21/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	166861	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
202187	Fee-for-Service	1699951582	1699951582	1	1	TABASSUM, VAJEEHA MD	11/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145442	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LANE	STE 301	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
202198	Fee-for-Service	1922143106	1922143106	1	1	TEQUA MED-PEDS, LLC	8/7/2012	207R00000X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	601 RIVERSIDE DR	STE 3 & 4	PARKER	AZ	85344	5119	00	None	34.151598	-114.285402	La Paz County
202213	Fee-for-Service	1497167787	1497167787	1	1	TAPADIA, ANJALI D MD	6/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155328	None	None	0	In state provider	None	200 STEIN PLAZA	1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06482757	-118.4443441	Los Angeles County
202216	Fee-for-Service	1083777163	1083777163	1	1	THE PERMANENTE MED GRP INC	12/29/2009	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	1725 EASTSHORE HIGHWAY	None	BERKELEY	CA	94710	1703	01	06001	37.87082044	-122.3045752	Alameda County
202252	Fee-for-Service	1699795609	1699795609	1	1	THU, LE MD	6/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	87608	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4799	12	06023	40.78355148	-124.1420294	Humboldt County
202254	Fee-for-Service	1245520386	1245520386	1	1	THE NEMOURS FOUNDATION	11/18/2019	282NC2000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	F THE NEMOURS FOUNDATION	13535 NEMOURS PKWY	None	ORLANDO	FL	32827	7402	00	None	28.37499835	-81.27311315	Orange County
202269	Fee-for-Service	1336544006	1336544006	1	1	TORRES, MICHAEL J DO	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13621	01	General Practice	0	In state provider	None	9089 BASELINE ROAD	SUITE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
202272	Fee-for-Service	1255327482	1255327482	1	1	TERRY J. HILL, 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	700 S TELEPHONE RD	None	MOORE	OK	73160	2502	00	None	35.332524	-97.49446348	Cleveland County
202295	Fee-for-Service	1013925551	1013925551	1	1	TAPLITZ, RANDY A MD	8/27/1995	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	67522	41	Internal Medicine	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
202298	Fee-for-Service	1962754333	1962754333	1	1	TOTAL RENAL CARE INC	12/1/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	8333 IOWA ST	STE 100	DOWNEY	CA	90241	4994	19	06037	33.93744359	-118.1339382	Los Angeles County
202311	Fee-for-Service	1306924899	1306924899	1	1	TYBURSKI, MARK D MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95194	25	Physical Medicine and Rehabilitation	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
202345	Fee-for-Service	1275651515	1275651515	1	46	THE ONCOLOGY INSTITUTE CA, A	12/2/2022	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2440 EAST SOUTH STREET	None	LONG BEACH	CA	90805	4426	19	06037	33.86013954	-118.163439	Los Angeles County
202483	Fee-for-Service	1629600168	1629600168	1	1	TLC MEDICAL TRANSPORTATION	8/2/2024	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	110 GATEWAY DR	#260	LINCOLN	CA	95648	3304	31	06061	38.88433725	-121.2931529	Placer County
202485	Fee-for-Service	1922143106	1922143106	1	1	TEQUA MED-PEDS, LLC	8/7/2012	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	601 RIVERSIDE DR	STE 3 & 4	PARKER	AZ	85344	5119	00	None	34.151598	-114.285402	La Paz County
202490	Fee-for-Service	1780974246	1780974246	1	1	TURAY, HAMID O DO	12/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14784	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
202514	Fee-for-Service	1578630646	1578630646	1	1	THOMAS, JOHN M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55827	05	Anesthesiology	0	In state provider	None	24331 EL TORO RD	STE 150	LAGUNA WOODS	CA	92637	8818	30	06059	33.60928782	-117.7295058	Orange County
202526	Fee-for-Service	1184701021	1184701021	1	1	TATMAN, JOHN L MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63598	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
202533	Fee-for-Service	1326400870	1326400870	1	1	TITZE, NICOLE D MD	6/15/2019	207P00000X	NA	Other	026	PHYSICIANS	152704	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
202539	Fee-for-Service	1003180613	1003180613	1	1	TOROSSIAN, LERNIK OD	9/20/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1450 SAN PABLO STREET	None	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
202573	Fee-for-Service	1912001363	1912001363	1	1	TRAN, NGAC TIEN MD	9/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	41161	08	Family Practice	0	In state provider	None	1545 SAINT MARKS PLZ	STE 1C	STOCKTON	CA	95207	6411	39	06077	37.98892524	-121.3254177	San Joaquin County
202625	Fee-for-Service	1679682199	1679682199	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5786	5845 E LOS ANGELES AVE	None	SIMI VALLEY	CA	93063	4256	56	06111	34.2717696	-118.676911	Ventura County
202631	Fee-for-Service	1275651515	1275651515	1	46	THE ONCOLOGY INSTITUTE CA, A	3/22/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	2440 EAST SOUTH STREET	None	LONG BEACH	CA	90805	4426	19	06037	33.86013954	-118.163439	Los Angeles County
202673	Fee-for-Service	1255489142	1255489142	1	1	TAN, GREGORY J MD	4/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78492	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
202685	Fee-for-Service	1245593748	1245593748	1	1	TRAN, MICHELLE B LMFT	11/7/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	801 S GRAND STREET	SUITE 780	LOS ANGELES	CA	90017	8590	19	06037	34.04532806	-118.258462	Los Angeles County
202689	Fee-for-Service	1811422330	1811422330	1	1	TRAN, JOHNATHAN V MD	11/18/2022	390200000X	NA	Other	026	PHYSICIANS	159719	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
202724	Fee-for-Service	1336313808	1336313808	1	1	TRUONG, NGHIA C MD	12/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102728	None	None	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 713	GARDEN GROVE	CA	92843	1921	30	06059	33.77450141	-117.9123364	Orange County
202732	Fee-for-Service	1831140391	1831140391	1	1	THOMAS R PORTER, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	988095 NEBRASKA MEDICAL	None	OMAHA	NE	68198	0000	00	None	0	0	None
202749	Fee-for-Service	1861532178	1861532178	1	1	TRAN, TRINH T MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76237	25	Physical Medicine and Rehabilitation	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
202782	Fee-for-Service	1720277866	1720277866	1	1	TOTAL RENAL CARE, INC	12/1/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BAKERSFIELD DIALYSIS CTR	5143 OFFICE PARK DR	None	BAKERSFIELD	CA	93309	0660	15	06029	35.36637977	-119.0594959	Kern County
202799	Fee-for-Service	1386653996	1386653996	1	1	TABAK, MOSHE MD AMC	11/13/2008	207L00000X	NA	Other	026	PHYSICIANS	40257	05	Anesthesiology	0	In state provider	None	4060 E WHITTIER BLVD	None	LOS ANGELES	CA	91505	4406	19	06037	34.02390148	-118.184319	Los Angeles County
202822	Fee-for-Service	1326400870	1326400870	1	1	TITZE, NICOLE D MD	6/15/2019	207P00000X	NA	Other	026	PHYSICIANS	152704	40	Pediatrics	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
202848	Fee-for-Service	1861990376	1861990376	1	1	THOMPSON, LEWIS R LMFT	5/30/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15431 ANACAPA RD	STE D	VICTORVILLE	CA	92392	2458	36	06071	34.50544107	-117.3250832	San Bernardino County
202872	Fee-for-Service	1184148850	1184148850	1	1	TORRES, JUAN A MD	2/11/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157408	None	None	0	In state provider	None	1400 E PALOMAR ST	None	CHULA VISTA	CA	91931	1800	37	06073	32.62382113	-116.9960539	San Diego County
202882	Fee-for-Service	1205154218	1205154218	1	1	TSENG, BRYON W MD	8/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124716	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
202910	Fee-for-Service	1770581894	1770581894	1	1	T J SAMSON COMMUNITY HOSP	5/30/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	310 N L ROGERS WELLS BLV	None	GLASGOW	KY	42141	1300	00	None	37.00604052	-85.924462	Barren County
202920	Fee-for-Service	1275651515	1275651515	1	46	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2440 EAST SOUTH STREET	None	LONG BEACH	CA	90805	4426	19	06037	33.86013954	-118.163439	Los Angeles County
202932	Fee-for-Service	1053602946	1053602946	1	1	TRUONG, LE N MD	9/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130531	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
202952	Fee-for-Service	1497120463	1497120463	1	1	THE CARDIOVASCULAR SURGICAL	4/16/2018	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2415 SONOMA STREET	SUITE B	REDDING	CA	96001	3026	45	06089	40.57308764	-122.4019424	Shasta County
202973	Fee-for-Service	1740338524	1740338524	1	1	TRAN, TU-MAI D MD	11/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87376	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
202981	Fee-for-Service	1962573865	1962573865	1	1	THAKKAR, JYOTSNA U MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36397	36	Psychiatry	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
202991	Fee-for-Service	1063890929	1063890929	1	1	TREVELLINE, MELISSA A MD	10/20/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	161980	None	None	0	In state provider	None	1111 GRAND AVENUE	UNIT L	DIAMOND BAR	CA	91765	4171	19	06037	34.00172352	-117.813184	Los Angeles County
202994	Fee-for-Service	1972595528	1972595528	1	1	TONNEMACHER, DAVID P MD	7/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	42261	41	Internal Medicine	0	In state provider	None	1510 S CENTRAL AVE	STE 610	GLENDALE	CA	91204	2505	19	06037	34.12709764	-118.2577911	Los Angeles County
203049	Fee-for-Service	1386843878	1386843878	1	1	TOTAL RENAL CARE, INC	7/1/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	17815 VENTURA BLVD	SUITE 100	ENCINO	CA	91316	3600	19	06037	34.16304434	-118.5206593	Los Angeles County
203065	Fee-for-Service	1174574560	1174574560	1	1	TONG, HARRISON H DO	7/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	8685	08	Family Practice	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
203075	Fee-for-Service	1578829362	1578829362	1	1	THOMAS, SEMARA A MD	2/18/2019	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	142222	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
203092	Fee-for-Service	1407809668	1407809668	2	1	TOWLE, LINDA M NP	10/4/2006	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	678 2ND ST W	None	SONOMA	CA	95476	6901	49	06097	38.28914695	-122.4617525	Sonoma County
203133	Fee-for-Service	1942244538	1942244538	1	1	TRAUMA MEDICAL GROUP OF	10/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	89	Surgery-Traumatic	0	In state provider	ROSEVILLE, INC.	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
203142	Fee-for-Service	1891832093	1891832093	1	1	TERHORST, ANGELA P LMFT	7/27/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
203143	Fee-for-Service	1306475256	1306475256	1	1	TAM, COURTNEY MD	12/22/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	189047	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
203154	Fee-for-Service	1841047198	1841047198	1	1	TAI YI NATURAL HEALTH CENTER	6/15/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	25571 JERONIMO RD	STE 10	MISSION VIEJO	CA	92691	2726	30	06059	33.62238892	-117.6842849	Orange County
203163	Fee-for-Service	1275623159	1275623159	1	1	TRAN, LOC V MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	69682	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
203208	Fee-for-Service	1275651515	1275651515	1	46	THE ONCOLOGY INSTITUTE CA, A	3/22/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	32	Radiation Therapy (D.O. only)	0	In state provider	None	2440 EAST SOUTH STREET	None	LONG BEACH	CA	90805	4426	19	06037	33.86013954	-118.163439	Los Angeles County
203226	Fee-for-Service	1811412968	1811412968	1	1	THOMASSON, DEANNA V CNP	11/16/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
203239	Fee-for-Service	1689783094	1689783094	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	650 WALNUT AVE	None	GREENFIELD	CA	93927	4928	27	06053	36.32858283	-121.2453921	Monterey County
203262	Fee-for-Service	1376622068	1376622068	1	1	TRAN, TUAN	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	42310	01	General Practice	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
203279	Fee-for-Service	1972595528	1972595528	1	1	TONNEMACHER, DAVID P MD	7/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	42261	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1510 S CENTRAL AVE	STE 610	GLENDALE	CA	91204	2505	19	06037	34.12709764	-118.2577911	Los Angeles County
203331	Fee-for-Service	1992799639	1992799639	1	1	TERAI ESCAMILLO, ANN A MD	11/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55477	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
203336	Fee-for-Service	1043329451	1043329451	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5539	5747 KANAN RD	None	AGOURA	CA	91301	1601	19	06037	34.1550486	-118.7567097	Los Angeles County
203394	Fee-for-Service	1649241662	1649241662	1	1	TSOULOS, NICHOLAS G MD	7/26/1973	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	21674	40	Pediatrics	0	In state provider	None	1001 E GRAND AVE	None	ESCONDIDO	CA	92025	4604	37	06073	33.12634291	-117.0682058	San Diego County
203438	Fee-for-Service	1164722476	1164722476	1	1	TORRANCE DIALYSIS CENTER LLC	10/4/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	20430 HAWTHORNE BLVD	None	TORRANCE	CA	90503	2404	19	06037	33.846102	-118.3536205	Los Angeles County
203463	Fee-for-Service	1447600978	1447600978	1	1	TANVEER, AROON MD	5/29/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	163317	08	Family Practice	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
203522	Fee-for-Service	1023099132	1023099132	1	1	TAKIEDDINE, MARWAN A MD	6/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2420 PROFESSIONAL COURT	SUITE 150	LAS VEGAS	NV	89128	0837	00	None	36.203769	-115.2550845	Clark County
203563	Fee-for-Service	1780093658	1780093658	1	1	TRAN, ANTHONY DO	10/5/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19922	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
203568	Fee-for-Service	1639295892	1639295892	1	1	TRAN, DIEM LINH P NP	1/24/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
203684	Fee-for-Service	1477780864	1477780864	1	1	TRAN, JOHN S MD	11/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	117003	01	General Practice	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
203686	Fee-for-Service	1376823153	1376823153	1	1	TAFTIAN, DAVID DO	9/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14852	None	None	0	In state provider	None	23803 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39750589	-118.552072	Los Angeles County
203688	Fee-for-Service	1952009763	1952009763	1	1	TOTAH ENTERPRISES LLC	8/28/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ON	15600 WASHINGTON AVE	F	SAN LORENZO	CA	94580	1467	01	06001	37.68225397	-122.137753	Alameda County
203721	Fee-for-Service	1114105947	1114105947	1	1	TORREY, ROBERT R MD	7/13/2010	208800000X	NA	Other	026	PHYSICIANS	95083	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
203733	Fee-for-Service	1649243866	1649243866	1	1	TANG, PEI-YUEN DO	11/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10628	08	Family Practice	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
203783	Fee-for-Service	1215070461	1215070461	1	1	TO, PHUONG T OD	1/9/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1850 N RIVERSIDE AVE	STE 100	RIALTO	CA	92376	8071	36	06071	34.132905	-117.3704675	San Bernardino County
203811	Fee-for-Service	1023099132	1023099132	1	1	TAKIEDDINE, MARWAN A MD	6/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	45	Nephrology (Renal-Kidney)	1	Border provider	None	2420 PROFESSIONAL COURT	SUITE 150	LAS VEGAS	NV	89128	0837	00	None	36.203769	-115.2550845	Clark County
203859	Fee-for-Service	1902816572	1902816572	1	1	TSUCHIMOTO, ERIN E MD	10/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75206	40	Pediatrics	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
203861	Fee-for-Service	1255538823	1255538823	1	1	TO, PHUONG N DO	12/16/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	17636	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
203883	Fee-for-Service	1073137691	1073137691	1	1	TU, CHARLES OD	11/2/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3451 S DOGWOOD AVE	SUITE 1334	EL CENTRO	CA	92243	7906	13	06025	32.762997	-115.530678	Imperial County
203945	Fee-for-Service	1821152273	1821152273	1	1	TOROSSIAN, GRETA OD	12/1/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CORP	330 N BRAND BLVD	STE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
203970	Fee-for-Service	1851682728	1851682728	1	1	TRAN, LINH N MD	7/30/2018	207RC0200X	NA	Other	026	PHYSICIANS	122603	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
203974	Fee-for-Service	1508560673	1508560673	1	1	TRANSAMERICA MEDICAL GROUP I	10/23/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1004 14TH AVE	None	DELANO	CA	93215	2246	15	06029	35.77449518	-119.2451571	Kern County
203977	Fee-for-Service	1740211010	1740211010	1	1	THOMAS,NICOLLE MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67225	08	Family Practice	0	In state provider	None	2705 LOMA VISTA RD	None	VENTURA	CA	93003	1581	56	06111	34.27504051	-119.2600018	Ventura County
204029	Fee-for-Service	1851597587	1851597587	1	1	TAN, HUNG-JUI MD	8/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123731	34	Urology and Urological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	7001	19	06037	34.06373445	-118.443537	Los Angeles County
204093	Fee-for-Service	1558435156	1558435156	1	1	TSAI, TA-KO CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	STE 106	125 E GLENOAKS BLVD	None	GLENDALE	CA	91207	2036	19	06037	34.15893574	-118.2541314	Los Angeles County
204107	Fee-for-Service	1013997964	1013997964	1	1	TESORIERO, RONALD B MD	1/23/2019	208600000X	NA	General Surgery	026	PHYSICIANS	107010	02	General Surgery	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
204120	Fee-for-Service	1972920312	1972920312	1	1	TANG, ERIC C MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137980	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
204178	Fee-for-Service	1790037927	1790037927	1	1	TAYLOR KESTER, LARA	4/25/2024	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
204202	Fee-for-Service	1912201765	1912201765	1	1	TSUI, ELAINA Y MD	8/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	116661	02	General Surgery	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
204235	Fee-for-Service	1750943841	1750943841	1	1	THOMAS, EMMA CRNA	6/13/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	5176 HILL RD E.	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
204287	Fee-for-Service	1548347768	1548347768	1	1	THOMAS STOEHR M.D.	6/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9205 SW BARNES RD	None	PORTLAND	OR	97225	6603	00	None	45.51093	-122.771907	Washington County
204288	Fee-for-Service	1659631547	1659631547	1	1	TSANG MUI CHUNG, MICHELLE S	5/23/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
204292	Fee-for-Service	1164085536	1164085536	1	1	TETREAULT, BREANNA J DO	10/18/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20241	None	None	0	In state provider	None	3100 SAN PABLO AVE	STE 300, 310	BERKELEY	CA	94702	2498	01	06001	37.85066636	-122.286288	Alameda County
204299	Fee-for-Service	1952579112	1952579112	1	1	TOOSIEMD INC	1/18/2011	208600000X	NA	General Surgery	026	PHYSICIANS	60211	02	General Surgery	0	In state provider	None	3601 VISTA WAY	STE 203	OCEANSIDE	CA	92056	4559	37	06073	33.18140858	-117.3093221	San Diego County
204308	Fee-for-Service	1699069724	1699069724	1	1	TURNER, ANDREW G MD	4/27/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	162635	36	Psychiatry	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
204410	Fee-for-Service	1457133993	1457133993	2	1	TDUONG INC	10/8/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13671 BEACH BLVD	SUITE B	WESTMINSTER	CA	92683	0000	30	06059	33.76360126	-117.9900561	Orange County
204421	Fee-for-Service	1306150362	1306150362	1	1	TARTAGLIONE, ROBERT E MD	11/19/2018	2085R0204X	NA	Other	026	PHYSICIANS	154911	30	Radiology	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
204422	Fee-for-Service	1417150848	1417150848	1	1	TEMECULA VALLEY OB/GYN	10/11/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL ASSOCIATES	25460 MEDICAL CENTER DR	STE 100	MURRIETA	CA	92562	5985	33	06065	33.5570278	-117.1862552	Riverside County
204434	Fee-for-Service	1649400789	1649400789	1	1	TOM, MICHAEL E MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121493	05	Anesthesiology	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
204450	Fee-for-Service	1235229139	1235229139	2	1	TEITELBAUM, ISAAC MD	4/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	13	Neurology (M.D. only)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
204559	Fee-for-Service	1588099634	1588099634	1	1	TORRES CAMPOS, JOSE YAIR LC	11/20/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
204565	Fee-for-Service	1710096169	1710096169	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	680 S STATE ST	None	UKIAH	CA	95482	4913	23	06045	39.14338748	-123.2065524	Mendocino County
204582	Fee-for-Service	1679651582	1679651582	1	1	TRINH, DZUNG MD	12/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	65282	01	General Practice	0	In state provider	None	4785 N 1ST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
204590	Fee-for-Service	1679645204	1679645204	1	1	TRAN, TRIEU T MD INC	1/27/2014	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	63498	25	Physical Medicine and Rehabilitation	0	In state provider	None	11190 WARNER AVENUE	SUITE 300	FOUNTAIN VALLEY	CA	92708	4045	30	06059	33.714	-117.9333585	Orange County
204620	Fee-for-Service	1164596714	1164596714	1	1	TEHAMA COUNTY	3/18/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SUPERINTENDENT	1005 HOAG ST	None	CORNING	CA	96021	2934	52	06103	39.9253268	-122.1868368	Tehama County
204628	Fee-for-Service	1306908058	1306908058	1	1	THE REGENTS OF THE UNIV	1/1/1991	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CA SCHOOL OF OPTOMETRY	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
204670	Fee-for-Service	1770546897	1770546897	1	1	TOTAL RENAL CARE, INC	5/11/1999	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	SOUTH HAYWARD DIALYSIS	254 JACKSON ST	None	HAYWARD	CA	94544	1907	01	06001	37.66028219	-122.0856058	Alameda County
204671	Fee-for-Service	1093324949	1093324949	1	1	TIGRAN TIRATURYAN MD INC	9/1/2020	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1509 WILSON TER	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
204718	Fee-for-Service	1275039794	1275039794	1	1	THUMAR, VISHAL MD	2/13/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	163419	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
204778	Fee-for-Service	1083897086	1083897086	1	1	TAVEAU, JON W DO	4/15/2008	207T00000X	NA	General Surgery	026	PHYSICIANS	9091	14	Neurological Surgery	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
204780	Fee-for-Service	1265126163	1265126163	1	1	TRUE HEALTH MEDICAL GROUP PC	7/15/2023	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1701 E CESAR E CHAVEZ AV	STE 536	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
204832	Fee-for-Service	1508308644	1508308644	1	1	TRANSFORMATIONAL EDUCATION	1/1/2025	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	INC	540 E MAIN ST	None	STOCKTON	CA	95202	3029	39	06077	37.95372254	-121.2836022	San Joaquin County
204837	Fee-for-Service	1033209143	1033209143	1	1	TODD B SETO	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	None	HONOLULU	HI	96813	0000	00	None	21.30800017	-157.8550765	Honolulu County
204842	Fee-for-Service	1033348230	1033348230	1	1	TWEEDLY, STEFANIE M PSYD	10/18/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4300 LONG BEACH BLVD	STE 340	LONG BEACH	CA	90807	2011	19	06037	33.83662572	-118.1900605	Los Angeles County
204856	Fee-for-Service	1659662583	1659662583	1	1	TAN, GORDON L MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122192	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
204879	Fee-for-Service	1679645204	1679645204	1	1	TRAN, TRIEU T MD INC	1/27/2014	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	63498	20	Orthopedic Surgery	0	In state provider	None	11190 WARNER AVENUE	SUITE 300	FOUNTAIN VALLEY	CA	92708	4045	30	06059	33.714	-117.9333585	Orange County
204914	Fee-for-Service	1306908058	1306908058	1	1	THE REGENTS OF THE UNIV	4/20/2023	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CA SCHOOL OF OPTOMETRY	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
204934	Fee-for-Service	1083913826	1083913826	1	1	TRENOU, TOYO A DO	4/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	101 CIVIC CTR LN	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
204975	Fee-for-Service	1447756994	1447756994	1	1	TSEVAT, REBECCA K MD	3/8/2022	207R00000X	NA	Other	026	PHYSICIANS	165160	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
205002	Fee-for-Service	1083736045	1083736045	1	1	TIORAN, TERESA A DO INC	5/15/2007	193400000X	NA	Other	026	PHYSICIANS	7113	None	None	0	In state provider	None	2701 OLD EUREKA WAY	STE 1F	REDDING	CA	96001	0000	45	06089	40.58555878	-122.4101367	Shasta County
205028	Fee-for-Service	1588771745	1588771745	1	1	TOCCI, STEPHEN L MD	4/13/2010	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	108023	20	Orthopedic Surgery	0	In state provider	None	26401 CROWN VALLEY PRKWY	STE 101	MISSION VIEJO	CA	92691	6350	30	06059	33.56378634	-117.6591556	Orange County
205040	Fee-for-Service	1871952879	1871952879	2	1	TURLOCK INPATIENT SERVICES	1/18/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AMC	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
205066	Fee-for-Service	1326300302	1326300302	1	1	TSANG, STEPHANIE OD	9/17/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1575 B STREET	None	HAYWARD	CA	94541	2944	01	06001	37.67905755	-122.072805	Alameda County
205089	Fee-for-Service	1790072775	1790072775	1	1	THOMPSON, JESS A DO	8/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13980	40	Pediatrics	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
205104	Fee-for-Service	1538473954	1538473954	1	1	TRINH, NGOC T OD	7/18/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
205128	Fee-for-Service	1780912683	1780912683	1	1	THOMAS, JAMES D MD	11/27/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	21216	08	Family Practice	0	In state provider	None	1201 E FLORENCE AVENUE	None	LOS ANGELES	CA	90001	2432	19	06037	33.97478347	-118.253943	Los Angeles County
205131	Fee-for-Service	1447360508	1447360508	1	1	TSE, DENNIS MD	1/31/1990	207R00000X	NA	Other	026	PHYSICIANS	64402	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2301 W MAGNOLIA BLVD	None	BURBANK	CA	91506	1735	19	06037	34.17252521	-118.3332018	Los Angeles County
205197	Fee-for-Service	1780406843	1780406843	1	1	THOMPSON, SARAH BIRTH DOULA	1/13/2025	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	33	06065	0	0	None
205215	Fee-for-Service	1154467181	1154467181	1	6	THE HUNTINGTON MEDICAL FOUND	4/13/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	10 CONGRESS ST	STE 208	PASADENA	CA	91105	3027	19	06037	34.13396893	-118.1528162	Los Angeles County
205227	Fee-for-Service	1093137887	1093137887	1	1	TURK, EVA P PHD	4/23/2018	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
205234	Fee-for-Service	1285249565	1285249565	1	1	THAROOR, ANU NP	11/3/2020	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
205265	Fee-for-Service	1255094660	1255094660	1	1	TUSTIN URGENT CARE APC	4/26/2022	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	TOS	4332 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3564	30	06059	33.80293995	-118.057394	Orange County
205289	Fee-for-Service	1790312015	1790312015	1	1	TONG, SARA DO	10/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19496	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
205315	Fee-for-Service	1194980912	1194980912	1	1	THAN, MICHAEL S MD	9/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99817	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
205418	Fee-for-Service	1427498450	1427498450	1	1	TELNET-RX INC	2/24/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2129 E BALL RD	None	ANAHEIM	CA	92806	5127	30	06059	33.8181285	-117.8869635	Orange County
205419	Fee-for-Service	1447360508	1447360508	1	1	TSE, DENNIS MD	1/31/1990	207R00000X	NA	Other	026	PHYSICIANS	64402	01	General Practice	0	In state provider	None	2301 W MAGNOLIA BLVD	None	BURBANK	CA	91506	1735	19	06037	34.17252521	-118.3332018	Los Angeles County
205449	Fee-for-Service	1043528383	1043528383	1	1	TERRY, PORSCHE M LCSW	11/21/2018	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	600 N MOUNTAIN AVE	STE B 106	UPLAND	CA	91786	4359	36	06071	34.10094187	-117.6700806	San Bernardino County
205461	Fee-for-Service	1528083227	1528083227	1	2	TRACY L MALAN RPT APC	6/19/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	PY	525 MELISSA AVE	STE B	BARSTOW	CA	92311	3002	36	06071	34.89483846	-117.0173202	San Bernardino County
205468	Fee-for-Service	1467634493	1467634493	1	1	TSAO, ANTHONY C MD	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101829	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
205490	Fee-for-Service	1255514527	1255514527	2	1	TOTAL TRANSPORT INC.	4/23/2020	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	12444 VICTORY BLVD.	515	LOS ANGELES	CA	91606	3199	19	06037	34.18663951	-118.4043555	Los Angeles County
205555	Fee-for-Service	1235176702	1235176702	1	1	TARZANA EMERGENCY MEDICAL AS	7/11/2001	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	SOCIATES	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
205587	Fee-for-Service	1023499605	1023499605	1	1	TOTAL RENAL CARE INC	12/6/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1415 3RD STREET	None	SAN RAFAEL	CA	94901	2826	21	06041	37.97255494	-122.5327678	Marin County
205619	Fee-for-Service	1790256808	1790256808	1	1	TIBURCIO VASQUEZ HEALTH	2/6/2023	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	25555 HESPERIAN BLVD	BLDG 2300 RM 2315	HAYWARD	CA	94545	2447	01	06001	37.64243568	-122.1038935	Alameda County
205631	Fee-for-Service	1730694365	1730694365	1	1	TAWFIK, MIRA	2/28/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3200 E GUASTI RD	#100	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
205635	Fee-for-Service	1205906229	1205906229	1	17	THE NEPHROLOGY GROUP, INC.	12/29/2021	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1140 OLIVEWOOD DRIVE	None	MERCED	CA	95348	1210	24	06047	37.31797909	-120.4881292	Merced County
205656	Fee-for-Service	1447287917	1447287917	1	1	TIERNEY, MATTHEW NP	10/9/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
205661	Fee-for-Service	1851720148	1851720148	1	1	TEO, MARINA	8/28/2023	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
205709	Fee-for-Service	1881828952	1881828952	1	1	TRAN, VICKI T MD	7/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113967	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
205730	Fee-for-Service	1760711485	1760711485	1	1	TAM, LUANN L INC	3/13/2012	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9080 COLIMA RD	None	WHITTIER	CA	90605	1600	19	06037	33.95062799	-118.0051627	Los Angeles County
205806	Fee-for-Service	1396770905	1396770905	2	1	TAMMELA, KAREN R MD	11/5/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	153083	15	Obstetrics (D.O. only)	0	In state provider	None	220 PALISADE DR	203	SANTA MARIA	CA	93454	8902	42	06083	34.95143521	-120.412098	Santa Barbara County
205817	Fee-for-Service	1528483708	1528483708	1	1	TRAN, VILAYPHONE K LMFT	12/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4624 ARLINGTON AVE	None	RIVERSIDE	CA	92504	2702	33	06065	33.94615854	-117.40365	Riverside County
205833	Fee-for-Service	1255013496	1255013496	1	1	TAYLOR, ASHLEY NP	4/16/2024	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
205840	Fee-for-Service	1609035666	1609035666	1	1	TSAI, WILSON S MD	8/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	106328	33	Thoracic Surgery	0	In state provider	None	365 LENNON LANE	STE 250	WALNUT CREEK	CA	94598	5915	07	06013	37.92784983	-122.0301444	Contra Costa County
205847	Fee-for-Service	1780190983	1780190983	1	1	THRIVE FULL BODY WELLNESS	3/12/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	4959 KATELLA AVE	STE C	CYPRESS	CA	90720	2747	30	06059	33.80314024	-118.0430958	Orange County
205875	Fee-for-Service	1073706545	1073706545	1	1	TOYAR, JASON P MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98614	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
205881	Fee-for-Service	1184605628	1184605628	1	1	TRINH, MIMI VAN T MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83342	08	Family Practice	0	In state provider	None	30300 RANCHO VIEJO RD	None	SAN JUAN CAPISTRA	CA	92675	1576	30	06059	33.52255638	-117.6650853	Orange County
205895	Fee-for-Service	1407965809	1407965809	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5821	1110 LOS OSOS VALLEY RD	None	LOS OSOS	CA	93402	3204	40	06079	35.31098481	-120.8309067	San Luis Obispo County
205906	Fee-for-Service	1790256808	1790256808	1	1	TIBURCIO VASQUEZ HEALTH	1/14/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	25555 HESPERIAN BLVD	BLDG 2300 RM 2315	HAYWARD	CA	94545	2447	01	06001	37.64243568	-122.1038935	Alameda County
205952	Fee-for-Service	1992814420	1992814420	1	1	THRIFTY DRUG STORE 5586	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	9650 BASELINE RD	None	RANCHO CUCAMONGA	CA	91701	5035	36	06071	34.12156148	-117.5947335	San Bernardino County
206016	Fee-for-Service	1922207372	1922207372	1	1	TRAN, BINH-TO MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79716	40	Pediatrics	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
206057	Fee-for-Service	1932722436	1932722436	1	1	TRUE LEGACY INC	2/22/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1722 1/2 COLORADO BLVD	None	LOS ANGELES	CA	90041	1338	19	06037	34.1392529	-118.2044748	Los Angeles County
206087	Fee-for-Service	1477212124	1477212124	1	1	TRUONG, KIM HOANG H PT	3/5/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	291 EAST MAIN ST.	D, E	LOS GATOS	CA	95030	6137	43	06085	37.22109751	-121.9747502	Santa Clara County
206117	Fee-for-Service	1831907419	1831907419	1	1	TONG, ALEX PT	1/30/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
206142	Fee-for-Service	1366656563	1366656563	1	1	TELL, SUSAN C CRNA	10/1/2002	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
206149	Fee-for-Service	1003195710	1003195710	1	1	TERRACE EMERGENCY PHYSICIANS	8/17/2011	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	9449 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1421	19	06037	34.24087386	-118.3954268	Los Angeles County
206161	Fee-for-Service	1073706545	1073706545	1	1	TOYAR, JASON P MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98614	22	Pathology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
206196	Fee-for-Service	1790256808	1790256808	1	1	TIBURCIO VASQUEZ HEALTH	1/14/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	25555 HESPERIAN BLVD	BLDG 2300 RM 2315	HAYWARD	CA	94545	2447	01	06001	37.64243568	-122.1038935	Alameda County
206211	Fee-for-Service	1386624179	1386624179	1	1	TANG, DAVID H MD	11/30/1982	207P00000X	NA	Other	026	PHYSICIANS	44271	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
206248	Fee-for-Service	1295263770	1295263770	1	1	TAWFIK, MELANIE E MD	8/22/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	157076	None	None	0	In state provider	None	25865 BARTON RD	D101, D102, D103, D104	LOMA LINDA	CA	92354	3895	36	06071	34.04824853	-117.2403225	San Bernardino County
206282	Fee-for-Service	1932135290	1932135290	1	1	TELLI, MELINDA L MD	11/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84689	41	Internal Medicine	0	In state provider	None	3555 CESAR CHAVEZ	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.74802705	-122.4207367	San Francisco County
206319	Fee-for-Service	1285716365	1285716365	1	1	TERRY, WILLA MICHELLE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4500 SAND POINT WAY NE	STE 100	SEATTLE	WA	98105	3954	00	None	47.66165594	-122.2864502	King County
206324	Fee-for-Service	1437705753	1437705753	1	1	TAYLOR, DEREK J PT	5/22/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	90 E THOUSAND OAKS BLVD	SUITE 200	THOUSAND OAKS	CA	91360	5716	56	06111	34.17902886	-118.8749335	Ventura County
206326	Fee-for-Service	1225019052	1225019052	1	1	TRIAS, ELMAN L MD	3/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85483	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
206329	Fee-for-Service	1770570988	1770570988	1	1	TOFIGHRAD, MEHRAN DPM	11/22/2000	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	8500 WILSHIRE BLVD	STE 707	BEVERLY HILLS	CA	90211	3105	19	06037	34.06521956	-118.3764689	Los Angeles County
206334	Fee-for-Service	1205384823	1205384823	1	1	TAN, AGNES P NP	5/14/2020	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
206345	Fee-for-Service	1932722436	1932722436	1	1	TRUE LEGACY INC	2/22/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1722 1/2 COLORADO BLVD	None	LOS ANGELES	CA	90041	1338	19	06037	34.1392529	-118.2044748	Los Angeles County
206349	Fee-for-Service	1992720916	1992720916	2	1	TRUONG, DANIEL D MD	4/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	46661	13	Neurology (M.D. only)	0	In state provider	None	9940 TALBERT AVE	SUITE 204	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166347	-117.955494	Orange County
206357	Fee-for-Service	1598748873	1598748873	1	1	THOMAS,KEITH G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MEDICAL CHEST ASSOC	902 FROSTWOOD STE # 188	None	HOUSTON	TX	77024	0000	00	None	29.78019	-95.54773247	Harris County
206381	Fee-for-Service	1578926986	1578926986	1	1	TRAN, MIMIE H	7/19/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15962	08	Family Practice	0	In state provider	None	1200 DISCOVERY DR	None	BAKERSFIELD	CA	93309	7032	15	06029	35.36397746	-119.0589062	Kern County
206499	Fee-for-Service	1750412300	1750412300	1	2	TAHOE FOREST HOSP DIST	4/28/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS RD	STE 260	TRUCKEE	CA	96161	4871	29	06057	39.32625521	-120.2012059	Nevada County
206519	Fee-for-Service	1386641900	1386641900	1	1	THOMPSON, LESTER D MD	10/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66281	22	Pathology (M.D. only)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
206535	Fee-for-Service	1114971256	1114971256	1	1	TIMMEL,KEVIN MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	520 S EAGLE RD	None	MERIDIAN	ID	83642	0000	00	None	43.600527	-116.3518425	Ada County
206611	Fee-for-Service	1134362387	1134362387	1	1	TAREKEGN, SELAMAWIT MD	7/11/2014	207R00000X	NA	Other	026	PHYSICIANS	121492	41	Internal Medicine	0	In state provider	None	199 E WEBSTER STREET	None	COLUSA	CA	95932	2954	06	06011	39.20737704	-122.0004043	Colusa County
206651	Fee-for-Service	1730784208	1730784208	1	1	TELECARE CORPORATION	3/4/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	WELL ORANGE	265 S ANITA DR	202	ORANGE	CA	92868	3346	30	06059	33.78499409	-117.8811837	Orange County
206711	Fee-for-Service	1144861659	1144861659	1	1	TINOSA HOSPICE INC	4/15/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	19531 VENTURA BLVD	UNIT 2	TARZANA	CA	91356	2957	19	06037	34.17281748	-118.5590745	Los Angeles County
206736	Fee-for-Service	1003020223	1003020223	1	1	TODD, DAVID P OD	2/22/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E SECOND STREET	SUITE 2	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
206758	Fee-for-Service	1174911911	1174911911	1	1	TON, AMANDA D NP	10/19/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
206771	Fee-for-Service	1942345269	1942345269	1	1	TORRES, ADRIANA LMFT	3/12/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
206772	Fee-for-Service	1093936841	1093936841	1	1	TESTER, JUNE M MD	10/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85565	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
206777	Fee-for-Service	1306921929	1306921929	1	2	THC-ORANGE COUNTY, LLC	9/1/2001	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	KINDRED HOSP-SAN FRAN	2800 BENEDICT DR	None	SAN LEANDRO	CA	94577	6840	01	06001	37.71593435	-122.131151	Alameda County
206785	Fee-for-Service	1841940780	1841940780	1	1	TRUCARE PHARMACY CORPORATION	7/8/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3110 CHINO AVE	STE 100	CHINO HILLS	CA	91709	1294	36	06071	34.01077341	-117.738406	San Bernardino County
206789	Fee-for-Service	1801888110	1801888110	1	1	TRAN, MICHAEL K MD INC	9/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	78193	18	Ophthalmology	0	In state provider	None	15355 BROOKHURST ST	STE 104	WESTMINSTER	CA	92683	7071	30	06059	33.73998831	-117.9548789	Orange County
206845	Fee-for-Service	1962699421	1962699421	1	1	TU, WILLIAM H MD	8/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96696	34	Urology and Urological Surgery	0	In state provider	None	39400 PASEO PADRE PRKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
206865	Fee-for-Service	1396895124	1396895124	1	1	THOMAS, WILLIAM A PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	450 WINSTON DR	APT 101	SAN FRANCISCO	CA	94132	1707	38	06075	37.727876	-122.4808572	San Francisco County
206908	Fee-for-Service	1952410300	1952410300	1	1	THRIFTY DRUG STORE 5448	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	4044 EAGLE ROCK BLVD	None	LOS ANGELES	CA	90065	3608	19	06037	34.12068136	-118.2273557	Los Angeles County
206924	Fee-for-Service	1861501223	1861501223	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05555	10349 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	2421	19	06037	34.258185	-118.467487	Los Angeles County
206925	Fee-for-Service	1649234949	1649234949	1	1	TRAN, ROGER N MD	10/13/2020	207QG0300X	NA	Adult Primary Care	026	PHYSICIANS	85461	38	Geriatrics	0	In state provider	None	8883 WESTMINSTER AVE	None	GARDEN GROVE	CA	92844	2608	30	06059	33.75942652	-117.974097	Orange County
206935	Fee-for-Service	1275651515	1275651515	1	32	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	2601 W ALAMEDA AVE	SUITE 300	BURBANK	CA	91505	4814	19	06037	34.15783817	-118.3293969	Los Angeles County
206939	Fee-for-Service	1972832657	1972832657	1	1	TOLUCA LAKE MNGMNT CORP	12/15/2009	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	ADMINISTRATOR	10537 MAGNOLIA BLVD	None	NORTH HOLLYWOOD	CA	91601	4114	19	06037	34.16492352	-118.3608675	Los Angeles County
206954	Fee-for-Service	1134408552	1134408552	1	1	TURRENTINE, CHRISTINE E PT	10/30/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1132 ACADEMY AVE	101	SANGER	CA	93657	3195	10	06019	36.69982659	-119.5544778	Fresno County
206963	Fee-for-Service	1225295926	1225295926	1	1	TRANS LIFE INC	2/10/2009	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	7742 GLORIA AVE	UNIT C	VAN NUYS	CA	91406	1819	19	06037	34.211646	-118.479272	Los Angeles County
206975	Fee-for-Service	1629235171	1629235171	1	1	THARIN, SUZANNE A MD	1/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124070	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
206997	Fee-for-Service	1144861659	1144861659	1	1	TINOSA HOSPICE INC	4/15/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	19531 VENTURA BLVD	UNIT 2	TARZANA	CA	91356	2957	19	06037	34.17281748	-118.5590745	Los Angeles County
207006	Fee-for-Service	1982324596	1982324596	1	2	TRUCARE NON MEDICAL TRANSIT	12/30/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	4160 TEMESCAL CANYON RD	SUITE 401	CORONA	CA	92883	4626	33	06065	33.81915655	-117.5075503	Riverside County
207023	Fee-for-Service	1659322626	1659322626	1	1	TORREY, CLARICE	12/18/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
207065	Fee-for-Service	1134935000	1134935000	1	1	THE CONSCIOUSNESS CENTER, AN	3/10/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	65 N MADISON AVE	STE 707	PASADENA	CA	91101	2046	19	06037	34.14705803	-118.1384317	Los Angeles County
207100	Fee-for-Service	1396996294	1396996294	1	1	TANGCHITNOB, EDWARD P MD	8/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110608	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3811 VALLEY CENTRE DR	None	SAN DIEGO	CA	92130	3318	37	06073	32.93760492	-117.2320932	San Diego County
207104	Fee-for-Service	1033295613	1033295613	1	1	THORNTON, ANDREA A PHD	4/24/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
207138	Fee-for-Service	1376578666	1376578666	1	1	TONG, GANG MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63920	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
207215	Fee-for-Service	1689696775	1689696775	1	1	TILLOU, ARETI MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73911	02	General Surgery	0	In state provider	None	1245 16TH ST	STE 120	SANTA MONICA	CA	90404	1240	19	06037	34.02726451	-118.4857138	Los Angeles County
207221	Fee-for-Service	1275651515	1275651515	1	32	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	2601 W ALAMEDA AVE	SUITE 300	BURBANK	CA	91505	4814	19	06037	34.15783817	-118.3293969	Los Angeles County
207305	Fee-for-Service	1588955207	1588955207	1	1	TRONGE, CHRISTINE M LCSW	8/23/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27832	-	NOT APPLICABLE	0	In state provider	None	9500 MALECH RD	None	SAN JOSE	CA	95037	2002	43	06085	37.22005276	-121.7324415	Santa Clara County
207317	Fee-for-Service	1902034028	1902034028	1	1	TAI, CINDY C MD	1/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	91172	02	General Surgery	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
207326	Fee-for-Service	1740399021	1740399021	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	951 N HARBOR BLVD	None	LA HABRA	CA	90631	3103	30	06059	33.940755	-117.9330985	Orange County
207376	Fee-for-Service	1144511338	1144511338	1	1	TEHRANI, PAYAM M MD	7/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126635	41	Internal Medicine	0	In state provider	None	3610 ATLANTIC AVE	None	LONG BEACH	CA	90807	3418	19	06037	33.822621	-118.185002	Los Angeles County
207389	Fee-for-Service	1992764682	1992764682	1	1	TILLITT, DAVID H MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1600 MEDICAL PARKWAY	None	CARSON CITY	NV	89703	4625	00	None	39.202263	-119.7841095	Consolidated Municipality of Carson City
207396	Fee-for-Service	1356619886	1356619886	1	1	TADEO, DIANE KARLA U LMFT	4/27/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	103859	-	NOT APPLICABLE	0	In state provider	None	503 OCEAN FRONT WALK	None	VENICE	CA	90291	2403	19	06037	33.99316887	-118.4791801	Los Angeles County
207502	Fee-for-Service	1689696775	1689696775	1	1	TILLOU, ARETI MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73911	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1245 16TH ST	STE 120	SANTA MONICA	CA	90404	1240	19	06037	34.02726451	-118.4857138	Los Angeles County
207510	Fee-for-Service	1275651515	1275651515	1	32	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	2601 W ALAMEDA AVE	SUITE 300	BURBANK	CA	91505	4814	19	06037	34.15783817	-118.3293969	Los Angeles County
207543	Fee-for-Service	1225316409	1225316409	1	1	TAWFIK, DAVID J MD	2/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123018	41	Internal Medicine	0	In state provider	None	4760 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
207559	Fee-for-Service	1831196112	1831196112	1	1	TINH, VU H MD	12/31/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	52030	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
207592	Fee-for-Service	1639332299	1639332299	1	1	TAN, SERENA Y S MD	2/26/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	109573	22	Pathology (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
207690	Fee-for-Service	1548453814	1548453814	1	1	TZAO, TZU-JEN MD	6/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96855	66	Emergency Medicine (Urgent Care)	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
207695	Fee-for-Service	1861491417	1861491417	1	1	TENDER CARE HOME HEALTH	10/11/1995	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	317 W LAS TUNAS DR	STE 208	SAN GABRIEL	CA	91776	1250	19	06037	34.10250022	-118.1033687	Los Angeles County
207760	Fee-for-Service	1295717502	1295717502	1	1	TAUTZ, TIMOTHY J MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60465	05	Anesthesiology	0	In state provider	None	2525 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
207780	Fee-for-Service	1902196249	1902196249	1	1	THOMAS GIBSON	8/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9205 SW BARNES RD	None	PORTLAND	OR	97225	6603	00	None	45.51093	-122.771907	Washington County
207797	Fee-for-Service	1275651515	1275651515	1	32	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	2601 W ALAMEDA AVE	SUITE 300	BURBANK	CA	91505	4814	19	06037	34.15783817	-118.3293969	Los Angeles County
207821	Fee-for-Service	1407492283	1407492283	1	1	TALBOT, JESSICA NP	7/14/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15975 HARBOR BOULEVARD	None	FOUNTAIN VALLEY	CA	92708	1303	30	06059	33.73140379	-117.9200162	Orange County
207829	Fee-for-Service	1689746927	1689746927	1	1	TRINH, HOANG N MD INC	6/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80075	08	Family Practice	0	In state provider	None	33077 ALVARADO NILES RD	None	UNION CITY	CA	94587	3109	01	06001	37.59324793	-122.0436351	Alameda County
207839	Fee-for-Service	1639430846	1639430846	1	1	THILO, REBECCA C MD	9/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128348	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
207860	Fee-for-Service	1730239781	1730239781	1	1	TAM, JIMMY K MD	3/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97077	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
207904	Fee-for-Service	1598846362	1598846362	1	1	THWAITES, DANIEL J MD	9/15/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75215	08	Family Practice	0	In state provider	None	401 PARADISE RD	STE E	MODESTO	CA	95351	3104	50	06099	37.62692973	-121.0131742	Stanislaus County
207990	Fee-for-Service	1326059882	1326059882	1	1	TRAN, ANDY D MD	7/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84251	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
208036	Fee-for-Service	1093711392	1093711392	1	1	TSUNG, STEPHEN S MD	1/1/2001	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	821 RYLAND ST	None	RENO	NV	89502	1602	00	None	39.52383943	-119.801365	Washoe County
208068	Fee-for-Service	1205906229	1205906229	1	3	THE NEPHROLOGY GROUP, INC.	8/17/2010	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	GROUP INC	800 N STREET	None	SANGER	CA	93657	3116	10	06019	36.70500385	-119.5569573	Fresno County
208086	Fee-for-Service	1275651515	1275651515	1	32	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	2601 W ALAMEDA AVE	SUITE 300	BURBANK	CA	91505	4814	19	06037	34.15783817	-118.3293969	Los Angeles County
208088	Fee-for-Service	1003175233	1003175233	1	1	TICE, MATTHEW R MD	1/4/2024	207P00000X	NA	Other	026	PHYSICIANS	191404	None	None	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4900	39	06077	37.80110374	-121.1974853	San Joaquin County
208137	Fee-for-Service	1184107500	1184107500	1	1	TAT PHARMACY INC	12/10/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9153 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92844	1308	30	06059	33.77402751	-117.9719865	Orange County
208153	Fee-for-Service	1235201070	1235201070	1	1	TOKUGAWA, DIANE A MD	7/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	53459	22	Pathology (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
208168	Fee-for-Service	1245240910	1245240910	1	1	TANG, ROLAND K MD	9/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	66731	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
208180	Fee-for-Service	1700952090	1700952090	1	1	TERZIAN, GARO A MD	4/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80146	41	Internal Medicine	0	In state provider	None	401 S GLENOAKS BLVD	STE 101	BURBANK	CA	91502	2707	19	06037	34.18077992	-118.3029503	Los Angeles County
208191	Fee-for-Service	1558504720	1558504720	1	1	TOWER, SEAN W MD	3/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	128619	30	Radiology	0	In state provider	None	1504 N WISHON AVE	None	FRESNO	CA	93728	1827	10	06019	36.763497	-119.8010405	Fresno County
208195	Fee-for-Service	1326466699	1326466699	1	1	THOMAS, CHLOE MD	4/24/2018	390200000X	NA	Other	026	PHYSICIANS	139787	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
208212	Fee-for-Service	1740286046	1740286046	1	1	TEW, JOEL MD	4/1/1996	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	77 PRINGLE WAY	None	RENO	NV	89502	1474	00	None	39.52484706	-119.7951825	Washoe County
208224	Fee-for-Service	1558416065	1558416065	1	1	TARSITANO, BEN F MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	50488	01	General Practice	0	In state provider	None	70 PENNY LN	STE B	WATSONVILLE	CA	95076	6020	44	06087	36.93104175	-121.7791002	Santa Cruz County
208247	Fee-for-Service	1134130602	1134130602	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05592	2060 S HACIENDA BLVD	None	HACIENDA HEIGHTS	CA	91745	4240	19	06037	33.99593067	-117.9680616	Los Angeles County
208289	Fee-for-Service	1568020527	1568020527	1	1	TOP CARE TRANSPORTATION LLC	8/20/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	7921 KINGSWOOD DR	A2C	CITRUS HEIGHTS	CA	95610	7710	34	06067	38.670192	-121.2705855	Sacramento County
208302	Fee-for-Service	1306994256	1306994256	1	1	TANG, TERESA S MD	8/20/2009	207R00000X	NA	Other	026	PHYSICIANS	66494	41	Internal Medicine	0	In state provider	None	4000 CIVIC CTR DR	None	SAN RAFAEL	CA	94903	4171	21	06041	38.0041783	-122.538861	Marin County
208358	Fee-for-Service	1205906229	1205906229	1	3	THE NEPHROLOGY GROUP, INC.	10/13/2017	207RN0300X	NA	Nephrology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	800 N STREET	None	SANGER	CA	93657	3116	10	06019	36.70500385	-119.5569573	Fresno County
208399	Fee-for-Service	1679071930	1679071930	1	1	TSENG, LAWRENCE W OD	6/4/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4200 CHINO HILLS PKWY	STE 390	CHINO HILLS	CA	91709	5825	36	06071	33.98274451	-117.7129305	San Bernardino County
208432	Fee-for-Service	1629019393	1629019393	1	1	TOY, STEPHANIE M MD	1/2/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	66550	40	Pediatrics	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
208462	Fee-for-Service	1326286840	1326286840	1	1	TISDALE, SARAH A	12/1/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	79763	-	NOT APPLICABLE	0	In state provider	None	241 EAST LAKE AVE	None	WATSONVILLE	CA	95076	4717	44	06087	36.91439331	-121.7546492	Santa Cruz County
208481	Fee-for-Service	1437592862	1437592862	1	1	TAN, HUNG-ENN MD	10/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134397	41	Internal Medicine	0	In state provider	None	555 CASTRO STREET	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38946454	-122.0815711	Santa Clara County
208567	Fee-for-Service	1205462215	1205462215	1	1	TSAO, JACKIE MD	11/11/2022	207R00000X	NA	Other	026	PHYSICIANS	178422	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
208590	Fee-for-Service	1629515705	1629515705	1	1	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	GROUP, A PSYCHOLOGY COR	111 N MARKET	STE 950	SAN JOSE	CA	95113	1112	43	06085	37.33791617	-121.8939388	Santa Clara County
208611	Fee-for-Service	1336727833	1336727833	1	1	TALWAR, SIDDHANT MD	8/3/2024	207PP0204X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
208661	Fee-for-Service	1669538187	1669538187	1	2	THRELFALL, ALEXANDER W MD	11/6/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	113086	36	Psychiatry	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
208674	Fee-for-Service	1639300346	1639300346	1	1	TACVORIAN, ANOUSH H DO	6/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
208713	Fee-for-Service	1457620528	1457620528	1	1	TAN, JENNY MD	6/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119050	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
208724	Fee-for-Service	1124009279	1124009279	1	1	THRUSH, JANE E MD	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	55452	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7601 STONERIDGE DR	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
208740	Fee-for-Service	1376930925	1376930925	1	1	THATCHER, JESSICA L CRNA	5/12/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
208759	Fee-for-Service	1326232992	1326232992	1	1	TUN, LAY M MD	5/21/2009	207R00000X	NA	Other	026	PHYSICIANS	101484	None	None	0	In state provider	None	1866 N ORANGE GROVE AVE	STE 202	POMONA	CA	91767	3031	19	06037	34.07771682	-117.7485431	Los Angeles County
208778	Fee-for-Service	1205906229	1205906229	1	20	THE NEPHROLOGY GROUP, INC.	8/14/2024	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1122 ROSE AVE	#2	SELMA	CA	93662	3257	10	06019	36.56886343	-119.597538	Fresno County
208810	Fee-for-Service	1033294905	1033294905	1	1	TAUBMAN, MURRAY OD	6/7/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12568 VALLEY VIEW ST	None	GARDEN GROVE	CA	92845	2006	30	06059	33.78049752	-118.0307808	Orange County
208862	Fee-for-Service	1831160969	1831160969	1	1	TRAN, LEYEN OD	6/16/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	2843 HYPERION AVE	None	LOS ANGELES	CA	90027	2505	19	06037	34.10896421	-118.2715009	Los Angeles County
208875	Fee-for-Service	1629515705	1629515705	1	1	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	111 N MARKET	STE 950	SAN JOSE	CA	95113	1112	43	06085	37.33791617	-121.8939388	Santa Clara County
208878	Fee-for-Service	1386796423	1386796423	1	1	TRI-COUNTY FAMILY MED CL	7/16/1986	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	P O BOX 97	2400 SIERRA ST	None	KINGSBURG	CA	93631	1458	10	06019	36.51783761	-119.5408635	Fresno County
208879	Fee-for-Service	1427120179	1427120179	1	1	TSAY, CINDY H MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55533	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
208896	Fee-for-Service	1184609208	1184609208	1	1	TARAZON, JENNIFER G CNP	12/8/2021	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
208898	Fee-for-Service	1124184338	1124184338	1	1	TOY, LELAND C OD	10/3/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7601 STONERIDGE DRIVE	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
208939	Fee-for-Service	1275651515	1275651515	1	38	THE ONCOLOGY INSTITUTE CA, A	10/17/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	440 N MOUNTAIN AVE	307	UPLAND	CA	91786	5183	36	06071	34.09896749	-117.6700715	San Bernardino County
208941	Fee-for-Service	1942567094	1942567094	1	1	THOTA, SWETHA MD	9/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132402	01	General Practice	0	In state provider	None	901 EL CAMINO REAL	None	SAN BRUNO	CA	94066	3009	41	06081	37.63110308	-122.4181613	San Mateo County
208966	Fee-for-Service	1487763769	1487763769	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9715 OTIS ST	None	SOUTH GATE	CA	90280	4931	19	06037	33.94527419	-118.1974136	Los Angeles County
208986	Fee-for-Service	1720269996	1720269996	1	1	TOTAL RENAL CARE, INC	9/19/2008	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1640 N LINCOLN ST	None	DIXON	CA	95620	9255	48	06095	38.46257895	-121.8359069	Solano County
208993	Fee-for-Service	1043369838	1043369838	1	1	TANNA, NILIMA N OT	11/17/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
208996	Fee-for-Service	1033730072	1033730072	1	1	THE WHOLENESS EMPOWERMENT GR	2/24/2022	101Y00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	OUP LICENSED CLINICAL SO	22365 BARTON RD	STE 302	GRAND TERRACE	CA	92313	5078	36	06071	34.03387854	-117.316818	San Bernardino County
208998	Fee-for-Service	1750412300	1750412300	1	6	TAHOE FOREST HOSP DIST	4/28/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10710 DONNER PASS RD	2ND FL	TRUCKEE	CA	96161	4884	29	06057	39.32660448	-120.1966779	Nevada County
209022	Fee-for-Service	1184660672	1184660672	1	1	TSUCHIYA, HOWARD K MD	3/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	74024	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
209043	Fee-for-Service	1942476940	1942476940	1	1	TSUI, CYNTHIA C MD	4/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138840	45	Nephrology (Renal-Kidney)	0	In state provider	None	365 LENNON LANE	SUITE 250	WALNUT CREEK	CA	94598	5915	07	06013	37.92784983	-122.0301444	Contra Costa County
209055	Fee-for-Service	1013198738	1013198738	1	3	TSELIKIS, SOFIA MD LTD	12/3/2018	193400000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	6900 N DURANGO DR	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
209066	Fee-for-Service	1205906229	1205906229	1	20	THE NEPHROLOGY GROUP, INC.	8/14/2024	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	1122 ROSE AVE	#2	SELMA	CA	93662	3257	10	06019	36.56886343	-119.597538	Fresno County
209086	Fee-for-Service	1871736314	1871736314	1	1	TASHJIAN, VARTAN MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	90459	14	Neurological Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
209111	Fee-for-Service	1154759694	1154759694	1	1	TOTAL RENAL CARE INC	10/21/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	422 OAK ST	None	BAKERSFIELD	CA	93304	1744	15	06029	35.36225395	-119.0388096	Kern County
209112	Fee-for-Service	1962609958	1962609958	1	1	TSAI, DEVIN DO	5/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14450	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
209121	Fee-for-Service	1942275250	1942275250	1	1	THOMAS, MARIAM R MD	3/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93868	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
209160	Fee-for-Service	1396930947	1396930947	1	1	TRIBBEY, CHARLES L OD	4/28/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	719 B HIGUERA ST	None	SAN LUIS OBISPO	CA	93401	3512	40	06079	35.27905918	-120.6641936	San Luis Obispo County
209164	Fee-for-Service	1629515705	1629515705	1	1	TWO CHAIRS BEHAVIORAL HEALTH	12/20/2021	101YP2500X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	111 N MARKET	STE 950	SAN JOSE	CA	95113	1112	43	06085	37.33791617	-121.8939388	Santa Clara County
209190	Fee-for-Service	1700462207	1700462207	1	1	TRANG, NGON MD	7/12/2024	207R00000X	NA	Other	026	PHYSICIANS	192102	41	Internal Medicine	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
209227	Fee-for-Service	1275651515	1275651515	1	38	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	32	Radiation Therapy (D.O. only)	0	In state provider	PE AND INNOVATION	440 N MOUNTAIN AVE	307	UPLAND	CA	91786	5183	36	06071	34.09896749	-117.6700715	San Bernardino County
209287	Fee-for-Service	1033730072	1033730072	1	1	THE WHOLENESS EMPOWERMENT GR	1/19/2021	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	OUP LICENSED CLINICAL SO	22365 BARTON RD	STE 302	GRAND TERRACE	CA	92313	5078	36	06071	34.03387854	-117.316818	San Bernardino County
209334	Fee-for-Service	1942901657	1942901657	1	1	TIGRAN ABRAHAMYAN NURSING IN	4/10/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	C	1100 E BROADWAY	UNIT 300	GLENDALE	CA	91205	4653	19	06037	34.14622171	-118.2415193	Los Angeles County
209352	Fee-for-Service	1770632176	1770632176	1	1	TU, ALEXANDER H MD	12/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80076	18	Ophthalmology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
209386	Fee-for-Service	1366964603	1366964603	1	1	TACHIBANA, BRYAN M PT	5/26/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
209450	Fee-for-Service	1306902739	1306902739	2	1	TIRMIZI, SYED O MD	9/15/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	53175	41	Internal Medicine	0	In state provider	None	2080 CENTURY PARK E	STE 1006	LOS ANGELES	CA	90067	2013	19	06037	34.05887194	-118.4122914	Los Angeles County
209455	Fee-for-Service	1629515705	1629515705	1	1	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	111 N MARKET	STE 950	SAN JOSE	CA	95113	1112	43	06085	37.33791617	-121.8939388	Santa Clara County
209511	Fee-for-Service	1043548985	1043548985	1	1	TWEED, ROSEMARIE DO APC	8/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	5397	None	None	0	In state provider	None	14114 BUSINESS CENTER DR	STE A	MORENO VALLEY	CA	92553	9113	33	06065	33.9148002	-117.2714647	Riverside County
209516	Fee-for-Service	1275651515	1275651515	1	38	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	440 N MOUNTAIN AVE	307	UPLAND	CA	91786	5183	36	06071	34.09896749	-117.6700715	San Bernardino County
209575	Fee-for-Service	1033730072	1033730072	1	1	THE WHOLENESS EMPOWERMENT GR	6/30/2021	101Y00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	OUP LICENSED CLINICAL SO	22365 BARTON RD	STE 302	GRAND TERRACE	CA	92313	5078	36	06071	34.03387854	-117.316818	San Bernardino County
209617	Fee-for-Service	1275651515	1275651515	1	41	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	23861 MCBEAN PARKWAY	SUITE E-30	VALENCIA	CA	91355	2077	19	06037	34.39567343	-118.5542698	Los Angeles County
209644	Fee-for-Service	1255342291	1255342291	1	1	TRIUNFANTE, ALAINE MAR M PT	5/23/2019	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
209731	Fee-for-Service	1790895464	1790895464	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05611	920 E VALLEY BLVD	None	ALHAMBRA	CA	91801	5226	19	06037	34.07903227	-118.1137535	Los Angeles County
209734	Fee-for-Service	1306902739	1306902739	2	1	TIRMIZI, SYED O MD	9/15/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	53175	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2080 CENTURY PARK E	STE 1006	LOS ANGELES	CA	90067	2013	19	06037	34.05887194	-118.4122914	Los Angeles County
209744	Fee-for-Service	1366498859	1366498859	1	1	TROXEL,SCOTT A MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62276	34	Urology and Urological Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
209782	Fee-for-Service	1114099363	1114099363	1	1	TAPIA, ARMANDO A OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
209802	Fee-for-Service	1699815456	1699815456	1	1	TEHAMA COE	7/1/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1135 LINCOLN ST	None	RED BLUFF	CA	96080	3125	52	06103	40.17867434	-122.2451497	Tehama County
209804	Fee-for-Service	1275651515	1275651515	1	38	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	440 N MOUNTAIN AVE	307	UPLAND	CA	91786	5183	36	06071	34.09896749	-117.6700715	San Bernardino County
209898	Fee-for-Service	1386022234	1386022234	1	1	THOMAS, JOEL MD	9/21/2020	207R00000X	NA	Other	026	PHYSICIANS	165407	41	Internal Medicine	0	In state provider	None	3500 LOMITA BLVD	300, 302, M100	TORRANCE	CA	90505	5038	19	06037	33.81384593	-118.3465974	Los Angeles County
209905	Fee-for-Service	1275651515	1275651515	1	41	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	23861 MCBEAN PARKWAY	SUITE E-30	VALENCIA	CA	91355	2077	19	06037	34.39567343	-118.5542698	Los Angeles County
209960	Fee-for-Service	1609119569	1609119569	1	1	TAN, RONALD W MD	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132704	41	Internal Medicine	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
210024	Fee-for-Service	1063917003	1063917003	1	1	TRAN, JEANNIE N MD	8/23/2021	208M00000X	NA	Other	026	PHYSICIANS	165427	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
210025	Fee-for-Service	1306902739	1306902739	2	1	TIRMIZI, SYED O MD	9/15/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	53175	08	Family Practice	0	In state provider	None	2080 CENTURY PARK E	STE 1006	LOS ANGELES	CA	90067	2013	19	06037	34.05887194	-118.4122914	Los Angeles County
210040	Fee-for-Service	1578521209	1578521209	1	1	TING, DONNA MD	10/1/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	67226	08	Family Practice	0	In state provider	None	799 FRONT ST	None	SOLEDAD	CA	93960	3017	27	06053	36.42508319	-121.3263137	Monterey County
210062	Fee-for-Service	1528088135	1528088135	1	1	TASHKIN, DONALD MD	1/1/1995	207RP1001X	NA	Pulmonology	026	PHYSICIANS	30288	41	Internal Medicine	0	In state provider	UCLA PROF SVCS OFF	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
210074	Fee-for-Service	1851453245	1851453245	1	1	TOM, LINDA L MD	7/31/1993	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	555 CASTRO ST	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38946454	-122.0815711	Santa Clara County
210128	Fee-for-Service	1538450069	1538450069	1	1	TSAI, JENNIFER C LMFT	10/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	91171	-	NOT APPLICABLE	0	In state provider	None	2001 THE ALAMEDA	None	SAN JOSE	CA	95126	1136	43	06085	37.34293689	-121.9270392	Santa Clara County
210168	Fee-for-Service	1346699816	1346699816	1	1	THOMPSON, ELIZABETH A MD	1/16/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163281	None	None	0	In state provider	None	8731 W PICO BLVD	None	LOS ANGELES	CA	90035	2205	19	06037	34.05456946	-118.3824636	Los Angeles County
210176	Fee-for-Service	1699118075	1699118075	1	1	TSOKOS, CHRISTOS G MD	7/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135429	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
210188	Fee-for-Service	1871592154	1871592154	1	1	TABATABAI, AMIR MD	1/5/2023	207RH0003X	NA	Oncology	026	PHYSICIANS	144611	None	None	0	In state provider	None	1779 DOMINICAN WAY	STE B	SANTA CRUZ	CA	95065	1526	44	06087	36.9902958	-121.9808957	Santa Cruz County
210194	Fee-for-Service	1275651515	1275651515	1	41	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	23861 MCBEAN PARKWAY	SUITE E-30	VALENCIA	CA	91355	2077	19	06037	34.39567343	-118.5542698	Los Angeles County
210211	Fee-for-Service	1497100606	1497100606	1	1	TSOI, GEOFFREY Y DO	10/15/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17304	08	Family Practice	0	In state provider	None	11160 WARNER AVE	SUITE 117	FOUNTAIN VALLEY	CA	92708	4010	30	06059	33.71630854	-117.934317	Orange County
210235	Fee-for-Service	1265069348	1265069348	1	1	TRAN, KIRK	10/18/2023	208M00000X	NA	Other	026	PHYSICIANS	187642	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
210236	Fee-for-Service	1699839993	1699839993	1	2	THE CHILDRENS CLINIC SERVING	2/3/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	17660 LAKEWOOD BLVD	None	BELLFLOWER	CA	90706	6410	19	06037	33.87138705	-118.142548	Los Angeles County
210262	Fee-for-Service	1043353568	1043353568	1	1	TRUONG, TRAM T DO	7/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	9845	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
210316	Fee-for-Service	1639452089	1639452089	1	1	TEKCHANDANI, LEENA MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116604	30	Radiology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
210349	Fee-for-Service	1528088135	1528088135	1	1	TASHKIN, DONALD MD	1/1/1995	207RP1001X	NA	Pulmonology	026	PHYSICIANS	30288	29	Pulmonary Diseases (M.D. only)	0	In state provider	UCLA PROF SVCS OFF	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
210386	Fee-for-Service	1740445154	1740445154	1	1	TIEN, PHUONG Q MD	6/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	111842	25	Physical Medicine and Rehabilitation	0	In state provider	None	11190 WARNER AVE	STE 308	FOUNTAIN VALLEY	CA	92708	4047	30	06059	33.714	-117.9333585	Orange County
210400	Fee-for-Service	1770558710	1770558710	1	1	TRI-CITY MEDICAL CTR	1/1/1995	273R00000X	NA	Other	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
210432	Fee-for-Service	1386039170	1386039170	1	1	TROPE, LEE A MD	6/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	143881	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
210480	Fee-for-Service	1275651515	1275651515	1	41	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	23861 MCBEAN PARKWAY	SUITE E-30	VALENCIA	CA	91355	2077	19	06037	34.39567343	-118.5542698	Los Angeles County
210498	Fee-for-Service	1396168167	1396168167	1	1	TINT, HTAY H MD	10/31/2020	207R00000X	NA	Other	026	PHYSICIANS	142789	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
210520	Fee-for-Service	1699839993	1699839993	1	2	THE CHILDRENS CLINIC SERVING	2/3/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	17660 LAKEWOOD BLVD	None	BELLFLOWER	CA	90706	6410	19	06037	33.87138705	-118.142548	Los Angeles County
210539	Fee-for-Service	1790744704	1790744704	1	2	THYGESON, JONATHAN	1/10/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	75063	None	None	0	In state provider	None	755 UNIVERSITY AVE	None	SACRAMENTO	CA	95825	6708	34	06067	38.565378	-121.419567	Sacramento County
210606	Fee-for-Service	1770563017	1770563017	1	1	TUCSON HEART HOSPITAL	7/6/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CARONDELET, LLC	4888 N STONE AVE	None	TUCSON	AZ	85704	5749	00	None	32.29425	-110.970225	Pima County
210648	Fee-for-Service	1336161892	1336161892	1	1	THOMAS, ROBERT L DO	4/10/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	360 S LOLA LN	None	PAHRUMP	NV	89048	0884	00	None	36.214524	-116.025615	Nye County
210699	Fee-for-Service	1649523762	1649523762	1	1	TORREGROSSA, JOELLE MD	11/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123301	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
210706	Fee-for-Service	1891966636	1891966636	1	1	TRUONG, HOA G DO	7/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8496	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
210711	Fee-for-Service	1619311453	1619311453	1	1	TAUB, REBECCA L MD	9/16/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162980	09	Gynecology (D.O. only)	0	In state provider	None	2500 MILVIA ST	None	BERKELEY	CA	94704	2636	01	06001	37.86338897	-122.2698455	Alameda County
210768	Fee-for-Service	1346266269	1346266269	1	1	TYSON, BRIAN M MD	11/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	88297	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
210769	Fee-for-Service	1275651515	1275651515	1	41	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	23861 MCBEAN PARKWAY	SUITE E-30	VALENCIA	CA	91355	2077	19	06037	34.39567343	-118.5542698	Los Angeles County
210778	Fee-for-Service	1053653576	1053653576	1	1	THAO, CHOUA MD	8/8/2019	207RC0200X	NA	Other	026	PHYSICIANS	162785	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
210787	Fee-for-Service	1417447426	1417447426	1	1	TORADO, CYRIL D	10/8/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173954	None	None	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
210802	Fee-for-Service	1477734176	1477734176	1	1	TURMAN, STEVEN L MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32276	41	Internal Medicine	0	In state provider	None	1330 TARA HILLS DR	STE J	PINOLE	CA	94564	2579	07	06013	37.99580466	-122.3048363	Contra Costa County
210830	Fee-for-Service	1275651515	1275651515	1	20	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	1250 S SUNSET AVE	101	WEST COVINA	CA	91790	3900	19	06037	34.0610671	-117.9463685	Los Angeles County
210831	Fee-for-Service	1184733610	1184733610	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05844	37950 47TH ST EAST	None	PALMDALE	CA	93552	4418	19	06037	34.57217781	-118.0449808	Los Angeles County
210892	Fee-for-Service	1770563017	1770563017	1	1	TUCSON HEART HOSPITAL	7/6/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CARONDELET, LLC	4888 N STONE AVE	None	TUCSON	AZ	85704	5749	00	None	32.29425	-110.970225	Pima County
210934	Fee-for-Service	1447852405	1447852405	1	1	TUTUNIK, YANA A PT	5/11/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5250 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91601	3186	19	06037	34.1665161	-118.3755868	Los Angeles County
210997	Fee-for-Service	1619311453	1619311453	1	1	TAUB, REBECCA L MD	9/16/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162980	15	Obstetrics (D.O. only)	0	In state provider	None	2500 MILVIA ST	None	BERKELEY	CA	94704	2636	01	06001	37.86338897	-122.2698455	Alameda County
211084	Fee-for-Service	1952489577	1952489577	1	1	TAMORIA, SHIRLEY A MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83064	08	Family Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
211090	Fee-for-Service	1982823720	1982823720	1	1	THAKKAR, RAJAN K MD	4/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	85	Surgery-Pediatric	2	Out of state provider	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
211100	Fee-for-Service	1174545297	1174545297	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	218 N MAIN ST	None	SEBASTOPOL	CA	95472	3436	49	06097	38.4036743	-122.8252125	Sonoma County
211118	Fee-for-Service	1275651515	1275651515	1	20	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	1250 S SUNSET AVE	101	WEST COVINA	CA	91790	3900	19	06037	34.0610671	-117.9463685	Los Angeles County
211126	Fee-for-Service	1942820337	1942820337	1	1	TAHATA, TIFFANY DO	4/7/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	21176	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
211133	Fee-for-Service	1215155833	1215155833	1	1	THARANI, RAVI MD	7/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86699	20	Orthopedic Surgery	0	In state provider	None	1505 WILSON TER	STE 200	GLENDALE	CA	91206	4073	19	06037	34.14960934	-118.2313491	Los Angeles County
211135	Fee-for-Service	1104837681	1104837681	1	1	THRIFTY DRUG STORE 5602	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	1841 E 4TH ST	None	ONTARIO	CA	91764	2601	36	06071	34.078815	-117.612522	San Bernardino County
211160	Fee-for-Service	1619925583	1619925583	1	1	TAYER, WENDY G PHD	7/1/2001	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
211173	Fee-for-Service	1942895065	1942895065	1	1	TALAMI HEALTH & WELLNESS, IN	5/27/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	C.	505 N MOLLISON	SUITE 103	EL CAJON	CA	92021	6159	37	06073	32.80048689	-116.9509459	San Diego County
211202	Fee-for-Service	1235147489	1235147489	1	1	TAO, JEFF MD	12/1/1994	207R00000X	NA	Other	026	PHYSICIANS	68301	70	Clinic (mixed specialty)	0	In state provider	None	10666 N TORREY PINES RD	# MS317	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
211208	Fee-for-Service	1275651515	1275651515	1	54	THE ONCOLOGY INSTITUTE CA, A	6/7/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INNOVATION	41865 BOARDWALK	SUITE 100	PALM DESERT	CA	92211	9026	33	06065	33.74625125	-116.3549824	Riverside County
211232	Fee-for-Service	1295958510	1295958510	1	1	TANAKA, STUART T LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
211264	Fee-for-Service	1336574854	1336574854	1	1	THOMAS, MELISSA D PT	5/21/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	50 NUGGET LANE	STE A	WEAVERVILLE	CA	96093	2120	53	06105	40.72205851	-122.9293599	Trinity County
211275	Fee-for-Service	1851357958	1851357958	1	1	THOMPSON, JAMES I DO	7/5/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	8259	05	Anesthesiology	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
211287	Fee-for-Service	1164805354	1164805354	1	1	TUNG, AMITY MD	8/3/2018	207QS0010X	NA	Adult Primary Care	026	PHYSICIANS	143950	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
211308	Fee-for-Service	1518292838	1518292838	1	1	TOMONA YAMASHIRO, LILIANA MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110242	01	General Practice	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
211339	Fee-for-Service	1649466285	1649466285	1	1	TODD, GRETA PHD	7/31/2012	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
211365	Fee-for-Service	1427117944	1427117944	1	1	TALIB, ZOHRAY M MD	12/11/2020	207R00000X	NA	Other	026	PHYSICIANS	160119	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
211368	Fee-for-Service	1255819702	1255819702	1	1	TRINIDAD, HEIDEL S RCP	9/6/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
211378	Fee-for-Service	1316751100	1316751100	1	1	THE CENTER FOR VIOLENCE-FREE	2/7/2025	251B00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	RELATIONSHIPS	344 PLACERVILLE DR	STE 11	PLACERVILLE	CA	95667	3971	09	06017	38.7312968	-120.8343258	El Dorado County
211400	Fee-for-Service	1215013982	1215013982	1	1	TURK, ANNE E PHD	7/11/2007	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
211409	Fee-for-Service	1275651515	1275651515	1	20	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	1250 S SUNSET AVE	101	WEST COVINA	CA	91790	3900	19	06037	34.0610671	-117.9463685	Los Angeles County
211443	Fee-for-Service	1396772703	1396772703	1	1	TAYLOR, KIMBERLY A DO	1/24/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	22258	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
211458	Fee-for-Service	1942895065	1942895065	1	1	TALAMI HEALTH & WELLNESS, IN	12/2/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	C.	505 N MOLLISON	SUITE 103	EL CAJON	CA	92021	6159	37	06073	32.80048689	-116.9509459	San Diego County
211490	Fee-for-Service	1639240146	1639240146	2	1	THROM, BILLY JR	10/13/2004	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	130 N BUTTE ST	STE AB	WILLOWS	CA	95988	2836	11	06021	39.52141639	-122.1953507	Glenn County
211494	Fee-for-Service	1275651515	1275651515	1	54	THE ONCOLOGY INSTITUTE CA, A	12/13/2023	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	INNOVATION	41865 BOARDWALK	SUITE 100	PALM DESERT	CA	92211	9026	33	06065	33.74625125	-116.3549824	Riverside County
211512	Fee-for-Service	1609300821	1609300821	1	1	TENA, RACHAEL L MD	5/26/2020	207P00000X	NA	Other	026	PHYSICIANS	158518	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
211520	Fee-for-Service	1730446246	1730446246	1	1	TORRES, KATHLEEN A MD	7/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135534	None	None	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3326	04	06007	39.74248474	-121.8493369	Butte County
211526	Fee-for-Service	1043575244	1043575244	1	1	TITIANU, MIRELA MD	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2640 E BARNETT RD	E333	MEDFORD	OR	97504	4301	00	None	42.31645852	-122.834421	Jackson County
211546	Fee-for-Service	1851473318	1851473318	1	1	TATRO, BRUCE G MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	60674	01	General Practice	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
211575	Fee-for-Service	1144597477	1144597477	1	1	TIBURCIO VASQUEZ HEALTH	1/9/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	680 W TENNYSON RD	None	HAYWARD	CA	94544	5236	01	06001	37.63204354	-122.0681454	Alameda County
211622	Fee-for-Service	1881771483	1881771483	1	1	TROY, STEPHANIE B MD	9/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97445	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
211630	Fee-for-Service	1396391017	1396391017	1	1	TONG, LAUREN M PT	4/13/2020	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
211659	Fee-for-Service	1013149012	1013149012	1	1	TOOFANINEJAD, AZADEH MD	9/3/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	15704	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3941 J STREET	STE 260	SACRAMENTO	CA	95819	3663	34	06067	38.570652	-121.4535465	Sacramento County
211661	Fee-for-Service	1114904166	1114904166	1	1	THATIPELLI, MALLIK R MD	1/14/2011	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	53592	41	Internal Medicine	0	In state provider	None	2808 F ST	STE A	BAKERSFIELD	CA	93301	1833	15	06029	35.3853	-119.023444	Kern County
211683	Fee-for-Service	1851520498	1851520498	1	1	THURSTON, STEVEN R OD	2/27/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	605 FLETCHER PKWY	None	EL CAJON	CA	92020	2522	37	06073	32.8075167	-116.9697503	San Diego County
211696	Fee-for-Service	1275651515	1275651515	1	20	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	1250 S SUNSET AVE	101	WEST COVINA	CA	91790	3900	19	06037	34.0610671	-117.9463685	Los Angeles County
211742	Fee-for-Service	1164493466	1164493466	1	1	THORNTON, AARON	4/1/1996	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ALL EYES ON ME OPTOMETRY	3417 FRUITVALE AVE	None	OAKLAND	CA	94602	2317	01	06001	37.79961797	-122.2164708	Alameda County
211760	Fee-for-Service	1487117875	1487117875	1	1	TAMASHIRO, CHASE M DPM	7/28/2022	390200000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	9017 RESEDA	SUITE 100	NORTHRIDGE	CA	91324	3922	19	06037	34.234155	-118.5360975	Los Angeles County
211772	Fee-for-Service	1043382278	1043382278	1	1	TOM, LAWRENCE R MD	2/28/2008	207RP1001X	NA	Pulmonology	026	PHYSICIANS	81589	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
211787	Fee-for-Service	1275651515	1275651515	1	54	THE ONCOLOGY INSTITUTE CA, A	6/7/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	INNOVATION	41865 BOARDWALK	SUITE 100	PALM DESERT	CA	92211	9026	33	06065	33.74625125	-116.3549824	Riverside County
211811	Fee-for-Service	1821044389	1821044389	1	1	TAIKWEL, EDNA K MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54127	None	None	0	In state provider	GARVEY HLTHY FAMILY MED	705 E GARVEY AVE	None	MONTEREY PARK	CA	91755	3024	19	06037	34.0626543	-118.1127966	Los Angeles County
211815	Fee-for-Service	1891006706	1891006706	1	1	TAYLOR, RUSSELL K MD	12/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120171	05	Anesthesiology	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
211845	Fee-for-Service	1750500591	1750500591	1	1	TAN, TZE-WOEI MD	8/11/2022	2086S0129X	NA	General Surgery	026	PHYSICIANS	176675	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
211850	Fee-for-Service	1114124369	1114124369	1	1	TANG, EDWARD Y MD	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	98847	20	Orthopedic Surgery	0	In state provider	None	1001 POTRERO AVE	RM 3A	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
211865	Fee-for-Service	1144597477	1144597477	1	1	TIBURCIO VASQUEZ HEALTH	1/9/2013	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	680 W TENNYSON RD	None	HAYWARD	CA	94544	5236	01	06001	37.63204354	-122.0681454	Alameda County
211893	Fee-for-Service	1891806998	1891806998	1	1	THRIFTY PAYLESS INC	11/2/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6454	1645 E TULARE AVE	None	TULARE	CA	93274	3155	54	06107	36.21106954	-119.322747	Tulare County
211898	Fee-for-Service	1629147533	1629147533	1	1	TANDINCO, ARTOTELES L MD	7/22/2008	2084P0800X	NA	Psychiatry	026	PHYSICIANS	44894	36	Psychiatry	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
211927	Fee-for-Service	1861275067	1861275067	1	1	TER HOVHANNISYAN, ARPINE NP	11/17/2023	208M00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15107 VANOWEN STREET	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
211937	Fee-for-Service	1912320433	1912320433	1	1	TIEDEMANN, CHELSEA L NP	12/12/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
211941	Fee-for-Service	1386956118	1386956118	1	1	TAHOE TRUCKEE UNIFIED	5/2/2010	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOL DISTRICT	11603 DONNER PASS RD	None	TRUCKEE	CA	96161	4953	29	06057	39.32609282	-120.2116134	Nevada County
211985	Fee-for-Service	1275651515	1275651515	1	20	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	1250 S SUNSET AVE	101	WEST COVINA	CA	91790	3900	19	06037	34.0610671	-117.9463685	Los Angeles County
212034	Fee-for-Service	1184915092	1184915092	1	1	THE PEACH TREE CLINIC INC	6/13/2011	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1445 VETERANS MEMORIAL	SUITE B	YUBA CITY	CA	95993	3011	51	06101	39.14469836	-121.6380819	Sutter County
212118	Fee-for-Service	1811972276	1811972276	1	1	TOMITA, KANAKO M OD	2/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1001 RIVERSIDE AVENUE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
212151	Fee-for-Service	1144597477	1144597477	1	1	TIBURCIO VASQUEZ HEALTH	1/9/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	680 W TENNYSON RD	None	HAYWARD	CA	94544	5236	01	06001	37.63204354	-122.0681454	Alameda County
212230	Fee-for-Service	1386956118	1386956118	1	1	TAHOE TRUCKEE UNIFIED	1/1/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	SCHOOL DISTRICT	11603 DONNER PASS RD	None	TRUCKEE	CA	96161	4953	29	06057	39.32609282	-120.2116134	Nevada County
212232	Fee-for-Service	1649541418	1649541418	1	1	TUEY, AUDREY F LCSW	1/6/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	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
212265	Fee-for-Service	1891976759	1891976759	1	1	TINITIGAN, MICHELLE A MD	6/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111439	08	Family Practice	0	In state provider	None	350 PARNASSUS AVE	None	SAN FRANCISCO	CA	94117	3608	38	06075	37.76403932	-122.4561371	San Francisco County
212274	Fee-for-Service	1275651515	1275651515	1	3	THE ONCOLOGY INSTITUTE CA, A	8/25/2009	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	8135 S PAINTER AVENUE	SUITE 103	WHITTIER	CA	90602	3171	19	06037	33.965829	-118.032738	Los Angeles County
212324	Fee-for-Service	1184915092	1184915092	1	1	THE PEACH TREE CLINIC INC	6/13/2011	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1445 VETERANS MEMORIAL	SUITE B	YUBA CITY	CA	95993	3011	51	06101	39.14469836	-121.6380819	Sutter County
212349	Fee-for-Service	1538153341	1538153341	1	1	TUNG, HOWARD MD	2/28/1992	207T00000X	NA	General Surgery	026	PHYSICIANS	58235	None	None	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
212354	Fee-for-Service	1750318044	1750318044	1	1	TORNABENE, VINCENT W MD	3/1/1999	207P00000X	NA	Other	026	PHYSICIANS	26147	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
212364	Fee-for-Service	1003925538	1003925538	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4224 E SHIELDS AVE	None	FRESNO	CA	93726	7120	10	06019	36.77953053	-119.753487	Fresno County
212371	Fee-for-Service	1013970516	1013970516	1	1	TOTAL RENAL CARE, INC	3/1/1996	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	21615 HESPERIAN BLVD	SUITE F	HAYWARD	CA	94541	7026	01	06001	37.66086627	-122.1153067	Alameda County
212406	Fee-for-Service	1831251933	1831251933	1	1	TAHOE FOREST HOSPITAL	12/1/1977	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10875 PIONEER TRAIL	None	TRUCKEE	CA	96161	0235	29	06057	39.33575474	-120.1815614	Nevada County
212409	Fee-for-Service	1962800235	1962800235	1	1	THE REGENTS OF THE UNIVERSIT	1/6/2015	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2100 W 3RD ST	STE 100	LOS ANGELES	CA	90057	1971	19	06037	34.06308947	-118.2733326	Los Angeles County
212418	Fee-for-Service	1508865528	1508865528	1	5	TAHOE CARSON VALLEY	11/10/2005	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
212475	Fee-for-Service	1871949347	1871949347	1	1	TSANG, LISA MD	9/12/2019	207R00000X	NA	Other	026	PHYSICIANS	155061	41	Internal Medicine	0	In state provider	None	901 CAMPUS DR.	None	DALY CITY	CA	94015	4900	41	06081	37.66535778	-122.4763793	San Mateo County
212489	Fee-for-Service	1346582749	1346582749	1	1	TONDRAVI, NADER MD	10/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156615	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	7403	19	06037	34.06633051	-118.4452686	Los Angeles County
212491	Fee-for-Service	1912074899	1912074899	1	1	TRAINA, TAD G MD	11/1/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	73829	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
212527	Fee-for-Service	1013371756	1013371756	1	1	TAILOR, NEELAM G MD	4/16/2024	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
212559	Fee-for-Service	1275651515	1275651515	1	3	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8135 S PAINTER AVENUE	SUITE 103	WHITTIER	CA	90602	3171	19	06037	33.965829	-118.032738	Los Angeles County
212564	Fee-for-Service	1649342981	1649342981	1	1	TRAN, TRI V MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66732	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
212596	Fee-for-Service	1891363685	1891363685	1	1	THOMAS, TARYN E PT	9/24/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
212610	Fee-for-Service	1992117949	1992117949	1	1	TABANGCURA, ANN M LMFT	4/30/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
212611	Fee-for-Service	1184915092	1184915092	1	1	THE PEACH TREE CLINIC INC	6/13/2011	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1445 VETERANS MEMORIAL	SUITE B	YUBA CITY	CA	95993	3011	51	06101	39.14469836	-121.6380819	Sutter County
212654	Fee-for-Service	1780602276	1780602276	1	1	THUNDER, RICHARD M MD	2/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72768	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
212692	Fee-for-Service	1962800235	1962800235	1	1	THE REGENTS OF THE UNIVERSIT	1/6/2015	231H00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2100 W 3RD ST	STE 100	LOS ANGELES	CA	90057	1971	19	06037	34.06308947	-118.2733326	Los Angeles County
212707	Fee-for-Service	1508865528	1508865528	1	5	TAHOE CARSON VALLEY	2/12/2018	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
212745	Fee-for-Service	1578103594	1578103594	1	1	TAYLOR, AARON M PT	12/2/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
212755	Fee-for-Service	1275651515	1275651515	1	14	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3851 KATELLA AVENUE	SUITE 355	LOS ALAMITOS	CA	90720	3309	30	06059	33.80319053	-118.0657305	Orange County
212762	Fee-for-Service	1134775711	1134775711	1	1	TANOURY, VICTORIA R CNP	9/6/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
212803	Fee-for-Service	1194041707	1194041707	1	1	TARASEVICIUTE, AGNE MD	8/2/2018	2080P0207X	NA	Hematology	026	PHYSICIANS	156303	68	Hematology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
212811	Fee-for-Service	1689703522	1689703522	1	1	TECCO, MEREDITH E MD	12/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	96601	36	Psychiatry	0	In state provider	None	3825 HOPYARD ROAD	SUITE 140	PLEASANTON	CA	94566	8528	01	06001	37.683009	-121.9036935	Alameda County
212846	Fee-for-Service	1386713980	1386713980	1	1	TRUONG, MINH OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 N HARBOR BLVD	STE C4	SANTA ANA	CA	92703	3368	30	06059	33.74559419	-117.9202196	Orange County
212849	Fee-for-Service	1275651515	1275651515	1	3	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	8135 S PAINTER AVENUE	SUITE 103	WHITTIER	CA	90602	3171	19	06037	33.965829	-118.032738	Los Angeles County
212885	Fee-for-Service	1326828740	1326828740	1	1	TAM, RACHEL NP	9/19/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
212893	Fee-for-Service	1104873520	1104873520	2	1	TUAN, KE H MD	6/27/2011	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	85944	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	929 CLAY ST	STE 305	SAN FRANCISCO	CA	94108	1570	38	06075	37.79398652	-122.4083496	San Francisco County
212898	Fee-for-Service	1184915092	1184915092	1	1	THE PEACH TREE CLINIC INC	6/13/2011	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1445 VETERANS MEMORIAL	SUITE B	YUBA CITY	CA	95993	3011	51	06101	39.14469836	-121.6380819	Sutter County
212902	Fee-for-Service	1528131075	1528131075	1	1	TO, YVONNE V OD	11/30/1994	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10968 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	3853	30	06059	33.7162557	-117.9375212	Orange County
212917	Fee-for-Service	1417190406	1417190406	1	1	TERAMOTO, DEANNA M	7/12/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	206 N JACKSON ST	STE 202	GLENDALE	CA	91206	4330	19	06037	34.14852285	-118.2501237	Los Angeles County
212927	Fee-for-Service	1619148798	1619148798	1	1	TOPADZHIKYAN, HAIK CRNA	7/12/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
212957	Fee-for-Service	1225310139	1225310139	1	1	TOKUSHIGE, FONDA LCSW	3/22/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
212967	Fee-for-Service	1306073481	1306073481	1	1	TAVERNETTI, RICHARD R MD	5/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114191	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 NORTH MCDOWELL BLVD	None	PETALUMA	CA	94954	2339	49	06097	38.25477	-122.63175	Sonoma County
212973	Fee-for-Service	1932367190	1932367190	1	1	TSE, CLIFFORD K MD	4/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	115222	08	Family Practice	0	In state provider	None	10305 PROMENADE PKWY	None	ELK GROVE	CA	95757	9400	34	06067	38.384523	-121.371318	Sacramento County
212985	Fee-for-Service	1134225626	1134225626	1	1	TAKATA, GLENN S. MD	2/28/1988	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	52851	01	General Practice	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
212994	Fee-for-Service	1508865528	1508865528	1	5	TAHOE CARSON VALLEY	12/9/2019	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
213040	Fee-for-Service	1275651515	1275651515	1	14	THE ONCOLOGY INSTITUTE CA, A	6/1/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	3851 KATELLA AVENUE	SUITE 355	LOS ALAMITOS	CA	90720	3309	30	06059	33.80319053	-118.0657305	Orange County
213062	Fee-for-Service	1356659882	1356659882	1	1	TOTAL RENAL CARE INC	2/1/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2351 CLAY ST	4TH FL	SAN FRANCISCO	CA	94114	1931	38	06075	37.79101512	-122.4316059	San Francisco County
213137	Fee-for-Service	1275651515	1275651515	1	3	THE ONCOLOGY INSTITUTE CA, A	8/25/2009	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	8135 S PAINTER AVENUE	SUITE 103	WHITTIER	CA	90602	3171	19	06037	33.965829	-118.032738	Los Angeles County
213151	Fee-for-Service	1558483800	1558483800	1	1	TIMOTHY JANIGA, M.D.	4/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 DAMONTE RANCH PKWY	STE 703	RENO	NV	89521	3911	00	None	39.42111331	-119.7527568	Washoe County
213183	Fee-for-Service	1396034591	1396034591	1	1	THERESA PHARMACY, INC.	7/8/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9860 KATELLA AVENUE	None	ANAHEIM	CA	92804	6418	30	06059	33.80304606	-117.9614659	Orange County
213190	Fee-for-Service	1881170199	1881170199	1	1	TRIAS SANCHEZ, ANGIE MD	4/30/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173412	08	Family Practice	0	In state provider	None	191 S BUENA VISTA STREET	SUITE 150	BURBANK	CA	91505	4522	19	06037	34.15872557	-118.3283863	Los Angeles County
213198	Fee-for-Service	1508991316	1508991316	1	1	TCHENG, WENDY Y MD	1/1/1999	2080P0207X	NA	Hematology	026	PHYSICIANS	64985	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
213215	Fee-for-Service	1891372868	1891372868	1	1	THARAYIL, JITHIL L MD	5/3/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
213243	Fee-for-Service	1952669285	1952669285	1	1	TANG, XIANNAN MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132121	13	Neurology (M.D. only)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
213262	Fee-for-Service	1386902211	1386902211	1	1	TSAI, JANICE MD	6/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126801	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
213264	Fee-for-Service	1972799369	1972799369	1	1	TOMFOHRDE, KEVIN MD	9/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10087	05	Anesthesiology	0	In state provider	None	3315 WATT AVENUE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
213284	Fee-for-Service	1508865528	1508865528	1	5	TAHOE CARSON VALLEY	9/15/2021	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
213331	Fee-for-Service	1275651515	1275651515	1	14	THE ONCOLOGY INSTITUTE CA, A	10/14/2020	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3851 KATELLA AVENUE	SUITE 355	LOS ALAMITOS	CA	90720	3309	30	06059	33.80319053	-118.0657305	Orange County
213362	Fee-for-Service	1992905723	1992905723	1	1	TAYLOR, BRIAN S MD	11/2/2010	2084P0800X	NA	Psychiatry	026	PHYSICIANS	75540	36	Psychiatry	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
213378	Fee-for-Service	1619016169	1619016169	1	1	TSENG, LILLIAN MD	11/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92639	41	Internal Medicine	0	In state provider	None	700 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
213404	Fee-for-Service	1639706021	1639706021	1	1	TITUS, MICHA MD	6/14/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
213409	Fee-for-Service	1114138476	1114138476	2	1	TUPAZ HOME LLC	5/18/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	14926 UNION AVE	None	SAN JOSE	CA	95124	4358	43	06085	37.251738	-121.9310835	Santa Clara County
213425	Fee-for-Service	1275651515	1275651515	1	3	THE ONCOLOGY INSTITUTE CA, A	8/25/2009	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	8135 S PAINTER AVENUE	SUITE 103	WHITTIER	CA	90602	3171	19	06037	33.965829	-118.032738	Los Angeles County
213450	Fee-for-Service	1750420451	1750420451	1	1	TORBATI, ARIAN MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64518	41	Internal Medicine	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
213467	Fee-for-Service	1184767360	1184767360	1	1	THIO, ANDREW MD INC	6/27/2008	208VP0000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	40700 CALIFORNIA OAKS RD	STE 108	MURRIETA	CA	92562	5751	33	06065	33.57067363	-117.2045035	Riverside County
213491	Fee-for-Service	1285208108	1285208108	1	1	TARIQ, NAVEEN MD	7/23/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
213558	Fee-for-Service	1194354159	1194354159	1	1	TAPRYAL, NEEL MD	8/28/2023	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
213564	Fee-for-Service	1467931303	1467931303	1	1	TANG, HUY T RCP	8/31/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
213572	Fee-for-Service	1508865528	1508865528	1	5	TAHOE CARSON VALLEY	2/12/2018	193200000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
213598	Fee-for-Service	1487707071	1487707071	1	1	TRUONG, TAN N OD	2/17/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	230 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
213609	Fee-for-Service	1841696895	1841696895	1	1	TENENBAUM, STEVEN F	3/20/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	3463 CIRCULO ADORNO	None	CARLSBAD	CA	92009	8908	37	06073	33.07386864	-117.2337339	San Diego County
213616	Fee-for-Service	1275651515	1275651515	1	14	THE ONCOLOGY INSTITUTE CA, A	6/1/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	3851 KATELLA AVENUE	SUITE 355	LOS ALAMITOS	CA	90720	3309	30	06059	33.80319053	-118.0657305	Orange County
213639	Fee-for-Service	1881703247	1881703247	1	1	THRIFTY PAYLESS INC	3/28/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6214	1001 N CENTRAL AVE	None	COMPTON	CA	90222	3647	19	06037	33.90337637	-118.2539093	Los Angeles County
213650	Fee-for-Service	1396755328	1396755328	1	1	THRIFTY PAYLESS INC	4/30/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5515	11172 LOS ALAMITOS BLVD	None	LOS ALAMITOS	CA	90720	3621	30	06059	33.8004084	-118.0717501	Orange County
213659	Fee-for-Service	1952377632	1952377632	1	1	TSAO, JOHN M MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	54844	41	Internal Medicine	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
213664	Fee-for-Service	1942886312	1942886312	1	1	TIR, VINCENT DO	11/7/2024	207R00000X	NA	Other	026	PHYSICIANS	23056	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
213705	Fee-for-Service	1205906229	1205906229	1	15	THE NEPHROLOGY GROUP, INC.	5/7/2021	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	233 E. CALDWELL AVE	None	VISALIA	CA	93277	7605	54	06107	36.297126	-119.2893975	Tulare County
213713	Fee-for-Service	1265438113	1265438113	1	1	TSAI, LONGWAY MD	3/6/1980	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	34395	01	General Practice	0	In state provider	None	12225 SOUTH ST	STE 101	ARTESIA	CA	90701	7046	19	06037	33.85857051	-118.0713645	Los Angeles County
213752	Fee-for-Service	1811075419	1811075419	1	1	TABAR, POROSHAT MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8104	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
213808	Fee-for-Service	1023765807	1023765807	1	1	TRAN, PATRICIA P OT	7/11/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	556 N 1ST ST	SUITE 201	SAN JOSE	CA	95112	5300	43	06085	37.34591974	-121.8977166	Santa Clara County
213832	Fee-for-Service	1396773990	1396773990	1	1	TRUEBA, DANIEL J JR MD	7/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74821	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
213856	Fee-for-Service	1215046016	1215046016	1	1	TSAI, YVONNE S MD	10/1/1998	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	61223	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	STE 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
213985	Fee-for-Service	1710034657	1710034657	1	1	TWIN PHARMACY, INC	7/15/2011	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	DABNEY PHARMACY	11115 S MAIN ST	None	LOS ANGELES	CA	90061	1925	19	06037	33.934284	-118.2739065	Los Angeles County
213995	Fee-for-Service	1205906229	1205906229	1	2	THE NEPHROLOGY GROUP, INC.	6/9/2008	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	568 E HERNDON AVE	STE 103	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
213999	Fee-for-Service	1952565582	1952565582	1	1	TSANG, LISA C OD	9/9/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
214036	Fee-for-Service	1184685471	1184685471	1	1	TRITES, ANAMARIE L	4/10/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9 WILLIAMSBURG LANE	None	CHICO	CA	95926	2225	04	06007	39.75249362	-121.8554242	Butte County
214044	Fee-for-Service	1497595565	1497595565	1	3	TURIYA ANESTHESIA	5/1/2024	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
214065	Fee-for-Service	1538222310	1538222310	1	1	THORNBURG, COURTNEY D MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55985	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
214085	Fee-for-Service	1285175315	1285175315	1	1	TARZANA TREATMENT CENTERS, I	12/13/2024	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC	44505 90TH ST W	None	LANCASTER	CA	93536	7705	19	06037	34.6920208	-118.2892539	Los Angeles County
214087	Fee-for-Service	1679663496	1679663496	1	1	TULARE FAMILY PRACTICE	3/14/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP	1070 N CHERRY ST	None	TULARE	CA	93274	2251	54	06107	36.22361913	-119.3373351	Tulare County
214121	Fee-for-Service	1760074892	1760074892	1	1	THE BISHOP FOUNDATION INC	3/30/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	3111 L STREET	None	SAN DIEGO	CA	92102	4321	37	06073	32.70742431	-117.1270778	San Diego County
214127	Fee-for-Service	1700027216	1700027216	1	1	TO, AN NGOC MD INC	3/2/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	36399	08	Family Practice	0	In state provider	None	87 N 6TH STREET	None	SAN JOSE	CA	95112	5423	43	06085	37.33991817	-121.8862077	Santa Clara County
214138	Fee-for-Service	1831739705	1831739705	1	1	THIES, NATALIE C LCSW	6/23/2020	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
214152	Fee-for-Service	1194769232	1194769232	1	1	TRUONG-YUE, PHUONG C MD	8/22/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	78810	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8500 FLORENCE AVE	2ND FLOOR	DOWNEY	CA	90240	4056	19	06037	33.94970699	-118.1216339	Los Angeles County
214153	Fee-for-Service	1427168293	1427168293	1	1	THRIFTY PAYLESS INC	2/2/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6071	1125 ALHAMBRA BLVD	None	SACRAMENTO	CA	95816	5286	34	06067	38.57067	-121.465458	Sacramento County
214170	Fee-for-Service	1558780783	1558780783	1	1	TIHESHA WESLEY	6/20/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	11755 MALAGA DR	UNIT 1132	RANCHO CUCAMONGA	CA	91730	8127	36	06071	34.1106397	-117.5491374	San Bernardino County
214215	Fee-for-Service	1356549232	1356549232	1	1	TSAI, JACSKON	4/12/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
214296	Fee-for-Service	1972126068	1972126068	1	1	TULIMIERO, MONICA MD	3/26/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187419	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
214324	Fee-for-Service	1467949065	1467949065	1	1	TORRES, MARISSA	6/3/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3808 W RIVERSIDE DR	STE 402	BURBANK	CA	91505	5301	19	06037	34.15252315	-118.3412174	Los Angeles County
214330	Fee-for-Service	1285714527	1285714527	1	1	TRAN,JOE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6621 FANNIN ST	None	HOUSTON	TX	77030	0000	00	None	29.70724683	-95.4026169	Harris County
214333	Fee-for-Service	1497595565	1497595565	1	3	TURIYA ANESTHESIA	5/1/2024	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
214356	Fee-for-Service	1972820892	1972820892	1	1	TURK, DAVID B MD	7/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149415	25	Physical Medicine and Rehabilitation	0	In state provider	None	2080 CENTURY PARK EAST	STE 300	LOS ANGELES	CA	90067	2006	19	06037	34.05887194	-118.4122914	Los Angeles County
214376	Fee-for-Service	1124093133	1124093133	1	1	TRAN, KHANH C MD	4/27/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68365	41	Internal Medicine	0	In state provider	None	2899 SENTER RD	STE 140	SAN JOSE	CA	95111	1182	43	06085	37.29783123	-121.8378063	Santa Clara County
214387	Fee-for-Service	1871185645	1871185645	1	1	TOOLE, JOSHUA T CRNA	4/17/2024	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
214413	Fee-for-Service	1851598544	1851598544	1	1	TU, ALEXANDER MD	1/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55538	40	Pediatrics	0	In state provider	None	1401 AVOCADO AVENUE	SUITE 802	NEWPORT BEACH	CA	92660	7720	30	06059	33.61235015	-117.8704573	Orange County
214455	Fee-for-Service	1558780783	1558780783	1	1	TIHESHA WESLEY	6/20/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	11755 MALAGA DR	UNIT 1132	RANCHO CUCAMONGA	CA	91730	8127	36	06071	34.1106397	-117.5491374	San Bernardino County
214462	Fee-for-Service	1225062771	1225062771	1	1	TIMM, J ROBIN PHD	9/14/2005	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
214514	Fee-for-Service	1598107195	1598107195	1	1	TONG, CECILIA S OD	9/24/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3601 COFFEE RD	None	MODESTO	CA	95355	1161	50	06099	37.69158077	-120.9761536	Stanislaus County
214542	Fee-for-Service	1942427497	1942427497	1	1	TURNING POINT OF CENTRAL	5/23/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA, INC	31411 ROAD 160	None	VISALIA	CA	93292	9019	54	06107	36.35976346	-119.2161743	Tulare County
214559	Fee-for-Service	1760594451	1760594451	1	1	TRUONG, PAUL T MD	10/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	53527	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11100 WARNER AVE	STE 152	FOUNTAIN VALLEY	CA	92708	7510	30	06059	33.716291	-117.9355051	Orange County
214597	Fee-for-Service	1457439234	1457439234	1	1	TRONCOSO, JOSE C MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	24505	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
214601	Fee-for-Service	1205906229	1205906229	1	11	THE NEPHROLOGY GROUP, INC.	1/1/2017	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	413 S BRIDGE STREET	None	VISALIA	CA	93277	2801	54	06107	36.32617706	-119.2890055	Tulare County
214629	Fee-for-Service	1245733476	1245733476	1	1	TON NU, MY LINH	10/19/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
214664	Fee-for-Service	1124093133	1124093133	1	1	TRAN, KHANH C MD	4/27/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68365	40	Pediatrics	0	In state provider	None	2899 SENTER RD	STE 140	SAN JOSE	CA	95111	1182	43	06085	37.29783123	-121.8378063	Santa Clara County
214724	Fee-for-Service	1609183748	1609183748	1	1	THAO, CRYSTAL LCSW	7/21/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
214767	Fee-for-Service	1093763104	1093763104	1	1	TRAN, HAI T MD	12/1/1998	207N00000X	NA	Dermatology	026	PHYSICIANS	83905	07	Dermatology	0	In state provider	None	12611 HESPERIA RD	# A	VICTORVILLE	CA	92395	7720	36	06071	34.48039624	-117.2907575	San Bernardino County
214798	Fee-for-Service	1144539586	1144539586	1	1	TOTAL RENAL CARE INC	12/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	320 JAMES WAY	STE 110	PISMO BEACH	CA	93449	2813	40	06079	35.13754612	-120.6250731	San Luis Obispo County
214808	Fee-for-Service	1073781506	1073781506	1	1	TSAI, VIVIAN C MD	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133217	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
214822	Fee-for-Service	1851375059	1851375059	1	1	TOTH, RONALD A PT	6/8/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	126 AVOCADO AVE	STE 107	PERRIS	CA	92571	2605	33	06065	33.8102395	-117.2244465	Riverside County
214848	Fee-for-Service	1275651515	1275651515	1	23	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	RE AND INNOVATION	2876 SYCAMORE DR	SUITE 201	SIMI VALLEY	CA	93065	1550	56	06111	34.28795345	-118.7438659	Ventura County
214849	Fee-for-Service	1982260345	1982260345	1	1	TORRES, KAYLA N	6/26/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3255 WEST CORTLAND AVE	UNIT 86	FRESNO	CA	93722	4825	10	06019	36.78157333	-119.8499323	Fresno County
214884	Fee-for-Service	1457439234	1457439234	1	1	TRONCOSO, JOSE C MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	24505	83	Rheumatology	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
214928	Fee-for-Service	1295723666	1295723666	1	1	TRAN, KHANH OD	11/26/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6850 LINCOLN AVE STE 204	None	BUENA PARK	CA	90620	4180	30	06059	33.8317925	-118.0136745	Orange County
214939	Fee-for-Service	1336178102	1336178102	1	1	TREYGER, LEONID MD	12/11/2002	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	64930	01	General Practice	0	In state provider	None	3234 MARYSVILLE BLVD	None	SACRAMENTO	CA	95815	1411	34	06067	38.626371	-121.4322615	Sacramento County
214984	Fee-for-Service	1073018164	1073018164	1	1	TLC HOMES LLC	3/19/2020	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5166 SUTHERLAND DR	None	CONCORD	CA	94521	3146	07	06013	37.95728532	-121.9660709	Contra Costa County
215023	Fee-for-Service	1629001698	1629001698	1	1	TUN, TIN MD	2/1/2022	207R00000X	NA	Other	026	PHYSICIANS	51476	None	None	0	In state provider	None	1850 W. FLORIDA AVE.	None	HEMET	CA	92545	6738	33	06065	33.74751552	-116.991432	Riverside County
215068	Fee-for-Service	1588623144	1588623144	1	1	TADROS, GEORGE MD	3/3/2025	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11180 WARNER AVE	STE 269	FOUNTAIN VALLEY	CA	92708	7516	30	06059	33.71632048	-117.9334575	Orange County
215088	Fee-for-Service	1013198738	1013198738	1	2	TSELIKIS, SOFIA MD LTD	12/3/2018	193400000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
215089	Fee-for-Service	1831126499	1831126499	1	1	TAUB, MARC D MD	5/31/1992	207P00000X	NA	Other	026	PHYSICIANS	76853	66	Emergency Medicine (Urgent Care)	0	In state provider	PARADISE VALLEY HOSPITAL	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
215136	Fee-for-Service	1275651515	1275651515	1	23	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	RE AND INNOVATION	2876 SYCAMORE DR	SUITE 201	SIMI VALLEY	CA	93065	1550	56	06111	34.28795345	-118.7438659	Ventura County
215138	Fee-for-Service	1982260345	1982260345	1	1	TORRES, KAYLA N	6/26/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3255 WEST CORTLAND AVE	UNIT 86	FRESNO	CA	93722	4825	10	06019	36.78157333	-119.8499323	Fresno County
215157	Fee-for-Service	1437599495	1437599495	1	1	TRIVEDI, ANAND D MD	11/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138513	03	Allergy	0	In state provider	None	11832 E ROSECRANS AVE	STE 200	NORWALK	CA	90650	4107	19	06037	33.90211977	-118.0813129	Los Angeles County
215199	Fee-for-Service	1245494475	1245494475	1	1	TRANMER, SERRA P DO	5/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9948	41	Internal Medicine	0	In state provider	None	1150 N INDIAN CYN DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
215203	Fee-for-Service	1083034896	1083034896	1	1	TSALTSKAN, VLADISLAV MD	7/13/2021	207RR0500X	NA	Other	026	PHYSICIANS	161173	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
215217	Fee-for-Service	1033630892	1033630892	1	1	TANG, JESSICA A MD	9/26/2024	207P00000X	NA	Other	026	PHYSICIANS	None	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
215253	Fee-for-Service	1508248451	1508248451	1	1	TAYLOR, CALEB MD	6/26/2023	207R00000X	NA	Other	026	PHYSICIANS	186319	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
215262	Fee-for-Service	1508865593	1508865593	1	1	TIMKO, TIMOTHY L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	561 W CENTRAL AVE	None	DELAWARE	OH	43015	1410	00	None	40.30622355	-83.08941312	Delaware County
215291	Fee-for-Service	1073625232	1073625232	1	1	THAI, DIEUMY MD., INC	5/31/1993	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	64401	25	Physical Medicine and Rehabilitation	0	In state provider	None	16401 MAGNOLIA ST	None	WESTMINSTER	CA	92683	7827	30	06059	33.72435637	-117.9720171	Orange County
215310	Fee-for-Service	1144557414	1144557414	1	1	TRINGALI, STEVEN DO	9/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11009	41	Internal Medicine	0	In state provider	None	2828 FRESNO ST	STE 203	FRESNO	CA	93721	1327	10	06019	36.7418099	-119.7838487	Fresno County
215313	Fee-for-Service	1063489573	1063489573	1	1	TODD, DONATO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	TACOMA ANESTHESIA	315 MARTIN LUTHER KING	None	TACOMA	WA	98411	0000	00	None	47.25960844	-122.4534238	Pierce County
215316	Fee-for-Service	1841812237	1841812237	1	1	TAKANTI, VARUN MD	10/10/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
215345	Fee-for-Service	1376545723	1376545723	1	1	TARNG, WILLIAM MD	2/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89784	41	Internal Medicine	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
215363	Fee-for-Service	1245306182	1245306182	1	1	THRIFTY PAYLESS INC	4/9/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2990 E NEES AVE	None	FRESNO	CA	93720	6008	10	06019	36.85225274	-119.7307483	Fresno County
215375	Fee-for-Service	1730293085	1730293085	1	1	TRAN, RAYMOND K MD	10/18/2017	207L00000X	NA	Other	026	PHYSICIANS	148031	05	Anesthesiology	0	In state provider	None	3630 EAST IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
215380	Fee-for-Service	1497805204	1497805204	1	1	TOWERY, REID A MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64071	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
215421	Fee-for-Service	1649692716	1649692716	1	1	TEAM PHYSICIANS OF NORTHERN	8/19/2016	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	CALIFORNIA MEDICAL GROUP	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
215426	Fee-for-Service	1275917692	1275917692	1	1	THE CHILDRENS CLINIC	8/24/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	2000 SAN GABRIEL AVE	None	LONG BEACH	CA	90810	3624	19	06037	33.79184648	-118.2238052	Los Angeles County
215427	Fee-for-Service	1275651515	1275651515	1	23	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	RE AND INNOVATION	2876 SYCAMORE DR	SUITE 201	SIMI VALLEY	CA	93065	1550	56	06111	34.28795345	-118.7438659	Ventura County
215444	Fee-for-Service	1265453872	1265453872	1	1	TRACY URGENT CARE MED	2/6/2001	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CLINIC INC	2160 W GRANT LINE RD	STE 230	TRACY	CA	95377	7334	39	06077	37.75399922	-121.455877	San Joaquin County
215466	Fee-for-Service	1205906229	1205906229	1	10	THE NEPHROLOGY GROUP, INC.	12/1/2016	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	900 N DOUTY STREET	SUITE B	HANFORD	CA	93230	3918	16	06031	36.33417687	-119.646063	Kings County
215467	Fee-for-Service	1205906229	1205906229	1	18	THE NEPHROLOGY GROUP, INC.	5/8/2023	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	1451 PACHECO BLVD	E	LOS BANOS	CA	93635	8612	24	06047	37.05673551	-120.8769615	Merced County
215477	Fee-for-Service	1629186820	1629186820	1	1	TOM, LINCOLN E MD	4/1/1995	302R00000X	NA	Other	026	PHYSICIANS	70555	01	General Practice	0	In state provider	None	24902 MOULTON PKWY	None	LAGUNA HILLS	CA	92637	6410	30	06059	33.60050959	-117.7165507	Orange County
215503	Fee-for-Service	1033630892	1033630892	1	1	TANG, JESSICA A MD	9/26/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
215547	Fee-for-Service	1154467181	1154467181	1	4	THE HUNTINGTON MEDICAL FOUND	4/13/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	FOUNDATION	301 W HUNTINGTON DR	STE 320	ARCADIA	CA	91007	1500	19	06037	34.13481053	-118.0425638	Los Angeles County
215549	Fee-for-Service	1841306016	1841306016	1	1	TRAN, KHANG VAN MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33941	08	Family Practice	0	In state provider	None	4616 EL CAJON BLVD	STE 9	SAN DIEGO	CA	92115	4426	37	06073	32.75567113	-117.0951834	San Diego County
215560	Fee-for-Service	1013417393	1013417393	1	1	TEGERSTRAND, JUSTIN M	10/23/2017	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2102 CIVIC CENTER DRIVE	None	REDDING	CA	96001	2704	45	06089	40.57610996	-122.3804753	Shasta County
215580	Fee-for-Service	1003045683	1003045683	1	1	TILESTON, KALI R MD	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113697	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
215581	Fee-for-Service	1073625232	1073625232	1	1	THAI, DIEUMY MD., INC	5/31/1993	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	64401	01	General Practice	0	In state provider	None	16401 MAGNOLIA ST	None	WESTMINSTER	CA	92683	7827	30	06059	33.72435637	-117.9720171	Orange County
215611	Fee-for-Service	1285110171	1285110171	1	1	T PANDYA MD INC	3/5/2019	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3851 KATELLA AVE	315	LOS ALAMITOS	CA	90720	3309	30	06059	33.80319053	-118.0657305	Orange County
215617	Fee-for-Service	1043969678	1043969678	1	1	TRUONG, JESSICA MD	5/6/2024	390200000X	NA	Other	026	PHYSICIANS	189487	66	Emergency Medicine (Urgent Care)	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
215622	Fee-for-Service	1093271702	1093271702	1	1	TSAI, JENNIFER MD	7/26/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182945	None	None	0	In state provider	None	2433 CENTRAL AVENUE	SUITE A	ALAMEDA	CA	94501	4564	01	06001	37.76358675	-122.2413153	Alameda County
215650	Fee-for-Service	1134743685	1134743685	1	1	TRUSTABLE HOSPICE INC	6/15/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6422 VAN NUYS BLVD	STE 104	VAN NUYS	CA	91401	1436	19	06037	34.187337	-118.448713	Los Angeles County
215651	Fee-for-Service	1558503169	1558503169	1	1	THUY T M NGUYEN M D INC	10/22/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9695 BASELINE RD	None	RANCHO CUCAMONGA	CA	91730	1314	36	06071	34.12150868	-117.5938959	San Bernardino County
215652	Fee-for-Service	1033464821	1033464821	2	1	TENNEY, JESSICA L MD	10/7/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	117230	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
215666	Fee-for-Service	1144919101	1144919101	1	1	TERRA VERDE LIVING LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	27563 LONGHILL DRIVE	None	RANCHO PALOS VERD	CA	90275	3712	19	06037	33.77409403	-118.372153	Los Angeles County
215713	Fee-for-Service	1275917692	1275917692	1	1	THE CHILDRENS CLINIC	8/24/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	2000 SAN GABRIEL AVE	None	LONG BEACH	CA	90810	3624	19	06037	33.79184648	-118.2238052	Los Angeles County
215724	Fee-for-Service	1275651515	1275651515	1	23	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	RE AND INNOVATION	2876 SYCAMORE DR	SUITE 201	SIMI VALLEY	CA	93065	1550	56	06111	34.28795345	-118.7438659	Ventura County
215734	Fee-for-Service	1144256371	1144256371	1	1	TICHO, SIMON R MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	81139	05	Anesthesiology	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
215737	Fee-for-Service	1730713488	1730713488	1	1	TIO, ANDREW-JUSTIN C CNP	8/30/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1720 S BASCOM AVE	None	CAMPBELL	CA	95008	0608	43	06085	37.292472	-121.9315815	Santa Clara County
215754	Fee-for-Service	1972823672	1972823672	1	1	THENKONDAR, KARTHIK N MD	9/12/2022	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	122951	None	None	0	In state provider	None	191 S BUENA VISTA STREET	SUITE 150	BURBANK	CA	91505	4522	19	06037	34.15872557	-118.3283863	Los Angeles County
215890	Fee-for-Service	1275651515	1275651515	1	44	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0000X	NA	Hematology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	25405 HANCOCK AVE	SUITE 101	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
215919	Fee-for-Service	1679942296	1679942296	1	1	TOYOS, LINA 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
215937	Fee-for-Service	1134743685	1134743685	1	1	TRUSTABLE HOSPICE INC	6/15/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6422 VAN NUYS BLVD	STE 104	VAN NUYS	CA	91401	1436	19	06037	34.187337	-118.448713	Los Angeles County
215940	Fee-for-Service	1033464821	1033464821	2	1	TENNEY, JESSICA L MD	10/7/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	117230	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
215941	Fee-for-Service	1073047544	1073047544	1	1	TIAN, TERRENCE Y DO	5/16/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	19526	None	None	0	In state provider	None	2625 W ALAMEDA AVE	300, 322	BURBANK	CA	91505	4819	19	06037	34.1577056	-118.329779	Los Angeles County
215959	Fee-for-Service	1821173592	1821173592	1	1	THIO, KEVIN K MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80085	40	Pediatrics	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
215965	Fee-for-Service	1083059265	1083059265	1	1	TESSEMA, JUDITH A MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136409	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
215969	Fee-for-Service	1720096829	1720096829	1	1	TSAI, CLARK S MD	3/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76192	18	Ophthalmology	0	In state provider	None	2700 GRANT ST	STE 100	CONCORD	CA	94520	2267	07	06013	37.98417931	-122.0361585	Contra Costa County
215995	Fee-for-Service	1780979021	1780979021	1	1	TRAN, MUI S CRNA	6/29/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
216003	Fee-for-Service	1275651515	1275651515	1	23	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	RE AND INNOVATION	2876 SYCAMORE DR	SUITE 201	SIMI VALLEY	CA	93065	1550	56	06111	34.28795345	-118.7438659	Ventura County
216024	Fee-for-Service	1326659491	1326659491	1	1	THE OARS SENIOR LIVING INC	7/1/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6550 GREENBACK LANE	None	CITRUS HEIGHTS	CA	95621	6227	34	06067	38.677473	-121.312305	Sacramento County
216093	Fee-for-Service	1013182138	1013182138	1	1	TANG, ALAN C MD	9/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104735	05	Anesthesiology	0	In state provider	None	1500 E DUARTE RD	BLDG 149	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
216177	Fee-for-Service	1275651515	1275651515	1	44	THE ONCOLOGY INSTITUTE CA, A	5/20/2022	207RH0000X	NA	Hematology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	25405 HANCOCK AVE	SUITE 101	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
216186	Fee-for-Service	1083054670	1083054670	1	1	TIONGSON, EMMANUELLE R MD	6/30/2017	2084N0402X	NA	Neurology	026	PHYSICIANS	123843	79	Neurology-Child	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
216225	Fee-for-Service	1578925756	1578925756	1	1	TO, HARRISON F MD	8/5/2020	207L00000X	NA	Other	026	PHYSICIANS	153820	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
216237	Fee-for-Service	1043611098	1043611098	1	1	TRAN, VIET H DO	10/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13081	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
216348	Fee-for-Service	1851623326	1851623326	1	2	THIESSEN, CHONNIE S LMFT	3/17/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	78401 HIGHWAY 111	SUITE U	LA QUINTA	CA	92253	2066	33	06065	33.71562752	-116.2964232	Riverside County
216351	Fee-for-Service	1518522424	1518522424	1	1	THOMPSON, SEAMUS LMFT	3/13/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1833 W MARCH LN	SUITE 6	STOCKTON	CA	95207	6415	39	06077	37.9875446	-121.3283031	San Joaquin County
216384	Fee-for-Service	1891053153	1891053153	1	1	TANG, AMANDA H MD	9/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141034	18	Ophthalmology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
216409	Fee-for-Service	1689828741	1689828741	1	1	TANGTUMNU, RINGFA NP	6/9/2009	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
216464	Fee-for-Service	1275651515	1275651515	1	44	THE ONCOLOGY INSTITUTE CA, A	3/1/2022	207RH0000X	NA	Hematology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	25405 HANCOCK AVE	SUITE 101	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
216476	Fee-for-Service	1306052667	1306052667	1	1	TONG, JAMES E MD	8/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91235	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
216489	Fee-for-Service	1417012188	1417012188	1	1	TABON, TANYA R LCSW	3/15/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
216490	Fee-for-Service	1588756910	1588756910	1	1	TSOI, NANCY L MD	8/4/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	87090	08	Family Practice	0	In state provider	None	2950 N SYCAMORE DR	STE 300	SIMI VALLEY	CA	93065	1210	56	06111	34.28932056	-118.7438673	Ventura County
216496	Fee-for-Service	1366404600	1366404600	1	1	TODD, MICHAEL R MD	12/10/2020	208600000X	NA	General Surgery	026	PHYSICIANS	161582	None	None	0	In state provider	None	2030 SUTTER PL	STE 1300	DAVIS	CA	95616	6201	57	06113	38.56292466	-121.7715423	Yolo County
216497	Fee-for-Service	1124393616	1124393616	1	1	THE BAIDEN GROUP INC	5/17/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3630 SMITH AVENUE	SUITE A	ACTON	CA	93510	1957	19	06037	34.46808762	-118.1958834	Los Angeles County
216525	Fee-for-Service	1437711629	1437711629	1	1	TRAN, JOEY P	5/18/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	618 BLOSSOM HILL RD STE	None	SAN JOSE	CA	95123	3048	43	06085	37.25052736	-121.8422415	Santa Clara County
216558	Fee-for-Service	1386222974	1386222974	1	1	THIND, JASPREET DO	10/21/2024	207R00000X	NA	Other	026	PHYSICIANS	22792	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
216589	Fee-for-Service	1336822147	1336822147	1	1	TROUSDALE, BENJAMIN NP	8/24/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3030 W OLYMPIC BLVD	STE 217	LOS ANGELES	CA	90006	6507	19	06037	34.05260995	-118.3015825	Los Angeles County
216593	Fee-for-Service	1578928297	1578928297	1	1	THIBAULT, NIKKI LMFT	6/13/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	105 E DE LA GUERRA ST	STE 4	SANTA BARBARA	CA	93101	2236	42	06083	34.42110231	-119.6981625	Santa Barbara County
216604	Fee-for-Service	1255606067	1255606067	1	1	TOUSSAINT, CHRISTINA M	9/15/2014	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	10929 SOUTH STREET	SUITE 202B	CERRITOS	CA	90703	5301	19	06037	33.85836353	-118.101204	Los Angeles County
216620	Fee-for-Service	1912283318	1912283318	1	1	TRAN, LIEN Q DO	12/20/2018	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	12022	12	Manipulative Therapy (D.O. only)	0	In state provider	None	2016 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
216655	Fee-for-Service	1538132576	1538132576	1	1	TSE, ANDREA MOES MD	5/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86682	05	Anesthesiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
216709	Fee-for-Service	1891974283	1891974283	1	1	TAN, KOK C MD	5/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120081	None	None	0	In state provider	None	4445 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
216714	Fee-for-Service	1306874581	1306874581	1	1	TOBON, SANDRA P MD	2/28/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	169803	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
216751	Fee-for-Service	1326083858	1326083858	1	1	TADIKONDA, MOHAN V MD	3/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	85738	13	Neurology (M.D. only)	0	In state provider	None	2880 ATLANTIC AVE	STE 280	LONG BEACH	CA	90806	1705	19	06037	33.809382	-118.185001	Los Angeles County
216755	Fee-for-Service	1275651515	1275651515	1	44	THE ONCOLOGY INSTITUTE CA, A	3/1/2022	207RH0000X	NA	Hematology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	25405 HANCOCK AVE	SUITE 101	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
216785	Fee-for-Service	1881881563	1881881563	1	1	TSE, JEANNIE P LCSW	9/12/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
216801	Fee-for-Service	1740623107	1740623107	1	1	TANG, SHERRY MD	8/9/2019	207ZP0102X	NA	Other	026	PHYSICIANS	161365	22	Pathology (M.D. only)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
216939	Fee-for-Service	1962820233	1962820233	1	1	TURLEY, MICHELLE C MD	5/6/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154747	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
216984	Fee-for-Service	1144213836	1144213836	1	1	TIMOTHY BRELJE	5/19/2024	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1213 GARFIELD AVE	None	HARLAN	IA	51537	2057	00	None	41.64744933	-95.3270283	Shelby County
217024	Fee-for-Service	1518019744	1518019744	1	1	TRUONG, LY H MD	2/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85566	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
217025	Fee-for-Service	1649296146	1649296146	1	1	TANZO, VENUS E MD	3/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51018	08	Family Practice	0	In state provider	None	498 W 4TH ST	None	PERRIS	CA	92570	2070	33	06065	33.78237192	-117.2367068	Riverside County
217035	Fee-for-Service	1962271767	1962271767	1	1	TAYLOR, TABITHA	12/23/2024	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	34	06067	0	0	None
217040	Fee-for-Service	1275651515	1275651515	1	44	THE ONCOLOGY INSTITUTE CA, A	3/1/2022	207RH0000X	NA	Hematology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	25405 HANCOCK AVE	SUITE 101	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
217047	Fee-for-Service	1205809381	1205809381	1	1	THE REDWOODS A COMMUNITY OF	3/1/1966	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SENIORS	40 CAMINO ALTO	None	MILL VALLEY	CA	94941	2956	21	06041	37.89488678	-122.529946	Marin County
217102	Fee-for-Service	1043701378	1043701378	1	1	TAPPIN, KEENIA M MD	6/4/2021	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	165256	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
217112	Fee-for-Service	1568889723	1568889723	1	1	TRAN, JENNY NP	3/21/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	24700 CALAROGA AVE	STE 103	HAYWARD	CA	94545	2160	01	06001	37.64903435	-122.1018438	Alameda County
217159	Fee-for-Service	1750018370	1750018370	1	1	TOTAL LAB SOLUTIONS LLC	5/15/2023	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	1250 STEPHENSON HWY STE	None	TROY	MI	48083	1115	00	None	42.54498	-83.12021405	Oakland County
217163	Fee-for-Service	1013992452	1013992452	1	1	TERAN, GUY MD	12/11/2002	207P00000X	NA	Other	026	PHYSICIANS	53014	01	General Practice	0	In state provider	None	1165 S DORA ST	STE E2	UKIAH	CA	95482	6353	23	06045	39.13602308	-123.2095502	Mendocino County
217177	Fee-for-Service	1154507648	1154507648	1	2	TITTLE, LARISSA A LMFT	4/8/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2309 PACIFIC COAST HWY	STE #103	HERMOSA BEACH	CA	90254	2752	19	06037	33.87101437	-118.3948248	Los Angeles County
217178	Fee-for-Service	1023127545	1023127545	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	72 875 HIGHWAY 111	None	PALM DESERT	CA	92260	3312	33	06065	33.721101	-116.3648803	Riverside County
217195	Fee-for-Service	1184931925	1184931925	1	1	TANIFOR, JOSEPH N	4/27/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	600 W MANCHESTER AVE	SUITE 5	LOS ANGELES	CA	90044	5700	19	06037	33.96003353	-118.2845745	Los Angeles County
217290	Fee-for-Service	1982069704	1982069704	1	1	THRIFTY PAYLESS INC	10/24/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8509 IRVINE CENTER DR	None	IRVINE	CA	92618	4298	30	06059	33.64572638	-117.7455302	Orange County
217316	Fee-for-Service	1649296146	1649296146	1	1	TANZO, VENUS E MD	3/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51018	40	Pediatrics	0	In state provider	None	498 W 4TH ST	None	PERRIS	CA	92570	2070	33	06065	33.78237192	-117.2367068	Riverside County
217389	Fee-for-Service	1841364031	1841364031	1	1	TRAPP, TERRENCE MD	1/1/1994	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	52845	08	Family Practice	0	In state provider	None	1095 LOS PALOS DR	None	SALINAS	CA	93901	3916	27	06053	36.65804253	-121.6451894	Monterey County
217426	Fee-for-Service	1679191753	1679191753	1	1	TANJI, KRISTEN LCSW	4/19/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
217441	Fee-for-Service	1376557843	1376557843	1	1	TALWAR, SHEFALI	3/4/2014	174400000X	NA	Other	026	PHYSICIANS	86303	None	None	0	In state provider	None	1820 OGDEN DR	2ND FLOOR	BURLINGAME	CA	94010	5384	41	06081	37.592447	-122.3869598	San Mateo County
217459	Fee-for-Service	1003344391	1003344391	1	1	TARUC-CARLOS, RACHEL N NP	11/20/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
217503	Fee-for-Service	1225456437	1225456437	1	1	TRAN, DARRELL R MD	3/4/2020	207L00000X	NA	Other	026	PHYSICIANS	141170	None	None	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
217544	Fee-for-Service	1306008834	1306008834	1	1	TAN, KENNETH T MD	11/13/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	66994	30	Radiology	0	In state provider	None	438 LAS TUNAS	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
217562	Fee-for-Service	1407145436	1407145436	1	1	TON, LOC P MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149551	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
217592	Fee-for-Service	1659396976	1659396976	1	1	TAYLOR, JOHN HOWARD MD	11/2/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	39562	04	Otology, Laryngology, Rhinology	0	In state provider	None	5565 GROSSMONT CENTER DR	BLDG 3101	LA MESA	CA	91942	3020	37	06073	32.77978322	-117.0094766	San Diego County
217597	Fee-for-Service	1902862170	1902862170	1	1	THE REGENTS OF THE UNIVERSIT	10/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NT ASSOCIATES	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
217599	Fee-for-Service	1427636828	1427636828	1	1	TOUMA, BRITTANIE DO	5/23/2024	207R00000X	NA	Other	026	PHYSICIANS	20751	41	Internal Medicine	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
217629	Fee-for-Service	1215047006	1215047006	1	1	THRIFTY PAYLESS INC	4/13/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6403	4701 WHITNEY AVE	None	CARMICHAEL	CA	95608	2953	34	06067	38.628702	-121.3547985	Sacramento County
217631	Fee-for-Service	1669469730	1669469730	1	1	THOMAS LU MD	7/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	23900 KATY FWY	None	KATY	TX	77494	1323	00	None	29.78594112	-95.78613398	Harris County
217673	Fee-for-Service	1720198401	1720198401	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	111 S SUNRISE WAY	None	PALM SPRINGS	CA	92262	6736	33	06065	33.822855	-116.528267	Riverside County
217719	Fee-for-Service	1316206550	1316206550	1	1	TANG, MAI OD INC	10/18/2013	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1893 W MALVERN AVE	None	FULLERTON	CA	92833	2403	30	06059	33.87987	-117.9611415	Orange County
217724	Fee-for-Service	1710349774	1710349774	1	1	TU, XINGYUAN	6/18/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	200 BROWN RD	SUITE 104	FREMONT	CA	94539	7955	01	06001	37.49494016	-121.9251914	Alameda County
217757	Fee-for-Service	1942650916	1942650916	1	1	TURNER, MEREDITH L OD	8/25/2016	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2132 EUREKA WAY	None	REDDING	CA	96001	0427	45	06089	40.58661765	-122.4029863	Shasta County
217768	Fee-for-Service	1154082964	1154082964	1	1	THE LOS ANGELES PHARMACY LLC	5/23/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8628 W PICO BLVD	None	LOS ANGELES	CA	90035	2302	19	06037	34.05392386	-118.3795095	Los Angeles County
217780	Fee-for-Service	1548210768	1548210768	1	1	TEIRSTEIN, PAUL S MD	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	52018	01	General Practice	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
217839	Fee-for-Service	1700317690	1700317690	1	1	TETARBE, MANAS DO	4/24/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	18209	None	None	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
217854	Fee-for-Service	1295995751	1295995751	1	1	TRACY, MICHAEL C MD	6/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109528	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
217866	Fee-for-Service	1982846135	1982846135	1	1	TAN, CYNTHIA S MD	7/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123298	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
217874	Fee-for-Service	1114036530	1114036530	1	2	THRIFTY PAYLESS INC	11/14/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1051 WEST VISALIA ROAD	None	EXETER	CA	93221	2204	54	06107	36.297373	-119.1558728	Tulare County
217886	Fee-for-Service	1659396976	1659396976	1	1	TAYLOR, JOHN HOWARD MD	11/2/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	39562	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5565 GROSSMONT CENTER DR	BLDG 3101	LA MESA	CA	91942	3020	37	06073	32.77978322	-117.0094766	San Diego County
217965	Fee-for-Service	1053375766	1053375766	1	1	THRUSH, JERRY H MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	66280	None	None	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
218101	Fee-for-Service	1104920297	1104920297	1	1	THAO, MAIYA D DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	374 W OLIVE AVE	STE A	MERCED	CA	95348	3137	24	06047	37.31914092	-120.4749911	Merced County
218142	Fee-for-Service	1295995751	1295995751	1	1	TRACY, MICHAEL C MD	6/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109528	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
218148	Fee-for-Service	1760560528	1760560528	1	1	TEKLU, AMANUEL Y MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76615	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
218173	Fee-for-Service	1447646971	1447646971	1	1	THIEL, GARRETT G MD	10/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147328	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
218212	Fee-for-Service	1558348706	1558348706	1	1	TABIBIAN, MAHNAZ MD	5/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	69190	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
218319	Fee-for-Service	1275899361	1275899361	1	1	TRAVIS DOWLING AYERS	8/3/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 CHILDRENS WAY	# 653	LITTLE ROCK	AR	72202	3500	00	None	34.742745	-92.2927905	Pulaski County
218328	Fee-for-Service	1457507915	1457507915	1	1	TEHRANI, FARAMARZ MD	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	107378	01	General Practice	0	In state provider	None	201 S ALVARADO	SUITE 612	LOS ANGELES	CA	90057	2386	19	06037	34.06417777	-118.2719543	Los Angeles County
218353	Fee-for-Service	1720323553	1720323553	1	1	TRINH, LIEN N LCSW	6/20/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	75608	-	NOT APPLICABLE	0	In state provider	None	5318 S CRENSHAW BLVD	None	LOS ANGELES	CA	90043	1810	19	06037	33.9944486	-118.3306429	Los Angeles County
218366	Fee-for-Service	1306051024	1306051024	1	1	TORNA, ALYA D MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109576	08	Family Practice	0	In state provider	None	9170 HAVEN AVE	STE 108	RANCHO CUCAMONGA	CA	91730	5416	36	06071	34.087491	-117.5758895	San Bernardino County
218383	Fee-for-Service	1003918509	1003918509	1	1	TATARU, CHRIS D MD	3/8/2011	207L00000X	NA	Other	026	PHYSICIANS	54926	05	Anesthesiology	0	In state provider	None	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2799	41	06081	37.48093988	-122.2531826	San Mateo County
218396	Fee-for-Service	1275633810	1275633810	1	1	TROXELL, MARIANNE C LMFT	9/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	355 GELLERT BLVD	STE. #280	DALY CITY	CA	94015	2665	41	06081	37.66608413	-122.4686507	San Mateo County
218419	Fee-for-Service	1598082018	1598082018	1	1	TOSCANO, EDGAR P M D INC	9/12/2011	207R00000X	NA	Other	026	PHYSICIANS	80296	45	Nephrology (Renal-Kidney)	0	In state provider	None	3114 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	2217	19	06037	34.02383346	-118.137193	Los Angeles County
218433	Fee-for-Service	1679864805	1679864805	1	1	TIANA, AHIMSA LMFT	5/19/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2910 H STREET	SUITES 106,109,112,205	EUREKA	CA	95501	4408	12	06023	40.78177748	-124.1613638	Humboldt County
218459	Fee-for-Service	1457460982	1457460982	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5979	901 SOQUEL AVE	None	SANTA CRUZ	CA	95062	2122	44	06087	36.97788307	-122.0142625	Santa Cruz County
218478	Fee-for-Service	1275651515	1275651515	1	21	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	999 N TUSTIN AVE	SUITE 212	SANTA ANA	CA	92705	6506	30	06059	33.754167	-117.834191	Orange County
218494	Fee-for-Service	1902065642	1902065642	1	1	TYSON, MAUREEN A MD	2/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	89337	25	Physical Medicine and Rehabilitation	0	In state provider	None	1906 E COMMERCENTER DR	STE 100	SAN BERNARDINO	CA	92408	3423	36	06071	34.066692	-117.282329	San Bernardino County
218498	Fee-for-Service	1558348706	1558348706	1	1	TABIBIAN, MAHNAZ MD	5/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	69190	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
218508	Fee-for-Service	1760693584	1760693584	1	1	TAKEUCHI, YUKA LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
218521	Fee-for-Service	1861963191	1861963191	1	1	TARAKCHYAN, VARTAN MD INC	12/26/2018	207L00000X	NA	Other	026	PHYSICIANS	73766	05	Anesthesiology	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
218586	Fee-for-Service	1821400839	1821400839	1	1	TUNG, JAMIE M MD	8/5/2020	208600000X	NA	General Surgery	026	PHYSICIANS	161863	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
218600	Fee-for-Service	1821311887	1821311887	1	1	TAN, CHRISTOPHER T CRNA	5/31/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
218603	Fee-for-Service	1134351836	1134351836	1	1	TANGANCO, TIFFANY O MD	9/8/2011	207L00000X	NA	Other	026	PHYSICIANS	114273	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
218608	Fee-for-Service	1750412300	1750412300	1	8	TAHOE FOREST HOSP DIST	4/11/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
218629	Fee-for-Service	1386221224	1386221224	1	1	THOMAS, TITO J MD	6/11/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
218654	Fee-for-Service	1962407767	1962407767	1	1	TAVAKOLI, SHAHRIYAR MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	48572	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	39000 BOB HOPE DRIVE	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
218655	Fee-for-Service	1306051024	1306051024	1	1	TORNA, ALYA D MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109576	01	General Practice	0	In state provider	None	9170 HAVEN AVE	STE 108	RANCHO CUCAMONGA	CA	91730	5416	36	06071	34.087491	-117.5758895	San Bernardino County
218691	Fee-for-Service	1992927503	1992927503	1	1	TAMRAZI, ANOBEL M MD	3/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	107656	30	Radiology	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
218708	Fee-for-Service	1598082018	1598082018	1	1	TOSCANO, EDGAR P M D INC	9/12/2011	207R00000X	NA	Other	026	PHYSICIANS	80296	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
218736	Fee-for-Service	1144365396	1144365396	1	1	TANG, MAI N OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1893 W MALVERN AVE	None	FULLERTON	CA	92833	2403	30	06059	33.87987	-117.9611415	Orange County
218766	Fee-for-Service	1275651515	1275651515	1	35	THE ONCOLOGY INSTITUTE CA, A	10/17/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	31515 RANCHO PUEBLO RD	SUITE 202	TEMECULA	CA	92592	4837	33	06065	33.47922478	-117.1107757	Riverside County
218824	Fee-for-Service	1568824159	1568824159	1	1	THIESMEYER, JESSICA W MD	7/18/2023	2086X0206X	NA	General Surgery	026	PHYSICIANS	187685	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
218838	Fee-for-Service	1275549578	1275549578	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 5665	13167 BLACK MOUNTAIN RD	None	SAN DIEGO	CA	92129	2684	37	06073	32.9577698	-117.127786	San Diego County
218856	Fee-for-Service	1821202805	1821202805	1	1	TONG, HOYT CHING MD	11/16/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	98172	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
218871	Fee-for-Service	1104188168	1104188168	1	1	TAFOYA, ELIA LCSW	9/18/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17326 EDWARD ROAD	None	CERRITOS	CA	90703	2444	19	06037	33.87401441	-118.0344613	Los Angeles County
218894	Fee-for-Service	1881617868	1881617868	1	1	TYSON, YVONNE MD	9/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	48985	08	Family Practice	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
218895	Fee-for-Service	1750412300	1750412300	1	8	TAHOE FOREST HOSP DIST	4/21/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
218898	Fee-for-Service	1932360179	1932360179	1	1	TRUONG, THACH-GIAO MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112693	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
218914	Fee-for-Service	1487083747	1487083747	1	1	TONG, CECILIA A LCSW	4/24/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
218942	Fee-for-Service	1962407767	1962407767	1	1	TAVAKOLI, SHAHRIYAR MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	48572	41	Internal Medicine	0	In state provider	None	39000 BOB HOPE DRIVE	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
219000	Fee-for-Service	1184979072	1184979072	1	1	TUNG, JAN OD	1/6/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1015 S NOGALES ST	SUITE 109	ROWLAND HEIGHTS	CA	91748	1309	19	06037	33.99637543	-117.8884823	Los Angeles County
219029	Fee-for-Service	1962849588	1962849588	1	2	TALMAGE, MARILYN J LMFT	1/31/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1023 4TH ST	STE. E	SANTA ROSA	CA	95404	4310	49	06097	38.444004	-122.706648	Sonoma County
219053	Fee-for-Service	1275651515	1275651515	1	21	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	999 N TUSTIN AVE	SUITE 212	SANTA ANA	CA	92705	6506	30	06059	33.754167	-117.834191	Orange County
219095	Fee-for-Service	1386176907	1386176907	1	1	TRAN, TUONG-VI MD	3/13/2023	2084N0402X	NA	Neurology	026	PHYSICIANS	159066	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
219165	Fee-for-Service	1639143894	1639143894	1	1	TRINH, ANH OD	6/19/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	318 E COMPTON BLVD	None	COMPTON	CA	90221	3206	19	06037	33.89597324	-118.2191747	Los Angeles County
219184	Fee-for-Service	1750412300	1750412300	1	8	TAHOE FOREST HOSP DIST	4/11/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
219185	Fee-for-Service	1932360179	1932360179	1	1	TRUONG, THACH-GIAO MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112693	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
219206	Fee-for-Service	1861958829	1861958829	1	2	THE CHILDRENS CLINIC SERVING	12/10/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1500 E ANAHEIM STREET	SUITE 100	LONG BEACH	CA	90813	4051	19	06037	33.78257848	-118.1727855	Los Angeles County
219209	Fee-for-Service	1528234549	1528234549	1	1	THIERMAN, SARA J MD	10/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117858	07	Dermatology	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
219274	Fee-for-Service	1396322335	1396322335	1	1	TANG, JONATHAN MD	7/12/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
219344	Fee-for-Service	1275651515	1275651515	1	35	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	31515 RANCHO PUEBLO RD	SUITE 202	TEMECULA	CA	92592	4837	33	06065	33.47922478	-117.1107757	Riverside County
219392	Fee-for-Service	1396350724	1396350724	1	1	TRUONG, KIM T CNP	3/30/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4235 PACIFIC COAST HWY	None	TORRANCE	CA	90505	5525	19	06037	33.80817211	-118.3588219	Los Angeles County
219408	Fee-for-Service	1497595565	1497595565	1	4	TURIYA ANESTHESIA	5/1/2024	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	13100 STUDEBAKER RD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
219437	Fee-for-Service	1760431738	1760431738	1	1	TANVEER, AISHA MD	12/21/2018	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	657 NORTH TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
219451	Fee-for-Service	1316101413	1316101413	1	1	TAGWERKER, BERNHARD MD	1/16/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152400	08	Family Practice	0	In state provider	None	1117 E DEVONSHIRE AVENUE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
219457	Fee-for-Service	1255428306	1255428306	1	1	TANIEGRA, EDNA D MD	12/19/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	56152	08	Family Practice	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
219472	Fee-for-Service	1932360179	1932360179	1	1	TRUONG, THACH-GIAO MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112693	68	Hematology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
219490	Fee-for-Service	1538308044	1538308044	1	1	TSAI, GARY MD	8/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113565	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
219493	Fee-for-Service	1861958829	1861958829	1	2	THE CHILDRENS CLINIC SERVING	12/10/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1500 E ANAHEIM STREET	SUITE 100	LONG BEACH	CA	90813	4051	19	06037	33.78257848	-118.1727855	Los Angeles County
219522	Fee-for-Service	1790758316	1790758316	1	1	TIDYMAN, MARK L MD	4/28/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	51798	08	Family Practice	0	In state provider	None	501 OAK AVE	None	DAVIS	CA	95616	3624	57	06113	38.54657247	-121.7528195	Yolo County
219530	Fee-for-Service	1275651515	1275651515	1	29	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	207 SANTA ANITA ST.	STE P05	SAN GABRIEL	CA	91776	1159	19	06037	34.10072807	-118.1066296	Los Angeles County
219550	Fee-for-Service	1679317044	1679317044	1	1	THE CURANDERA LLC	1/10/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
219575	Fee-for-Service	1003104704	1003104704	1	1	TREXLER, ALISON M MD	1/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136881	36	Psychiatry	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
219582	Fee-for-Service	1194059584	1194059584	1	1	TAPIA, MANUEL A MD	5/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128966	01	General Practice	0	In state provider	None	1001 POTRERO AVE	RM 4F	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
219587	Fee-for-Service	1629692330	1629692330	1	1	TAFOYA, DENISE G CRNA	6/25/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
219614	Fee-for-Service	1225147630	1225147630	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1029 E CAPITOL EXPRESSWY	None	SAN JOSE	CA	95121	2415	43	06085	37.299689	-121.8222282	Santa Clara County
219624	Fee-for-Service	1609808187	1609808187	1	2	TAFARA, FACIKA MD	1/25/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	79253	-	NOT APPLICABLE	0	In state provider	None	3928 ILLINOIS STREET	SUITES 101 & 103	SAN DIEGO	CA	92104	3058	37	06073	32.749074	-117.127758	San Diego County
219630	Fee-for-Service	1275651515	1275651515	1	35	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	31515 RANCHO PUEBLO RD	SUITE 202	TEMECULA	CA	92592	4837	33	06065	33.47922478	-117.1107757	Riverside County
219635	Fee-for-Service	1780828780	1780828780	1	1	TROMPETA, ANDREE V MD	1/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125751	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
219667	Fee-for-Service	1316134067	1316134067	1	1	TAILOR, REKHA U MD	4/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	100441	None	None	0	In state provider	None	1911 WILLIAMS DRIVE	STE 200	OXNARD	CA	93036	0673	56	06111	34.219566	-119.1539365	Ventura County
219677	Fee-for-Service	1477049310	1477049310	1	1	TINKER, ERIN K PT	3/25/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
219682	Fee-for-Service	1144750464	1144750464	1	1	TOSINI, TOMMASO MD	5/18/2020	390200000X	NA	Other	026	PHYSICIANS	160610	08	Family Practice	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
219695	Fee-for-Service	1497595565	1497595565	1	4	TURIYA ANESTHESIA	5/1/2024	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	13100 STUDEBAKER RD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
219701	Fee-for-Service	1487038048	1487038048	1	1	TRAVIS, DEREK J LMFT	2/26/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3551 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
219724	Fee-for-Service	1144346487	1144346487	2	1	TINA B JASPAN	8/1/2012	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1936 N HIGHLAND AVE	SUITE B	JACKSON	TN	38305	4537	00	None	35.65334291	-88.8285662	Madison County
219728	Fee-for-Service	1831622588	1831622588	1	1	TRUONG, LAETITIA MD	9/1/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157343	08	Family Practice	0	In state provider	None	11420 WARNER AVE.	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
219784	Fee-for-Service	1093292559	1093292559	1	1	THANGIAH, NARESH P RCP	10/11/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
219809	Fee-for-Service	1720473119	1720473119	1	1	TSE, JUSTIN R MD	4/21/2020	111NR0200X	NA	Other	026	PHYSICIANS	144837	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
219813	Fee-for-Service	1700326477	1700326477	1	1	TIMON-HILL, PAULA M LCSW	9/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
219818	Fee-for-Service	1275651515	1275651515	1	29	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	207 SANTA ANITA ST.	STE P05	SAN GABRIEL	CA	91776	1159	19	06037	34.10072807	-118.1066296	Los Angeles County
219893	Fee-for-Service	1699744086	1699744086	1	1	TAN, GERALDINE G MD	2/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81859	41	Internal Medicine	0	In state provider	None	1220 ROSSMOOR PKWY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
219897	Fee-for-Service	1306073762	1306073762	1	1	THRIFTY PAYLESS INC	9/28/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2020 E COOPER AVE	None	FRESNO	CA	93730	5403	10	06019	36.89568209	-119.7466498	Fresno County
219910	Fee-for-Service	1134227325	1134227325	1	2	THICH, AMY OD	2/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1844 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	2517	38	06075	37.78692536	-122.4401699	San Francisco County
219918	Fee-for-Service	1275651515	1275651515	1	35	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	31515 RANCHO PUEBLO RD	SUITE 202	TEMECULA	CA	92592	4837	33	06065	33.47922478	-117.1107757	Riverside County
219920	Fee-for-Service	1174701098	1174701098	1	1	TARCZYNSKI, ALISON G LCSW	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	67198	-	NOT APPLICABLE	0	In state provider	None	15305 RAYEN STREET	None	NORTH HILLS	CA	91343	5117	19	06037	34.23191048	-118.4657625	Los Angeles County
219938	Fee-for-Service	1831676873	1831676873	1	1	THE BEST CARE EVER HOME	1/20/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HEALTH INC	14545 FRIAR ST	STE 216	VAN NUYS	CA	91411	2399	19	06037	34.18570347	-118.450386	Los Angeles County
219944	Fee-for-Service	1275651515	1275651515	1	53	THE ONCOLOGY INSTITUTE CA, A	4/10/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	13768 ROSWELL AVE	SUITE 105	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
219960	Fee-for-Service	1154575850	1154575850	1	1	TAY, CANDICE A MD	12/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94353	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
219968	Fee-for-Service	1689783052	1689783052	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 E 1ST ST	None	TUSTIN	CA	92780	3418	30	06059	33.74565081	-117.8175691	Orange County
220091	Fee-for-Service	1821381724	1821381724	1	1	TAKASHI NAKAMURA, M.D.	2/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
220106	Fee-for-Service	1275651515	1275651515	1	29	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	207 SANTA ANITA ST.	STE P05	SAN GABRIEL	CA	91776	1159	19	06037	34.10072807	-118.1066296	Los Angeles County
220117	Fee-for-Service	1225147697	1225147697	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6150 VAN BUREN BLVD	None	RIVERSIDE	CA	92503	8014	33	06065	33.94414599	-117.4540636	Riverside County
220140	Fee-for-Service	1982651717	1982651717	2	1	THIESZEN, SHELDON MD	2/12/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183718	None	None	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
220173	Fee-for-Service	1083792600	1083792600	1	1	THOMAS, CARL L JR MD	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	60036	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
220184	Fee-for-Service	1891743761	1891743761	1	1	TINSLEY, LARRY R MD	10/5/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	26313	20	Orthopedic Surgery	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3899	36	06071	34.04824949	-117.2401425	San Bernardino County
220198	Fee-for-Service	1629156112	1629156112	1	1	TIWARI, NEERAJ MD	9/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90882	41	Internal Medicine	0	In state provider	None	5601 DEER VALLEY RD	None	ANTIOCH	CA	94531	8577	07	06013	37.9518204	-121.7780768	Contra Costa County
220207	Fee-for-Service	1417907510	1417907510	1	1	TRAUMA TEAM MED GRP INC	2/15/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
220213	Fee-for-Service	1902838352	1902838352	1	1	TAHOE CARSON RADIOLOGY LOOS	1/1/1979	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	1	Border provider	None	2874 N CARSON ST	STE 300	CARSON CITY	NV	89706	1683	00	None	39.185271	-119.7710595	Consolidated Municipality of Carson City
220216	Fee-for-Service	1275651515	1275651515	1	35	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	31515 RANCHO PUEBLO RD	SUITE 202	TEMECULA	CA	92592	4837	33	06065	33.47922478	-117.1107757	Riverside County
220232	Fee-for-Service	1275651515	1275651515	1	53	THE ONCOLOGY INSTITUTE CA, A	4/10/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	13768 ROSWELL AVE	SUITE 105	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
220246	Fee-for-Service	1093227738	1093227738	1	1	THE HOSPICE OF SAN DIEGO	11/25/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12975 BROOKPRINTER PLACE	STE 150	POWAY	CA	92064	8895	37	06073	32.94362054	-117.0472842	San Diego County
220250	Fee-for-Service	1942300330	1942300330	1	1	TEDESCO, DOMINIC J MD	12/31/1988	208G00000X	NA	General Surgery	026	PHYSICIANS	45715	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	168 N BRENT ST	# 203	VENTURA	CA	93003	2817	56	06111	34.27448266	-119.2572489	Ventura County
220297	Fee-for-Service	1043329436	1043329436	1	1	THRIFTY PAYLESS INC	11/12/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6344	1421 E WASHINGTON BLVD	None	PASADENA	CA	91104	2650	19	06037	34.16909558	-118.1206609	Los Angeles County
220330	Fee-for-Service	1023547825	1023547825	1	1	TALEB, MARIAM MD	11/9/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	169707	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
220377	Fee-for-Service	1275639262	1275639262	1	1	TOMIOKA, MERCEDES MD	2/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	79604	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HAROBR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
220395	Fee-for-Service	1275651515	1275651515	1	29	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	207 SANTA ANITA ST.	STE P05	SAN GABRIEL	CA	91776	1159	19	06037	34.10072807	-118.1066296	Los Angeles County
220418	Fee-for-Service	1245282557	1245282557	1	1	TAYLOR, DANETTE MD	8/12/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	67159	08	Family Practice	0	In state provider	None	831 VIA SUERTE	STE 102	SAN CLEMENTE	CA	92673	6531	30	06059	33.4630839	-117.5988297	Orange County
220446	Fee-for-Service	1568673960	1568673960	1	1	TUPAZ HOME LLC	5/20/2005	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1850 POTRERO DR	None	SAN JOSE	CA	95124	1756	43	06085	37.27152278	-121.9206434	Santa Clara County
220452	Fee-for-Service	1750504387	1750504387	1	1	TRAN, BRYAN H MD	10/22/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	54928	None	None	0	In state provider	None	27800 MEDICAL CENTER ROA	SUITE 144	MISSION VIEJO	CA	92691	6447	30	06059	33.55952733	-117.6645199	Orange County
220475	Fee-for-Service	1891743761	1891743761	1	1	TINSLEY, LARRY R MD	10/5/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	26313	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
220484	Fee-for-Service	1356728299	1356728299	1	1	TRUONG, ALLISON K MD	7/3/2018	207N00000X	NA	Dermatology	026	PHYSICIANS	146828	07	Dermatology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
220494	Fee-for-Service	1275651515	1275651515	1	21	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	999 N TUSTIN AVE	SUITE 212	SANTA ANA	CA	92705	6506	30	06059	33.754167	-117.834191	Orange County
220520	Fee-for-Service	1275651515	1275651515	1	53	THE ONCOLOGY INSTITUTE CA, A	7/17/2023	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	13768 ROSWELL AVE	SUITE 105	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
220521	Fee-for-Service	1124057443	1124057443	1	1	THOMPSON, KEALANALANI R	11/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
220530	Fee-for-Service	1821428210	1821428210	1	1	TRAINER BERRY, PAMELA M CPO	12/16/2013	222Z00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1500 S SUNKIST ST	#D	ANAHEIM	CA	92806	5815	30	06059	33.81049166	-117.8830649	Orange County
220535	Fee-for-Service	1093227738	1093227738	1	1	THE HOSPICE OF SAN DIEGO	11/25/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12975 BROOKPRINTER PLACE	STE 150	POWAY	CA	92064	8895	37	06073	32.94362054	-117.0472842	San Diego County
220585	Fee-for-Service	1790982254	1790982254	1	1	TAGOYLO, GINO H MD	6/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125922	30	Radiology	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
220652	Fee-for-Service	1467846709	1467846709	1	1	TRAN, HENRY V OD	7/31/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	44815 FIG AVE	None	LANCASTER	CA	93534	3144	19	06037	34.69630244	-118.1431105	Los Angeles County
220686	Fee-for-Service	1275651515	1275651515	1	29	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	207 SANTA ANITA ST.	STE P05	SAN GABRIEL	CA	91776	1159	19	06037	34.10072807	-118.1066296	Los Angeles County
220724	Fee-for-Service	1275651515	1275651515	1	31	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	4646 BROCKTON AVE	SUITE 203-2	RIVERSIDE	CA	92506	0173	33	06065	33.9760171	-117.3860626	Riverside County
220782	Fee-for-Service	1275651515	1275651515	1	21	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	999 N TUSTIN AVE	SUITE 212	SANTA ANA	CA	92705	6506	30	06059	33.754167	-117.834191	Orange County
220807	Fee-for-Service	1275651515	1275651515	1	53	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	13768 ROSWELL AVE	SUITE 105	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
220818	Fee-for-Service	1437602273	1437602273	1	1	THOMAS, JAMES H LCSW	7/10/2023	101YA0400X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	590 SEARLS AVE	12	NEVADA CITY	CA	95959	3043	29	06057	39.25154223	-121.02399	Nevada County
220824	Fee-for-Service	1700129889	1700129889	1	1	TELEFUS, PHILLIP MD	10/28/2019	208VP0014X	NA	Other	026	PHYSICIANS	142788	05	Anesthesiology	0	In state provider	None	250 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
220852	Fee-for-Service	1407804925	1407804925	1	1	TAYLOR, WILLIAM EARL MD	5/1/1999	207P00000X	NA	Other	026	PHYSICIANS	32391	41	Internal Medicine	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
220857	Fee-for-Service	1588827844	1588827844	1	1	TAPSON, GREGORY S MD INC	4/2/2012	193400000X	NA	Other	026	PHYSICIANS	71123	None	None	0	In state provider	None	26366 CARMEL RANCHO LANE	STE H	CARMEL	CA	93923	8721	27	06053	36.54073084	-121.9069263	Monterey County
220872	Fee-for-Service	1598166613	1598166613	1	1	TORRES, CHRISTINA M LCSW	6/27/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	83697	-	NOT APPLICABLE	0	In state provider	None	710 E 111TH PLACE	None	LOS ANGELES	CA	90059	1518	19	06037	33.93454026	-118.2626368	Los Angeles County
220911	Fee-for-Service	1194756858	1194756858	1	1	TO, RICK MINH-LUAN N MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80962	08	Family Practice	0	In state provider	None	87 N 6TH ST	None	SAN JOSE	CA	95112	5423	43	06085	37.33991817	-121.8862077	Santa Clara County
220976	Fee-for-Service	1922062041	1922062041	1	1	TOMLINSON, ANN E CRNA	9/6/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	30	06059	33.746805	-117.834147	Orange County
220989	Fee-for-Service	1154467181	1154467181	1	2	THE HUNTINGTON MEDICAL FOUND	4/13/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	375 HUNTINGTON DR	STE G	SAN MARINO	CA	91108	2357	19	06037	34.1067704	-118.1349621	Los Angeles County
220999	Fee-for-Service	1740231422	1740231422	1	1	TAMESIS, RICHARD R MD	7/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	51345	None	None	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
221006	Fee-for-Service	1710054572	1710054572	1	1	TANIZAWA, RICHARD T OD	12/24/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	23781 MAQUINA AVE	None	MISSION VIEJO	CA	92691	2716	30	06059	33.61792093	-117.6778904	Orange County
221008	Fee-for-Service	1275651515	1275651515	1	31	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	4646 BROCKTON AVE	SUITE 203-2	RIVERSIDE	CA	92506	0173	33	06065	33.9760171	-117.3860626	Riverside County
221020	Fee-for-Service	1134582356	1134582356	1	1	THEOPHANOUS, CHRISTOS N MD	9/29/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	174037	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
221022	Fee-for-Service	1285737692	1285737692	1	1	TAN, HO T MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	32071	08	Family Practice	0	In state provider	None	890 JACKSON ST	STE 202	SAN FRANCISCO	CA	94133	4848	38	06075	37.79566645	-122.4097018	San Francisco County
221048	Fee-for-Service	1306896048	1306896048	1	1	TAO, DAVID M MD	8/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53379	None	None	0	In state provider	None	9542 E ARTESIA BLVD	None	BELLFLOWER	CA	90706	6511	19	06037	33.87472553	-118.1294775	Los Angeles County
221050	Fee-for-Service	1639124126	1639124126	1	1	TINTINALLI, ANNE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	22101 MOROSS RD	None	GROSSE POINTE	MI	48236	2148	00	None	42.41918818	-82.91538222	Wayne County
221070	Fee-for-Service	1275651515	1275651515	1	9	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ND INNOVATION	3628 E. IMPERIAL HWY.	SUITE 401	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
221072	Fee-for-Service	1275651515	1275651515	1	21	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	999 N TUSTIN AVE	SUITE 212	SANTA ANA	CA	92705	6506	30	06059	33.754167	-117.834191	Orange County
221090	Fee-for-Service	1386665883	1386665883	1	1	TONG, DAVID C MD	7/31/1992	2084N0400X	NA	Neurology	026	PHYSICIANS	48639	13	Neurology (M.D. only)	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
221115	Fee-for-Service	1710267778	1710267778	1	1	TANG, MICHAEL M DO	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14505	36	Psychiatry	0	In state provider	None	1001 SNEATH LANE	STE 204	SAN BRUNO	CA	94066	2349	41	06081	37.63462925	-122.4259247	San Mateo County
221127	Fee-for-Service	1518460302	1518460302	1	1	THAI, TYDUS T MD	9/16/2019	207R00000X	NA	Other	026	PHYSICIANS	163346	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
221139	Fee-for-Service	1407804925	1407804925	1	1	TAYLOR, WILLIAM EARL MD	5/1/1999	207P00000X	NA	Other	026	PHYSICIANS	32391	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
221141	Fee-for-Service	1134367832	1134367832	1	1	TABISH, RAINIE D PSYD	1/11/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2008 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
221157	Fee-for-Service	1972612331	1972612331	1	1	THRIFTY PAYLESS INC	4/30/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 MAIN ST	None	LIVINGSTON	CA	95334	1428	24	06047	37.385523	-120.723349	Merced County
221168	Fee-for-Service	1275651515	1275651515	1	4	THE ONCOLOGY INSTITUTE CA, A	11/4/2009	174400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	3300 E. SOUTH ST.	304	LAKEWOOD	CA	90805	4594	19	06037	33.86018093	-118.1537163	Los Angeles County
221170	Fee-for-Service	1346233467	1346233467	1	1	TRASK, DOUGLAS K MD	2/3/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	153807	04	Otology, Laryngology, Rhinology	0	In state provider	None	101 CITY DR S	BLDG 25	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
221183	Fee-for-Service	1013083153	1013083153	1	1	TAAN, KARISSA	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
221213	Fee-for-Service	1326409749	1326409749	1	1	TURCIOS, NATALLY PT	2/24/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	740 S PLACENTIA AVE	STE 100	PLACENTIA	CA	92870	6832	30	06059	33.86285731	-117.8822066	Orange County
221216	Fee-for-Service	1275651515	1275651515	1	39	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	7320 WOODLAKE	SUITE 160	WEST HILLS	CA	91307	1481	19	06037	34.20245266	-118.6321273	Los Angeles County
221283	Fee-for-Service	1427079268	1427079268	1	1	TRAN, MINH-HA DO	7/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10842	22	Pathology (M.D. only)	0	In state provider	None	101 THE CITY DRIVE S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
221294	Fee-for-Service	1740493048	1740493048	1	1	TIEN, WENDY C MD	1/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99688	30	Radiology	0	In state provider	None	1624 W OLIVE AVE	STE F	BURBANK	CA	91506	2459	19	06037	34.1673422	-118.3229985	Los Angeles County
221295	Fee-for-Service	1275651515	1275651515	1	31	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	4646 BROCKTON AVE	SUITE 203-2	RIVERSIDE	CA	92506	0173	33	06065	33.9760171	-117.3860626	Riverside County
221296	Fee-for-Service	1659662005	1659662005	1	1	TOM, CLIFFORD C MD	8/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107810	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
221299	Fee-for-Service	1255822284	1255822284	1	1	TABIBZADEH, MAJIDREZA LAC	6/22/2020	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	8840 WARNER AVE	SUITE 100	FOUNTAIN VALLEY	CA	92780	3852	30	06059	33.71570241	-117.9745591	Orange County
221318	Fee-for-Service	1285174169	1285174169	1	1	TAHOE FOREST HOSPITAL	3/21/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CLINIC PEDIATRICS	10956 DONNER PASS RD	2ND AND 3RD FLOOR	TRUCKEE	CA	96161	4860	29	06057	39.32625521	-120.2012059	Nevada County
221325	Fee-for-Service	1033168042	1033168042	1	1	THIBAULT, MARIE-JOSEE MD	2/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	51019	07	Dermatology	0	In state provider	None	200 UCLA MEDICAL PLZ	BLDG 465	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
221353	Fee-for-Service	1699749747	1699749747	1	1	TRAN MEDICAL CLINIC INC	10/1/2000	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2899 SENTER RD	STE 140	SAN JOSE	CA	95111	1182	43	06085	37.29783123	-121.8378063	Santa Clara County
221360	Fee-for-Service	1275651515	1275651515	1	9	THE ONCOLOGY INSTITUTE CA, A	1/28/2013	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	ND INNOVATION	3628 E. IMPERIAL HWY.	SUITE 401	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
221385	Fee-for-Service	1538321088	1538321088	1	1	TREVINO, BETH A MD	7/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99175	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
221407	Fee-for-Service	1104993922	1104993922	1	1	TRENT, CHRISTOPHER S MD	12/31/1988	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	64732	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
221452	Fee-for-Service	1851596894	1851596894	1	1	THOMSON, MARK D PT	6/8/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4650 PALM AVENUE	None	SAN DIEGO	CA	92154	8404	37	06073	32.5839467	-117.0337851	San Diego County
221455	Fee-for-Service	1770221988	1770221988	1	1	TYDINGCO, DARLENE	9/10/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
221456	Fee-for-Service	1275651515	1275651515	1	4	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	174400000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3300 E. SOUTH ST.	304	LAKEWOOD	CA	90805	4594	19	06037	33.86018093	-118.1537163	Los Angeles County
221491	Fee-for-Service	1386332146	1386332146	1	1	TUCKER, SAVANNAH N BIRTH DOU	7/3/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	44	06087	0	0	None
221505	Fee-for-Service	1275651515	1275651515	1	39	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	7320 WOODLAKE	SUITE 160	WEST HILLS	CA	91307	1481	19	06037	34.20245266	-118.6321273	Los Angeles County
221583	Fee-for-Service	1275651515	1275651515	1	31	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	4646 BROCKTON AVE	SUITE 203-2	RIVERSIDE	CA	92506	0173	33	06065	33.9760171	-117.3860626	Riverside County
221593	Fee-for-Service	1275564775	1275564775	1	1	TAHERI, PARVIZ P MD	6/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	42680	30	Radiology	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
221609	Fee-for-Service	1285174169	1285174169	1	1	TAHOE FOREST HOSPITAL	3/21/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CLINIC PEDIATRICS	10956 DONNER PASS RD	2ND AND 3RD FLOOR	TRUCKEE	CA	96161	4860	29	06057	39.32625521	-120.2012059	Nevada County
221614	Fee-for-Service	1154494748	1154494748	1	1	TERSCHLUSE, LAUREN M LMFT	6/23/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
221620	Fee-for-Service	1194751941	1194751941	1	1	TRUONG, SIEU PHI MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67527	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
221642	Fee-for-Service	1699749747	1699749747	1	1	TRAN MEDICAL CLINIC INC	10/1/2000	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	2899 SENTER RD	STE 140	SAN JOSE	CA	95111	1182	43	06085	37.29783123	-121.8378063	Santa Clara County
221646	Fee-for-Service	1275651515	1275651515	1	9	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ND INNOVATION	3628 E. IMPERIAL HWY.	SUITE 401	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
221694	Fee-for-Service	1285708941	1285708941	1	1	TALCOVE, DAVIDA E MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53086	01	General Practice	0	In state provider	None	2780 JUNIPERO SERRA BLVD	None	DALY CITY	CA	94015	1634	41	06081	37.69052698	-122.4710669	San Mateo County
221718	Fee-for-Service	1811956279	1811956279	1	1	TOTAL RENAL CARE, INC	9/12/1980	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	118 HILLIARD AVE	None	MONTEREY PARK	CA	91754	1118	19	06037	34.0672827	-118.1238092	Los Angeles County
221726	Fee-for-Service	1063866630	1063866630	1	1	TAVAKOLI, HESAM MD	7/1/2019	390200000X	NA	Other	026	PHYSICIANS	157939	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
221745	Fee-for-Service	1275651515	1275651515	1	4	THE ONCOLOGY INSTITUTE CA, A	11/4/2009	174400000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	3300 E. SOUTH ST.	304	LAKEWOOD	CA	90805	4594	19	06037	33.86018093	-118.1537163	Los Angeles County
221761	Fee-for-Service	1932238656	1932238656	1	1	TSANG, CHIU-LAP W MD	6/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	39454	41	Internal Medicine	0	In state provider	None	110 N VALERIA ST	STE 404	FRESNO	CA	93701	2168	10	06019	36.74388938	-119.7847725	Fresno County
221790	Fee-for-Service	1275651515	1275651515	1	39	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	7320 WOODLAKE	SUITE 160	WEST HILLS	CA	91307	1481	19	06037	34.20245266	-118.6321273	Los Angeles County
221831	Fee-for-Service	1275858821	1275858821	1	1	TANG, CATHY J MD	8/4/2019	390200000X	NA	Other	026	PHYSICIANS	118948	24	Plastic Surgery	0	In state provider	None	101 THE CITY DR S	BLDG 55	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
221839	Fee-for-Service	1366049207	1366049207	1	1	TOUCH OF CARE ASSISTED LIVIN	6/14/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	885 S ESPLANADE ST	None	ORANGE	CA	92869	1010	30	06059	33.77377512	-117.8096725	Orange County
221871	Fee-for-Service	1275651515	1275651515	1	31	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	4646 BROCKTON AVE	SUITE 203-2	RIVERSIDE	CA	92506	0173	33	06065	33.9760171	-117.3860626	Riverside County
221893	Fee-for-Service	1285174169	1285174169	1	1	TAHOE FOREST HOSPITAL	1/30/2023	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CLINIC PEDIATRICS	10956 DONNER PASS RD	2ND AND 3RD FLOOR	TRUCKEE	CA	96161	4860	29	06057	39.32625521	-120.2012059	Nevada County
221929	Fee-for-Service	1699749747	1699749747	1	1	TRAN MEDICAL CLINIC INC	10/1/2000	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2899 SENTER RD	STE 140	SAN JOSE	CA	95111	1182	43	06085	37.29783123	-121.8378063	Santa Clara County
221933	Fee-for-Service	1275651515	1275651515	1	9	THE ONCOLOGY INSTITUTE CA, A	1/28/2013	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ND INNOVATION	3628 E. IMPERIAL HWY.	SUITE 401	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
221934	Fee-for-Service	1275651515	1275651515	1	36	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	1701 CESAR E CHAVEZ AVE	SUITE 535	LOS ANGELES	CA	90033	2464	19	06037	34.05112725	-118.2173921	Los Angeles County
221954	Fee-for-Service	1659612588	1659612588	1	1	TRAVERSO, ANGELA C PT	5/13/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6759 SIERRA CT	SUITE A	DUBLIN	CA	94568	2670	01	06001	37.70825702	-121.9144925	Alameda County
221980	Fee-for-Service	1043708639	1043708639	1	1	TSAOI, DERICK S MD	2/28/2023	390200000X	NA	Other	026	PHYSICIANS	166536	None	None	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
221981	Fee-for-Service	1285708941	1285708941	1	1	TALCOVE, DAVIDA E MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53086	41	Internal Medicine	0	In state provider	None	2780 JUNIPERO SERRA BLVD	None	DALY CITY	CA	94015	1634	41	06081	37.69052698	-122.4710669	San Mateo County
221996	Fee-for-Service	1578760724	1578760724	1	1	TRAXLER, MARGARET M	7/6/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	110 N LA BREA AVENUE	None	INGLEWOOD	CA	90301	1708	19	06037	33.96345848	-118.3533454	Los Angeles County
222012	Fee-for-Service	1326073743	1326073743	1	2	TALREJA, DRAUPADI B MD	11/29/2018	207RH0003X	NA	Oncology	026	PHYSICIANS	31459	41	Internal Medicine	0	In state provider	None	11550 INDIAN HILLS RD	SUITE 330	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
222025	Fee-for-Service	1821673427	1821673427	1	1	TORRES, ZAIRA NP	5/5/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
222031	Fee-for-Service	1275651515	1275651515	1	4	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	174400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3300 E. SOUTH ST.	304	LAKEWOOD	CA	90805	4594	19	06037	33.86018093	-118.1537163	Los Angeles County
222061	Fee-for-Service	1194965004	1194965004	1	1	THRIFTY PAYLESS INC.	6/22/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06561	11352 BRYANT ST	None	YUCAIPA	CA	92399	3121	36	06071	34.047792	-117.034487	San Bernardino County
222077	Fee-for-Service	1275651515	1275651515	1	39	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	7320 WOODLAKE	SUITE 160	WEST HILLS	CA	91307	1481	19	06037	34.20245266	-118.6321273	Los Angeles County
222079	Fee-for-Service	1811196553	1811196553	1	1	TESFAY, SAMUEL Y MD	8/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84101	10	Gastroenterology (M.D. only)	0	In state provider	None	1505 S MAIN ST	None	WALNUT CREEK	CA	94596	4606	07	06013	37.89003052	-122.0574583	Contra Costa County
222105	Fee-for-Service	1275651515	1275651515	1	26	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	21605 HAWTHORNE BLVD	SUITE 200	TORRANCE	CA	90503	6618	19	06037	33.83210846	-118.3528553	Los Angeles County
222109	Fee-for-Service	1649319666	1649319666	1	1	TRAN, DONNY N MD	7/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133199	01	General Practice	0	In state provider	None	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	4200	30	06059	33.77387145	-117.9966555	Orange County
222129	Fee-for-Service	1063949972	1063949972	1	1	TRAN, VAN T MD	8/4/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	170843	None	None	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
222164	Fee-for-Service	1750100251	1750100251	1	1	TRITZ, SARAH PT	2/28/2025	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
222204	Fee-for-Service	1881620540	1881620540	1	1	TALANO,JAMES V MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 2ND AVE NORTH	STE 301	NAPLES	FL	34102	0000	00	None	26.14928087	-81.7981656	Collier County
222219	Fee-for-Service	1275651515	1275651515	1	9	THE ONCOLOGY INSTITUTE CA, A	1/28/2013	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	ND INNOVATION	3628 E. IMPERIAL HWY.	SUITE 401	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
222221	Fee-for-Service	1275651515	1275651515	1	45	THE ONCOLOGY INSTITUTE CA, A	3/22/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INNOVATION	16404 COLIMA RD	None	HACIENDA HEIGHTS	CA	91745	5502	19	06037	33.98596755	-117.9536776	Los Angeles County
222235	Fee-for-Service	1235524208	1235524208	1	1	TSOUFAKIS, AMANDA MD	5/25/2023	390200000X	NA	Other	026	PHYSICIANS	185123	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
222252	Fee-for-Service	1548784457	1548784457	1	1	TRONAAS, BETTY J NP	12/28/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	974 W FOOTHILL BLVD	None	UPLAND	CA	91786	3728	36	06071	34.106562	-117.6651435	San Bernardino County
222287	Fee-for-Service	1336123504	1336123504	1	1	TATE, DAVID J MD	5/1/1994	2085R0001X	NA	Other	026	PHYSICIANS	75355	41	Internal Medicine	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
222318	Fee-for-Service	1699842450	1699842450	1	1	THOMAS, TANU O MD	6/25/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	94942	18	Ophthalmology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
222320	Fee-for-Service	1912342296	1912342296	1	1	TENWOLDE, BOBBI J MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133578	01	General Practice	0	In state provider	None	11670 ATWOOD RD	None	AUBURN	CA	95603	9522	31	06061	38.93485327	-121.0988193	Placer County
222352	Fee-for-Service	1922219476	1922219476	2	1	TUPAZ HOMES LLC	6/6/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1955 PATIO DR	None	SAN JOSE	CA	95125	5652	43	06085	37.28848179	-121.921578	Santa Clara County
222357	Fee-for-Service	1215268099	1215268099	1	1	TRUE 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	12626 RIVERSIDE DRIVE	#408	ALLEY VILLAGE	CA	91607	3420	19	06037	34.15758449	-118.408131	Los Angeles County
222372	Fee-for-Service	1275651515	1275651515	1	39	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	7320 WOODLAKE	SUITE 160	WEST HILLS	CA	91307	1481	19	06037	34.20245266	-118.6321273	Los Angeles County
222386	Fee-for-Service	1861958829	1861958829	1	1	THE CHILDRENS CLINIC SERVING	3/8/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	445 E ANAHEIM STREET	None	WILMINGTON	CA	90744	4600	19	06037	33.78025372	-118.2579305	Los Angeles County
222392	Fee-for-Service	1275651515	1275651515	1	26	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	21605 HAWTHORNE BLVD	SUITE 200	TORRANCE	CA	90503	6618	19	06037	33.83210846	-118.3528553	Los Angeles County
222398	Fee-for-Service	1699227009	1699227009	1	1	THRIVE PROSTHETICS	6/27/2017	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	6600 COYLE AVE	STE 2	CARMICHAEL	CA	95608	6344	34	06067	38.667807	-121.310748	Sacramento County
222411	Fee-for-Service	1093763484	1093763484	2	1	TRINH, HOI K MD	4/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51429	41	Internal Medicine	0	In state provider	None	6590 STOCKTON BOULEVARD	SUITE 100	SACRAMENTO	CA	95823	1612	34	06067	38.506617	-121.4347095	Sacramento County
222512	Fee-for-Service	1275651515	1275651515	1	45	THE ONCOLOGY INSTITUTE CA, A	3/22/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	INNOVATION	16404 COLIMA RD	None	HACIENDA HEIGHTS	CA	91745	5502	19	06037	33.98596755	-117.9536776	Los Angeles County
222548	Fee-for-Service	1548265036	1548265036	1	4	TRUXTUN RADIOLOGY	5/17/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	3001 SILLECT AVE	None	BAKERSFIELD	CA	93308	6337	15	06029	35.38601911	-119.0400416	Kern County
222553	Fee-for-Service	1205841970	1205841970	1	1	TARANGO, NIMALJEET K NP	5/30/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
222561	Fee-for-Service	1326255621	1326255621	1	1	TRIPP, MATTHEW L MD	3/7/2008	207P00000X	NA	Other	026	PHYSICIANS	102727	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
222574	Fee-for-Service	1336123504	1336123504	1	1	TATE, DAVID J MD	5/1/1994	2085R0001X	NA	Other	026	PHYSICIANS	75355	30	Radiology	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
222597	Fee-for-Service	1780802421	1780802421	1	1	THANIK, VISHAL	6/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
222598	Fee-for-Service	1386176477	1386176477	1	1	TAXAK, PRITEE MD	5/14/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	2301 BAHAMAS DR	None	BAKERSFIELD	CA	93309	0663	15	06029	35.37447628	-119.0453594	Kern County
222599	Fee-for-Service	1245567395	1245567395	1	1	TELISCHAK, KRISTEN M MD	9/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124068	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	MC:5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
222610	Fee-for-Service	1669689626	1669689626	1	1	TESSEL, TERZA LCSW	4/7/2014	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	17337 VENTURA BOULEVARD	SUITE 327	ENCINO	CA	91316	4921	19	06037	34.16102943	-118.5108514	Los Angeles County
222642	Fee-for-Service	1205840741	1205840741	1	1	TSAI, JANE MD	9/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	88637	41	Internal Medicine	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
222644	Fee-for-Service	1215268099	1215268099	1	1	TRUE CARE HOSPICE INC	7/5/2011	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12626 RIVERSIDE DRIVE	#408	ALLEY VILLAGE	CA	91607	3420	19	06037	34.15758449	-118.408131	Los Angeles County
222673	Fee-for-Service	1861958829	1861958829	1	1	THE CHILDRENS CLINIC SERVING	3/8/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	445 E ANAHEIM STREET	None	WILMINGTON	CA	90744	4600	19	06037	33.78025372	-118.2579305	Los Angeles County
222681	Fee-for-Service	1275651515	1275651515	1	26	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	21605 HAWTHORNE BLVD	SUITE 200	TORRANCE	CA	90503	6618	19	06037	33.83210846	-118.3528553	Los Angeles County
222688	Fee-for-Service	1073931887	1073931887	2	1	THEO PHARMACEUTICALS INC	8/29/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13701 BEACH BLVD	#A2	WESTMINSTER	CA	92683	3201	30	06059	33.76324302	-117.9900533	Orange County
222692	Fee-for-Service	1730288747	1730288747	1	1	TELLECHEA-SANCHEZ, SELMIRA	1/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	83438	40	Pediatrics	0	In state provider	None	1107 S MISSION RD	None	FALLBROOK	CA	92028	3224	37	06073	33.37242711	-117.2534301	San Diego County
222695	Fee-for-Service	1093763484	1093763484	2	1	TRINH, HOI K MD	4/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51429	01	General Practice	0	In state provider	None	6590 STOCKTON BOULEVARD	SUITE 100	SACRAMENTO	CA	95823	1612	34	06067	38.506617	-121.4347095	Sacramento County
222722	Fee-for-Service	1922367929	1922367929	1	1	TOOMARI, SHAHDOKHT S PSYD	11/3/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	9107 WILSHIRE BLVD	SUITE 200	BEVERLY HILLS	CA	90210	5522	19	06037	34.06708751	-118.390068	Los Angeles County
222748	Fee-for-Service	1205249968	1205249968	1	1	TONG, OLIVIA C MD	7/11/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	163411	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
222755	Fee-for-Service	1366501934	1366501934	1	1	TSUDA, TOSHIMASA MD	12/1/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	80275	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
222759	Fee-for-Service	1043224587	1043224587	1	1	THAI, CHRISTINE T MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64729	08	Family Practice	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
222765	Fee-for-Service	1942707229	1942707229	1	1	THORNE, ANDREW MD	1/1/2022	390200000X	NA	Other	026	PHYSICIANS	163974	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
222798	Fee-for-Service	1275651515	1275651515	1	36	THE ONCOLOGY INSTITUTE CA, A	10/17/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	1701 CESAR E CHAVEZ AVE	SUITE 535	LOS ANGELES	CA	90033	2464	19	06037	34.05112725	-118.2173921	Los Angeles County
222867	Fee-for-Service	1205984168	1205984168	1	1	TOBEN, ALAN L MD	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	61170	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
222882	Fee-for-Service	1417504317	1417504317	1	1	TUBBS, JILL A CNP	2/19/2020	163W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1895 ORANGE TREE LANE	STE 102	REDLANDS	CA	92374	0112	36	06071	34.06779452	-117.2169225	San Bernardino County
222888	Fee-for-Service	1730379371	1730379371	1	1	TRAN, CAM THUY Q MD	4/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	93494	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
222934	Fee-for-Service	1902024219	1902024219	1	1	TODD, LAURA J LCSW	11/17/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
222937	Fee-for-Service	1902027220	1902027220	1	1	THE HELP GROUP PROJECT 6	7/17/1990	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	16026 GRESHAM ST	None	NORTH HILLS	CA	91343	4838	19	06037	34.23098589	-118.4817608	Los Angeles County
222969	Fee-for-Service	1275651515	1275651515	1	26	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	21605 HAWTHORNE BLVD	SUITE 200	TORRANCE	CA	90503	6618	19	06037	33.83210846	-118.3528553	Los Angeles County
222971	Fee-for-Service	1417447707	1417447707	1	1	TSE, YUCHAI INC	8/16/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8177 FERGUSON GREEN	None	BUENA PARK	CA	90621	1314	30	06059	33.89020483	-117.9908752	Orange County
222992	Fee-for-Service	1699025460	1699025460	1	1	TOTAL RENAL CARE INC	12/1/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4201 E LA PALMA AVE	None	ANAHEIM	CA	92807	1815	30	06059	33.85948104	-117.8254536	Orange County
223028	Fee-for-Service	1124256680	1124256680	1	1	THOMAS, SHEENA M MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118493	41	Internal Medicine	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
223030	Fee-for-Service	1831781772	1831781772	1	1	TRICOLICI, ELEONORA NP	3/8/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	151 N SUNRISE AVE	STE 1205	ROSEVILLE	CA	95661	2926	31	06061	38.74746043	-121.2655348	Placer County
223074	Fee-for-Service	1699839993	1699839993	1	1	THE CHILDRENS CLINIC SERVING	7/1/2005	261QC1500X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CHILDREN AND THEIR FAMIL	1060 E 70TH ST	None	LONG BEACH	CA	90805	1008	19	06037	33.8818064	-118.1800311	Los Angeles County
223086	Fee-for-Service	1275651515	1275651515	1	36	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	1701 CESAR E CHAVEZ AVE	SUITE 535	LOS ANGELES	CA	90033	2464	19	06037	34.05112725	-118.2173921	Los Angeles County
223132	Fee-for-Service	1700895430	1700895430	1	1	THOMAS K. REID, MD PROF CORP	5/19/2006	207W00000X	NA	Ophthalmology	026	PHYSICIANS	54353	None	None	0	In state provider	None	157 PIONEER LANE	None	BISHOP	CA	93514	2557	14	06027	37.362672	-118.407366	Inyo County
223158	Fee-for-Service	1447761283	1447761283	1	2	TELEKOM TRANSPORTATION LLC	1/25/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2128 AUTO PARK	STE A	ESCONDIDO	CA	92029	1344	37	06073	33.12000468	-117.1121481	San Diego County
223162	Fee-for-Service	1154467181	1154467181	1	8	THE HUNTINGTON MEDICAL FOUND	5/13/2024	207K00000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	100 W. CALIFORNIA BLVD.	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
223256	Fee-for-Service	1275651515	1275651515	1	26	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	21605 HAWTHORNE BLVD	SUITE 200	TORRANCE	CA	90503	6618	19	06037	33.83210846	-118.3528553	Los Angeles County
223267	Fee-for-Service	1922356369	1922356369	1	1	TRI-STATE COMMUNITY	2/4/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER	820 W. BROADWAY STREET	None	NEEDLES	CA	92363	2729	36	06071	34.83897407	-114.6052958	San Bernardino County
223302	Fee-for-Service	1881654788	1881654788	1	1	THOMAS, JAMES A MD	12/11/2023	2080P0203X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
223317	Fee-for-Service	1770014805	1770014805	1	1	TAUSIF, FAIZ N MD	11/3/2022	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	181165	None	None	0	In state provider	None	43112 N 15TH WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
223326	Fee-for-Service	1952410342	1952410342	1	1	THRIFTY DRUG STORE 5556	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16642 SOLEDAD CANYON RD	None	CANYON COUNTRY	CA	91387	3217	19	06037	34.42662199	-118.4262946	Los Angeles County
223327	Fee-for-Service	1427167915	1427167915	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5820	1251 JOHNSON AVE	None	SAN LUIS OBISPO	CA	93401	3306	40	06079	35.28243189	-120.6554161	San Luis Obispo County
223362	Fee-for-Service	1699839993	1699839993	1	1	THE CHILDRENS CLINIC SERVING	7/1/2005	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CHILDREN AND THEIR FAMIL	1060 E 70TH ST	None	LONG BEACH	CA	90805	1008	19	06037	33.8818064	-118.1800311	Los Angeles County
223376	Fee-for-Service	1275651515	1275651515	1	45	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	INNOVATION	16404 COLIMA RD	None	HACIENDA HEIGHTS	CA	91745	5502	19	06037	33.98596755	-117.9536776	Los Angeles County
223417	Fee-for-Service	1376691683	1376691683	1	1	TONKINSON, BRIEN W MD	7/14/2011	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	54644	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	1351 E SPRUCE	None	FRESNO	CA	93720	3342	10	06019	36.84136088	-119.7588077	Fresno County
223419	Fee-for-Service	1265157226	1265157226	1	1	TAPIA, MARCOS S PT	1/16/2023	225100000X	NA	Physical Therapist	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
223450	Fee-for-Service	1154467181	1154467181	1	8	THE HUNTINGTON MEDICAL FOUND	12/28/2024	207K00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	100 W. CALIFORNIA BLVD.	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
223464	Fee-for-Service	1457324055	1457324055	1	1	THOMAS WHITESIDE	12/2/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	390 E LONGVIEW ST	None	FAYETTEVILLE	AR	72703	4618	00	None	36.111726	-94.1517135	Washington County
223506	Fee-for-Service	1366520918	1366520918	1	1	TANG, MARLENA MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71297	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
223554	Fee-for-Service	1922356369	1922356369	1	1	TRI-STATE COMMUNITY	2/4/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER	820 W. BROADWAY STREET	None	NEEDLES	CA	92363	2729	36	06071	34.83897407	-114.6052958	San Bernardino County
223556	Fee-for-Service	1447753496	1447753496	1	1	TUMBER, NAVDEEP MD	9/22/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173558	None	None	0	In state provider	None	3440 HILLCREST AVE	SUITE 150	ANTIOCH	CA	94531	6369	07	06013	37.98703099	-121.7803342	Contra Costa County
223581	Fee-for-Service	1386861409	1386861409	1	1	TSAI, TINYEE L MD	6/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88191	07	Dermatology	0	In state provider	None	2580 SR MARY COLUMBA DR	None	RED BLUFF	CA	96080	4356	52	06103	40.14842672	-122.2180085	Tehama County
223583	Fee-for-Service	1417947649	1417947649	1	1	TROTTER, TRACY MD	4/30/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	40069	40	Pediatrics	0	In state provider	None	200 PORTER DR	STE 300	SAN RAMON	CA	94583	1524	07	06013	37.77372204	-121.9911155	Contra Costa County
223590	Fee-for-Service	1639220296	1639220296	1	1	TOAN VAN ON	3/1/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THANH THUY PHARMACY	6830 STOCKTON BLVD	STE 160	SACRAMENTO	CA	95823	2392	34	06067	38.502711	-121.4329725	Sacramento County
223651	Fee-for-Service	1265469704	1265469704	1	1	TZIMENATOS, LEAH S MD	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100330	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
223665	Fee-for-Service	1275651515	1275651515	1	36	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	1701 CESAR E CHAVEZ AVE	SUITE 535	LOS ANGELES	CA	90033	2464	19	06037	34.05112725	-118.2173921	Los Angeles County
223706	Fee-for-Service	1346635232	1346635232	1	1	TURNER, BRANDEN P MD	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146709	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
223815	Fee-for-Service	1386890747	1386890747	1	1	TAM, WANNY MD	6/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102686	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
223835	Fee-for-Service	1275735961	1275735961	1	1	THAU, HELAINE M PHD	9/12/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	43112 N 15TH ST WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
223843	Fee-for-Service	1922356369	1922356369	1	1	TRI-STATE COMMUNITY	2/4/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER	820 W. BROADWAY STREET	None	NEEDLES	CA	92363	2729	36	06071	34.83897407	-114.6052958	San Bernardino County
223857	Fee-for-Service	1366720708	1366720708	1	1	TURNING POINT OF CENTRAL	12/16/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA INC	451 EAST SAMOA STREET	None	LINDSAY	CA	93247	2160	54	06107	36.20518072	-119.0867096	Tulare County
223907	Fee-for-Service	1245459833	1245459833	1	1	TOKRAKS, STEPHEN P DO	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11829	41	Internal Medicine	0	In state provider	None	4311 THIRD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
223932	Fee-for-Service	1972614501	1972614501	1	1	THOMAS, CURT S DPM	2/23/2006	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
223934	Fee-for-Service	1790598811	1790598811	1	1	THE VILLAGE DOULA COLLECTIVE	2/11/2025	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	04	06007	0	0	None
223938	Fee-for-Service	1265469704	1265469704	1	1	TZIMENATOS, LEAH S MD	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100330	40	Pediatrics	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
223951	Fee-for-Service	1275651515	1275651515	1	45	THE ONCOLOGY INSTITUTE CA, A	5/20/2022	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	INNOVATION	16404 COLIMA RD	None	HACIENDA HEIGHTS	CA	91745	5502	19	06037	33.98596755	-117.9536776	Los Angeles County
223987	Fee-for-Service	1649253477	1649253477	1	1	TON, HENDRY MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70512	None	None	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
224059	Fee-for-Service	1851821888	1851821888	1	1	TRIEU, ANGIE OD	1/16/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2280 E CARSON ST	None	LONG BEACH	CA	90807	3044	19	06037	33.83241248	-118.164456	Los Angeles County
224065	Fee-for-Service	1699985044	1699985044	1	1	TRIVEDI, MANISHA L MD	1/3/2018	207LP2900X	NA	Other	026	PHYSICIANS	146373	05	Anesthesiology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
224075	Fee-for-Service	1972732014	1972732014	1	1	TAM, KIT W MD	6/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126094	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X STREET	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
224081	Fee-for-Service	1134163314	1134163314	1	1	THOMSON, MATTHEW J	1/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	77597	30	Radiology	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
224082	Fee-for-Service	1790825032	1790825032	1	1	TAEKMAN, HOWARD P MD INC	10/17/1984	208600000X	NA	General Surgery	026	PHYSICIANS	23214	02	General Surgery	0	In state provider	None	2023 VALE RD	STE 201	SAN PABLO	CA	94806	3898	07	06013	37.95369824	-122.3378493	Contra Costa County
224115	Fee-for-Service	1356822142	1356822142	1	1	TOGETHER PSYCHIATRIC NURSE P	11/18/2019	103TP2700X	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3030 W OLYMPIC BLVD	STE 217	LOS ANGELES	CA	90006	6507	19	06037	34.05260995	-118.3015825	Los Angeles County
224145	Fee-for-Service	1275737793	1275737793	1	1	THOMPSON, FANSHEN LCSW	12/9/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
224151	Fee-for-Service	1558326371	1558326371	1	1	TON, KIET A MD	10/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	130978	01	General Practice	0	In state provider	None	10326 BOLSA AVE	None	WESTMINSTER	CA	92683	6763	30	06059	33.7448397	-117.9492705	Orange County
224169	Fee-for-Service	1790179133	1790179133	1	1	TIARRAZ, ROYA LMFT	9/17/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4419 VAN NUYS BLVD	SUITE 305	SHERMAN OAKS	CA	91403	5735	19	06037	34.151697	-118.448716	Los Angeles County
224175	Fee-for-Service	1700828852	1700828852	1	1	THE METROHEALTH SYSTEM	7/18/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2500 METROHEALTH DRIVE	None	CLEVELAND	OH	44109	1900	00	None	41.46242416	-81.69888235	Cuyahoga County
224188	Fee-for-Service	1972525889	1972525889	1	1	THRIFTY PAYLESS INC	1/1/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5670 E 2ND ST	None	LONG BEACH	CA	90803	3904	19	06037	33.75687759	-118.1233626	Los Angeles County
224238	Fee-for-Service	1275651515	1275651515	1	36	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	1701 CESAR E CHAVEZ AVE	SUITE 535	LOS ANGELES	CA	90033	2464	19	06037	34.05112725	-118.2173921	Los Angeles County
224239	Fee-for-Service	1023127487	1023127487	1	1	THRIFTY PAYLESS INC	2/25/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5725	23965 IRONWOOD AVE	None	MORENO VALLEY	CA	92557	7153	33	06065	33.94660048	-117.2447325	Riverside County
224279	Fee-for-Service	1770663890	1770663890	1	1	THOMPSON, JOHN C MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	83902	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
224320	Fee-for-Service	1790874642	1790874642	1	1	TORBATI, SHAUN S	11/20/2007	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	23232 PERALTA DR	STE 113	LAGUNA HILLS	CA	92653	1436	30	06059	33.62507998	-117.7250262	Orange County
224349	Fee-for-Service	1043728116	1043728116	1	1	TERWILLIGER, ALICIA PT	4/26/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1120 HUTCHINSON DRIVE	None	DAVIS	CA	95616	5270	57	06113	38.53834973	-121.7626055	Yolo County
224363	Fee-for-Service	1972732014	1972732014	1	1	TAM, KIT W MD	6/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126094	41	Internal Medicine	0	In state provider	None	4501 X STREET	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
224378	Fee-for-Service	1093829921	1093829921	1	1	TRAN, KIMLY T OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7250 CARSON BLVD	None	LONG BEACH	CA	90808	2358	19	06037	33.829335	-118.0906155	Los Angeles County
224402	Fee-for-Service	1689739054	1689739054	1	1	TASLIMI, MASOUD M MD	12/1/2000	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	50370	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON ST	STE 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
224405	Fee-for-Service	1356822142	1356822142	1	1	TOGETHER PSYCHIATRIC NURSE P	11/18/2019	103TP2700X	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	3030 W OLYMPIC BLVD	STE 217	LOS ANGELES	CA	90006	6507	19	06037	34.05260995	-118.3015825	Los Angeles County
224406	Fee-for-Service	1689691461	1689691461	1	1	TEE, GRACE K MD	2/21/2008	207R00000X	NA	Other	026	PHYSICIANS	94181	41	Internal Medicine	0	In state provider	None	175 N JACKSON AVE	SUITE 215	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
224420	Fee-for-Service	1407210214	1407210214	1	1	TAYLOR, BLAKE MD	9/7/2023	207T00000X	NA	General Surgery	026	PHYSICIANS	185595	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
224422	Fee-for-Service	1104843028	1104843028	1	1	THORNG, SINAVY SD	7/6/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	709 E ANAHEIM ST	None	LONG BEACH	CA	90813	3507	19	06037	33.78263447	-118.1827035	Los Angeles County
224463	Fee-for-Service	1700828852	1700828852	1	1	THE METROHEALTH SYSTEM	7/18/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2500 METROHEALTH DRIVE	None	CLEVELAND	OH	44109	1900	00	None	41.46242416	-81.69888235	Cuyahoga County
224487	Fee-for-Service	1720553456	1720553456	1	1	TILL, DALE MD	7/14/2023	390200000X	NA	Other	026	PHYSICIANS	186622	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
224542	Fee-for-Service	1720197064	1720197064	1	1	THRIFTY PAYLESS INC	3/8/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6459	1735 E WALNUT AVE	None	VISALIA	CA	93292	1394	54	06107	36.312075	-119.2734315	Tulare County
224569	Fee-for-Service	1770663890	1770663890	1	1	THOMPSON, JOHN C MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	83902	45	Nephrology (Renal-Kidney)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
224579	Fee-for-Service	1063602860	1063602860	1	1	THURSTON, DANYELA M LMFT	12/27/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1452 OREGON STREET	None	REDDING	CA	96001	1620	45	06089	40.58366131	-122.3945244	Shasta County
224657	Fee-for-Service	1073730826	1073730826	1	1	TAMEZ, JOSE M LMFT	5/15/2024	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
224682	Fee-for-Service	1386753747	1386753747	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05758	31541 SANTA MARGARITA PK	None	RANCHO SANTA MARG	CA	92688	1837	30	06059	33.650262	-117.581445	Orange County
224693	Fee-for-Service	1053892794	1053892794	1	1	TU, BEVERLY OD	12/4/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
224694	Fee-for-Service	1356822142	1356822142	1	1	TOGETHER PSYCHIATRIC NURSE P	5/22/2023	103TP2700X	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3030 W OLYMPIC BLVD	STE 217	LOS ANGELES	CA	90006	6507	19	06037	34.05260995	-118.3015825	Los Angeles County
224702	Fee-for-Service	1598874083	1598874083	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3230 W SLAUSON AVE	None	LOS ANGELES	CA	90043	2564	19	06037	33.98898353	-118.3289895	Los Angeles County
224719	Fee-for-Service	1679902993	1679902993	1	1	TRUSTED HOSPICE CARE INC	4/13/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	310 E ROWLAND STREET	None	COVINA	CA	91723	9313	33	06065	34.07886604	-117.8855304	Los Angeles County
224727	Fee-for-Service	1841887460	1841887460	1	1	TANG, FUJIE PT	8/16/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
224734	Fee-for-Service	1770535072	1770535072	1	1	THOMAS, JEFFREY E MD	5/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	67705	13	Neurology (M.D. only)	0	In state provider	None	2100 WEBSTER ST	STE 332	SAN FRANCISCO	CA	94115	2378	38	06075	37.7904826	-122.4324477	San Francisco County
224760	Fee-for-Service	1649254426	1649254426	1	1	TATE, JAMES R MD	3/5/2009	174400000X	NA	Other	026	PHYSICIANS	89157	24	Plastic Surgery	0	In state provider	PLASTIC SURGERY	2888 EUREKA WAY	STE 100	REDDING	CA	96001	0210	45	06089	40.58556034	-122.4159705	Shasta County
224763	Fee-for-Service	1831546464	1831546464	1	1	THRIFTY PAYLESS INC	11/13/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1670 GARNET AVE	None	SAN DIEGO	CA	92109	3116	37	06073	32.80011909	-117.2395333	San Diego County
224861	Fee-for-Service	1841852035	1841852035	1	1	THORNHILL, JOY LMFT	8/24/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
224872	Fee-for-Service	1831115799	1831115799	1	1	TEKLE, ELSA MD INC	8/25/2005	193400000X	NA	Other	026	PHYSICIANS	78066	05	Anesthesiology	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
224925	Fee-for-Service	1548265036	1548265036	1	8	TRUXTUN RADIOLOGY	5/11/2018	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	210 N CHESTER AVE	None	BAKERSFIELD	CA	93308	4841	15	06029	35.407179	-119.0208925	Kern County
224937	Fee-for-Service	1972096659	1972096659	1	1	TRUONG, SHANI H MD	8/10/2021	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	173718	None	None	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
224954	Fee-for-Service	1427375534	1427375534	1	1	TENGORA CORPORATION	2/15/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	26522 LA ALAMEDA	SUITE 205	MISSION VIEJO	CA	92691	6546	30	06059	33.56418834	-117.6673172	Orange County
224955	Fee-for-Service	1881150548	1881150548	1	1	THE CHILDRENS CLINIC SERVING	3/8/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1900 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	5502	19	06037	33.791976	-118.1850125	Los Angeles County
224958	Fee-for-Service	1558640391	1558640391	1	1	TIEN, ALBERT L OD INC	12/30/2011	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2449 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	2305	19	06037	34.02110396	-118.1279811	Los Angeles County
224972	Fee-for-Service	1023262714	1023262714	1	1	TRUONG, VU D DO	1/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	10843	30	Radiology	0	In state provider	None	2801 K STREET	SUITE 502	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
225004	Fee-for-Service	1871521716	1871521716	1	1	TABASSIAN, ZAHRA MD	1/24/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	47974	41	Internal Medicine	0	In state provider	None	994 S LA BREA AVE	None	INGLEWOOD	CA	90301	3816	19	06037	33.950556	-118.3525415	Los Angeles County
225012	Fee-for-Service	1679902993	1679902993	1	1	TRUSTED 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	310 E ROWLAND STREET	None	COVINA	CA	91723	9313	33	06065	34.07886604	-117.8855304	Los Angeles County
225019	Fee-for-Service	1770535072	1770535072	1	1	THOMAS, JEFFREY E MD	5/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	67705	30	Radiology	0	In state provider	None	2100 WEBSTER ST	STE 332	SAN FRANCISCO	CA	94115	2378	38	06075	37.7904826	-122.4324477	San Francisco County
225099	Fee-for-Service	1659459493	1659459493	1	1	THORNTON, AARON R MD	4/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64771	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
225102	Fee-for-Service	1770835829	1770835829	1	1	TANG, YUXI LCSW	9/12/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
225120	Fee-for-Service	1750459822	1750459822	1	1	THOMPSON, MATTHEW W	1/11/2013	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
225132	Fee-for-Service	1578672812	1578672812	1	1	THRIFTY PAYLESS INC	2/16/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6468	7339 MILLIKEN AVE	STE 110	RANCHO CUCAMONGA	CA	91730	7442	36	06071	34.120665	-117.556191	San Bernardino County
225137	Fee-for-Service	1730448689	1730448689	1	1	TARVER, CHRISTOPHER C MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126799	25	Physical Medicine and Rehabilitation	0	In state provider	None	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
225177	Fee-for-Service	1710626528	1710626528	1	1	TRAN SISTERS CORP	6/28/2022	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16173 HARBOR BLVD	None	FOUNTAIN VALLEY	CA	92708	1305	30	06059	33.7284389	-117.9200265	Orange County
225205	Fee-for-Service	1942319371	1942319371	1	1	THRIFTY PAYLESS, INC	9/1/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4593 N CEDAR AVE	None	FRESNO	CA	93726	2540	10	06019	36.80077813	-119.7543395	Fresno County
225207	Fee-for-Service	1841693959	1841693959	1	1	TAGMAZYAN, KARINE MD MPH INC	12/31/2014	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	122509	01	General Practice	0	In state provider	None	900 N PACIFIC AVE	None	GLENDALE	CA	91203	3644	19	06037	34.15872548	-118.2640471	Los Angeles County
225243	Fee-for-Service	1881150548	1881150548	1	1	THE CHILDRENS CLINIC SERVING	3/8/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1900 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	5502	19	06037	33.791976	-118.1850125	Los Angeles County
225281	Fee-for-Service	1730342395	1730342395	1	1	TENG, EDDIE MD	11/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111766	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	SUITE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
225292	Fee-for-Service	1871521716	1871521716	1	1	TABASSIAN, ZAHRA MD	1/24/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	47974	45	Nephrology (Renal-Kidney)	0	In state provider	None	994 S LA BREA AVE	None	INGLEWOOD	CA	90301	3816	19	06037	33.950556	-118.3525415	Los Angeles County
225329	Fee-for-Service	1942561501	1942561501	1	1	TRAN, AN H MD	1/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122525	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
225332	Fee-for-Service	1992041149	1992041149	1	1	TOTAL RENAL CARE INC	9/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1427 S GLENDALE AVE	None	GLENDALE	CA	91205	3313	19	06037	34.12783312	-118.2528677	Los Angeles County
225363	Fee-for-Service	1548287543	1548287543	1	1	TSCHANG, TAI-PO MD	2/28/1987	207ZP0105X	NA	Other	026	PHYSICIANS	32867	22	Pathology (M.D. only)	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
225418	Fee-for-Service	1730185687	1730185687	1	1	TAN, JESUS K MD	3/31/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	31335	04	Otology, Laryngology, Rhinology	0	In state provider	None	2865 ATLANTIC AVE	STE 225	LONG BEACH	CA	90806	7428	19	06037	33.809418	-118.185058	Los Angeles County
225423	Fee-for-Service	1679532956	1679532956	1	1	TANGREDI, LAURA M MD	4/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	7723	01	General Practice	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
225454	Fee-for-Service	1053470773	1053470773	1	1	TARBAUX, NANINE M OD	2/27/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27309 MADISON AVE	None	TEMECULA	CA	92590	5685	33	06065	33.52449693	-117.166286	Riverside County
225455	Fee-for-Service	1588773907	1588773907	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3207 CROW CANYON PL	None	SAN RAMON	CA	94583	1315	07	06013	37.77573917	-121.9721328	Contra Costa County
225462	Fee-for-Service	1205241122	1205241122	1	1	THOMAS, MARIA JOANA A MD	6/1/2023	174400000X	NA	Other	026	PHYSICIANS	149260	None	None	0	In state provider	None	333 UNIVERSITY AVE	SUITE 120	SACRAMENTO	CA	95825	0000	34	06067	38.570976	-121.416651	Sacramento County
225463	Fee-for-Service	1700529484	1700529484	1	1	TRAN, JOSEPH NP	5/15/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8601 S BROADWAY	None	LOS ANGELES	CA	90003	3319	19	06037	33.9598857	-118.2783041	Los Angeles County
225503	Fee-for-Service	1932219714	1932219714	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	220 W EAST AVE	None	CHICO	CA	95926	7215	04	06007	39.75511871	-121.864131	Butte County
225516	Fee-for-Service	1447325972	1447325972	1	1	TAYLOR, ANNALIESE LMFT	6/14/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
225520	Fee-for-Service	1174055180	1174055180	1	1	TAICH, ZACHARY J MD	2/13/2023	207R00000X	NA	Other	026	PHYSICIANS	169704	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
225533	Fee-for-Service	1831203488	1831203488	1	1	THE MARY LANNING MEMORIAL HO	12/14/2018	282NR1301X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	715 NORTH ST JOSEPH AVE	None	HASTINGS	NE	68901	4451	00	None	40.58976654	-98.3875094	Adams County
225612	Fee-for-Service	1154306074	1154306074	1	1	TAYLOR, STEPHANIE S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45700	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	40 DORMODY CT	None	MONTEREY	CA	93940	2908	27	06053	36.59443073	-121.8965084	Monterey County
225623	Fee-for-Service	1689744989	1689744989	1	1	THORNBURY, SHARON A	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
225628	Fee-for-Service	1548265036	1548265036	1	13	TRUXTUN RADIOLOGY	2/20/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	8787 HALL ROAD	None	LAMONT	CA	93241	1953	15	06029	35.25969451	-118.908099	Kern County
225633	Fee-for-Service	1346286465	1346286465	1	1	TOLLIVER, GREGG L MD	6/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88295	41	Internal Medicine	0	In state provider	None	165 ROWLAND WAY	None	NOVATO	CA	94945	5038	21	06041	38.09824386	-122.559872	Marin County
225660	Fee-for-Service	1922299338	1922299338	1	1	TOTAL WELLNESS INC	11/9/2010	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3191 B MISSION INN AVE	None	RIVERSIDE	CA	92507	4138	33	06065	33.98015514	-117.3677324	Riverside County
225667	Fee-for-Service	1770667479	1770667479	1	1	TAGA, SCOTT A MD	11/1/1998	207ZP0102X	NA	Other	026	PHYSICIANS	79036	01	General Practice	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
225748	Fee-for-Service	1639227465	1639227465	1	1	TELLEZ, THOMAS T MD	7/31/1995	207P00000X	NA	Other	026	PHYSICIANS	55415	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
225760	Fee-for-Service	1477780351	1477780351	1	1	TILMAN KOELSCH MD	8/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
225798	Fee-for-Service	1295889905	1295889905	1	1	TABLIZO, MARY ANNE A	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76613	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
225823	Fee-for-Service	1831203488	1831203488	1	1	THE MARY LANNING MEMORIAL HO	12/14/2018	282NR1301X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	715 NORTH ST JOSEPH AVE	None	HASTINGS	NE	68901	4451	00	None	40.58976654	-98.3875094	Adams County
225826	Fee-for-Service	1164648549	1164648549	1	1	TANG, KHOI QUANG MD INC	11/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	82013	34	Urology and Urological Surgery	0	In state provider	None	8915 WESTMINSTER AVENUE	None	GARDEN GROVE	CA	92844	2609	30	06059	33.75942652	-117.974097	Orange County
225840	Fee-for-Service	1508390410	1508390410	1	1	TADLOCK, JOSHUA C MD	8/26/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	181459	None	None	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
225845	Fee-for-Service	1194828996	1194828996	1	1	TOLENTINO-MACARAEG, A MD	10/20/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	52490	40	Pediatrics	0	In state provider	None	591 MCCRAY ST	STE 231	HOLLISTER	CA	95023	2224	35	06069	36.85020209	-121.397521	San Benito County
225893	Fee-for-Service	1144242264	1144242264	1	1	THE SCOOTER STORE-PHOENX LLC	8/24/2004	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	23910 N. 19TH AVENUE	SUITE #14	PHOENIX	AZ	85085	1832	00	None	33.702939	-112.102425	Maricopa County
225899	Fee-for-Service	1154306074	1154306074	1	1	TAYLOR, STEPHANIE S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45700	66	Emergency Medicine (Urgent Care)	0	In state provider	None	40 DORMODY CT	None	MONTEREY	CA	93940	2908	27	06053	36.59443073	-121.8965084	Monterey County
225922	Fee-for-Service	1346286465	1346286465	1	1	TOLLIVER, GREGG L MD	6/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88295	77	Infectious Disease	0	In state provider	None	165 ROWLAND WAY	None	NOVATO	CA	94945	5038	21	06041	38.09824386	-122.559872	Marin County
225970	Fee-for-Service	1104931179	1104931179	1	1	TREVOR, EVERETT D MD	9/6/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	30436	41	Internal Medicine	0	In state provider	None	2701 OLD EUREKA WAY	STE ONE-I	REDDING	CA	96001	0000	45	06089	40.58555878	-122.4101367	Shasta County
226018	Fee-for-Service	1124609821	1124609821	1	1	TRAN, ANNA MD	8/22/2023	390200000X	NA	Other	026	PHYSICIANS	21281	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
226028	Fee-for-Service	1114971280	1114971280	1	1	TENDER LOVING CARE	2/14/2005	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HLTHCARE SVS WESTERN LLC	24301 SOUTHLAND DR	SUITE 411	HAYWARD	CA	94545	1546	01	06001	37.65344508	-122.1045736	Alameda County
226046	Fee-for-Service	1366902439	1366902439	1	1	TRUONG, TAI	6/18/2024	207R00000X	NA	Other	026	PHYSICIANS	177756	41	Internal Medicine	0	In state provider	None	500 S MAIN ST	STE 101	ORANGE	CA	92868	4535	30	06059	33.77991974	-117.8674745	Orange County
226048	Fee-for-Service	1669570271	1669570271	1	1	TUREEN, JAY MD	1/1/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	41623	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	# 683M	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
226085	Fee-for-Service	1295889905	1295889905	1	1	TABLIZO, MARY ANNE A	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76613	01	General Practice	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
226086	Fee-for-Service	1275897605	1275897605	1	1	TANG, STANLEY S OD	1/19/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6555 COYLE AVE	SUITE 200	SACRAMENTO	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento
226089	Fee-for-Service	1437636867	1437636867	1	1	TATES, JOHN RCP	11/20/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
226106	Fee-for-Service	1730531716	1730531716	1	1	THOMAS, MERCY CNP	5/18/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2514 BERRYESSA RD	None	SAN JOSE	CA	95132	2947	43	06085	37.38738217	-121.8595232	Santa Clara County
226139	Fee-for-Service	1790894145	1790894145	1	1	THRIFTY PAYLESS INC	1/4/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15800 IMPERIAL HWY	None	LA MIRADA	CA	90638	2512	19	06037	33.91725633	-117.993891	Los Angeles County
226151	Fee-for-Service	1588907315	1588907315	1	1	TUAN, KATHERINE J MD	10/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132432	41	Internal Medicine	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
226176	Fee-for-Service	1487780813	1487780813	1	1	THOMSON, LOUISE E J MD	1/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91738	30	Radiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
226224	Fee-for-Service	1053677492	1053677492	1	1	TRINH, VICTORIA T MD	10/7/2022	390200000X	NA	Other	026	PHYSICIANS	173994	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
226237	Fee-for-Service	1417502899	1417502899	1	1	TORRES, MARIVETTE C	6/17/2022	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	25880 TOURNAMENT RD	SUITE 109	VALENCIA	CA	91355	2384	19	06037	34.39184204	-118.5626441	Los Angeles County
226241	Fee-for-Service	1922154921	1922154921	1	1	TUREK, AHMET O MD	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137395	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
226271	Fee-for-Service	1821084294	1821084294	1	1	THESING, MICHAEL J MD	2/15/2022	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	164057	None	None	0	In state provider	None	2185 CITRACADA PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
226279	Fee-for-Service	1528170800	1528170800	1	1	TRAN, LAN MD	4/4/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	45627	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
226291	Fee-for-Service	1528420973	1528420973	1	1	THOMASHOW, MICHAEL A MD	10/11/2019	208M00000X	NA	Other	026	PHYSICIANS	154000	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
226292	Fee-for-Service	1992235139	1992235139	1	1	TURBAN, JACK L MD	9/8/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	170298	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
226303	Fee-for-Service	1720153620	1720153620	1	1	THE EARLWOOD, LLC	8/15/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	20820 EARL ST	None	TORRANCE	CA	90503	4307	19	06037	33.84070834	-118.3580407	Los Angeles County
226326	Fee-for-Service	1053515288	1053515288	1	1	TORRES, MAYRA N LMFT	9/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
226333	Fee-for-Service	1366902439	1366902439	1	1	TRUONG, TAI	6/18/2024	207R00000X	NA	Other	026	PHYSICIANS	177756	45	Nephrology (Renal-Kidney)	0	In state provider	None	500 S MAIN ST	STE 101	ORANGE	CA	92868	4535	30	06059	33.77991974	-117.8674745	Orange County
226335	Fee-for-Service	1417033226	1417033226	1	1	TODD J CZARTOSKI	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SWEDISH NEUROSCIENCE	747 BROADWAY	None	SEATTLE	WA	98122	0000	00	None	47.608326	-122.3207985	King County
226400	Fee-for-Service	1811937618	1811937618	1	1	TROSINO, LISA J MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	61724	66	Emergency Medicine (Urgent Care)	0	In state provider	None	PUEBLO AT BATH	None	SANTA BARBARA	CA	93105	3323	42	06083	34.430526	-119.72196	Santa Barbara County
226426	Fee-for-Service	1245695105	1245695105	1	1	TRUEMED SACRAMENTO, INC	10/9/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5330 PRIMROSE DR	SUITE 133	FAIR OAKS	CA	95628	3541	34	06067	38.662623	-121.275936	Sacramento County
226441	Fee-for-Service	1417472028	1417472028	1	1	TOUCKLEY, LARAH LPCC	8/14/2021	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	591 CAMINO DE LA REINA	802	SAN DIEGO	CA	92108	3102	37	06073	32.76632791	-117.1616245	San Diego County
226464	Fee-for-Service	1164531596	1164531596	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	446 E WASHINGTON BLVD	None	LOS ANGELES	CA	90015	3721	19	06037	34.02892009	-118.260291	Los Angeles County
226485	Fee-for-Service	1851656953	1851656953	1	1	TOROSSIAN, ARTOUR MD	1/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129604	78	Neoplastic Diseases/Oncology	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
226493	Fee-for-Service	1336219278	1336219278	1	1	TRAN, LIEU A LCSW	12/16/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON STREET	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
226534	Fee-for-Service	1871629717	1871629717	1	1	TSE, CHUN-KEE V MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	48038	14	Neurological Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
226560	Fee-for-Service	1548265036	1548265036	1	5	TRUXTUN RADIOLOGY	12/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	42	Nuclear Medicine	0	In state provider	MEDICAL GROUP, LP	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
226638	Fee-for-Service	1306589197	1306589197	1	1	TOFT, MORGAN G CCC-SLP	6/16/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
226672	Fee-for-Service	1912985292	1912985292	1	1	TIEN, ALBERT L OD	6/6/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	43112 N 15TH WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
226675	Fee-for-Service	1487865523	1487865523	1	1	TRAN, LILY H MD	12/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118437	01	General Practice	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
226718	Fee-for-Service	1275651515	1275651515	1	37	THE ONCOLOGY INSTITUTE CA, A	10/17/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	425 HAALAND DR.	SUITE 103	THOUSAND OAKS	CA	91361	5230	56	06111	34.17512608	-118.8697623	Ventura County
226794	Fee-for-Service	1710568720	1710568720	1	1	TRAN, PHONG T MD	11/5/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
226808	Fee-for-Service	1205019262	1205019262	1	1	THEARD, LESLIE A LCSW	4/21/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
226819	Fee-for-Service	1871629717	1871629717	1	1	TSE, CHUN-KEE V MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	48038	13	Neurology (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
226846	Fee-for-Service	1548265036	1548265036	1	5	TRUXTUN RADIOLOGY	12/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP, LP	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
226852	Fee-for-Service	1326059551	1326059551	1	1	TRAN, MATTHEW T MD	1/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66985	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
226890	Fee-for-Service	1548265036	1548265036	1	7	TRUXTUN RADIOLOGY	11/28/2011	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	20960 SAGE LANE	#B	TEHACHAPI	CA	93561	6408	15	06029	35.12375735	-118.4787472	Kern County
226943	Fee-for-Service	1144717901	1144717901	1	1	TRODELLO, CAMERON	4/25/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	175705	07	Dermatology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
226963	Fee-for-Service	1346416575	1346416575	1	1	TURNER, SCOTT G MD	1/26/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	170960	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
227007	Fee-for-Service	1275651515	1275651515	1	37	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	425 HAALAND DR.	SUITE 103	THOUSAND OAKS	CA	91361	5230	56	06111	34.17512608	-118.8697623	Ventura County
227034	Fee-for-Service	1629515705	1629515705	1	6	TWO CHAIRS BEHAVIORAL HEALTH	8/16/2021	101YP2500X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	GROUP, A PSYCHOLOGY COR	244 CALIFORNIA	STE 300	SAN FRANCISCO	CA	94111	4302	38	06075	37.79331375	-122.3995607	San Francisco County
227063	Fee-for-Service	1972741999	1972741999	1	1	TOTAL RENAL CARE INC	2/18/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2201 JUNIPERO SERRA BLVD	STE A	DALY CITY	CA	94014	1908	41	06081	37.69712605	-122.4703529	San Mateo County
227068	Fee-for-Service	1205906229	1205906229	1	16	THE NEPHROLOGY GROUP, INC.	11/19/2021	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1313 EAST HERNDON AVENUE	106	FRESNO	CA	93720	3306	10	06019	36.834984	-119.7641925	Fresno County
227074	Fee-for-Service	1033178520	1033178520	1	1	THIRY-ZARAGOZA, MONIQUE A MD	7/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	84066	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
227086	Fee-for-Service	1245767037	1245767037	1	1	TRAN, TAM K MD	9/30/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	170139	08	Family Practice	0	In state provider	None	7830 CLAIREMONT MESA BLV	STE 100	SAN DIEGO	CA	92111	1619	37	06073	32.83285853	-117.1522755	San Diego County
227091	Fee-for-Service	1114507506	1114507506	1	1	TO, MEI KUEN ERICA CNP	2/23/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8101 GREENBACK LN	None	FAIR OAKS	CA	95628	2502	34	06067	38.679237	-121.261662	Sacramento County
227116	Fee-for-Service	1730210766	1730210766	1	1	TAYLAN, MICHAEL A MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65607	05	Anesthesiology	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
227171	Fee-for-Service	1558388231	1558388231	1	1	TONG, MARK L MD INC	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	80662	08	Family Practice	0	In state provider	None	1000 FOWLER WAY	STE 1A	PLACERVILLE	CA	95667	5738	09	06017	38.72679661	-120.7923668	El Dorado County
227197	Fee-for-Service	1598721227	1598721227	1	1	TACHIBANA, MIKIO MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	35433	41	Internal Medicine	0	In state provider	None	11100 WARNER AVE	STE 154	FOUNTAIN VALLEY	CA	92708	7510	30	06059	33.716291	-117.9355051	Orange County
227198	Fee-for-Service	1275651515	1275651515	1	8	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	101 E BEVERLY	SUITE 200	MONTEBELLO	CA	90640	4315	19	06037	34.01556395	-118.0983878	Los Angeles County
227294	Fee-for-Service	1730473232	1730473232	1	1	TUCHMAN, ALEXANDER MD	8/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	114155	14	Neurological Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
227295	Fee-for-Service	1275651515	1275651515	1	37	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	425 HAALAND DR.	SUITE 103	THOUSAND OAKS	CA	91361	5230	56	06111	34.17512608	-118.8697623	Ventura County
227319	Fee-for-Service	1629515705	1629515705	1	6	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	244 CALIFORNIA	STE 300	SAN FRANCISCO	CA	94111	4302	38	06075	37.79331375	-122.3995607	San Francisco County
227362	Fee-for-Service	1295092203	1295092203	1	1	TONEY, ALEXIS N J MD	6/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126594	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
227480	Fee-for-Service	1538509161	1538509161	1	1	TOTAL RENAL CARE INC	3/19/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	14251 WINCHESTER BLVD	STE 100	LOS GATOS	CA	95032	1811	43	06085	37.26123366	-121.9624938	Santa Clara County
227485	Fee-for-Service	1275651515	1275651515	1	8	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	101 E BEVERLY	SUITE 200	MONTEBELLO	CA	90640	4315	19	06037	34.01556395	-118.0983878	Los Angeles County
227520	Fee-for-Service	1760721658	1760721658	1	1	TA, PHILONG V MD	10/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129302	None	None	0	In state provider	None	14642 NEWPORT AVE	STE 105	TUSTIN	CA	92780	6058	30	06059	33.73082212	-117.8293987	Orange County
227540	Fee-for-Service	1275914772	1275914772	1	1	TSANG, ANLY K MD	11/8/2018	207R00000X	NA	Other	026	PHYSICIANS	152844	41	Internal Medicine	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
227562	Fee-for-Service	1013104389	1013104389	1	2	TRACY SURGERY CENTER, LLC	8/7/2019	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2160 W GRANT LINE RD	SUITE 120	TRACY	CA	95377	7330	39	06077	37.75399922	-121.455877	San Joaquin County
227569	Fee-for-Service	1982760948	1982760948	1	1	TOWN OF CORTE MADERA	3/1/1998	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	FIRE DEPARTMENT	342 TAMALPAIS DR	None	CORTE MADERA	CA	94925	1492	21	06041	37.92555551	-122.5268308	Marin County
227572	Fee-for-Service	1831109974	1831109974	1	1	TORRES, KATHLEEN M MD	2/1/1995	207R00000X	NA	Other	026	PHYSICIANS	78619	41	Internal Medicine	0	In state provider	None	2201 MISSION AVE	None	OCEANSIDE	CA	92054	2328	37	06073	33.20742226	-117.3612486	San Diego County
227579	Fee-for-Service	1356422596	1356422596	1	1	TRAUL, DAVID K MD	5/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	OREGON SURGICAL SPEC PC	520 MEDICAL CENTER DR	STE 300	MEDFORD	OR	97504	4316	00	None	42.318801	-122.831728	Jackson County
227584	Fee-for-Service	1275651515	1275651515	1	37	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	425 HAALAND DR.	SUITE 103	THOUSAND OAKS	CA	91361	5230	56	06111	34.17512608	-118.8697623	Ventura County
227609	Fee-for-Service	1629515705	1629515705	1	6	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	244 CALIFORNIA	STE 300	SAN FRANCISCO	CA	94111	4302	38	06075	37.79331375	-122.3995607	San Francisco County
227627	Fee-for-Service	1619088440	1619088440	1	1	TIU, GRISELDA E MD	1/31/1995	207R00000X	NA	Other	026	PHYSICIANS	49565	68	Hematology	0	In state provider	None	655 EUCLID AVE	STE 210	NATIONAL CITY	CA	91950	2971	37	06073	32.68353398	-117.082625	San Diego County
227639	Fee-for-Service	1710272687	1710272687	1	1	TULLY, LAURA DYANN MD	10/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122643	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
227646	Fee-for-Service	1669653374	1669653374	1	1	TAYLOR, MEGHEDI	5/22/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
227660	Fee-for-Service	1972763027	1972763027	1	1	TODD MATTHEW ALTER, 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	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
227679	Fee-for-Service	1639428568	1639428568	1	1	TORRES, JENNIFER LCSW	5/20/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	595 E. COLORADO BLVD,	205	PASADENA	CA	91101	3562	19	06037	34.14588202	-118.1380722	Los Angeles County
227708	Fee-for-Service	1326371055	1326371055	1	1	THOMPSON, DARCY L MD	8/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144392	66	Emergency Medicine (Urgent Care)	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
227710	Fee-for-Service	1457907040	1457907040	1	1	THREE BRIDGES PSYCHOLOGY & M	1/19/2020	103TF0200X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	EDIATION	402 COLUSA AVE	None	EL CERRITO	CA	94530	3327	07	06013	37.90450365	-122.2912318	Contra Costa County
227750	Fee-for-Service	1679682033	1679682033	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE 5835	345 TOWN CTR W	None	SANTA MARIA	CA	93458	5076	42	06083	34.95011722	-120.4374402	Santa Barbara County
227761	Fee-for-Service	1609118777	1609118777	1	1	THOMASSIAN, ARA MD	7/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132991	41	Internal Medicine	0	In state provider	None	12660 RIVERSIDE DR	None	NORTH HOLLYWOOD	CA	91607	3430	19	06037	34.1575795	-118.409499	Los Angeles County
227774	Fee-for-Service	1275651515	1275651515	1	8	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PROFESSIONAL CORPORATION	101 E BEVERLY	SUITE 200	MONTEBELLO	CA	90640	4315	19	06037	34.01556395	-118.0983878	Los Angeles County
227843	Fee-for-Service	1295024206	1295024206	1	1	TOTAL RENAL CARE INC	6/1/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1100 TRANCAS STREET	SUITES 266 & 267	NAPA	CA	94558	2921	28	06055	38.32316569	-122.2981938	Napa County
227871	Fee-for-Service	1275651515	1275651515	1	37	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	425 HAALAND DR.	SUITE 103	THOUSAND OAKS	CA	91361	5230	56	06111	34.17512608	-118.8697623	Ventura County
227894	Fee-for-Service	1629515705	1629515705	1	6	TWO CHAIRS BEHAVIORAL HEALTH	8/16/2021	101YP2500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	244 CALIFORNIA	STE 300	SAN FRANCISCO	CA	94111	4302	38	06075	37.79331375	-122.3995607	San Francisco County
227903	Fee-for-Service	1346861333	1346861333	1	1	TRINER, DANIEL A MD	3/28/2025	208800000X	NA	Other	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
227915	Fee-for-Service	1619088440	1619088440	1	1	TIU, GRISELDA E MD	1/31/1995	207R00000X	NA	Other	026	PHYSICIANS	49565	41	Internal Medicine	0	In state provider	None	655 EUCLID AVE	STE 210	NATIONAL CITY	CA	91950	2971	37	06073	32.68353398	-117.082625	San Diego County
227932	Fee-for-Service	1659451482	1659451482	2	1	TRAN, CHRISTINE H MD	6/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	79303	40	Pediatrics	0	In state provider	None	12555 GARDEN GROVE BLVD	SUITE 304	GARDEN GROVE	CA	92843	1908	30	06059	33.77450946	-117.913041	Orange County
227996	Fee-for-Service	1861463572	1861463572	1	1	TAUSSIG, SALLY B RN	2/28/1996	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
227998	Fee-for-Service	1457907040	1457907040	1	1	THREE BRIDGES PSYCHOLOGY & M	6/7/2022	103TF0200X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	EDIATION	402 COLUSA AVE	None	EL CERRITO	CA	94530	3327	07	06013	37.90450365	-122.2912318	Contra Costa County
228007	Fee-for-Service	1275651515	1275651515	1	22	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	2067 W VISTA WAY	STE 295	VISTA	CA	92083	6031	37	06073	33.18505594	-117.285958	San Diego County
228014	Fee-for-Service	1346089240	1346089240	1	1	TRANSNET MEDICAL TRANSPORTAT	6/10/2024	347E00000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ION, LLC	6550 VAN BUREN BLVD	STE E	RIVERSIDE	CA	92503	1544	33	06065	33.949953	-117.4540065	Riverside County
228061	Fee-for-Service	1275651515	1275651515	1	8	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PROFESSIONAL CORPORATION	101 E BEVERLY	SUITE 200	MONTEBELLO	CA	90640	4315	19	06037	34.01556395	-118.0983878	Los Angeles County
228063	Fee-for-Service	1316056732	1316056732	1	1	THRIFTY PAYLESS INC	5/8/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5825	1690 E GRAND AVE	None	ARROYO GRANDE	CA	93420	2469	40	06079	35.12098499	-120.6085337	San Luis Obispo County
228091	Fee-for-Service	1194354316	1194354316	1	1	TANG, ELAINE MD	11/20/2023	208M00000X	NA	Other	026	PHYSICIANS	189311	None	None	0	In state provider	None	2700 GRANT ST	STE 200	CONCORD	CA	94520	2266	07	06013	37.98417931	-122.0361585	Contra Costa County
228101	Fee-for-Service	1336899046	1336899046	1	1	TAYLOR, MADELYNN MD	3/6/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	189130	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
228107	Fee-for-Service	1487978318	1487978318	1	1	TUNG, PAUL K DO	4/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13785	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
228156	Fee-for-Service	1831523067	1831523067	1	1	TIBBITS, EMILY M MD	7/6/2020	208600000X	NA	General Surgery	026	PHYSICIANS	134813	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
228159	Fee-for-Service	1154467181	1154467181	1	1	THE HUNTINGTON MEDICAL FOUND	4/13/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	FOUNDATION	1346 EAST FOOTHILL BLVD	STE 201	LA CANADA	CA	91011	2143	19	06037	34.20780552	-118.2076252	Los Angeles County
228179	Fee-for-Service	1063434223	1063434223	1	1	TORRES, ABEL MD	11/30/1985	207N00000X	NA	Dermatology	026	PHYSICIANS	43597	07	Dermatology	0	In state provider	None	11370 ANDERSON ST	# 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
228185	Fee-for-Service	1063584050	1063584050	1	1	TALJANOVIC, MIHRA S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	UNIVERSITY MEDICAL CTR	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
228202	Fee-for-Service	1528116415	1528116415	1	1	TRAN, CHI K MD	12/1/1997	207R00000X	NA	Other	026	PHYSICIANS	78809	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
228204	Fee-for-Service	1619088440	1619088440	1	1	TIU, GRISELDA E MD	1/31/1995	207R00000X	NA	Other	026	PHYSICIANS	49565	78	Neoplastic Diseases/Oncology	0	In state provider	None	655 EUCLID AVE	STE 210	NATIONAL CITY	CA	91950	2971	37	06073	32.68353398	-117.082625	San Diego County
228230	Fee-for-Service	1114217619	1114217619	1	1	TRENKLE, DARCY K MD	7/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123302	36	Psychiatry	0	In state provider	None	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
228251	Fee-for-Service	1063518355	1063518355	1	1	TRAN, DANIEL M T MD	2/11/2011	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	44772	40	Pediatrics	0	In state provider	None	275 W HERNDON AVE	None	CLOVIS	CA	93612	0204	10	06019	36.83766747	-119.715174	Fresno County
228286	Fee-for-Service	1457907040	1457907040	1	1	THREE BRIDGES PSYCHOLOGY & M	11/27/2019	103TF0200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	EDIATION	402 COLUSA AVE	None	EL CERRITO	CA	94530	3327	07	06013	37.90450365	-122.2912318	Contra Costa County
228296	Fee-for-Service	1275651515	1275651515	1	22	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	2067 W VISTA WAY	STE 295	VISTA	CA	92083	6031	37	06073	33.18505594	-117.285958	San Diego County
228306	Fee-for-Service	1144968868	1144968868	1	1	THOW, KELLY L PT	1/22/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1085 W EL CAMINO REAL	None	SUNNYVALE	CA	94087	1030	43	06085	37.37270741	-122.0517412	Santa Clara County
228350	Fee-for-Service	1275651515	1275651515	1	8	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PROFESSIONAL CORPORATION	101 E BEVERLY	SUITE 200	MONTEBELLO	CA	90640	4315	19	06037	34.01556395	-118.0983878	Los Angeles County
228363	Fee-for-Service	1295768638	1295768638	1	1	TARSA, MARYAM MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69894	01	General Practice	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
228405	Fee-for-Service	1548265036	1548265036	1	10	TRUXTUN RADIOLOGY	2/15/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	67 EVANS ROAD	None	WOFFORD HEIGHTS	CA	93285	9640	15	06029	35.70661847	-118.4580008	Kern County
228410	Fee-for-Service	1750412300	1750412300	1	1	TAHOE FOREST HOSP DIST	4/28/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS RD	STE 340	TRUCKEE	CA	96161	4885	29	06057	39.32625521	-120.2012059	Nevada County
228487	Fee-for-Service	1104843812	1104843812	2	1	THE SCOOTER STRE SD LLC	3/10/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ALLIANCE SEATING&MOBILIT	7736 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92111	1533	37	06073	32.83276948	-117.1544535	San Diego County
228497	Fee-for-Service	1083310254	1083310254	1	1	TOPPENBERG, JOSHUA CRNA	3/4/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	15630 18TH AVE	None	CLEARLAKE	CA	95422	9336	17	06033	38.93612361	-122.6201499	Lake County
228509	Fee-for-Service	1134270994	1134270994	1	1	TU, RICHARD ML DPM	10/15/2008	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4475 UNIVERSITY AVE	None	SAN DIEGO	CA	92105	1731	37	06073	32.74958647	-117.098073	San Diego County
228569	Fee-for-Service	1326209982	1326209982	1	1	THE CENTER FOR INTEGRATED	3/3/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	FAMILY & HEALTH SERVICE	540 S EREMLAND DRIVE	STE A-E	COVINA	CA	91723	3186	19	06037	34.079904	-117.8863235	Los Angeles County
228578	Fee-for-Service	1891884359	1891884359	1	1	TYLOR, DALE A	9/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	100181	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	2557 MOWRY AVENUE	SUITE 30	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
228585	Fee-for-Service	1275651515	1275651515	1	22	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	2067 W VISTA WAY	STE 295	VISTA	CA	92083	6031	37	06073	33.18505594	-117.285958	San Diego County
228591	Fee-for-Service	1275651515	1275651515	1	17	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 271	MISSION VIEJO	CA	92691	8520	30	06059	33.56347704	-117.66546	Orange County
228620	Fee-for-Service	1679661714	1679661714	1	1	TURLOCK EYECARE	1/1/1979	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CORPORATION	2020 COLORADO AVE	STE A	TURLOCK	CA	95382	2002	50	06099	37.51154259	-120.8352538	Stanislaus County
228628	Fee-for-Service	1275651515	1275651515	1	40	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	1011 E DEVONSHIRE AVE	SUITE 201	HEMET	CA	92543	3033	33	06065	33.75118151	-116.9615025	Riverside County
228678	Fee-for-Service	1891964490	1891964490	1	1	TAUB, MORRIS MD INC	1/1/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	27806	41	Internal Medicine	0	In state provider	None	658 W 7TH ST	None	SAN PEDRO	CA	90731	3118	19	06037	33.73790682	-118.2913808	Los Angeles County
228679	Fee-for-Service	1275651515	1275651515	1	28	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	50 BELLEFONTAINE ST	SUITE 401	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
228700	Fee-for-Service	1750412300	1750412300	1	5	TAHOE FOREST HOSP DIST	4/28/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10956 DONNER PASS RD	STE 330	TRUCKEE	CA	96161	4885	29	06057	39.32625521	-120.2012059	Nevada County
228771	Fee-for-Service	1740279454	1740279454	1	1	TANG, MAY Y	6/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82643	40	Pediatrics	0	In state provider	None	17909 SOLEDAD CANYON RD	None	CANYON COUNTRY	CA	91387	3210	19	06037	34.41652621	-118.4458684	Los Angeles County
228786	Fee-for-Service	1750486999	1750486999	1	1	TAN, HAU H MD INC	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63428	41	Internal Medicine	0	In state provider	None	7871 UNIVERSITY AVE	B	LA MESA	CA	91942	0471	37	06073	32.76324243	-117.0282838	San Diego County
228822	Fee-for-Service	1649649419	1649649419	1	1	TEEN, JASSAMINE LCSW	5/10/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82696	-	NOT APPLICABLE	0	In state provider	None	710 E 111TH PLACE	None	LOS ANGELES	CA	90059	1518	19	06037	33.93454026	-118.2626368	Los Angeles County
228842	Fee-for-Service	1265909592	1265909592	1	1	TILUS, LYDIA-CARLIE B DOULA	7/7/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	41	06081	0	0	None
228875	Fee-for-Service	1275651515	1275651515	1	22	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	2067 W VISTA WAY	STE 295	VISTA	CA	92083	6031	37	06073	33.18505594	-117.285958	San Diego County
228880	Fee-for-Service	1275651515	1275651515	1	17	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 271	MISSION VIEJO	CA	92691	8520	30	06059	33.56347704	-117.66546	Orange County
228885	Fee-for-Service	1801315171	1801315171	1	1	THOMAS, DANIELLE M NP	12/11/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	40285 WINCHESTER RD	STE 103	TEMECULA	CA	92591	5547	33	06065	33.53330454	-117.1488732	Riverside County
228916	Fee-for-Service	1275651515	1275651515	1	40	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	1011 E DEVONSHIRE AVE	SUITE 201	HEMET	CA	92543	3033	33	06065	33.75118151	-116.9615025	Riverside County
228919	Fee-for-Service	1538699913	1538699913	1	1	TAN, YING MD	1/9/2024	208600000X	NA	General Surgery	026	PHYSICIANS	159195	None	None	0	In state provider	None	1095 MARSHALL WAY	STE 202	PLACERVILLE	CA	95667	5722	09	06017	38.7257686	-120.7910663	El Dorado County
228924	Fee-for-Service	1962707406	1962707406	1	1	TRUEMED INC	10/20/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	400 OYSTER POINT BLVD	SUITE 201	S SAN FRANCISCO	CA	94080	1918	41	06081	37.66637638	-122.3833791	San Mateo County
228928	Fee-for-Service	1396223624	1396223624	1	1	TENARI, LETONU N LCSW	10/12/2022	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
228951	Fee-for-Service	1497595565	1497595565	1	1	TURIYA ANESTHESIA	5/1/2024	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	555 HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
228983	Fee-for-Service	1275651515	1275651515	1	56	THE ONCOLOGY INSTITUTE CA, A	8/23/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	1001 S. STATE STREET	SUITE A	HEMET	CA	92543	7188	33	06065	33.731505	-116.971599	Riverside County
229011	Fee-for-Service	1275651515	1275651515	1	60	THE ONCOLOGY INSTITUTE CA, A	5/16/2024	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	32	Radiation Therapy (D.O. only)	0	In state provider	INNOVATION	27450 YNEZ RD	SUITE 116	TEMECULA	CA	92591	4671	33	06065	33.50684549	-117.1502048	Riverside County
229014	Fee-for-Service	1720685720	1720685720	1	1	TARZANA SENIOR LIVING INC	6/15/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5236 OTIS AVE	None	TARZANA	CA	91356	4212	19	06037	34.16682759	-118.535523	Los Angeles County
229028	Fee-for-Service	1871642546	1871642546	1	1	THOMPSON, MELINDA R OD	8/18/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	700 N H ST	None	LOMPOC	CA	93436	4521	42	06083	34.64936471	-120.4577269	Santa Barbara County
229039	Fee-for-Service	1568680023	1568680023	1	1	TAN, JOHN F MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	103406	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC:5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
229063	Fee-for-Service	1184142341	1184142341	1	1	TA, MINHDAN T PHD	3/3/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	750 B	2870	SAN DIEGO	CA	92101	8114	37	06073	32.71782447	-117.157905	San Diego County
229066	Fee-for-Service	1689913816	1689913816	1	1	TLC FOR YOU INC	10/21/2014	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1650 ZANKER ROAD	SUITE 135	SAN JOSE	CA	95112	1115	43	06085	37.37293615	-121.9101443	Santa Clara County
229088	Fee-for-Service	1154384121	1154384121	1	1	TOTAL RENAL CARE, INC	12/1/1998	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	UNITED DIALYSIS CENTER	3111 LONG BEACH BLVD	None	LONG BEACH	CA	94607	0000	19	06037	33.813918	-118.1893965	Los Angeles County
229099	Fee-for-Service	1316258304	1316258304	1	1	TEKMYSTER, GENE DO	4/2/2020	2081S0010X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	18060	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
229102	Fee-for-Service	1043517410	1043517410	1	1	THOMPSON, JAMISON R DO	8/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12021	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
229149	Fee-for-Service	1255858486	1255858486	1	1	TORRES, KARINNA LCSW	8/15/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4401 SEPULVEDA BLVD	210	SHERMAN OAKS	CA	91403	3934	19	06037	34.150356	-118.467397	Los Angeles County
229161	Fee-for-Service	1275651515	1275651515	1	22	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	2067 W VISTA WAY	STE 295	VISTA	CA	92083	6031	37	06073	33.18505594	-117.285958	San Diego County
229169	Fee-for-Service	1275651515	1275651515	1	17	THE ONCOLOGY INSTITUTE CA, A	5/11/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 271	MISSION VIEJO	CA	92691	8520	30	06059	33.56347704	-117.66546	Orange County
229200	Fee-for-Service	1700192556	1700192556	1	1	TERVALON, MELANIE M MD	7/6/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	45727	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
229206	Fee-for-Service	1275651515	1275651515	1	40	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	1011 E DEVONSHIRE AVE	SUITE 201	HEMET	CA	92543	3033	33	06065	33.75118151	-116.9615025	Riverside County
229218	Fee-for-Service	1255625273	1255625273	1	2	TODD, EMILY MD	5/13/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	123697	36	Psychiatry	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
229237	Fee-for-Service	1497595565	1497595565	1	1	TURIYA ANESTHESIA	5/1/2024	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	555 HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
229261	Fee-for-Service	1275651515	1275651515	1	56	THE ONCOLOGY INSTITUTE CA, A	8/23/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1001 S. STATE STREET	SUITE A	HEMET	CA	92543	7188	33	06065	33.731505	-116.971599	Riverside County
229291	Fee-for-Service	1487693172	1487693172	1	1	TRAN, THE-HUY M MD	3/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74543	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
229300	Fee-for-Service	1275651515	1275651515	1	60	THE ONCOLOGY INSTITUTE CA, A	5/16/2024	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	INNOVATION	27450 YNEZ RD	SUITE 116	TEMECULA	CA	92591	4671	33	06065	33.50684549	-117.1502048	Riverside County
229328	Fee-for-Service	1568680023	1568680023	1	1	TAN, JOHN F MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	103406	68	Hematology	0	In state provider	None	725 WELCH ROAD	MC:5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
229378	Fee-for-Service	1790721082	1790721082	1	1	TURBOW, BERNARD MD	2/28/1991	208800000X	NA	Other	026	PHYSICIANS	7420	34	Urology and Urological Surgery	0	In state provider	None	11100 WARNER AVE	STE 102	FOUNTAIN VALLEY	CA	92708	7500	30	06059	33.716291	-117.9355051	Orange County
229386	Fee-for-Service	1316258304	1316258304	1	1	TEKMYSTER, GENE DO	4/2/2020	2081S0010X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	18060	25	Physical Medicine and Rehabilitation	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
229387	Fee-for-Service	1326235995	1326235995	1	1	TICKOO, ROMA MD	4/29/2020	208VP0000X	NA	Other	026	PHYSICIANS	164731	41	Internal Medicine	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
229442	Fee-for-Service	1225005655	1225005655	1	1	TOMPKINS, JEREMY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	311 SOUTH L ST	None	TACOMA	WA	98045	0000	00	None	47.25954964	-122.4549815	Pierce County
229444	Fee-for-Service	1164713343	1164713343	1	1	THOMPSON, CHRISTA J LCSW	8/13/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23 W ST CHARLES ST	None	SAN ANDREAS	CA	95249	0000	05	06009	38.19634106	-120.6814732	Calaveras County
229454	Fee-for-Service	1275651515	1275651515	1	17	THE ONCOLOGY INSTITUTE CA, A	5/11/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 271	MISSION VIEJO	CA	92691	8520	30	06059	33.56347704	-117.66546	Orange County
229469	Fee-for-Service	1275651515	1275651515	1	15	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	900 S MAIN ST	STE 204	CORONA	CA	92882	3401	33	06065	33.87190191	-117.5669613	Riverside County
229488	Fee-for-Service	1255579389	1255579389	1	1	TEXAS REGIONAL MEDICAL	6/19/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER LTD	231 SOUTH COLLINS	None	SUNNYVALE	TX	75182	4624	00	None	32.77825244	-96.56741955	Dallas County
229493	Fee-for-Service	1275651515	1275651515	1	40	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	1011 E DEVONSHIRE AVE	SUITE 201	HEMET	CA	92543	3033	33	06065	33.75118151	-116.9615025	Riverside County
229544	Fee-for-Service	1275651515	1275651515	1	28	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	50 BELLEFONTAINE ST	SUITE 401	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
229548	Fee-for-Service	1104901255	1104901255	1	1	TRAN, LYNN E MD	8/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	69480	04	Otology, Laryngology, Rhinology	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
229560	Fee-for-Service	1437179694	1437179694	1	1	TRAN, BICH-THUY T MD	1/17/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	55555	41	Internal Medicine	0	In state provider	None	2501 N SEPULVEDA BLVD	STE 100	MANHATTAN BEACH	CA	90266	2735	19	06037	33.895098	-118.396119	Los Angeles County
229580	Fee-for-Service	1396316261	1396316261	1	1	TOVANI, MICHELLE E CRNA	8/2/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
229599	Fee-for-Service	1588623797	1588623797	1	1	TYLEN, ULF MD	1/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
229615	Fee-for-Service	1568680023	1568680023	1	1	TAN, JOHN F MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	103406	78	Neoplastic Diseases/Oncology	0	In state provider	None	725 WELCH ROAD	MC:5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
229667	Fee-for-Service	1770739625	1770739625	1	1	TOLBERT, LORAN M	11/18/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
229680	Fee-for-Service	1003861576	1003861576	1	1	TABANDEH, HOMAYOUN MD	12/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89087	18	Ophthalmology	0	In state provider	None	1127 WILSHIRE BLVD	STE 1620	LOS ANGELES	CA	90017	4007	19	06037	34.05270508	-118.2641005	Los Angeles County
229690	Fee-for-Service	1407417595	1407417595	1	1	TOOLE, AUBREY M PHD	9/1/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
229717	Fee-for-Service	1124577671	1124577671	1	1	TROYER, CORY L PT	12/11/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
229742	Fee-for-Service	1154467181	1154467181	1	7	THE HUNTINGTON MEDICAL FOUND	4/13/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	83	Rheumatology	0	In state provider	FOUNDATION	55 E CALIFORNIA BLVD	STE 204	PASADENA	CA	91105	3954	19	06037	34.13582278	-118.1491634	Los Angeles County
229746	Fee-for-Service	1508974924	1508974924	1	1	TERASHIMA, HIROSHI MD	9/20/1990	174400000X	NA	Other	026	PHYSICIANS	40210	01	General Practice	0	In state provider	None	424 28TH ST	None	OAKLAND	CA	94609	3603	01	06001	37.81660247	-122.2659563	Alameda County
229762	Fee-for-Service	1275651515	1275651515	1	15	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	900 S MAIN ST	STE 204	CORONA	CA	92882	3401	33	06065	33.87190191	-117.5669613	Riverside County
229775	Fee-for-Service	1255579389	1255579389	1	1	TEXAS REGIONAL MEDICAL	6/19/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER LTD	231 SOUTH COLLINS	None	SUNNYVALE	TX	75182	4624	00	None	32.77825244	-96.56741955	Dallas County
229776	Fee-for-Service	1346657327	1346657327	1	1	TAN, NICHOLAS G DPM	5/30/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
229780	Fee-for-Service	1275651515	1275651515	1	40	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	1011 E DEVONSHIRE AVE	SUITE 201	HEMET	CA	92543	3033	33	06065	33.75118151	-116.9615025	Riverside County
229830	Fee-for-Service	1275651515	1275651515	1	28	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	50 BELLEFONTAINE ST	SUITE 401	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
229838	Fee-for-Service	1710601208	1710601208	1	1	TRANQUILITY MEDICAL TRANSPOR	6/8/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	T LLC	11490 BURBANK BLVD	6H	NORTH HOLLYWOOD	CA	91601	2389	19	06037	34.17212154	-118.3819905	Los Angeles County
229855	Fee-for-Service	1902439573	1902439573	1	1	THOMAS, SARAH ANGELINA T	3/20/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3418 LOMA VISTA RD	A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
229866	Fee-for-Service	1144389073	1144389073	1	1	TURNER, LINDA D LMFT	7/26/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1809 W. REDLANDS BLVD	None	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
229870	Fee-for-Service	1710914544	1710914544	1	1	TUNG, VICTOR MD	8/22/2006	207R00000X	NA	Other	026	PHYSICIANS	5041	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
229883	Fee-for-Service	1558867531	1558867531	1	1	TOMAJAN, DAVID MD	8/5/2024	2081P0010X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	164996	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
229907	Fee-for-Service	1275651515	1275651515	1	50	THE ONCOLOGY INSTITUTE CA, A	12/2/2022	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9808 VENICE BLVD	SUITE 603	CULVER CITY	CA	90232	6819	19	06037	34.0236396	-118.3980847	Los Angeles County
229915	Fee-for-Service	1447344338	1447344338	1	1	TERRAMANI, THOMAS T MD	2/8/2015	2086S0129X	NA	General Surgery	026	PHYSICIANS	61003	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6719 ALVARADO RD	STE 303	SAN DIEGO	CA	92120	5264	37	06073	32.77684978	-117.055137	San Diego County
229919	Fee-for-Service	1609580935	1609580935	1	1	TRUONG, TONY L	4/7/2023	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
229945	Fee-for-Service	1346309952	1346309952	1	1	TUNG, JIM K MD	2/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72263	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
229956	Fee-for-Service	1417275827	1417275827	1	1	TSAI, KATY K J MD	6/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124908	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
229973	Fee-for-Service	1447022462	1447022462	1	1	THOMAS, CARLY J CNM	7/9/2024	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
229999	Fee-for-Service	1730312950	1730312950	1	1	TANTOCO, HIL L CRNA	8/31/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
230028	Fee-for-Service	1154467181	1154467181	1	7	THE HUNTINGTON MEDICAL FOUND	4/13/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	FOUNDATION	55 E CALIFORNIA BLVD	STE 204	PASADENA	CA	91105	3954	19	06037	34.13582278	-118.1491634	Los Angeles County
230046	Fee-for-Service	1275651515	1275651515	1	49	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	6121 N THESTA AVENUE	203-205	FRESNO	CA	93710	8603	10	06019	36.82493955	-119.783139	Fresno County
230049	Fee-for-Service	1861757320	1861757320	1	1	TOULOEI, KHASHA DO	10/24/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	14183	None	None	0	In state provider	None	2021 SANTA MONICA BLVD	# 600E	SANTA MONICA	CA	90404	2166	19	06037	34.02922048	-118.4793681	Los Angeles County
230086	Fee-for-Service	1740625235	1740625235	1	1	TODOS PARA LA SALUD	6/1/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	4420 N 1ST STREET	STE 123	FRESNO	CA	93726	2328	10	06019	36.798138	-119.772224	Fresno County
230089	Fee-for-Service	1922539972	1922539972	1	1	THAKKAR, NANCY MD	1/21/2022	207R00000X	NA	Other	026	PHYSICIANS	169937	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
230120	Fee-for-Service	1184970808	1184970808	1	1	TAMJIDI, DESIREE PHD	3/15/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	16200 VENTURA BLVD	403	ENCINO	CA	91436	4692	19	06037	34.15659457	-118.485532	Los Angeles County
230121	Fee-for-Service	1275651515	1275651515	1	28	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	50 BELLEFONTAINE ST	SUITE 401	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
230156	Fee-for-Service	1275651515	1275651515	1	42	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	12370 HESPERIA RD	SUITE 17	VICTORVILLE	CA	92395	7719	36	06071	34.47625382	-117.2913208	San Bernardino County
230185	Fee-for-Service	1285743716	1285743716	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05856	335 W OLIVE AVE	None	MADERA	CA	93637	5402	20	06039	36.95295945	-120.060126	Madera County
230195	Fee-for-Service	1275651515	1275651515	1	30	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	11100 WARNER AVE	STE. 214	FOUNTAIN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
230202	Fee-for-Service	1821148636	1821148636	1	1	TSENG, SAMUEL M MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70593	01	General Practice	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
230204	Fee-for-Service	1447344338	1447344338	1	1	TERRAMANI, THOMAS T MD	2/8/2015	2086S0129X	NA	General Surgery	026	PHYSICIANS	61003	02	General Surgery	0	In state provider	None	6719 ALVARADO RD	STE 303	SAN DIEGO	CA	92120	5264	37	06073	32.77684978	-117.055137	San Diego County
230227	Fee-for-Service	1154432011	1154432011	1	1	TVERDY, LINDSAY 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	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
230232	Fee-for-Service	1376652891	1376652891	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13803 FOOTHILL RD	None	SYLMAR	CA	91342	3013	19	06037	34.31045666	-118.4341493	Los Angeles County
230235	Fee-for-Service	1437711686	1437711686	1	1	TU, LONA K	11/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
230307	Fee-for-Service	1386062446	1386062446	1	1	TANIMOTO, AKI MD	7/31/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	163002	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
230325	Fee-for-Service	1366551897	1366551897	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05490	2412 PICO BLVD	None	SANTA MONICA	CA	90405	1827	19	06037	34.02234088	-118.4640254	Los Angeles County
230329	Fee-for-Service	1548265036	1548265036	1	16	TRUXTUN RADIOLOGY	2/25/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	2400 WIBLE RD	STE 14	BAKERSFIELD	CA	93304	4734	15	06029	35.3328934	-119.0389535	Kern County
230334	Fee-for-Service	1275651515	1275651515	1	49	THE ONCOLOGY INSTITUTE CA, A	7/6/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	6121 N THESTA AVENUE	203-205	FRESNO	CA	93710	8603	10	06019	36.82493955	-119.783139	Fresno County
230361	Fee-for-Service	1558383695	1558383695	1	1	TANENBAUM, NADINE D MD	1/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110240	45	Nephrology (Renal-Kidney)	0	In state provider	None	3011 CERES AVE	STE 100	CHICO	CA	95973	9803	04	06007	39.77592447	-121.8384651	Butte County
230363	Fee-for-Service	1720433907	1720433907	1	1	TRAN, GLORIA E MD	2/9/2021	207R00000X	NA	Other	026	PHYSICIANS	168703	None	None	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
230373	Fee-for-Service	1740625235	1740625235	1	1	TODOS PARA LA SALUD	6/1/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	4420 N 1ST STREET	STE 123	FRESNO	CA	93726	2328	10	06019	36.798138	-119.772224	Fresno County
230378	Fee-for-Service	1497052443	1497052443	1	1	TSANG, SHUNLING MD	4/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114902	01	General Practice	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
230379	Fee-for-Service	1720011927	1720011927	1	1	TIMOTHY F OBERMILLER 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	350 HERITAGE WAY	STE 2100	KALISPELL	MT	59901	0000	00	None	48.216645	-114.324948	Flathead County
230404	Fee-for-Service	1164536314	1164536314	2	1	TILLEY APOTHECARIES INC	6/9/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11411 BROOKSHIRE AVE	STE 107	DOWNEY	CA	90241	5008	19	06037	33.93667091	-118.1309273	Los Angeles County
230414	Fee-for-Service	1275651515	1275651515	1	56	THE ONCOLOGY INSTITUTE CA, A	12/13/2023	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1001 S. STATE STREET	SUITE A	HEMET	CA	92543	7188	33	06065	33.731505	-116.971599	Riverside County
230444	Fee-for-Service	1275651515	1275651515	1	42	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	12370 HESPERIA RD	SUITE 17	VICTORVILLE	CA	92395	7719	36	06071	34.47625382	-117.2913208	San Bernardino County
230477	Fee-for-Service	1407172372	1407172372	1	1	TRAN, HANH N NP	6/21/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DRIVE	8201	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
230480	Fee-for-Service	1659826360	1659826360	1	1	TAN, ALEXANDRIA LCSW	1/27/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
230482	Fee-for-Service	1629308515	1629308515	1	1	TANK, NIKI H MD	5/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114900	01	General Practice	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
230484	Fee-for-Service	1275651515	1275651515	1	30	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	11100 WARNER AVE	STE. 214	FOUNTAIN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
230493	Fee-for-Service	1447344338	1447344338	1	1	TERRAMANI, THOMAS T MD	2/8/2015	2086S0129X	NA	General Surgery	026	PHYSICIANS	61003	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	6719 ALVARADO RD	STE 303	SAN DIEGO	CA	92120	5264	37	06073	32.77684978	-117.055137	San Diego County
230507	Fee-for-Service	1508032350	1508032350	1	1	TAY, YOU S MD	8/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110064	41	Internal Medicine	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
230550	Fee-for-Service	1275095648	1275095648	1	1	TRAN, ALVIS MD	9/15/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180634	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
230622	Fee-for-Service	1275651515	1275651515	1	15	THE ONCOLOGY INSTITUTE CA, A	7/20/2017	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	900 S MAIN ST	STE 204	CORONA	CA	92882	3401	33	06065	33.87190191	-117.5669613	Riverside County
230658	Fee-for-Service	1740625235	1740625235	1	1	TODOS PARA LA SALUD	6/26/2023	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	4420 N 1ST STREET	STE 123	FRESNO	CA	93726	2328	10	06019	36.798138	-119.772224	Fresno County
230671	Fee-for-Service	1457856999	1457856999	1	1	TAITANO, LISSA PT	2/25/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7525 METROPOLITAN DR	STE 306	SAN DIEGO	CA	92108	4404	37	06073	32.77677653	-117.1592911	San Diego County
230695	Fee-for-Service	1588084602	1588084602	1	1	TAKADA, SAE MD	10/1/2019	207R00000X	NA	Other	026	PHYSICIANS	139993	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
230696	Fee-for-Service	1275651515	1275651515	1	56	THE ONCOLOGY INSTITUTE CA, A	8/23/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	1001 S. STATE STREET	SUITE A	HEMET	CA	92543	7188	33	06065	33.731505	-116.971599	Riverside County
230731	Fee-for-Service	1275651515	1275651515	1	42	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	12370 HESPERIA RD	SUITE 17	VICTORVILLE	CA	92395	7719	36	06071	34.47625382	-117.2913208	San Bernardino County
230768	Fee-for-Service	1407913379	1407913379	1	1	TRUDEAU, JOSEPH D MD	3/19/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	167780	30	Radiology	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
230770	Fee-for-Service	1629308515	1629308515	1	1	TANK, NIKI H MD	5/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114900	41	Internal Medicine	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
230771	Fee-for-Service	1275651515	1275651515	1	30	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	11100 WARNER AVE	STE. 214	FOUNTAIN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
230782	Fee-for-Service	1568088540	1568088540	1	1	TEGEGNE, ZENEBU S NP	7/24/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
230853	Fee-for-Service	1558798835	1558798835	1	1	TRAVIS, ROBERT C LMFT	4/15/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	114771	-	NOT APPLICABLE	0	In state provider	None	3939 ATLANTIC AVE	SUITE 102	LONG BEACH	CA	90807	3535	19	06037	33.830073	-118.1851065	Los Angeles County
230889	Fee-for-Service	1811959687	1811959687	1	1	TIMOTHY MCCAVIT,MD	1/6/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 7TH AVE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
230894	Fee-for-Service	1467928481	1467928481	1	1	TRANSPORTATION IS US	8/24/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	337 N VINEYARD AVE	400 UNIT 11	ONTARIO	CA	91764	4453	36	06071	34.066728	-117.611622	San Bernardino County
230909	Fee-for-Service	1275651515	1275651515	1	49	THE ONCOLOGY INSTITUTE CA, A	7/6/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	6121 N THESTA AVENUE	203-205	FRESNO	CA	93710	8603	10	06019	36.82493955	-119.783139	Fresno County
230919	Fee-for-Service	1023192093	1023192093	1	1	TRAHMS, SCOTT MD	7/2/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	81296	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
230921	Fee-for-Service	1275651515	1275651515	1	51	THE ONCOLOGY INSTITUTE CA, A	9/6/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	120 W HELLMAN AVE	202	MONTEREY PARK	CA	91754	1209	19	06037	34.06972847	-118.124154	Los Angeles County
230931	Fee-for-Service	1942211438	1942211438	1	2	TOWNSHIP PHARMACY LLC	12/23/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	CY	108 W 1325 N	None	CEDAR CITY	UT	84721	7791	00	None	37.70107753	-113.064912	Iron County
230949	Fee-for-Service	1154398733	1154398733	1	1	TONTZ, WILLIAM L MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	41138	20	Orthopedic Surgery	0	In state provider	None	4060 4TH AVE	STE 630	SAN DIEGO	CA	92103	2118	37	06073	32.75053673	-117.1616539	San Diego County
230950	Fee-for-Service	1740625235	1740625235	1	1	TODOS PARA LA SALUD	12/19/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	4420 N 1ST STREET	STE 123	FRESNO	CA	93726	2328	10	06019	36.798138	-119.772224	Fresno County
230971	Fee-for-Service	1275651515	1275651515	1	24	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	3965 5TH AVE	SUITE 230	SAN DIEGO	CA	92103	3107	37	06073	32.749335	-117.160413	San Diego County
230980	Fee-for-Service	1275651515	1275651515	1	28	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	50 BELLEFONTAINE ST	SUITE 401	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
231019	Fee-for-Service	1275651515	1275651515	1	42	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	12370 HESPERIA RD	SUITE 17	VICTORVILLE	CA	92395	7719	36	06071	34.47625382	-117.2913208	San Bernardino County
231040	Fee-for-Service	1922139526	1922139526	1	1	TRIGGER, BRANDON DO MD	8/18/2023	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	4300 MARKETPOINTE DRIVE	SUITE 100	MINNEAPOLIS	MN	55435	5435	00	None	44.8612569	-93.33472789	Hennepin County
231059	Fee-for-Service	1629308515	1629308515	1	1	TANK, NIKI H MD	5/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114900	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
231060	Fee-for-Service	1275651515	1275651515	1	30	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	11100 WARNER AVE	STE. 214	FOUNTAIN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
231127	Fee-for-Service	1598829640	1598829640	1	1	TORRES, MARTHA L LMFT	8/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	325 W HOSPITALITY LN	STE 200	SAN BERNARDINO	CA	92374	2861	36	06071	34.0658995	-117.29034	San Bernardino County
231151	Fee-for-Service	1467625277	1467625277	1	1	TUMMURU, GIRI R MD	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112908	None	None	0	In state provider	None	520 WEST I STREET	None	LOS BANOS	CA	93635	3419	24	06047	37.06346603	-120.8593647	Merced County
231155	Fee-for-Service	1447887948	1447887948	1	1	TRAN, JASON H MD	1/2/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	180753	None	None	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
231178	Fee-for-Service	1225253081	1225253081	1	1	TSAO, CHRISTINA W MD	6/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94091	30	Radiology	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
231199	Fee-for-Service	1275651515	1275651515	1	49	THE ONCOLOGY INSTITUTE CA, A	12/2/2022	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	6121 N THESTA AVENUE	203-205	FRESNO	CA	93710	8603	10	06019	36.82493955	-119.783139	Fresno County
231205	Fee-for-Service	1023192093	1023192093	1	1	TRAHMS, SCOTT MD	7/2/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	81296	10	Gastroenterology (M.D. only)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
231209	Fee-for-Service	1275651515	1275651515	1	51	THE ONCOLOGY INSTITUTE CA, A	12/2/2022	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	120 W HELLMAN AVE	202	MONTEREY PARK	CA	91754	1209	19	06037	34.06972847	-118.124154	Los Angeles County
231221	Fee-for-Service	1316206550	1316206550	1	2	TANG, MAI OD INC	10/18/2013	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12300 SEAL BEACH BLVD	None	SEAL BEACH	CA	90740	2709	30	06059	33.78303	-118.069389	Orange County
231228	Fee-for-Service	1023180551	1023180551	1	1	TSUI, ANDY PT	5/3/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1914 TICE VALLEY BLVD	None	WALNUT CREEK	CA	94595	2203	07	06013	37.87851556	-122.0745896	Contra Costa County
231262	Fee-for-Service	1275651515	1275651515	1	24	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	3965 5TH AVE	SUITE 230	SAN DIEGO	CA	92103	3107	37	06073	32.749335	-117.160413	San Diego County
231265	Fee-for-Service	1801191663	1801191663	1	1	THU, AYE MOE MD	7/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113966	41	Internal Medicine	0	In state provider	None	1225 WILSHIRE BOULEVARD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
231296	Fee-for-Service	1407816325	1407816325	1	1	TAN, SHIRLEY Z MD	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	45758	22	Pathology (M.D. only)	0	In state provider	None	438 W LAS TUNAS DR	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
231302	Fee-for-Service	1275651515	1275651515	1	7	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	ND INNOVATION	710 N. EUCLID ST	SUITE 106	ANAHEIM	CA	92801	4122	30	06059	33.8420837	-117.9415765	Orange County
231309	Fee-for-Service	1275651515	1275651515	1	42	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	12370 HESPERIA RD	SUITE 17	VICTORVILLE	CA	92395	7719	36	06071	34.47625382	-117.2913208	San Bernardino County
231346	Fee-for-Service	1275651515	1275651515	1	50	THE ONCOLOGY INSTITUTE CA, A	9/30/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	9808 VENICE BLVD	SUITE 603	CULVER CITY	CA	90232	6819	19	06037	34.0236396	-118.3980847	Los Angeles County
231348	Fee-for-Service	1700977105	1700977105	1	1	THE HEALTH CARE AUTHORITY	12/21/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FOR BAPTIST HEALTH	2105 EAST SOUTH BLVD	None	MONTGOMERY	AL	36116	2498	00	None	32.32716446	-86.2775042	Montgomery County
231389	Fee-for-Service	1528564853	1528564853	1	1	TLISOV, EULIA R DO	10/13/2021	207R00000X	NA	Other	026	PHYSICIANS	18043	None	None	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
231404	Fee-for-Service	1447779806	1447779806	1	1	TABORGA, LUZ A NP	11/8/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8311 FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
231447	Fee-for-Service	1063664258	1063664258	1	1	TOPOREK, SCOTT D MD	7/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112550	41	Internal Medicine	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
231456	Fee-for-Service	1275651515	1275651515	1	58	THE ONCOLOGY INSTITUTE CA, A	9/7/2023	2471R0002X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INNOVATION	554 SAN BERNARDINO RD	None	COVINA	CA	91723	1747	19	06037	34.09085021	-117.8800144	Los Angeles County
231466	Fee-for-Service	1568553030	1568553030	1	1	TRUMBULL, ROBIN L MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	30670	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2644 M ST	STE A	MERCED	CA	95340	2826	24	06047	37.31137227	-120.4794155	Merced County
231483	Fee-for-Service	1831549898	1831549898	1	1	TUMATI, VANYA MD	10/8/2021	207L00000X	NA	Other	026	PHYSICIANS	172911	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
231497	Fee-for-Service	1275651515	1275651515	1	51	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	120 W HELLMAN AVE	202	MONTEREY PARK	CA	91754	1209	19	06037	34.06972847	-118.124154	Los Angeles County
231531	Fee-for-Service	1467995951	1467995951	1	1	TONY MAKHLOUF MD INC	12/12/2017	207RR0500X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	143 PARROT LANE	None	SIMI VALLEY	CA	93065	3151	56	06111	34.2590175	-118.7946405	Ventura County
231537	Fee-for-Service	1912193616	1912193616	1	1	THAI, JUDY MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88854	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
231546	Fee-for-Service	1275651515	1275651515	1	24	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	3965 5TH AVE	SUITE 230	SAN DIEGO	CA	92103	3107	37	06073	32.749335	-117.160413	San Diego County
231556	Fee-for-Service	1609871235	1609871235	1	1	TARAGANO, EVAN S MD	10/9/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53392	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
231574	Fee-for-Service	1841745692	1841745692	1	1	TSUTSUMI, CHRISTINA T	10/14/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
231587	Fee-for-Service	1275651515	1275651515	1	52	THE ONCOLOGY INSTITUTE CA, A	12/6/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	INNOVATION	18250 ROSCOE BLVD.,	SUITE 325	LOS ANGELES	CA	91325	4277	19	06037	34.22076142	-118.5313223	Los Angeles County
231588	Fee-for-Service	1629092309	1629092309	1	1	TITO, ELIZABETH P MD	5/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148486	02	General Surgery	0	In state provider	None	121 SOTOYOME ST	STE 203	SANTA ROSA	CA	95405	4822	49	06097	38.44224	-122.70195	Sonoma County
231631	Fee-for-Service	1306949706	1306949706	1	1	TAN, SERENA T MD	4/23/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	75455	None	None	0	In state provider	None	320 DARDANELLI LN	STE 16	LOS GATOS	CA	95032	1419	43	06085	37.262079	-121.9673345	Santa Clara County
231632	Fee-for-Service	1982224804	1982224804	1	1	THOMAS, RISHI R DO	7/18/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	20002	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
231634	Fee-for-Service	1275651515	1275651515	1	50	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	9808 VENICE BLVD	SUITE 603	CULVER CITY	CA	90232	6819	19	06037	34.0236396	-118.3980847	Los Angeles County
231636	Fee-for-Service	1700977105	1700977105	1	1	THE HEALTH CARE AUTHORITY	12/21/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FOR BAPTIST HEALTH	2105 EAST SOUTH BLVD	None	MONTGOMERY	AL	36116	2498	00	None	32.32716446	-86.2775042	Montgomery County
231690	Fee-for-Service	1003855289	1003855289	1	1	TARDIEU, BERT G MD	9/1/2008	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	TARDIEU, BERT G MD	47 SAN BENANCIO RD	None	SALINAS	CA	93908	9133	27	06053	36.57635318	-121.7169598	Monterey County
231736	Fee-for-Service	1457441412	1457441412	1	1	TAN, JEANNIE T MD	9/14/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76539	18	Ophthalmology	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
231745	Fee-for-Service	1275651515	1275651515	1	58	THE ONCOLOGY INSTITUTE CA, A	9/7/2023	2471R0002X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INNOVATION	554 SAN BERNARDINO RD	None	COVINA	CA	91723	1747	19	06037	34.09085021	-117.8800144	Los Angeles County
231752	Fee-for-Service	1649488479	1649488479	1	1	TEFERA, SOLOMON T PA	9/30/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	16713	-	NOT APPLICABLE	0	In state provider	None	218 E COMMONWEALTH AVE	None	FULLERTON	CA	92832	1911	30	06059	33.87035552	-117.9211545	Orange County
231756	Fee-for-Service	1568553030	1568553030	1	1	TRUMBULL, ROBIN L MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	30670	08	Family Practice	0	In state provider	None	2644 M ST	STE A	MERCED	CA	95340	2826	24	06047	37.31137227	-120.4794155	Merced County
231757	Fee-for-Service	1427131424	1427131424	1	1	TACTILE SYSTEMS TECHNOLOGY	12/9/2015	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	3701 WAYZATA BLVD	SUITE 300	MINNEAPOLIS	MN	55416	3791	00	None	44.96945762	-93.32761413	Hennepin County
231768	Fee-for-Service	1396792255	1396792255	1	1	TIMOTHY MCAVOY	1/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1751 E MAIN ST	None	WAUKESHA	WI	53186	3940	00	None	43.02236328	-88.19669404	Waukesha County
231771	Fee-for-Service	1922203496	1922203496	1	1	THOMAS, STEPHEN MD	7/23/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161717	30	Radiology	0	In state provider	None	8933 ACTIVITY RD	None	SAN DIEGO	CA	92126	4427	37	06073	32.89637448	-117.133497	San Diego County
231784	Fee-for-Service	1275651515	1275651515	1	51	THE ONCOLOGY INSTITUTE CA, A	9/6/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	120 W HELLMAN AVE	202	MONTEREY PARK	CA	91754	1209	19	06037	34.06972847	-118.124154	Los Angeles County
231805	Fee-for-Service	1528021490	1528021490	1	1	TRAN, VU A MD	12/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	79456	None	None	0	In state provider	None	3325 CHANATE RD	None	SANTA ROSA	CA	95405	1707	49	06097	38.469537	-122.707314	Sonoma County
231823	Fee-for-Service	1912193616	1912193616	1	1	THAI, JUDY MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88854	05	Anesthesiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
231835	Fee-for-Service	1275651515	1275651515	1	24	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	3965 5TH AVE	SUITE 230	SAN DIEGO	CA	92103	3107	37	06073	32.749335	-117.160413	San Diego County
231848	Fee-for-Service	1851710669	1851710669	1	1	THOUIN, JOSEPH L MD	3/25/2019	207R00000X	NA	Other	026	PHYSICIANS	142032	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
231878	Fee-for-Service	1275651515	1275651515	1	52	THE ONCOLOGY INSTITUTE CA, A	7/17/2023	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	INNOVATION	18250 ROSCOE BLVD.,	SUITE 325	LOS ANGELES	CA	91325	4277	19	06037	34.22076142	-118.5313223	Los Angeles County
231924	Fee-for-Service	1275651515	1275651515	1	50	THE ONCOLOGY INSTITUTE CA, A	9/30/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	9808 VENICE BLVD	SUITE 603	CULVER CITY	CA	90232	6819	19	06037	34.0236396	-118.3980847	Los Angeles County
231948	Fee-for-Service	1508874298	1508874298	1	1	TANTISIRA, LALITA K MD	12/3/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	170095	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
231974	Fee-for-Service	1780115147	1780115147	1	1	TUWATANANURAK, JUSTIN P MD	9/19/2022	207L00000X	NA	Other	026	PHYSICIANS	177360	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
231978	Fee-for-Service	1003855289	1003855289	1	1	TARDIEU, BERT G MD	3/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	70944	20	Orthopedic Surgery	0	In state provider	TARDIEU, BERT G MD	47 SAN BENANCIO RD	None	SALINAS	CA	93908	9133	27	06053	36.57635318	-121.7169598	Monterey County
231984	Fee-for-Service	1467668798	1467668798	1	1	TISDALE SARA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1400 E BOULDER	None	COLORADO SPRINGS	CO	80909	0000	00	None	38.8388119	-104.7995065	El Paso County
232016	Fee-for-Service	1588026546	1588026546	1	1	TOWLE, DARYN C MD	6/4/2019	390200000X	NA	Other	026	PHYSICIANS	152562	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	STE 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
232072	Fee-for-Service	1508278359	1508278359	1	3	THE ROADS FOUNDATION	8/23/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3737 MARTIN LUTHER KING	STE 402	LYNWOOD	CA	90262	3533	19	06037	33.92872742	-118.2006921	Los Angeles County
232116	Fee-for-Service	1053765909	1053765909	1	1	THOMAS, ROBERT L MD	6/24/2019	208M00000X	NA	Other	026	PHYSICIANS	151319	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
232122	Fee-for-Service	1275651515	1275651515	1	24	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	3965 5TH AVE	SUITE 230	SAN DIEGO	CA	92103	3107	37	06073	32.749335	-117.160413	San Diego County
232123	Fee-for-Service	1508807066	1508807066	1	1	TRAN, TAN D MD	11/17/2014	174400000X	NA	Other	026	PHYSICIANS	69009	10	Gastroenterology (M.D. only)	0	In state provider	None	292 COTTAGE AVE	None	MANTECA	CA	95336	4942	39	06077	37.80091643	-121.1982511	San Joaquin County
232141	Fee-for-Service	1972587459	1972587459	1	1	TYLER, THOMAS D MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50482	18	Ophthalmology	0	In state provider	None	1140 LAUREL ST	STE A	SAN CARLOS	CA	94070	5009	41	06081	37.49943614	-122.2527389	San Mateo County
232164	Fee-for-Service	1275651515	1275651515	1	7	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ND INNOVATION	710 N. EUCLID ST	SUITE 106	ANAHEIM	CA	92801	4122	30	06059	33.8420837	-117.9415765	Orange County
232173	Fee-for-Service	1154303493	1154303493	1	1	TACHERON, BEN MD	11/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	5330 SOUTH HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
232208	Fee-for-Service	1275651515	1275651515	1	33	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	1513 GRAND AVE	STE. 360	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
232212	Fee-for-Service	1275651515	1275651515	1	30	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	11100 WARNER AVE	STE. 214	FOUNTAIN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
232256	Fee-for-Service	1285699900	1285699900	1	1	TOTAL RENAL CARE, INC	8/1/1998	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	UCLA DIALYSIS CENTER	10630 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	4837	19	06037	34.05290122	-118.4303294	Los Angeles County
232336	Fee-for-Service	1588687461	1588687461	1	1	TEMPLETON, AMANDA J MD	5/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80446	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
232355	Fee-for-Service	1508278359	1508278359	1	3	THE ROADS FOUNDATION	8/23/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3737 MARTIN LUTHER KING	STE 402	LYNWOOD	CA	90262	3533	19	06037	33.92872742	-118.2006921	Los Angeles County
232359	Fee-for-Service	1003827387	1003827387	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5780	720 N VENTURA RD	None	OXNARD	CA	93030	4413	56	06111	34.20991677	-119.1945419	Ventura County
232394	Fee-for-Service	1083903124	1083903124	1	4	TORRANCE HEALTH ASSOCIATION	10/19/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	717 SOUTH AVERILL AVENUE	None	SAN PEDRO	CA	90732	3813	19	06037	33.7370883	-118.3078499	Los Angeles County
232411	Fee-for-Service	1508807066	1508807066	1	1	TRAN, TAN D MD	11/17/2014	174400000X	NA	Other	026	PHYSICIANS	69009	41	Internal Medicine	0	In state provider	None	292 COTTAGE AVE	None	MANTECA	CA	95336	4942	39	06077	37.80091643	-121.1982511	San Joaquin County
232420	Fee-for-Service	1952518425	1952518425	1	1	TRUONG, NGOC-HAI T MD	4/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65597	None	None	0	In state provider	None	17100 EUCLID STREET	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
232440	Fee-for-Service	1992840417	1992840417	1	1	THOMPSON, KELLY LCSW	3/21/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
232444	Fee-for-Service	1588951263	1588951263	1	1	TAM-MCSORLEY MAYLYNN L DPM	8/8/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
232453	Fee-for-Service	1275651515	1275651515	1	7	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	ND INNOVATION	710 N. EUCLID ST	SUITE 106	ANAHEIM	CA	92801	4122	30	06059	33.8420837	-117.9415765	Orange County
232469	Fee-for-Service	1912364639	1912364639	1	1	TORRES, MAYRA A LPCC	6/7/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
232471	Fee-for-Service	1851754956	1851754956	1	1	TSANG, MICHELLE MD	7/9/2019	390200000X	NA	Other	026	PHYSICIANS	152261	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
232495	Fee-for-Service	1275651515	1275651515	1	33	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	1513 GRAND AVE	STE. 360	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
232498	Fee-for-Service	1275651515	1275651515	1	50	THE ONCOLOGY INSTITUTE CA, A	9/30/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	9808 VENICE BLVD	SUITE 603	CULVER CITY	CA	90232	6819	19	06037	34.0236396	-118.3980847	Los Angeles County
232500	Fee-for-Service	1841653573	1841653573	1	1	TROPE, ALEXANDER C MD	1/14/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	150590	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
232549	Fee-for-Service	1689826661	1689826661	1	1	TIWANA, JASBIR S MD	12/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105298	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
232583	Fee-for-Service	1780311571	1780311571	1	1	TAYLOR, RITA CHARMAINE	12/6/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3337 W FLORIDA AVE	SP 58	HEMET	CA	92545	3513	33	06065	33.7473147	-117.0072343	Riverside County
232642	Fee-for-Service	1679799266	1679799266	1	1	TASWELL, CARL MD	12/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	65826	36	Psychiatry	0	In state provider	None	101 THE CITY DR SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
232644	Fee-for-Service	1508278359	1508278359	1	3	THE ROADS FOUNDATION	8/17/2023	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3737 MARTIN LUTHER KING	STE 402	LYNWOOD	CA	90262	3533	19	06037	33.92872742	-118.2006921	Los Angeles County
232657	Fee-for-Service	1417461062	1417461062	1	1	TERRELL, TRACEA MD	5/2/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	86304	01	General Practice	0	In state provider	None	515 MICHIGAN BLVD	None	WEST SACRAMENTO	CA	95691	2705	57	06113	38.58298316	-121.5265736	Yolo County
232659	Fee-for-Service	1497970057	1497970057	1	1	TOMEH, CHAFEEK MD	7/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120732	04	Otology, Laryngology, Rhinology	0	In state provider	None	725 WELCH RD	MC5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
232739	Fee-for-Service	1275651515	1275651515	1	7	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ND INNOVATION	710 N. EUCLID ST	SUITE 106	ANAHEIM	CA	92801	4122	30	06059	33.8420837	-117.9415765	Orange County
232786	Fee-for-Service	1275651515	1275651515	1	33	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	1513 GRAND AVE	STE. 360	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
232810	Fee-for-Service	1750592119	1750592119	2	1	TUPAZ HOMES LLC	6/6/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	4328 SAYOKO CIRCLE	None	SAN JOSE	CA	95136	2337	43	06085	37.27014206	-121.8367782	Santa Clara County
232817	Fee-for-Service	1033178819	1033178819	1	1	THAKKAR, BHAVIK V MD	8/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	53926	41	Internal Medicine	0	In state provider	None	11525 BROOKSHIRE AVE	400	DOWNEY	CA	90241	4985	19	06037	33.93544635	-118.1318321	Los Angeles County
232828	Fee-for-Service	1255646915	1255646915	1	1	TESI ROCHA, ANA C MD	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125750	40	Pediatrics	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
232850	Fee-for-Service	1093973760	1093973760	1	1	TABRIZI, MOHSEN MD	9/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108941	41	Internal Medicine	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
232851	Fee-for-Service	1316219058	1316219058	1	1	TRACY, ROBERT A DO	8/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12632	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 SOUTH GRAND AVENUE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
232873	Fee-for-Service	1780311571	1780311571	1	1	TAYLOR, RITA CHARMAINE	12/6/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3337 W FLORIDA AVE	SP 58	HEMET	CA	92545	3513	33	06065	33.7473147	-117.0072343	Riverside County
232899	Fee-for-Service	1780624403	1780624403	1	1	TORRES, JAMES T MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65306	05	Anesthesiology	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
232926	Fee-for-Service	1679799266	1679799266	1	1	TASWELL, CARL MD	12/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	65826	42	Nuclear Medicine	0	In state provider	None	101 THE CITY DR SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
232988	Fee-for-Service	1760157564	1760157564	1	1	THE HOPE THERAPY	12/17/2024	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8379 JADE DR	None	RANCHO CUCAMONGA	CA	91701	4561	36	06071	34.13201648	-117.623205	San Bernardino County
232997	Fee-for-Service	1265725931	1265725931	1	1	TRIVEDI, PUJA N DO	8/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11779	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
233024	Fee-for-Service	1578069183	1578069183	1	2	TOTAL RENAL CARE INC	7/1/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	26861 BOUQUET CANYON RD	None	SANTA CLARITA	CA	91350	2372	19	06037	34.43373816	-118.5298962	Los Angeles County
233027	Fee-for-Service	1275651515	1275651515	1	52	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	INNOVATION	18250 ROSCOE BLVD.,	SUITE 325	LOS ANGELES	CA	91325	4277	19	06037	34.22076142	-118.5313223	Los Angeles County
233064	Fee-for-Service	1760646640	1760646640	1	1	TORRES, CRISTINA LMFT	4/5/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3551 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
233072	Fee-for-Service	1275651515	1275651515	1	33	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	1513 GRAND AVE	STE. 360	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
233172	Fee-for-Service	1922494681	1922494681	1	1	THE DOCTORS OFFICE & WALK-IN	2/27/2023	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CLINIC CA INC.	3863 CLAIREMONT DRIVE	None	SAN DIEGO	CA	92117	5831	37	06073	32.81064075	-117.2008928	San Diego County
233193	Fee-for-Service	1710905260	1710905260	1	1	TRULOCK, ELBERT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	600 SOUTH EUCLID	CAMPUS BOX 8015	SAINT LOUIS	MO	63110	1032	00	None	38.63518793	-90.26307576	St. Louis city
233215	Fee-for-Service	1053798744	1053798744	1	1	TAYLOR, LACHARONDA LCSW	5/5/2023	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
233229	Fee-for-Service	1275971459	1275971459	1	1	TANO, ZACHARY E MD	6/29/2022	390200000X	NA	Other	026	PHYSICIANS	177286	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
233316	Fee-for-Service	1275651515	1275651515	1	52	THE ONCOLOGY INSTITUTE CA, A	12/6/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INNOVATION	18250 ROSCOE BLVD.,	SUITE 325	LOS ANGELES	CA	91325	4277	19	06037	34.22076142	-118.5313223	Los Angeles County
233358	Fee-for-Service	1275651515	1275651515	1	1	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	11525 BROOKSHIRE AVE	SUITE 202	DOWNEY	CA	90241	4983	19	06037	33.93544635	-118.1318321	Los Angeles County
233360	Fee-for-Service	1275651515	1275651515	1	33	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	1513 GRAND AVE	STE. 360	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
233376	Fee-for-Service	1073565172	1073565172	1	1	TOOLE, CASEY J DO	6/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10675	None	None	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
233390	Fee-for-Service	1013310135	1013310135	1	2	THE OASIS MEDICAL CLINIC INC	11/29/2018	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	418 E ARBOR VITAE ST	None	INGLEWOOD	CA	90301	3450	19	06037	33.9526858	-118.3501337	Los Angeles County
233460	Fee-for-Service	1811301401	1811301401	1	1	TSE, JULIE	7/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1617 ST MARKS PLAZA	STE D	STOCKTON	CA	95207	6423	39	06077	37.98864819	-121.3268062	San Joaquin County
233483	Fee-for-Service	1679512982	1679512982	1	1	THOMAS RAND MD	12/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
233490	Fee-for-Service	1215015342	1215015342	1	1	TOTARO, MICHAEL J L MD	12/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75298	01	General Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
233503	Fee-for-Service	1902198450	1902198450	1	1	TOTAL RENAL CARE INC	11/30/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	16506 LAKEWOOD BLVD	STE 100	BELLFLOWER	CA	90706	5165	19	06037	33.88470916	-118.1424401	Los Angeles County
233536	Fee-for-Service	1437593415	1437593415	1	1	TAM, ALLISON C MD	7/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147106	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
233543	Fee-for-Service	1720122781	1720122781	1	1	THRIFTY PAYLESS, INC.	9/15/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06438	39782 WINCHESTER RD.	None	TEMECULA	CA	95291	3551	33	06065	33.53985988	-117.1443873	Riverside County
233567	Fee-for-Service	1457409245	1457409245	1	1	TAN, LINDSAY MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	51189	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
233572	Fee-for-Service	1891409520	1891409520	1	1	TRAN, DENISE M NP	1/26/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	568 E HERNDON AVE	STE 201	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
233577	Fee-for-Service	1396778064	1396778064	1	1	TEXAS HEALTH HARRIS	3/29/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	METHODIST HOSPITAL CLEBU	201 WALLS DR	None	CLEBURNE	TX	76033	4007	00	None	32.33146421	-97.43736666	Johnson County
233588	Fee-for-Service	1437321346	1437321346	1	1	TSENG, CHARLES Y MD	6/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102751	24	Plastic Surgery	0	In state provider	None	200 MEDICAL PLAZA	STE 465	LOS ANGELES	CA	90024	5817	19	06037	34.06527974	-118.4462792	Los Angeles County
233593	Fee-for-Service	1508151036	1508151036	1	1	TONG, BRANDON DO	9/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13253	41	Internal Medicine	0	In state provider	None	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
233605	Fee-for-Service	1275651515	1275651515	1	7	THE ONCOLOGY INSTITUTE CA, A	10/14/2020	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ND INNOVATION	710 N. EUCLID ST	SUITE 106	ANAHEIM	CA	92801	4122	30	06059	33.8420837	-117.9415765	Orange County
233611	Fee-for-Service	1942358684	1942358684	1	1	TROTTA, KARLA C	7/8/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	568 N SUNRISE AVE	STE 250	ROSEVILLE	CA	95661	3035	31	06061	38.7576732	-121.2534645	Placer County
233645	Fee-for-Service	1275651515	1275651515	1	1	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	11525 BROOKSHIRE AVE	SUITE 202	DOWNEY	CA	90241	4983	19	06037	33.93544635	-118.1318321	Los Angeles County
233666	Fee-for-Service	1982934709	1982934709	1	1	TABLADA-QUINTANILLA,	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	110098	40	Pediatrics	0	In state provider	MICHELLE MD	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
233712	Fee-for-Service	1902947625	1902947625	1	1	TUFAIL, HUMAYUN MD	7/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103258	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
233752	Fee-for-Service	1235153040	1235153040	1	1	TARN, DERJUNG M MD	8/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72710	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
233761	Fee-for-Service	1508927179	1508927179	1	1	TREVINO, SALVADOR D PHD	11/29/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 N SAN ANTONIO RD	None	SANTA BARBARA	CA	93110	1332	42	06083	34.4458497	-119.779596	Santa Barbara County
233824	Fee-for-Service	1639499247	1639499247	1	1	THIYANARATNAM, JAYANTHA MD	12/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132808	07	Dermatology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
233854	Fee-for-Service	1457409245	1457409245	1	1	TAN, LINDSAY MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	51189	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
233865	Fee-for-Service	1396778064	1396778064	1	1	TEXAS HEALTH HARRIS	5/25/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	METHODIST HOSPITAL CLEBU	201 WALLS DR	None	CLEBURNE	TX	76033	4007	00	None	32.33146421	-97.43736666	Johnson County
233935	Fee-for-Service	1275651515	1275651515	1	1	THE ONCOLOGY INSTITUTE CA, A	2/26/2008	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	11525 BROOKSHIRE AVE	SUITE 202	DOWNEY	CA	90241	4983	19	06037	33.93544635	-118.1318321	Los Angeles County
233985	Fee-for-Service	1881905305	1881905305	1	1	TAHIR, OSMAN M DO	8/16/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	15615	30	Radiology	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
234064	Fee-for-Service	1093893653	1093893653	1	1	THU, TUN	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67315	45	Nephrology (Renal-Kidney)	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
234118	Fee-for-Service	1326210907	1326210907	1	2	TLC MED TRANSPORTATION LLC	12/7/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	4558 ROSEVILLE RD	B	NORTH HIGHLANDS	CA	95660	5520	34	06067	38.650761	-121.3903845	Sacramento County
234140	Fee-for-Service	1013053784	1013053784	1	1	THYGESON, CINDY Y MD	3/2/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	108395	36	Psychiatry	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
234176	Fee-for-Service	1275845133	1275845133	1	1	TAHAEI, SEYED A MD	3/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133899	None	None	0	In state provider	None	2120 PROFESSIONAL DR	None	ROSEVILLE	CA	95661	3700	31	06061	38.74247397	-121.2508672	Placer County
234180	Fee-for-Service	1376652610	1376652610	1	1	THRIFY PAYLESS INC	10/19/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6302	150 E LERDO HWY	None	SHAFTER	CA	93263	2702	15	06029	35.49986286	-119.2770864	Kern County
234183	Fee-for-Service	1497595565	1497595565	1	2	TURIYA ANESTHESIA	5/1/2024	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1145 REDONDO BEACH BLVD	None	GARDENA	CA	90247	3511	19	06037	33.89242734	-118.2947128	Los Angeles County
234220	Fee-for-Service	1922043272	1922043272	1	1	TIN, MOE THANT MD	6/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81818	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
234221	Fee-for-Service	1275651515	1275651515	1	1	THE ONCOLOGY INSTITUTE CA, A	2/26/2008	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	11525 BROOKSHIRE AVE	SUITE 202	DOWNEY	CA	90241	4983	19	06037	33.93544635	-118.1318321	Los Angeles County
234259	Fee-for-Service	1770692147	1770692147	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05544	6410 PLATT AVE	None	CANOGA PARK	CA	91307	3216	19	06037	34.18724909	-118.6427266	Los Angeles County
234270	Fee-for-Service	1932284601	1932284601	1	1	TSO, PATRICK C MD	11/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	83697	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
234279	Fee-for-Service	1508504648	1508504648	1	1	TRAN, JENNIFER OD	8/2/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
234317	Fee-for-Service	1427058924	1427058924	1	1	TOLBY, NOAH 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	350 N WILMOT RD	None	TUCSON	AZ	85711	2602	00	None	32.227209	-110.8556595	Pima County
234349	Fee-for-Service	1386177194	1386177194	1	1	TARZI, FAWAZ P MD	7/4/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	171017	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
234378	Fee-for-Service	1770202582	1770202582	1	1	TARZIBACHI, EUGENIA LMFT	5/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1408 CHAPIN AVE	STE. 6	BURLINGAME	CA	94010	4080	41	06081	37.57844797	-122.349618	San Mateo County
234442	Fee-for-Service	1023553633	1023553633	1	1	TRI-CITY HEALTH SERVICES	1/31/2017	193400000X	NA	Other	026	PHYSICIANS	52139	66	Emergency Medicine (Urgent Care)	0	In state provider	GROUP INC	6260 EL CAMINO REAL	None	CARLSBAD	CA	92009	1609	37	06073	33.12215813	-117.266659	San Diego County
234452	Fee-for-Service	1295814762	1295814762	1	1	TYSON,ELIZABETH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 N MEDICAL DR	None	SALT LAKE CITY	UT	84113	1103	00	None	40.77069459	-111.8370155	Salt Lake County
234471	Fee-for-Service	1497595565	1497595565	1	2	TURIYA ANESTHESIA	5/1/2024	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	1145 REDONDO BEACH BLVD	None	GARDENA	CA	90247	3511	19	06037	33.89242734	-118.2947128	Los Angeles County
234473	Fee-for-Service	1194058255	1194058255	1	1	THAI, HAO N MD	10/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106695	01	General Practice	0	In state provider	None	9191 WESTMINSTER AVE	SUITE 205	GARDEN GROVE	CA	92844	2751	30	06059	33.75946879	-117.9688437	Orange County
234510	Fee-for-Service	1275651515	1275651515	1	1	THE ONCOLOGY INSTITUTE CA, A	2/26/2008	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	11525 BROOKSHIRE AVE	SUITE 202	DOWNEY	CA	90241	4983	19	06037	33.93544635	-118.1318321	Los Angeles County
234513	Fee-for-Service	1548470842	1548470842	1	1	TAMARAPPOO, BALAJI K MD	7/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	104611	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
234516	Fee-for-Service	1104935626	1104935626	1	1	THRIFTY PAYLESS INC	4/1/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID # 6318	3000 S ARCHIBALD AVE	None	ONTARIO	CA	91761	7918	36	06071	34.018713	-117.593658	San Bernardino County
234537	Fee-for-Service	1659502813	1659502813	1	1	TORRES, STEPHEN J MD	2/16/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	158190	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
234558	Fee-for-Service	1932284601	1932284601	1	1	TSO, PATRICK C MD	11/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	83697	18	Ophthalmology	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
234606	Fee-for-Service	1942319397	1942319397	1	1	THRIFTY PAYLESS INC	1/20/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	26 OLD MAMMOTH RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.64571214	-118.9660874	Mono County
234632	Fee-for-Service	1285907188	1285907188	1	1	TRINITY SURGICAL SOLUTIONS,	3/25/2022	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	INC	44815 FIG AVE	100	LANCASTER	CA	93534	3144	19	06037	34.69630244	-118.1431105	Los Angeles County
234655	Fee-for-Service	1467403519	1467403519	1	1	TURULL, DEBRA A DO	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	5980	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1902 ROYALTY DR	STE 240	POMONA	CA	91767	2921	19	06037	34.07791925	-117.746146	Los Angeles County
234675	Fee-for-Service	1891085924	1891085924	1	1	THOMAS, PATRICK G MD	6/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135782	66	Emergency Medicine (Urgent Care)	0	In state provider	None	207 WEST LEGION ROAD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
234715	Fee-for-Service	1629432059	1629432059	1	1	TAN, TING XU MD	7/10/2020	207P00000X	NA	Other	026	PHYSICIANS	168085	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
234718	Fee-for-Service	1609125970	1609125970	1	1	TOLUCA HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4511 DENNY AVENUE	None	NORTH HOLLYWOOD	CA	91602	2347	19	06037	34.15269768	-118.3648245	Los Angeles County
234724	Fee-for-Service	1205868445	1205868445	1	1	TEWARI, KRISHNANSU MD	3/26/1997	207VX0201X	NA	Obstetrics & Gynecology	026	PHYSICIANS	60161	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
234790	Fee-for-Service	1336460914	1336460914	1	1	TRAN, TIMOTHY T MD	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123698	01	General Practice	0	In state provider	None	12302 GARDEN GROVE BLVD	SUITE 7	GARDEN GROVE	CA	92843	1833	30	06059	33.77428392	-117.9181185	Orange County
234832	Fee-for-Service	1710580659	1710580659	1	1	TUANA, MELANIE E NP	6/10/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
234845	Fee-for-Service	1245341882	1245341882	1	1	THORNTON, CAROLINE M MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77270	07	Dermatology	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
234847	Fee-for-Service	1922340579	1922340579	1	1	THOMAS, ANDREW J MD	6/25/2021	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	171386	None	None	0	In state provider	None	123 MARGARET LN	STE C1	GRASS VALLEY	CA	95945	5268	29	06057	39.22839146	-121.0455763	Nevada County
234876	Fee-for-Service	1962663393	1962663393	1	1	TOWN CENTER PLAZA URGENT	4/21/2009	261QU0200X	NA	Other	026	PHYSICIANS	46329	66	Emergency Medicine (Urgent Care)	0	In state provider	None	19015 TOWN CENTER DR	STE 102	APPLE VALLEY	CA	92308	8995	36	06071	34.46573792	-117.2485123	San Bernardino County
234889	Fee-for-Service	1124472568	1124472568	1	1	TSENG, KELLY MD	9/8/2021	207L00000X	NA	Other	026	PHYSICIANS	172216	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
234892	Fee-for-Service	1003964941	1003964941	1	1	THE, MAY L MD	5/6/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	69680	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
234952	Fee-for-Service	1104903038	1104903038	1	1	THANASSI, MARK MD	7/17/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86578	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
234978	Fee-for-Service	1275651515	1275651515	1	57	THE ONCOLOGY INSTITUTE CA, A	9/7/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	INNOVATION	10226 LAKEWOOD BLVD	STE B	DOWNEY	CA	90421	2874	19	06037	33.9465855	-118.1175703	Los Angeles County
235001	Fee-for-Service	1942734538	1942734538	2	1	TAM, ASHLIE DO	12/27/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	18370	40	Pediatrics	0	In state provider	None	117 W BUNNY AVE	None	SANTA MARIA	CA	93458	2805	42	06083	34.96327701	-120.4368111	Santa Barbara County
235006	Fee-for-Service	1609125970	1609125970	1	1	TOLUCA HOSPICE INC	12/2/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4511 DENNY AVENUE	None	NORTH HOLLYWOOD	CA	91602	2347	19	06037	34.15269768	-118.3648245	Los Angeles County
235037	Fee-for-Service	1245266576	1245266576	1	1	TING, GRACE DPM INC	8/1/2002	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	27 W MAIN ST	STE G	ALHAMBRA	CA	91801	3500	19	06037	34.09489351	-118.1274697	Los Angeles County
235049	Fee-for-Service	1013544618	1013544618	1	1	TONG, JUNE MD	3/1/2024	207L00000X	NA	Other	026	PHYSICIANS	185907	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
235112	Fee-for-Service	1073567384	1073567384	1	1	TAYLOR, JAMES W. DO	4/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3100 CHANNING WAY	None	IDAHO FALLS	ID	83403	0000	00	None	43.470198	-111.9901955	Bonneville County
235142	Fee-for-Service	1174677157	1174677157	1	1	TRAN, HANG N MD	3/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106543	40	Pediatrics	0	In state provider	None	3291 LOMA VISTA	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
235179	Fee-for-Service	1932261039	1932261039	1	1	TAHOE FOREST HOSPITAL	6/22/1983	275N00000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4856	29	06057	39.3245308	-120.2013097	Nevada County
235232	Fee-for-Service	1831440809	1831440809	1	1	TORRES, JOE R CNP	5/13/2021	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	801 SANTA FE WAY	None	SHAFTER	CA	93263	3158	15	06029	35.49142021	-119.260004	Kern County
235236	Fee-for-Service	1790010858	1790010858	1	1	TURNER, ANDRES MD	8/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115918	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	RM 4F	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
235270	Fee-for-Service	1275651515	1275651515	1	57	THE ONCOLOGY INSTITUTE CA, A	12/13/2023	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	INNOVATION	10226 LAKEWOOD BLVD	STE B	DOWNEY	CA	90421	2874	19	06037	33.9465855	-118.1175703	Los Angeles County
235286	Fee-for-Service	1174690077	1174690077	1	1	TITTLE, LESLIE A MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	70899	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
235302	Fee-for-Service	1598175655	1598175655	1	1	THOMPSON, JUSTIN M MD	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138995	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	95817	2200	43	06085	37.43721275	-122.1744449	Santa Clara County
235463	Fee-for-Service	1134207921	1134207921	1	1	TSUKAYAMA, TED A MD	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	51428	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
235529	Fee-for-Service	1124066337	1124066337	1	1	TRUJILLO, ANGELINA L MD	11/30/1982	207RE0101X	NA	Endocrinology	026	PHYSICIANS	43857	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
235558	Fee-for-Service	1275651515	1275651515	1	57	THE ONCOLOGY INSTITUTE CA, A	9/7/2023	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INNOVATION	10226 LAKEWOOD BLVD	STE B	DOWNEY	CA	90421	2874	19	06037	33.9465855	-118.1175703	Los Angeles County
235559	Fee-for-Service	1235344086	1235344086	1	2	TAVARUA HEALTH SERVICES	11/6/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	8207 WHITTIER BLVD.	None	PICO RIVERA	CA	90660	2521	19	06037	34.00669483	-118.0961646	Los Angeles County
235598	Fee-for-Service	1851414437	1851414437	1	1	TIMM, ROMY N	6/22/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
235606	Fee-for-Service	1316022155	1316022155	1	1	TIMOTHY FRANTZ MD INC	8/1/1993	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	69967	04	Otology, Laryngology, Rhinology	0	In state provider	None	331 ELM ST	None	RED BLUFF	CA	96080	3402	52	06103	40.17542475	-122.2340147	Tehama County
235673	Fee-for-Service	1649721838	1649721838	1	1	TOMEI, LISA M LMFT	9/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3160 TELEGRAPH RD	STE 200	VENTURA	CA	93003	3250	56	06111	34.27228149	-119.2529119	Ventura County
235683	Fee-for-Service	1750630737	1750630737	1	1	THE WOMENS CENTER AT ST ROSE	8/15/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	HOSPITAL	27225 CALAROGA AVENUE	None	HAYWARD	CA	94545	4338	01	06001	37.63194474	-122.0897225	Alameda County
235713	Fee-for-Service	1295112480	1295112480	1	1	TORRES, SUSANA MD	10/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145115	01	General Practice	0	In state provider	None	3201 DATA DR	None	RANCHO CORDOVA	CA	95670	7374	34	06067	38.58561	-121.2838875	Sacramento County
235727	Fee-for-Service	1104529387	1104529387	1	1	TROJANOWSKI, ALEJANDRA NP	5/3/2024	363L00000X	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
235747	Fee-for-Service	1295218212	1295218212	1	1	TRAN, TRAN T NP	4/16/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
235749	Fee-for-Service	1134207921	1134207921	1	1	TSUKAYAMA, TED A MD	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	51428	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
235771	Fee-for-Service	1720218274	1720218274	1	1	TKACZUK, ROSEANNE PT	10/7/2022	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
235791	Fee-for-Service	1164034260	1164034260	1	1	TIN RX AT THE TOWER INC.	9/18/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1801 COLORADO AVE	STE 300	TURLOCK	CA	95382	2708	50	06099	37.50941613	-120.8353105	Stanislaus County
235814	Fee-for-Service	1538308044	1538308044	1	2	TSAI, GARY MD	2/15/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	113565	-	NOT APPLICABLE	0	In state provider	None	30500 ARRASTRE CANYON RD	None	ACTON	CA	93510	2160	19	06037	34.449291	-118.1973465	Los Angeles County
235820	Fee-for-Service	1720272933	1720272933	1	1	THRIFTY PAYLESS INC.	3/3/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6481	32450 CLINTON KEITH RD	None	WILDOMAR	CA	92595	8662	33	06065	33.58977536	-117.2518923	Riverside County
235848	Fee-for-Service	1710640271	1710640271	1	1	TABRON, HANNA	3/8/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1301 E BIDWELL ST	#101	FOLSOM	CA	95630	3452	34	06067	38.66841	-121.151025	Sacramento County
235860	Fee-for-Service	1124077102	1124077102	1	1	TOMA, LOUAY MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51209	20	Orthopedic Surgery	0	In state provider	None	2700 GRANT ST	STE 309	CONCORD	CA	94520	2267	07	06013	37.98417931	-122.0361585	Contra Costa County
235890	Fee-for-Service	1316022155	1316022155	1	1	TIMOTHY FRANTZ MD INC	8/1/1993	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	69967	66	Emergency Medicine (Urgent Care)	0	In state provider	None	331 ELM ST	None	RED BLUFF	CA	96080	3402	52	06103	40.17542475	-122.2340147	Tehama County
235908	Fee-for-Service	1689625147	1689625147	1	1	THORNTON, BRIAN D MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72684	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
235961	Fee-for-Service	1154708378	1154708378	1	1	TSURUTA, SUSY G MD	9/30/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	162679	40	Pediatrics	0	In state provider	None	1400 E PALOMAR ST	None	CHULA VISTA	CA	91931	1800	37	06073	32.62382113	-116.9960539	San Diego County
235964	Fee-for-Service	1275514986	1275514986	1	1	TAGHIZADEH, BEHZAD MD	6/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56208	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5555 RESERVOIR DR	None	SAN DIEGO	CA	92120	5186	37	06073	32.77628471	-117.0563688	San Diego County
235974	Fee-for-Service	1871777045	1871777045	1	1	TRENTO, LUCA U MD	12/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98754	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
235988	Fee-for-Service	1407439300	1407439300	1	2	TARZANA TREATMENT CENTERS, I	3/1/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC.	7131 RESEDA BLVD.	None	RESEDA	CA	91335	4211	19	06037	34.200207	-118.5360655	Los Angeles County
236017	Fee-for-Service	1174055636	1174055636	1	1	TRINH, ELYSE MD	1/28/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	159067	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
236027	Fee-for-Service	1316357841	1316357841	1	1	TSENG, STEVE K DO	10/14/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	17599	None	None	0	In state provider	None	500 N GARFIELD AVE	STE 204	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
236066	Fee-for-Service	1760610570	1760610570	1	1	TRAN, ANNIE T OD	2/26/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
236076	Fee-for-Service	1275611063	1275611063	1	1	TAHARKA, ANANSE MD	3/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	47378	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1001 POTRERO AVE	# 5H	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
236108	Fee-for-Service	1417316787	1417316787	1	1	TEJANO, MICHAEL J	3/25/2016	No Taxonomy Provided	NA	None	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
236148	Fee-for-Service	1831208354	1831208354	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 5676	69155 RAMON RD	None	CATHEDRAL CITY	CA	92234	3344	33	06065	33.813567	-116.456769	Riverside County
236162	Fee-for-Service	1184733511	1184733511	1	1	THRIFTY PAYLESS INC	4/1/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5807	2501 HIGHWAY 46	None	WASCO	CA	93280	2919	15	06029	35.60150154	-119.3543055	Kern County
236173	Fee-for-Service	1154474971	1154474971	1	1	TREVINO, BRUCE A MD	8/21/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53793	08	Family Practice	0	In state provider	None	1200 SMITH ST	None	KINGSBURG	CA	93631	2216	10	06019	36.51294219	-119.54905	Fresno County
236180	Fee-for-Service	1194024356	1194024356	1	1	TROKE, JOSHUA J MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122731	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
236321	Fee-for-Service	1093167520	1093167520	1	1	TEMPLE, DANIEL E MD	9/13/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	162901	08	Family Practice	0	In state provider	None	1779 DOMINICAN WAY	STE B	SANTA CRUZ	CA	95065	1526	44	06087	36.9902958	-121.9808957	Santa Cruz County
236330	Fee-for-Service	1073614442	1073614442	1	1	THOMPSON,JOHN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3705 5TH AVE	STE 3950	PITTSBURGH	PA	15213	0000	00	None	40.44154544	-79.95885126	Allegheny County
236398	Fee-for-Service	1629256177	1629256177	1	1	TISON, GEOFFREY H MD	4/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119699	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
236414	Fee-for-Service	1639115900	1639115900	1	1	TSAO, BRYAN E MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63192	13	Neurology (M.D. only)	0	In state provider	None	11370 ANDERSON ST	STE 2400	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
236420	Fee-for-Service	1902377591	1902377591	1	1	TOTAL RENAL CARE INC	2/5/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	11859 WILSHIRE BLVD	STE 100	LOS ANGELES	CA	90025	6616	19	06037	34.04718709	-118.463742	Los Angeles County
236437	Fee-for-Service	1952317596	1952317596	1	1	TERRY, DOUGLAS W MD	4/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54504	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	SAN FRANCISCO	CA	95204	6019	39	06077	37.79020958	-122.4240554	San Francisco County
236468	Fee-for-Service	1194744722	1194744722	2	1	TABAS, ERIC MD	10/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	52667	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	490 POST STREET	STE 939	SAN FRANCISCO	CA	94102	1414	38	06075	37.78812774	-122.4096884	San Francisco County
236487	Fee-for-Service	1457807935	1457807935	1	1	TSUI, CHI-HO B MD	9/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144759	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
236516	Fee-for-Service	1801830500	1801830500	1	1	TRIAD OF ALABAMA LLC	2/19/2021	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4370 W MAIN ST	None	DOTHAN	AL	36305	1056	00	None	31.237821	-85.456782	Houston County
236624	Fee-for-Service	1538342357	1538342357	1	1	THERAPEUTIC PAIN MANAGEMENT	7/3/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INC	6929 N WILLOW AVE	# 103	FRESNO	CA	93710	5956	10	06019	36.8372729	-119.7297062	Fresno County
236660	Fee-for-Service	1255331294	1255331294	1	1	TAY, EMERALD S MD	10/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	72223	41	Internal Medicine	0	In state provider	None	828 E VALLEY BLVD	STE C	SAN GABRIEL	CA	91776	4600	19	06037	34.08018612	-118.0895417	Los Angeles County
236677	Fee-for-Service	1548265036	1548265036	1	12	TRUXTUN RADIOLOGY	2/19/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	2000 PHYSICIANS BLVD	None	BAKERSFIELD	CA	93301	1277	15	06029	35.396994	-119.0084938	Kern County
236761	Fee-for-Service	1295897395	1295897395	1	1	TAHOE FOREST HOSPITAL	6/5/1986	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
236773	Fee-for-Service	1639644420	1639644420	1	1	TING, MARIAN LMFT	4/22/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18334 OAK CANYON ROAD	UNIT 312	SANTA CLARITA	CA	91387	6375	19	06037	34.40626008	-118.4567013	Los Angeles County
236776	Fee-for-Service	1336220359	1336220359	1	1	TERAOKA, JEFFREY MD	11/30/1989	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	58917	01	General Practice	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
236802	Fee-for-Service	1801830500	1801830500	1	1	TRIAD OF ALABAMA LLC	2/19/2021	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4370 W MAIN ST	None	DOTHAN	AL	36305	1056	00	None	31.237821	-85.456782	Houston County
236846	Fee-for-Service	1720289200	1720289200	1	1	THOMA DAVID C DO	4/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111120	30	Radiology	0	In state provider	None	400 PARNASSUS AVENUE	BOX 0648	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
236869	Fee-for-Service	1346328127	1346328127	1	1	TAN, CLINSON B MD	6/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	66308	05	Anesthesiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
236897	Fee-for-Service	1285945618	1285945618	1	1	TAILLAC, COSETTE J LCSW	12/11/2015	No Taxonomy Provided	NA	None	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
236927	Fee-for-Service	1326011164	1326011164	1	1	TRIPP, GERALD W MD	5/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2551 W.84TH AVE	None	WESTMINSTER	CO	80031	0000	00	None	39.84905501	-105.0182452	Adams County
236928	Fee-for-Service	1437438538	1437438538	1	1	TANDINGAN, THERESA L NP	8/3/2016	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
236943	Fee-for-Service	1225203862	1225203862	1	1	TURLEY, RICHARD MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114690	84	Surgery-Head and Neck	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
236970	Fee-for-Service	1043852205	1043852205	1	1	TRAN, HELEN	11/30/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	516 E PALMDALE BLVD	None	PALMDALE	CA	93550	4603	19	06037	34.57961309	-118.1198918	Los Angeles County
237007	Fee-for-Service	1548929953	1548929953	1	1	TRACY, RICHARD K CPO	12/14/2021	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	18250 ROSCOE	250	NORTHRIDGE	CA	91325	4226	19	06037	34.22076142	-118.5313223	Los Angeles County
237031	Fee-for-Service	1245369941	1245369941	1	1	TELEGRAPH DERMATOLOGY ME	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	GROUP INC	8337 TELEGRAPH RD	STE 210	PICO RIVERA	CA	90660	4938	19	06037	33.96454327	-118.1134473	Los Angeles County
237037	Fee-for-Service	1073804118	1073804118	1	1	THOMAS, OTTO J MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123150	None	None	0	In state provider	None	726 FOURTH STREET	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
237159	Fee-for-Service	1346328127	1346328127	1	1	TAN, CLINSON B MD	6/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	66308	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
237160	Fee-for-Service	1679087001	1679087001	1	1	TRUSTED QUALITY HOME HEALTH	2/25/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	6742 VAN NUYS BLVD	STE 106	VAN NUYS	CA	91405	4611	19	06037	34.19343344	-118.4487213	Los Angeles County
237183	Fee-for-Service	1972662500	1972662500	1	1	TRYBUS, IWONA A MD	2/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77948	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
237260	Fee-for-Service	1871002576	1871002576	1	1	TANAKA, TRISHA L CCC-SLP	10/10/2019	235Z00000X	NA	Other	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
237290	Fee-for-Service	1497710842	1497710842	1	1	TAGLIERI, JOSETTE R DO	12/31/1987	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	5258	08	Family Practice	0	In state provider	None	18800 MAIN ST	STE 104	HUNTINGTON BEACH	CA	92648	1717	30	06059	33.68890364	-117.9949974	Orange County
237422	Fee-for-Service	1548265036	1548265036	1	14	TRUXTUN RADIOLOGY	2/25/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	815 MARTIN LUTHER KING J	None	BAKERSFIELD	CA	93307	1365	15	06029	35.3655	-118.985202	Kern County
237589	Fee-for-Service	1457316697	1457316697	1	1	TENG, FRANCES Y MD	2/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	73396	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	50 ALESSANDRO PL	STE 440	PASADENA	CA	91105	3146	19	06037	34.13101049	-118.151532	Los Angeles County
237596	Fee-for-Service	1043528383	1043528383	1	2	TERRY, PORSCHE M LCSW	6/9/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ALTH SERVICES	6949 SADDLEBACK PL	None	RANCHO CUCAMONGA	CA	91701	4853	36	06071	34.12877151	-117.6085515	San Bernardino County
237604	Fee-for-Service	1073615126	1073615126	1	1	TRAUTWEIN, ERIC P MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	82126	41	Internal Medicine	0	In state provider	None	515 E MICHELTORENA ST	SUITE C	SANTA BARBARA	CA	93103	2257	42	06083	34.43172339	-119.7024817	Santa Barbara County
237613	Fee-for-Service	1558622878	1558622878	1	1	TURNING POINT ALCOHOL AND	1/3/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	DRUG EDUCATION PROGRAM I	3756 SANTA ROSALIA DR	SUITE C617	LOS ANGELES	CA	90008	3606	19	06037	34.00888336	-118.3389334	Los Angeles County
237624	Fee-for-Service	1881202166	1881202166	1	1	TIANO, DANIEL G PT	7/23/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1495 VICTOR AVE	STE D	REDDING	CA	96003	4093	45	06089	40.586022	-122.338834	Shasta County
237668	Fee-for-Service	1427167832	1427167832	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 5832	2424 SPRING ST	None	PASO ROBLES	CA	93446	1226	40	06079	35.63963756	-120.6924422	San Luis Obispo County
237683	Fee-for-Service	1548639792	1548639792	1	1	TOTAL RENAL CARE INC	2/26/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	8331 BRIMHALL ROAD	STE 902 BLDG 900	BAKERSFIELD	CA	93312	2249	15	06029	35.36631	-119.095938	Kern County
237691	Fee-for-Service	1790195824	1790195824	1	1	TILAN, JUSTIN U MD	7/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130327	20	Orthopedic Surgery	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
237699	Fee-for-Service	1205906229	1205906229	1	13	THE NEPHROLOGY GROUP, INC.	6/9/2020	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	20041 VALLEY BLVD.	UNIT 4	TEHACHAPI	CA	93561	6746	15	06029	35.12453048	-118.487709	Kern County
237747	Fee-for-Service	1275691107	1275691107	1	1	TSENG, JOHN J MD APC	5/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53439	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	736 S GARFIELD AVENUE	SUITE B	ALHAMBRA	CA	91801	4437	19	06037	34.087842	-118.1230415	Los Angeles County
237807	Fee-for-Service	1215014162	1215014162	1	1	TYAN, JEANNE K MD	7/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84153	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
237847	Fee-for-Service	1174677637	1174677637	1	1	TANAKA, KOUICHI R MD	12/31/1995	207RH0003X	NA	Oncology	026	PHYSICIANS	15205	78	Neoplastic Diseases/Oncology	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
237898	Fee-for-Service	1740335199	1740335199	1	1	TRAN, DUC T MD	6/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	55588	41	Internal Medicine	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
237906	Fee-for-Service	1801299292	1801299292	1	1	THOMPSON, KARI LPCC	8/16/2023	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
237918	Fee-for-Service	1831361278	1831361278	1	1	TONG, GARRICK G MD	4/6/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	102192	None	None	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
237977	Fee-for-Service	1487697249	1487697249	1	1	TRIFUNOVIC, BORIS MD	10/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	80384	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
237996	Fee-for-Service	1003042342	1003042342	1	1	TABASSOMI, MOSTAFA MD	11/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106160	41	Internal Medicine	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
238000	Fee-for-Service	1063430338	1063430338	1	1	TENG, EDMOND H MD	6/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81213	79	Neurology-Child	0	In state provider	None	300 MEDICAL PLAZA STE B2	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
238055	Fee-for-Service	1770583999	1770583999	1	1	TRINITAS REGIONAL MEDICAL	8/26/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	225 WILLIAMSON ST	None	ELIZABETH	NJ	07202	9998	00	None	40.65967168	-74.21442364	Union County
238059	Fee-for-Service	1851558514	1851558514	1	1	TSENG, WARREN H MD	8/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	103915	02	General Surgery	0	In state provider	None	4647 ZION AVENUE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
238084	Fee-for-Service	1598859100	1598859100	1	1	TOM H PIATT MD INC	9/2/2005	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	628 LINCOLN CENTER	None	STOCKTON	CA	95207	2640	39	06077	38.01170151	-121.3236614	San Joaquin County
238087	Fee-for-Service	1598836470	1598836470	1	1	THOMPSON, JOSETTE M MD	5/31/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	77901	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
238122	Fee-for-Service	1326436023	1326436023	1	1	THOMAS, ERIKA L LMFT	10/19/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
238137	Fee-for-Service	1174677637	1174677637	1	1	TANAKA, KOUICHI R MD	12/31/1995	207RH0003X	NA	Oncology	026	PHYSICIANS	15205	41	Internal Medicine	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
238426	Fee-for-Service	1174677637	1174677637	1	1	TANAKA, KOUICHI R MD	12/31/1995	207RH0003X	NA	Oncology	026	PHYSICIANS	15205	68	Hematology	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
238434	Fee-for-Service	1518622067	1518622067	1	1	TORRES, TAMI JO D NP	4/11/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11234 ANDERSON ST	STE 6100,6300,7200,7300	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
238444	Fee-for-Service	1942311832	1942311832	1	1	TSIMEREKIS, CHRISTOS MD	2/1/2001	207RE0101X	NA	Endocrinology	026	PHYSICIANS	81141	67	Endocrinology	0	In state provider	None	11100 WARNER AVE	STE 354	FOUNTAIN VALLEY	CA	92708	7513	30	06059	33.716291	-117.9355051	Orange County
238453	Fee-for-Service	1942228739	1942228739	1	1	TSONG, DAVID E MD	9/23/2019	207R00000X	NA	Other	026	PHYSICIANS	24898	41	Internal Medicine	0	In state provider	None	17822 BEACH BLVD	352	HUNTINGTON BEACH	CA	92647	7176	30	06059	33.70331388	-117.9890471	Orange County
238502	Fee-for-Service	1588707194	1588707194	1	1	TSANG, WAYNE K MD	5/31/1994	207R00000X	NA	Other	026	PHYSICIANS	70393	45	Nephrology (Renal-Kidney)	0	In state provider	None	20911 EARL ST	STE 220	TORRANCE	CA	90503	4353	19	06037	33.840459	-118.3580985	Los Angeles County
238520	Fee-for-Service	1245610559	1245610559	1	1	TRAN, PAUL T PT	12/31/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	520 S. VIRGIL AVE	201	LOS ANGELES	CA	90020	1425	19	06037	34.064487	-118.2870305	Los Angeles County
238565	Fee-for-Service	1033519491	1033519491	1	1	THRASHER, SESALI S LCSW	8/14/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
238590	Fee-for-Service	1619950516	1619950516	1	1	TEUBER, SUZANNE S MD	1/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	65699	None	None	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
238591	Fee-for-Service	1063689842	1063689842	1	1	TRINH, KIM MD	5/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108396	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 OLD RIVER RD	None	BAKERSFIELD	CA	93311	9781	15	06029	35.351487	-119.1143025	Kern County
238612	Fee-for-Service	1902378458	1902378458	1	1	THOMAS, LORRAINE J PSYD	10/29/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
238638	Fee-for-Service	1992183008	1992183008	1	1	TYAGI, VINEET MD	6/18/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	166436	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
238644	Fee-for-Service	1073687893	1073687893	1	1	THUMAN, CAROL L NP	8/8/2017	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
238732	Fee-for-Service	1942311832	1942311832	1	1	TSIMEREKIS, CHRISTOS MD	2/1/2001	207RE0101X	NA	Endocrinology	026	PHYSICIANS	81141	41	Internal Medicine	0	In state provider	None	11100 WARNER AVE	STE 354	FOUNTAIN VALLEY	CA	92708	7513	30	06059	33.716291	-117.9355051	Orange County
238742	Fee-for-Service	1063457174	1063457174	1	1	TERNLUND, STEPHEN P	6/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82232	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
238743	Fee-for-Service	1821039678	1821039678	1	1	THE STONEBROOK CONVALESCENT	3/30/2000	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER, INC	4367 CONCORD BLVD	None	CONCORD	CA	94521	1145	07	06013	37.9753587	-121.984754	Contra Costa County
238768	Fee-for-Service	1891854097	1891854097	1	1	THOMSEN, THOMAS N MD	1/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85482	36	Psychiatry	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
238791	Fee-for-Service	1588707194	1588707194	1	1	TSANG, WAYNE K MD	5/31/1994	207R00000X	NA	Other	026	PHYSICIANS	70393	41	Internal Medicine	0	In state provider	None	20911 EARL ST	STE 220	TORRANCE	CA	90503	4353	19	06037	33.840459	-118.3580985	Los Angeles County
238808	Fee-for-Service	1174581458	1174581458	1	1	TARANTINO, SALVATORE MD	3/1/2019	207R00000X	NA	Other	026	PHYSICIANS	41845	41	Internal Medicine	0	In state provider	None	8881 FLETCHER PKWY	STE 102	LA MESA	CA	91942	3129	37	06073	32.78442148	-117.0073814	San Diego County
238853	Fee-for-Service	1073612511	1073612511	1	1	THORNTON, APRIL S LMFT	7/15/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	305 N. HARBOR BLVD.	205	FULLERTON	CA	92832	2833	30	06059	33.872697	-117.924428	Orange County
238855	Fee-for-Service	1770896805	1770896805	1	1	THOMAS, DEBRA A MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104446	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	57	06113	38.746836	-121.250529	Placer County
238861	Fee-for-Service	1174543078	1174543078	1	1	TABBUTT, SARAH MD	10/27/2008	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	73360	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
238863	Fee-for-Service	1548265036	1548265036	1	15	TRUXTUN RADIOLOGY	2/25/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	704 LEBEC ROAD	None	LEBEC	CA	93243	0000	15	06029	34.82081411	-118.8844069	Kern County
238873	Fee-for-Service	1962166199	1962166199	1	1	TRANSITX TECHNOLOGIES INC	1/2/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	17875 VON KARMAN AVE	134	IRVINE	CA	92614	6200	30	06059	33.68548262	-117.8463669	Orange County
238881	Fee-for-Service	1487853693	1487853693	1	1	TIMILSINA, NABIN MD	7/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117412	41	Internal Medicine	0	In state provider	None	300 MEDICAL PLAZA	SUITE 200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
238899	Fee-for-Service	1407932932	1407932932	1	1	TSENG, JAMES W MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64988	05	Anesthesiology	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
238904	Fee-for-Service	1093033672	1093033672	1	1	TODO, TSUYOSHI MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104613	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90098	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
238906	Fee-for-Service	1356891741	1356891741	1	1	TAMBLIN, ROBERT S NP	5/3/2022	364SA2200X	NA	Other	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
238998	Fee-for-Service	1235107566	1235107566	1	5	THE REGENTS OF THE UNIVERSIT	9/14/2018	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2336 SANTA MONICA BLVD	SUITE 304	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
238999	Fee-for-Service	1235107566	1235107566	1	3	THE REGENTS OF THE UNIVERSIT	3/6/2020	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	MEDICINE PROFESS'L GROUP	200 MEDICAL PLAZA #530	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
239041	Fee-for-Service	1700980166	1700980166	1	2	TRAN, ALAN THAI MD INC	11/16/2020	208200000X	NA	General Surgery	026	PHYSICIANS	71031	24	Plastic Surgery	0	In state provider	None	7631 WYOMING STREET	SUITE 206	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
239050	Fee-for-Service	1598859100	1598859100	1	4	TOM H PIATT MD INC	9/22/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1660 W YOSEMITE AVE	#4	MANTECA	CA	95337	5194	39	06077	37.79729955	-121.243644	San Joaquin County
239060	Fee-for-Service	1114211687	1114211687	1	1	TAYLOR, KEVIN W MD	6/16/2021	207R00000X	NA	Other	026	PHYSICIANS	158375	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
239079	Fee-for-Service	1912153396	1912153396	1	1	TRENT, CALEB J MD	7/1/2022	207P00000X	NA	Other	026	PHYSICIANS	175824	None	None	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
239115	Fee-for-Service	1326551003	1326551003	1	1	THEOTOKOS LLC	3/12/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5550 CARMEL MOUNTAIN RD	SUITE 111	SAN DIEGO	CA	92130	4861	37	06073	32.92872573	-117.1973729	San Diego County
239118	Fee-for-Service	1467454819	1467454819	1	1	TALIEH, ARDESHIR A MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	48638	38	Geriatrics	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
239148	Fee-for-Service	1285830141	1285830141	2	1	TOWBIN, ALEXANDER	4/3/2024	2085P0229X	NA	Other	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
239162	Fee-for-Service	1205966421	1205966421	1	1	TANGHAL, SHARON DL LCSW	3/22/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
239186	Fee-for-Service	1902824642	1902824642	1	1	TORRANCE ANESTHESIA	8/31/1989	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
239198	Fee-for-Service	1295799534	1295799534	1	1	TRAN, KINH TU MD	7/30/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	52706	08	Family Practice	0	In state provider	None	15975 HARBOR BLVD	None	FOUNTAIN VALLEY	CA	92708	1303	30	06059	33.73140379	-117.9200162	Orange County
239240	Fee-for-Service	1194794263	1194794263	1	1	TRUONG, TU N MD	2/28/1993	207R00000X	NA	Other	026	PHYSICIANS	50756	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1025 ATLANTIC AVE	None	LONG BEACH	CA	90813	3402	19	06037	33.779403	-118.1850775	Los Angeles County
239241	Fee-for-Service	1508407552	1508407552	1	1	THE LATINO EQUITY ADVOCACY A	10/3/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ND POLICY INSTITUTE, THE	1515 DIVISADERO ST	108	FRESNO	CA	93721	1115	10	06019	36.74364042	-119.7929545	Fresno County
239273	Fee-for-Service	1699713974	1699713974	1	1	TING, JUK DO	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	7323	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 W E ST	None	TEHACHAPI	CA	93561	1607	15	06029	35.13009994	-118.4488237	Kern County
239286	Fee-for-Service	1235107566	1235107566	1	5	THE REGENTS OF THE UNIVERSIT	9/14/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2336 SANTA MONICA BLVD	SUITE 304	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
239290	Fee-for-Service	1235107566	1235107566	1	3	THE REGENTS OF THE UNIVERSIT	6/2/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	MEDICINE PROFESS'L GROUP	200 MEDICAL PLAZA #530	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
239324	Fee-for-Service	1437611589	1437611589	1	1	TAYLOR, COLLEEN	8/10/2023	207P00000X	NA	Other	026	PHYSICIANS	185899	None	None	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
239327	Fee-for-Service	1700980166	1700980166	1	2	TRAN, ALAN THAI MD INC	11/16/2020	208200000X	NA	General Surgery	026	PHYSICIANS	71031	02	General Surgery	0	In state provider	None	7631 WYOMING STREET	SUITE 206	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
239406	Fee-for-Service	1467454819	1467454819	1	1	TALIEH, ARDESHIR A MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	48638	41	Internal Medicine	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
239421	Fee-for-Service	1437356599	1437356599	1	1	TANG, DARLENE A LCSW	5/26/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
239437	Fee-for-Service	1285830141	1285830141	2	1	TOWBIN, ALEXANDER	4/3/2024	2085P0229X	NA	Other	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
239439	Fee-for-Service	1548457278	1548457278	2	1	TEAM MAKENA LLC	3/8/2024	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	130 MCCORMICK AVE	107	COSTA MESA	CA	92626	3316	30	06059	33.68228615	-117.8744936	Orange County
239444	Fee-for-Service	1942206552	1942206552	1	1	TUTHILL, ALAN R DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	10201 MISSION GORGE RD	None	SANTEE	CA	92071	3027	37	06073	32.83844552	-116.9759925	San Diego County
239482	Fee-for-Service	1801097464	1801097464	1	1	TAKAHASHI, KIMBERLY K MD	10/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99410	34	Urology and Urological Surgery	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
239487	Fee-for-Service	1447476312	1447476312	1	1	THOMAS, SEAN R MD INC	2/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	55585 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	2505	36	06071	34.11800429	-116.451382	San Bernardino County
239520	Fee-for-Service	1396894986	1396894986	1	1	TARAU, GABRIELA MD	7/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103329	30	Radiology	0	In state provider	None	1867 E FIR AVE	STE 104	FRESNO	CA	93720	0000	10	06019	36.8391095	-119.7486135	Fresno County
239529	Fee-for-Service	1194794263	1194794263	1	1	TRUONG, TU N MD	2/28/1993	207R00000X	NA	Other	026	PHYSICIANS	50756	41	Internal Medicine	0	In state provider	None	1025 ATLANTIC AVE	None	LONG BEACH	CA	90813	3402	19	06037	33.779403	-118.1850775	Los Angeles County
239541	Fee-for-Service	1467651620	1467651620	1	1	TANG, XUONG K DO	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9919	25	Physical Medicine and Rehabilitation	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
239560	Fee-for-Service	1811183643	1811183643	1	2	TOWNS, MARK F MD	5/19/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	100676	-	NOT APPLICABLE	0	In state provider	None	750 SPAANS DRIVE	SUITES C,D AND F	GALT	CA	95632	8609	34	06067	38.265354	-121.302423	Sacramento County
239574	Fee-for-Service	1093905838	1093905838	1	1	TAO, KEVIN K MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136574	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2540 EAST ST	None	CONCORD	CA	94520	1906	07	06013	37.98292379	-122.0341876	Contra Costa County
239577	Fee-for-Service	1124470448	1124470448	1	1	TANG-WAI, RICHARD	1/9/2018	2084E0001X	NA	Neurology	026	PHYSICIANS	143221	13	Neurology (M.D. only)	0	In state provider	None	25845 BARTON ROAD	SUITE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
239581	Fee-for-Service	1235107566	1235107566	1	3	THE REGENTS OF THE UNIVERSIT	10/11/2018	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICINE PROFESS'L GROUP	200 MEDICAL PLAZA #530	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
239605	Fee-for-Service	1457389207	1457389207	1	2	THOMAS H MURPHY OD INC	1/8/2025	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	262 GIBSON DRIVE	STE 130	ROSEVILLE	CA	95678	5881	31	06061	38.77643086	-121.2742611	Placer County
239612	Fee-for-Service	1093975229	1093975229	1	1	TERREROS, CARMEN	8/2/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	70383	08	Family Practice	0	In state provider	None	801 NORTH TUSTIN AVENUE	SUITE 607	SANTA ANA	CA	92705	3610	30	06059	33.752286	-117.8341735	Orange County
239620	Fee-for-Service	1386134187	1386134187	1	1	TELEMI, EDVIN MD	4/15/2025	207T00000X	NA	General Surgery	026	PHYSICIANS	None	14	Neurological Surgery	0	In state provider	None	300 STEIN PLZ	420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
239701	Fee-for-Service	1255403903	1255403903	1	1	THEIN, TUN MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	53785	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
239716	Fee-for-Service	1063521458	1063521458	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5961	701 E BLITHEDALE AVE	None	MILL VALLEY	CA	94941	1526	21	06041	37.9011934	-122.5257359	Marin County
239755	Fee-for-Service	1326166968	1326166968	1	1	TERRY, BENELIA LMFT	12/26/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6321 QUARTZ PLACE	None	NEWARK	CA	94560	5116	01	06001	37.52168986	-122.0078009	Alameda County
239774	Fee-for-Service	1447476312	1447476312	1	1	THOMAS, SEAN R MD INC	2/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	55585 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	2505	36	06071	34.11800429	-116.451382	San Bernardino County
239807	Fee-for-Service	1407373921	1407373921	1	1	TIBURCIO VASQUEZ HEALTH	10/12/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTEMITTENT	1633 EAST AVE	None	HAYWARD	CA	94541	5314	01	06001	37.67250121	-122.0686664	Alameda County
239813	Fee-for-Service	1437380789	1437380789	1	1	TEBI, SINA MD	11/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115277	67	Endocrinology	0	In state provider	None	23845 MCBEAN PARKWAY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
239867	Fee-for-Service	1124470448	1124470448	1	1	TANG-WAI, RICHARD	1/9/2018	2084E0001X	NA	Neurology	026	PHYSICIANS	143221	79	Neurology-Child	0	In state provider	None	25845 BARTON ROAD	SUITE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
239896	Fee-for-Service	1831154483	1831154483	1	1	TEMPLETON, DEBRA J MD	1/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87723	None	None	0	In state provider	None	2512 SAMARITAN CT	STE K	SAN JOSE	CA	95124	4002	43	06085	37.25087737	-121.9503926	Santa Clara County
239915	Fee-for-Service	1730101528	1730101528	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05794	1809 CECIL AVE	None	DELANO	CA	93215	1519	15	06029	35.77588848	-119.231352	Kern County
239923	Fee-for-Service	1245226786	1245226786	1	1	THAIK, CYNTHIA M MD APMC	4/4/2003	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	82312	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2211 W MAGNOLIA BLVD	STE 140	BURBANK	CA	91506	1763	19	06037	34.1728873	-118.3320905	Los Angeles County
240017	Fee-for-Service	1477786978	1477786978	1	1	TRAN, LINH A LPCC	8/10/2020	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	591 CAMINO DE LA REINA	SUITE 210	SAN DIEGO	CA	92108	3104	37	06073	32.76632791	-117.1616245	San Diego County
240018	Fee-for-Service	1316029192	1316029192	2	1	TOI MANAGEMENT, LLC	2/7/2024	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15262 GOLDENWEST ST	None	WESTMINSTER	CA	92683	6169	30	06059	33.74024479	-118.0069179	Orange County
240067	Fee-for-Service	1447476312	1447476312	1	1	THOMAS, SEAN R MD INC	2/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	55585 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	2505	36	06071	34.11800429	-116.451382	San Bernardino County
240075	Fee-for-Service	1023468220	1023468220	1	1	THORSEN, DEAN DO	2/26/2021	207L00000X	NA	Other	026	PHYSICIANS	17232	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
240097	Fee-for-Service	1407373921	1407373921	1	1	TIBURCIO VASQUEZ HEALTH	10/12/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTEMITTENT	1633 EAST AVE	None	HAYWARD	CA	94541	5314	01	06001	37.67250121	-122.0686664	Alameda County
240103	Fee-for-Service	1437380789	1437380789	1	1	TEBI, SINA MD	11/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115277	41	Internal Medicine	0	In state provider	None	23845 MCBEAN PARKWAY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
240111	Fee-for-Service	1356017172	1356017172	1	1	THIREY, KATHRYN PT	12/20/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	81 CERNON ST.	None	VACAVILLE	CA	95688	2803	48	06095	38.36102104	-121.9906107	Solano County
240127	Fee-for-Service	1508278359	1508278359	1	6	THE ROADS FOUNDATION	3/27/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	16415 COLORADO AVENUE	SUITE 308	PARAMOUNT	CA	90723	5053	19	06037	33.8853075	-118.1614695	Los Angeles County
240155	Fee-for-Service	1407316060	1407316060	1	1	TIAN, YE MD	3/24/2023	208M00000X	NA	Other	026	PHYSICIANS	183759	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
240165	Fee-for-Service	1750490173	1750490173	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5963	910 DIABLO AVE	None	NOVATO	CA	94947	7311	21	06041	38.10411343	-122.5719769	Marin County
240208	Fee-for-Service	1245226786	1245226786	1	1	THAIK, CYNTHIA M MD APMC	4/4/2003	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	82312	41	Internal Medicine	0	In state provider	None	2211 W MAGNOLIA BLVD	STE 140	BURBANK	CA	91506	1763	19	06037	34.1728873	-118.3320905	Los Angeles County
240215	Fee-for-Service	1235166836	1235166836	2	1	THOMAS, EVANGELEA A NP	6/14/2005	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3737 MARTIN LUTHER KING	SUITE B	LYNWOOD	CA	90262	3513	19	06037	33.92872742	-118.2006921	Los Angeles County
240223	Fee-for-Service	1093906976	1093906976	1	1	THANKAVEL, BHARATH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
240229	Fee-for-Service	1245509926	1245509926	1	1	TINDALL, RACHEL P MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142865	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
240247	Fee-for-Service	1255490850	1255490850	1	1	TSE, DAVID G MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	85342	33	Thoracic Surgery	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
240376	Fee-for-Service	1962845321	1962845321	1	1	TANG, JUN MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118520	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
240385	Fee-for-Service	1407373921	1407373921	1	1	TIBURCIO VASQUEZ HEALTH	2/18/2025	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTEMITTENT	1633 EAST AVE	None	HAYWARD	CA	94541	5314	01	06001	37.67250121	-122.0686664	Alameda County
240397	Fee-for-Service	1891912440	1891912440	1	1	TUNE, BRYAN W CRNA	4/23/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
240415	Fee-for-Service	1508278359	1508278359	1	6	THE ROADS FOUNDATION	3/27/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	16415 COLORADO AVENUE	SUITE 308	PARAMOUNT	CA	90723	5053	19	06037	33.8853075	-118.1614695	Los Angeles County
240417	Fee-for-Service	1609943521	1609943521	1	1	TEETEN, STANLEY MD	5/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90083	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
240427	Fee-for-Service	1639273071	1639273071	1	1	THONGSAMOUTH, ORATHAY OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	517 E CAMPBELL AVE	None	CAMPBELL	CA	95008	2101	43	06085	37.28710819	-121.9406194	Santa Clara County
240475	Fee-for-Service	1437471752	1437471752	1	1	TCHAMALA, MADELEINE CRNA	6/4/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
240511	Fee-for-Service	1558578948	1558578948	1	1	TRUONG, KIM P DO	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8106	40	Pediatrics	0	In state provider	ATTN MGA OFFICE	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
240535	Fee-for-Service	1245711373	1245711373	1	1	TLCS INC	2/25/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	3737 MARCONI AVE	None	SACRAMENTO	CA	95821	5303	34	06067	38.618109	-121.3764615	Sacramento County
240545	Fee-for-Service	1275651515	1275651515	1	16	THE ONCOLOGY INSTITUTE CA, A	11/3/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	399 E HIGHLAND AVE	SUITE 501	SAN BERNARDINO	CA	92404	3879	36	06071	34.1358627	-117.2757898	San Bernardino County
240546	Fee-for-Service	1861501272	1861501272	1	1	THRIFTY PAYLESS INC	4/17/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5469	31797 HWY 70 S	None	TEMECULA	CA	92592	0000	33	06065	0	0	None
240601	Fee-for-Service	1013198738	1013198738	1	1	TSELIKIS, SOFIA MD LTD	12/3/2018	193400000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
240677	Fee-for-Service	1598754558	1598754558	1	1	THREASA H FROUGE, MD	12/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9201 W THOMAS RD	None	PHOENIX	AZ	85037	0000	00	None	33.47892	-112.2579	Maricopa County
240687	Fee-for-Service	1528074705	1528074705	1	1	TSAI, WAN C MD	11/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143919	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
240746	Fee-for-Service	1063918696	1063918696	1	1	TSANG, ALEXANDER	10/31/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	164842	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
240763	Fee-for-Service	1295285989	1295285989	1	1	THOMPSON, SADE LMFT	2/3/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5150 CANDLEWOOD ST	STE 18J	LAKEWOOD	CA	90712	1925	19	06037	33.85362254	-118.1326815	Los Angeles County
240769	Fee-for-Service	1003570391	1003570391	1	1	THE JUDAHH PROJECT	11/26/2024	101Y00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	6700 FREEPORT BLVD	STE 107	SACRAMENTO	CA	95822	5926	34	06067	38.505213	-121.5054045	Sacramento County
240792	Fee-for-Service	1457390502	1457390502	1	1	TRUONG, TRANG T MD	6/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77626	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
240798	Fee-for-Service	1659558328	1659558328	1	1	TRUONG, MICHELLE V Y NP	10/24/2016	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
240829	Fee-for-Service	1275651515	1275651515	1	16	THE ONCOLOGY INSTITUTE CA, A	11/3/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	399 E HIGHLAND AVE	SUITE 501	SAN BERNARDINO	CA	92404	3879	36	06071	34.1358627	-117.2757898	San Bernardino County
240860	Fee-for-Service	1265038251	1265038251	1	1	TOTAL RENAL CARE INC	3/7/2022	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1328 COFFEE RD	None	MODESTO	CA	95355	3103	50	06099	37.66269938	-120.9756398	Stanislaus County
240865	Fee-for-Service	1528269081	1528269081	1	1	TABRIZI, HESSAM K MD	9/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101967	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
240886	Fee-for-Service	1154397768	1154397768	1	1	TIEU, KEVIN KHAI T MD	3/3/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	77268	None	None	0	In state provider	None	7631 WYOMING ST	STE 201	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
240898	Fee-for-Service	1588893028	1588893028	1	1	TANG, LAI MING D LCSW	5/18/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
240908	Fee-for-Service	1437626488	1437626488	1	1	THE KHACHATRYAN CORPORATION,	4/1/2020	104100000X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	VICES	591 CAMINO DE LA REINA	SUITE 210	SAN DIEGO	CA	92108	3104	37	06073	32.76632791	-117.1616245	San Diego County
240932	Fee-for-Service	1861413361	1861413361	1	1	THOMASON, CAROL P CNM	5/9/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
240965	Fee-for-Service	1851462055	1851462055	1	1	TSAI, TSUONG WU MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51644	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3581 PALMER DR	STE 202	CAMERON PARK	CA	95682	8237	09	06017	38.66109103	-120.9649544	El Dorado County
240977	Fee-for-Service	1528074705	1528074705	1	1	TSAI, WAN C MD	11/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143919	40	Pediatrics	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
241024	Fee-for-Service	1063404606	1063404606	1	2	THOMAS, WALTER A MD	3/9/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	67913	None	None	0	In state provider	None	258 LOMBARD STREET	SUITE 200	THOUSAND OAKS	CA	91360	5806	56	06111	34.1780735	-118.8720855	Ventura County
241030	Fee-for-Service	1396744066	1396744066	1	1	TAI, KUANGKAI MD	2/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	68063	40	Pediatrics	0	In state provider	None	15725 POMERADO ROAD	#107	POWAY	CA	92064	2435	37	06073	33.00037882	-117.0580735	San Diego County
241032	Fee-for-Service	1679797849	1679797849	1	1	TUPPER, TRACI L MD	6/7/2018	207RE0101X	NA	Endocrinology	026	PHYSICIANS	154752	67	Endocrinology	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
241038	Fee-for-Service	1902212962	1902212962	1	1	TOTAL RENAL CARE INC	11/7/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1221 ROSSMOOR PKWY	None	WALNUT CREEK	CA	94595	2539	07	06013	37.87821508	-122.0707424	Contra Costa County
241090	Fee-for-Service	1528771854	1528771854	1	1	TSIEH, CORINNA NP	3/14/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
241112	Fee-for-Service	1609101542	1609101542	1	1	TANAKA AUDIOLOGY AND HEARING	8/23/2010	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1135 S SUNSET AVE	SUITE 319	WEST COVINA	CA	91790	3938	19	06037	34.06215064	-117.9453997	Los Angeles County
241121	Fee-for-Service	1275651515	1275651515	1	16	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	399 E HIGHLAND AVE	SUITE 501	SAN BERNARDINO	CA	92404	3879	36	06071	34.1358627	-117.2757898	San Bernardino County
241137	Fee-for-Service	1295813186	1295813186	1	1	TARANTINO, CARLO D MD	8/31/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81214	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
241194	Fee-for-Service	1437626488	1437626488	1	1	THE KHACHATRYAN CORPORATION,	4/1/2020	104100000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	VICES	591 CAMINO DE LA REINA	SUITE 210	SAN DIEGO	CA	92108	3104	37	06073	32.76632791	-117.1616245	San Diego County
241218	Fee-for-Service	1760591127	1760591127	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 6032	19205 SONOMA HWY	None	SONOMA	CA	95476	5413	49	06097	38.29925675	-122.4752238	Sonoma County
241226	Fee-for-Service	1225471097	1225471097	1	1	THUMU, SIRISHA MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147279	01	General Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
241234	Fee-for-Service	1437420023	1437420023	1	1	TORRES, CLAUDIA LMFT	6/8/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15336 DEVONSHIRE	UNIT 6	MISSION HILLS	CA	91345	3205	19	06037	34.25726849	-118.4664285	Los Angeles County
241235	Fee-for-Service	1710583752	1710583752	1	1	TRUONG, LYNN	4/29/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	21829	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
241255	Fee-for-Service	1851462055	1851462055	1	1	TSAI, TSUONG WU MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51644	78	Neoplastic Diseases/Oncology	0	In state provider	None	3581 PALMER DR	STE 202	CAMERON PARK	CA	95682	8237	09	06017	38.66109103	-120.9649544	El Dorado County
241337	Fee-for-Service	1699762500	1699762500	1	1	TRIGGS, KEVIN JOSEPH	10/31/1989	174400000X	NA	Other	026	PHYSICIANS	57138	20	Orthopedic Surgery	0	In state provider	SUITE 510	1310 W STEWART DR	None	ORANGE	CA	92868	3854	30	06059	33.78236048	-117.8664975	Orange County
241360	Fee-for-Service	1992870299	1992870299	1	1	TARIQ, SHABANA MD	11/3/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88352	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
241374	Fee-for-Service	1386658482	1386658482	1	1	TWITCHELL, GEOFFREY R PHD	2/3/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
241388	Fee-for-Service	1174622708	1174622708	1	1	TUCKER, WILLIAM N MD	9/13/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54696	None	None	0	In state provider	None	404 AUBURN FOLSOM RD	None	AUBURN	CA	95603	5515	31	06061	38.88979813	-121.0768498	Placer County
241410	Fee-for-Service	1275651515	1275651515	1	16	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	399 E HIGHLAND AVE	SUITE 501	SAN BERNARDINO	CA	92404	3879	36	06071	34.1358627	-117.2757898	San Bernardino County
241415	Fee-for-Service	1396821815	1396821815	1	1	TAN, KENNETH C MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70510	40	Pediatrics	0	In state provider	None	245 TERRACINA BLVD	STE 207A	REDLANDS	CA	92373	4869	36	06071	34.03858912	-117.2066515	San Bernardino County
241436	Fee-for-Service	1841366416	1841366416	1	1	TANG, PAULETTE C Y PHD	8/2/2005	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
241456	Fee-for-Service	1215489059	1215489059	1	1	TOLEIKIS, JENNIFER PSYD	5/11/2023	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
241466	Fee-for-Service	1174143473	1174143473	1	2	TRUSTED ANESTHESIA PARTNERS,	2/24/2022	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC.	1145 WEST REDONDO BEACH	None	GARDENA	CA	90247	3511	19	06037	33.89242734	-118.2947128	Los Angeles County
241480	Fee-for-Service	1477662526	1477662526	1	1	TCHEN, CHRISTINA MD	10/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86104	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
241484	Fee-for-Service	1437626488	1437626488	1	1	THE KHACHATRYAN CORPORATION,	4/1/2020	104100000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	VICES	591 CAMINO DE LA REINA	SUITE 210	SAN DIEGO	CA	92108	3104	37	06073	32.76632791	-117.1616245	San Diego County
241512	Fee-for-Service	1366811101	1366811101	1	1	THORDARSON, MICAELA A PHD	11/21/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	STE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
241541	Fee-for-Service	1851462055	1851462055	1	1	TSAI, TSUONG WU MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51644	68	Hematology	0	In state provider	None	3581 PALMER DR	STE 202	CAMERON PARK	CA	95682	8237	09	06017	38.66109103	-120.9649544	El Dorado County
241574	Fee-for-Service	1275651515	1275651515	1	6	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	1510 S CENTRAL AVE	SUITE 240	GLENDALE	CA	91204	2570	19	06037	34.12709764	-118.2577911	Los Angeles County
241612	Fee-for-Service	1609808187	1609808187	1	1	TAFARA, FACIKA MD	10/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79253	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
241642	Fee-for-Service	1265443691	1265443691	1	1	THRIFTY PAYLESS	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5747	1016 BAYSIDE DR	None	NEWPORT BEACH	CA	92660	7462	30	06059	33.61074567	-117.8918963	Orange County
241685	Fee-for-Service	1649296641	1649296641	1	1	TONG, KAREN A MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	71966	30	Radiology	0	In state provider	None	25455 BARTON RD	STE 107B	LOMA LINDA	CA	92354	3139	36	06071	34.04805253	-117.249534	San Bernardino County
241707	Fee-for-Service	1447515713	1447515713	1	1	TANG, MARIA L CRNA	5/9/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	5893 COPLEY DR	None	SAN DIEGO	CA	92111	7906	37	06073	32.84332697	-117.1728709	San Diego County
241729	Fee-for-Service	1467528075	1467528075	1	1	TOLUIE, KAMRAN MD INC	8/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	54366	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	465 N ROXBURY DR	STE 811	BEVERLY HILLS	CA	90210	4211	19	06037	34.06832918	-118.4072114	Los Angeles County
241735	Fee-for-Service	1043370505	1043370505	1	1	TSANG, VICTOR W MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11708	02	General Surgery	0	In state provider	A PROFESSIONAL CORP	2395 MONTPELIER DR	STE 5	SAN JOSE	CA	95116	1619	43	06085	37.36538903	-121.8473325	Santa Clara County
241762	Fee-for-Service	1770899395	1770899395	1	1	TAN, MARILYN J MD	10/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113366	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
241765	Fee-for-Service	1023307766	1023307766	1	1	THIEM, TRACY D PHD	6/16/2015	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
241766	Fee-for-Service	1023617248	1023617248	1	1	TIMBANG, MARIELLA YSOBEL R O	7/9/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	T	41769 ENTERPRISE CIR N	STE 104	TEMECULA	CA	92590	5626	33	06065	33.51823541	-117.1701538	Riverside County
241796	Fee-for-Service	1407857147	1407857147	1	1	TOKATLIAN, EDWARD O. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4530 E MUIRWOOD DR	STE 105	PHOENIX	AZ	85048	7693	00	None	33.303006	-111.9855375	Maricopa County
241849	Fee-for-Service	1326001835	1326001835	1	1	TORTORELLI, CYNTHIA L MD	12/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151623	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
241851	Fee-for-Service	1063521425	1063521425	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05569	13333 RIVERSIDE DR	None	SHERMAN OAKS	CA	91423	2508	19	06037	34.1576395	-118.4235165	Los Angeles County
241865	Fee-for-Service	1275651515	1275651515	1	6	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	1510 S CENTRAL AVE	SUITE 240	GLENDALE	CA	91204	2570	19	06037	34.12709764	-118.2577911	Los Angeles County
241867	Fee-for-Service	1972580967	1972580967	1	1	TRAKHTENBROIT, ANATOLE D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4411 MEDICAL DR	STE 300	SAN ANTONIO	TX	78229	3824	00	None	29.51000304	-98.57210273	Bexar County
241871	Fee-for-Service	1912070897	1912070897	1	1	TRAN, LOC H MD	5/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85192	05	Anesthesiology	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
241907	Fee-for-Service	1366567968	1366567968	1	1	TORIAN, TYRA C LCSW	1/8/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ERVICES	13666 HAWTHORNE BLVD	SUITE #3	HAWTHORNE	CA	90250	5815	19	06037	33.907761	-118.3523925	Los Angeles County
241909	Fee-for-Service	1922031541	1922031541	1	1	TEXAS HEALTH HARRIS METHODIS	1/8/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL STEPHENVILLE	411 N BELKNAP	None	STEPHENVILLE	TX	76401	3415	00	None	32.22264673	-98.20448297	Erath County
241915	Fee-for-Service	1669530721	1669530721	1	1	TIJERINA, AIMEE J	2/20/2009	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	755 N PEACH AVE	STE G14	CLOVIS	CA	93611	7264	10	06019	36.843633	-119.7201405	Fresno County
241977	Fee-for-Service	1275651515	1275651515	1	59	THE ONCOLOGY INSTITUTE CA, A	9/15/2023	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INNOVATION	15980 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	9587	36	06071	34.47094004	-117.3147508	San Bernardino County
241982	Fee-for-Service	1962488007	1962488007	1	3	TERI INC	3/12/1993	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CARLO HOUSE	411 CARLO ST	None	SAN MARCOS	CA	92078	2331	37	06073	33.14909779	-117.2047481	San Diego County
241991	Fee-for-Service	1316009285	1316009285	1	1	TORO, ELIZABETH A MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	57660	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2329 OAK PARK LN	None	SANTA BARBARA	CA	93105	4280	42	06083	34.4291325	-119.7252464	Santa Barbara County
241992	Fee-for-Service	1558339077	1558339077	1	1	TAKEDA, NORMAN L OD	10/17/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1325 FLORIN RD	None	SACRAMENTO	CA	95831	3618	34	06067	38.496519	-121.508856	Sacramento County
242018	Fee-for-Service	1467528075	1467528075	1	1	TOLUIE, KAMRAN MD INC	8/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	54366	41	Internal Medicine	0	In state provider	None	465 N ROXBURY DR	STE 811	BEVERLY HILLS	CA	90210	4211	19	06037	34.06832918	-118.4072114	Los Angeles County
242026	Fee-for-Service	1073862611	1073862611	1	1	TOWNSON, RYANN LMFT	10/14/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3575 PERSHING AVE	None	SAN DIEGO	CA	92104	3413	37	06073	32.74353067	-117.1346152	San Diego County
242036	Fee-for-Service	1609985159	1609985159	1	1	THRIFTY PAYLESS, INC	4/19/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	650 MANGROVE AVE	None	CHICO	CA	95926	3947	04	06007	39.73488678	-121.8356242	Butte County
242044	Fee-for-Service	1568481554	1568481554	1	1	TONG, SHUMEI MD	3/31/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71230	40	Pediatrics	0	In state provider	None	149 W HOBSONWAY	None	BLYTHE	CA	92225	1616	33	06065	33.61044152	-114.597882	Riverside County
242097	Fee-for-Service	1629240577	1629240577	1	1	THC- ORANGE COUNTY LLC	9/19/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	875 N BREA BLVD	None	BREA	CA	92821	2606	30	06059	33.93434103	-117.8932895	Orange County
242108	Fee-for-Service	1487866315	1487866315	1	1	THE CHARLOTTE-MECKLENBURG HO	9/19/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	920 CHURCH ST N	None	CONCORD	NC	28025	2927	00	None	35.435556	-80.603055	Cabarrus County
242112	Fee-for-Service	1326563495	1326563495	1	1	TOPPEN, LAURA R NP	5/17/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
242151	Fee-for-Service	1275651515	1275651515	1	6	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PROFESSIONAL CORPORATION	1510 S CENTRAL AVE	SUITE 240	GLENDALE	CA	91204	2570	19	06037	34.12709764	-118.2577911	Los Angeles County
242155	Fee-for-Service	1134207939	1134207939	1	1	TATAPUDY, MEERA	5/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	48571	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
242157	Fee-for-Service	1194151639	1194151639	1	1	TORRECILLAS, JESSICA R PSYD	5/16/2020	390200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
242191	Fee-for-Service	1902860414	1902860414	1	1	TORRANCE SURGERY CENTER LP	2/1/2009	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	23560 CRENSHAW BLVD	SUITE 104	TORRANCE	CA	90505	5233	19	06037	33.811677	-118.328042	Los Angeles County
242199	Fee-for-Service	1922031541	1922031541	1	1	TEXAS HEALTH HARRIS METHODIS	1/8/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL STEPHENVILLE	411 N BELKNAP	None	STEPHENVILLE	TX	76401	3415	00	None	32.22264673	-98.20448297	Erath County
242217	Fee-for-Service	1093824179	1093824179	1	1	THOMAS H MATSKO	8/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2800 11TH AVE S	STE 18	GREAT FALLS	MT	59405	5263	00	None	47.492307	-111.258567	Cascade County
242258	Fee-for-Service	1568466589	1568466589	1	1	THREATT, CHRIS B MD	5/8/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79072	34	Urology and Urological Surgery	0	In state provider	None	1541 FLORIDA AVE	STE 306	MODESTO	CA	95350	4439	50	06099	37.666863	-120.9962775	Stanislaus County
242265	Fee-for-Service	1275651515	1275651515	1	59	THE ONCOLOGY INSTITUTE CA, A	9/15/2023	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INNOVATION	15980 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	9587	36	06071	34.47094004	-117.3147508	San Bernardino County
242319	Fee-for-Service	1366465734	1366465734	1	1	TYRE, NANCY MD	11/16/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	56060	08	Family Practice	0	In state provider	None	1414 S GRAND AVE	FL 2	LOS ANGELES	CA	90015	3067	19	06037	34.03661142	-118.2657227	Los Angeles County
242356	Fee-for-Service	1891830105	1891830105	1	1	TOPKIS, JEFFREY DO INC	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	4423	05	Anesthesiology	0	In state provider	None	631 HOSPITAL RD	STE 124	NEWPORT BEACH	CA	92663	3521	30	06059	33.62575121	-117.9304464	Orange County
242383	Fee-for-Service	1447367636	1447367636	1	1	TAIT, DOUGLAS B MD	11/30/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	17374	30	Radiology	0	In state provider	None	342 BONNIE CIR	STE C	CORONA	CA	92880	6974	33	06065	33.8850664	-117.6101862	Riverside County
242399	Fee-for-Service	1487866315	1487866315	1	1	THE CHARLOTTE-MECKLENBURG HO	9/19/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	920 CHURCH ST N	None	CONCORD	NC	28025	2927	00	None	35.435556	-80.603055	Cabarrus County
242418	Fee-for-Service	1396747721	1396747721	1	1	TAN, STANLEY A MD	8/7/2024	207RE0101X	NA	Endocrinology	026	PHYSICIANS	23082	41	Internal Medicine	0	In state provider	None	20642 JOHN DR	None	CASTRO VALLEY	CA	94546	5103	01	06001	37.69270814	-122.090934	Alameda County
242440	Fee-for-Service	1275651515	1275651515	1	6	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PROFESSIONAL CORPORATION	1510 S CENTRAL AVE	SUITE 240	GLENDALE	CA	91204	2570	19	06037	34.12709764	-118.2577911	Los Angeles County
242507	Fee-for-Service	1447593033	1447593033	1	1	TOROSSIAN, MARIAM MD	8/1/2019	207RP1001X	NA	Pulmonology	026	PHYSICIANS	133961	None	None	0	In state provider	None	201 S BUENA VISTA ST	STE 440	BURBANK	CA	91505	4577	19	06037	34.15978726	-118.3289164	Los Angeles County
242549	Fee-for-Service	1780077727	1780077727	1	1	TRINITY HOME HEALTH INC	3/26/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14549 ARCHWOOD ST	SUITE 320	VAN NUYS	CA	91405	4633	19	06037	34.19296379	-118.4505327	Los Angeles County
242550	Fee-for-Service	1679757124	1679757124	1	1	THOMAS, DESLIN MD	9/15/2010	390200000X	NA	Other	026	PHYSICIANS	110241	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
242566	Fee-for-Service	1982182903	1982182903	1	1	THERAPY IN A BAG, LICENSED C	5/9/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LINICAL SOCIAL WORKER, I	4164 BROCKTON AVE	None	RIVERSIDE	CA	92501	3400	33	06065	33.98077024	-117.3813862	Riverside County
242579	Fee-for-Service	1730467457	1730467457	1	1	TENDULKAR, NIKHIL MD	10/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	123149	None	None	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
242599	Fee-for-Service	1538278965	1538278965	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05642	1363 E VISTA WAY	None	VISTA	CA	92084	4041	37	06073	33.2193499	-117.226052	San Diego County
242678	Fee-for-Service	1366552044	1366552044	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11961 VALLEY VIEW ST	None	GARDEN GROVE	CA	92845	1238	30	06059	33.7887573	-118.0286384	Orange County
242708	Fee-for-Service	1396747721	1396747721	1	1	TAN, STANLEY A MD	8/7/2024	207RE0101X	NA	Endocrinology	026	PHYSICIANS	23082	67	Endocrinology	0	In state provider	None	20642 JOHN DR	None	CASTRO VALLEY	CA	94546	5103	01	06001	37.69270814	-122.090934	Alameda County
242713	Fee-for-Service	1669794012	1669794012	1	1	THAI, LINDA MD	3/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111102	01	General Practice	0	In state provider	None	1514 VALLEY VISTA DR	None	DIAMOND BAR	CA	91765	3929	19	06037	33.99491668	-117.8399137	Los Angeles County
242727	Fee-for-Service	1275651515	1275651515	1	6	THE ONCOLOGY INSTITUTE CA, A	12/31/2012	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PROFESSIONAL CORPORATION	1510 S CENTRAL AVE	SUITE 240	GLENDALE	CA	91204	2570	19	06037	34.12709764	-118.2577911	Los Angeles County
242753	Fee-for-Service	1144364233	1144364233	1	1	TOMPKINS, LUCY MD	10/31/1983	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	51887	77	Infectious Disease	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
242766	Fee-for-Service	1922582972	1922582972	1	1	THRIVE HOME HEALTH AGENCY	2/17/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9060 WALKER STREET	None	CYPRESS	CA	90630	3160	30	06059	33.830577	-118.0369735	Orange County
242796	Fee-for-Service	1518586171	1518586171	1	1	TACON, PHILLIP R MD	6/14/2023	207R00000X	NA	Other	026	PHYSICIANS	185471	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
242797	Fee-for-Service	1932218351	1932218351	1	1	THRIFTY PAYLESS INC	2/15/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3860 SEPULVEDA BLVD	None	TORRANCE	CA	90505	2408	19	06037	33.82572558	-118.3537355	Los Angeles County
242842	Fee-for-Service	1932603289	1932603289	1	1	TISE, CHRISTINA G MD	7/11/2022	207SG0201X	NA	Other	026	PHYSICIANS	165301	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
242879	Fee-for-Service	1750480158	1750480158	1	1	TON, HOANG TICH MD	6/1/1983	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	39237	08	Family Practice	0	In state provider	None	642 N BROADWAY	STE 2	LOS ANGELES	CA	90012	2838	19	06037	34.05972766	-118.2396237	Los Angeles County
242896	Fee-for-Service	1609011782	1609011782	1	1	TAYLOR, SHARON G MD	7/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101861	40	Pediatrics	0	In state provider	None	3605 ALAMO STREET	SUITE 100	SIMI VALLEY	CA	93063	2186	56	06111	34.28647147	-118.726119	Ventura County
242928	Fee-for-Service	1730612680	1730612680	1	1	TAN, TONG-SHUAN A DO	11/14/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16819	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
242935	Fee-for-Service	1457460883	1457460883	1	1	THRIFTY PAYLESS INC	6/18/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	24991 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	5708	33	06065	33.91719647	-117.226989	Riverside County
242966	Fee-for-Service	1235472663	1235472663	1	1	TAO, AMY R MD	11/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134637	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
242994	Fee-for-Service	1093555351	1093555351	1	1	TORAL, CESAR A PT	8/22/2024	225100000X	NA	Physical Therapist	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
243040	Fee-for-Service	1144364233	1144364233	1	1	TOMPKINS, LUCY MD	10/31/1983	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	51887	01	General Practice	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
243056	Fee-for-Service	1962488007	1962488007	1	10	TERI INC	7/6/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	4602 ALLENDE AVE	None	OCEANSIDE	CA	92057	6146	37	06073	33.2383561	-117.306541	San Diego County
243095	Fee-for-Service	1487972162	1487972162	1	1	TABIBZADEH, JENNIFER	9/23/2011	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIST APC	1150 BROADWAY	None	CHULA VISTA	CA	91911	2707	37	06073	32.60682	-117.0830115	San Diego County
243102	Fee-for-Service	1306342860	1306342860	1	1	TIRPAK, ELIZABETH T NP	12/18/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
243107	Fee-for-Service	1558957191	1558957191	1	1	THERALINK TECHNOLOGIES, INC.	12/8/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	15000 WEST 6TH AVENUE	SUITE 400	GOLDEN	CO	80401	5047	00	None	39.72355763	-105.1661413	Jefferson County
243118	Fee-for-Service	1558469643	1558469643	1	1	TRUTA, BRINDUSA MD	9/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93496	None	None	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
243146	Fee-for-Service	1619395134	1619395134	1	1	TIEN, CONNIE MD	10/23/2017	207R00000X	NA	Other	026	PHYSICIANS	141062	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
243170	Fee-for-Service	1992866628	1992866628	1	1	TEJADA, VICKY A LCSW	3/7/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	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
243189	Fee-for-Service	1346706264	1346706264	1	1	TROTTA, CHELSEA CRNA	6/2/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
243218	Fee-for-Service	1932144326	1932144326	1	1	TSENG, LILI A MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104379	18	Ophthalmology	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
243223	Fee-for-Service	1538673124	1538673124	1	1	TABAREZ, MATTHEW J	1/2/2019	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	41	Internal Medicine	0	In state provider	None	14221 EUCLID ST	STE F	GARDEN GROVE	CA	92843	4991	30	06059	33.757191	-117.937638	Orange County
243267	Fee-for-Service	1003845785	1003845785	1	1	TONTONOZ, PETER J MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65732	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
243284	Fee-for-Service	1992084776	1992084776	1	1	TRILLIUM MED SPA, COSMETIC	4/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103922	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	SURGERY & LASER CENTER	32144 AGOURA RD	STE 207	WESTLAKE VILLAGE	CA	91361	4052	19	06037	34.14848408	-118.8208595	Los Angeles County
243298	Fee-for-Service	1700315264	1700315264	1	1	THOMPSON, COLE P MD	6/15/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176786	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
243316	Fee-for-Service	1386650745	1386650745	1	1	TREVINO, CHRIS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3223 8TH ST	None	METAIRIE	LA	70002	1623	00	None	30.01636823	-90.15581839	Jefferson Parish
243322	Fee-for-Service	1477084010	1477084010	1	1	THAKKAR, ANJALI MD	6/24/2020	208M00000X	NA	Other	026	PHYSICIANS	161363	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
243329	Fee-for-Service	1780211995	1780211995	1	1	TALWAR, JUSTIN S MD	6/16/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
243353	Fee-for-Service	1356755896	1356755896	1	1	TORAL, ADARE T LPCC	8/24/2022	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1119 PALM ST	E	SAN LUIS OBISPO	CA	93401	3113	40	06079	35.2837298	-120.6603583	San Luis Obispo County
243397	Fee-for-Service	1326041658	1326041658	1	1	TRINH, HUY MD	6/9/2004	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	61514	None	None	0	In state provider	None	2340 MONTPELIER DR	STE A	SAN JOSE	CA	95116	1622	43	06085	37.36500087	-121.8478263	Santa Clara County
243432	Fee-for-Service	1730610031	1730610031	1	1	TUCKER, MELANIE D LMFT	9/16/2022	174400000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	136 N 3RD ST	None	LOMPOC	CA	93436	7002	42	06083	34.64013944	-120.4451768	Santa Barbara County
243438	Fee-for-Service	1174054035	1174054035	1	1	TRIVEDI, AKASH A MD	10/18/2022	390200000X	NA	Other	026	PHYSICIANS	177547	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
243462	Fee-for-Service	1326089277	1326089277	1	1	TERAN, LUCERNO S MD	11/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88879	None	None	0	In state provider	None	1627 E ANAHEIM ST	None	LONG BEACH	CA	90813	3809	19	06037	33.78263549	-118.171296	Los Angeles County
243545	Fee-for-Service	1023016375	1023016375	1	1	TRAN, VIHN T MD	3/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	62255	18	Ophthalmology	0	In state provider	RETINA CONSULTANTS OF LA	850 S ATLANTIC BLVD	# 360	MONTEREY PARK	CA	91754	4730	19	06037	34.05097684	-118.1379979	Los Angeles County
243548	Fee-for-Service	1528597424	1528597424	1	1	THIAGARAJAN, KARTHY MD	11/3/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169709	None	None	0	In state provider	None	7005 MILBURN AVE	101	FRESNO	CA	93722	2161	10	06019	36.83744262	-119.8791265	Fresno County
243600	Fee-for-Service	1134732522	1134732522	1	1	TORRES, JOANN PT	2/15/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
243603	Fee-for-Service	1356599039	1356599039	1	1	TUCKER, CATHERINE C LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
243609	Fee-for-Service	1316934144	1316934144	1	1	TLC EMERGENCY SERVICES INC	6/4/2014	3416L0300X	NA	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	2	Out of state provider	None	638 BURNET AVENUE	None	SYRACUSE	NY	13203	2404	00	None	43.051968	-76.134618	Onondaga County
243658	Fee-for-Service	1245569821	1245569821	1	1	TOTAL RENAL CARE INC	4/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2705 LOMA VISTA RD	STE 101	VENTURA	CA	93003	1596	56	06111	34.27504051	-119.2600018	Ventura County
243755	Fee-for-Service	1326697004	1326697004	1	1	TAVAKOLY, DEANNA LMFT	10/24/2022	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
243780	Fee-for-Service	1073534400	1073534400	1	1	TELLEZ, WILLIAM MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	38107	05	Anesthesiology	0	In state provider	None	11999 SAN VICENTE BLVD	STE 440	LOS ANGELES	CA	90049	5042	19	06037	34.05233327	-118.4727195	Los Angeles County
243782	Fee-for-Service	1689203143	1689203143	1	1	TAGUMA, KRISTIE MD	1/13/2024	390200000X	NA	Other	026	PHYSICIANS	189423	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
243819	Fee-for-Service	1902808744	1902808744	1	1	THE FELLOWSHIP CENTER , INC	10/24/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	L SERVICES PROGRAM INC.	737 E GRAND AVE, 745 E G	None	ESCONDIDO	CA	92025	4404	37	06073	33.12514674	-117.0720868	San Diego County
243824	Fee-for-Service	1619344918	1619344918	1	1	TSANG, DARWIN C OD	9/16/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1225 N MCDOWELL BLVD	None	PETALUMA	CA	94954	1112	49	06097	38.2702492	-122.6613983	Sonoma County
243825	Fee-for-Service	1962462226	1962462226	1	1	TIFT REGIONAL MEDICAL CENTER	3/4/2017	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	901 18TH STREET E	None	TIFTON	GA	31794	3699	00	None	31.47048433	-83.49170027	Tift County
243830	Fee-for-Service	1891715033	1891715033	1	1	TAN, STEVEN MD	2/16/2024	207R00000X	NA	Other	026	PHYSICIANS	67912	None	None	0	In state provider	None	1000 VETERAN AVE	RM 2226	LOS ANGELES	CA	90024	2704	19	06037	34.0605595	-118.4499527	Los Angeles County
243834	Fee-for-Service	1487906871	1487906871	1	1	THE STEPHOUSE RECOVERY, INC.	5/24/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	10529 SLATER AVE	10505,10507,10537	FOUNTAIN VALLEY	CA	92708	4841	30	06059	33.70910384	-117.944985	Orange County
243838	Fee-for-Service	1174558480	1174558480	1	1	TINA SCHNAPPER MD	2/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	590 COUNTRY CLUB PKWY	STE B	EUGENE	OR	97401	6025	00	None	44.06393879	-123.0919866	Lane County
243879	Fee-for-Service	1124542261	1124542261	1	1	TIET, DESIREE M LCSW	5/23/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
243888	Fee-for-Service	1053513788	1053513788	1	1	TAGANAS, ALMA E	7/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94974	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
243890	Fee-for-Service	1124724133	1124724133	1	1	TRAN, KENNETT NP	12/19/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
243892	Fee-for-Service	1518429315	1518429315	1	1	THURSTON, JACOB MD	7/24/2024	390200000X	NA	Other	026	PHYSICIANS	None	04	Otology, Laryngology, Rhinology	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
243904	Fee-for-Service	1740410307	1740410307	1	1	THAMSOPIT, DENA OD	12/30/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 PALMDALE RD	UNIT B10	ADELANTO	CA	92301	6709	36	06071	34.50671749	-117.4015485	San Bernardino County
243931	Fee-for-Service	1275651515	1275651515	1	48	THE ONCOLOGY INSTITUTE CA, A	6/9/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1411 S. GARFIELD AVE	304, 306, AND 308	ALHAMBRA	CA	91801	5022	19	06037	34.07787	-118.1230385	Los Angeles County
243939	Fee-for-Service	1972612380	1972612380	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 6007	3142 G ST	None	MERCED	CA	95340	1368	24	06047	37.319373	-120.469211	Merced County
243949	Fee-for-Service	1427014588	1427014588	1	1	TURK, SYLVIA F LMFT	9/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
243975	Fee-for-Service	1164697769	1164697769	1	1	TALERICO, LISA PHD	6/2/2008	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
243979	Fee-for-Service	1326183641	1326183641	1	1	TANG, JESSICA Y MFT	10/24/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	48377	-	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
243996	Fee-for-Service	1265675615	1265675615	1	1	TABIB, RAMONA MD	12/3/2010	207U00000X	NA	Other	026	PHYSICIANS	104733	42	Nuclear Medicine	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
244050	Fee-for-Service	1518178904	1518178904	2	1	TUPAZ HOMES LLC	6/6/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2893 ROSS AVE	None	SAN JOSE	CA	95124	1848	43	06085	37.2686351	-121.9201245	Santa Clara County
244066	Fee-for-Service	1861993412	1861993412	1	1	TRETIAK, DMITRIY A NP	6/29/2018	193400000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
244102	Fee-for-Service	1700362571	1700362571	1	1	TRUONG, JENNY T OD	1/31/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	77 CADILLAC DRIVE	SUITE 240	SACRAMENTO	CA	95825	8363	34	06067	38.572551	-121.4181585	Sacramento County
244114	Fee-for-Service	1962462226	1962462226	1	1	TIFT REGIONAL MEDICAL CENTER	3/4/2017	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	901 18TH STREET E	None	TIFTON	GA	31794	3699	00	None	31.47048433	-83.49170027	Tift County
244138	Fee-for-Service	1588893580	1588893580	1	1	TRILESSKAYA, MARINA MD	3/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	103051	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
244172	Fee-for-Service	1124439047	1124439047	1	1	TRIEU, ERIC Q MD	8/22/2019	207RH0002X	NA	Adult Primary Care	026	PHYSICIANS	139229	41	Internal Medicine	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
244211	Fee-for-Service	1346533536	1346533536	1	1	TORELI, ALEKSANDRE	6/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 OCEAN PARKWAY	None	BROOKLYN	NY	11235	7745	00	None	40.586031	-73.9657305	Kings County
244213	Fee-for-Service	1508278359	1508278359	1	5	THE ROADS FOUNDATION	1/3/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	4525 ATHERTON ST	SECOND FLOOR	LONG BEACH	CA	90815	3700	19	06037	33.78988246	-118.1397653	Los Angeles County
244219	Fee-for-Service	1275651515	1275651515	1	48	THE ONCOLOGY INSTITUTE CA, A	12/2/2022	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1411 S. GARFIELD AVE	304, 306, AND 308	ALHAMBRA	CA	91801	5022	19	06037	34.07787	-118.1230385	Los Angeles County
244232	Fee-for-Service	1518545946	1518545946	1	1	TRINH, BRIAN DO	8/30/2024	207R00000X	NA	Other	026	PHYSICIANS	21497	41	Internal Medicine	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
244260	Fee-for-Service	1790841948	1790841948	1	1	TORTORICE, FRANK MD	10/1/1998	207R00000X	NA	Other	026	PHYSICIANS	54494	01	General Practice	0	In state provider	None	1800 SULLIVAN AVE	RM 302	DALY CITY	CA	94015	2223	41	06081	37.68077723	-122.4728941	San Mateo County
244262	Fee-for-Service	1194425686	1194425686	1	1	TUKI, ELIUD MWANGI	3/16/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1742 ASPEN GROVE LN	None	DIAMOND BAR	CA	91765	2954	19	06037	33.99005964	-117.8226505	Los Angeles County
244263	Fee-for-Service	1184679284	1184679284	1	1	TRUJILLO, JOSHUA A MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	49567	01	General Practice	0	In state provider	None	201 E LAKEVIEW AVE	None	WOODLAKE	CA	93286	1301	54	06107	36.4172997	-119.0975768	Tulare County
244272	Fee-for-Service	1427030402	1427030402	1	1	TARZY, NEIL T MD	6/16/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60255	08	Family Practice	0	In state provider	None	306 W EL NORTE PKWY	STE S	ESCONDIDO	CA	92026	1960	37	06073	33.14056104	-117.0942385	San Diego County
244325	Fee-for-Service	1710166749	1710166749	1	1	TOMASSI, MICHELLE P MD	2/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138956	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
244370	Fee-for-Service	1528266962	1528266962	1	1	TRUONG, HUY N MD	1/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111385	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
244428	Fee-for-Service	1588893580	1588893580	1	1	TRILESSKAYA, MARINA MD	3/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	103051	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
244432	Fee-for-Service	1639392590	1639392590	1	1	TRAN, MYHANH T OD	6/22/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1752 E CARSON ST	None	CARSON	CA	90745	2506	19	06037	33.83164817	-118.2409337	Los Angeles County
244473	Fee-for-Service	1750005864	1750005864	1	1	TEKWANI, ROOPLEKHA S NP	1/9/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
244500	Fee-for-Service	1508278359	1508278359	1	5	THE ROADS FOUNDATION	1/3/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	4525 ATHERTON ST	SECOND FLOOR	LONG BEACH	CA	90815	3700	19	06037	33.78988246	-118.1397653	Los Angeles County
244507	Fee-for-Service	1275651515	1275651515	1	48	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1411 S. GARFIELD AVE	304, 306, AND 308	ALHAMBRA	CA	91801	5022	19	06037	34.07787	-118.1230385	Los Angeles County
244551	Fee-for-Service	1194425686	1194425686	1	1	TUKI, ELIUD MWANGI	3/16/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1742 ASPEN GROVE LN	None	DIAMOND BAR	CA	91765	2954	19	06037	33.99005964	-117.8226505	Los Angeles County
244557	Fee-for-Service	1184679284	1184679284	1	1	TRUJILLO, JOSHUA A MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	49567	08	Family Practice	0	In state provider	None	201 E LAKEVIEW AVE	None	WOODLAKE	CA	93286	1301	54	06107	36.4172997	-119.0975768	Tulare County
244572	Fee-for-Service	1497774061	1497774061	1	1	TUNELL, ERIC DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2081 W US HIGHWAY 70	None	THATCHER	AZ	85552	5445	00	None	32.83671733	-109.7340269	Graham County
244604	Fee-for-Service	1598813388	1598813388	1	1	TANG, BRUCE Y MD	4/30/1989	207RR0500X	NA	Other	026	PHYSICIANS	46428	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
244615	Fee-for-Service	1649692716	1649692716	1	2	TEAM PHYSICIANS OF NORTHERN	10/4/2021	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7300 MEDICAL CENTER DR.	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
244633	Fee-for-Service	1013007517	1013007517	1	1	TRAN, KEVIN A DC	10/3/2016	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1108 WARD AVE	BLDG A SUITE 1	PATTERSON	CA	95363	8529	50	06099	37.48636445	-121.1407911	Stanislaus County
244645	Fee-for-Service	1043589211	1043589211	1	1	TOVMASSIAN, GREGORY DPM	2/22/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6600 MERCY COURT	STE 150	FAIR OAKS	CA	95628	3190	34	06067	38.666565	-121.309857	Sacramento County
244741	Fee-for-Service	1740625235	1740625235	1	2	TODOS PARA LA SALUD	8/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3030 N FRESNO STREET	None	FRESNO	CA	93703	1100	10	06019	36.77828036	-119.7815087	Fresno County
244761	Fee-for-Service	1710012455	1710012455	1	1	TARZANA TREATMENT CENTERS	11/10/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	2101 MAGNOLIA AVE	None	LONG BEACH	CA	90806	4521	19	06037	33.79557701	-118.1981495	Los Angeles County
244790	Fee-for-Service	1689145955	1689145955	1	1	TSUI, JOHN	2/5/2019	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
244793	Fee-for-Service	1275651515	1275651515	1	48	THE ONCOLOGY INSTITUTE CA, A	6/9/2022	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	1411 S. GARFIELD AVE	304, 306, AND 308	ALHAMBRA	CA	91801	5022	19	06037	34.07787	-118.1230385	Los Angeles County
244797	Fee-for-Service	1669707063	1669707063	1	1	TOY, STANLEY JR MD	5/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	32125	01	General Practice	0	In state provider	None	14362 E RAMONA BLVD	None	BALDWIN PARK	CA	91706	3241	19	06037	34.08622063	-117.9606346	Los Angeles County
244867	Fee-for-Service	1831179001	1831179001	1	1	TOTTEN, VICKEN Y MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	44689	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
244878	Fee-for-Service	1316971468	1316971468	1	1	THOMPSON, GARY J MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8339	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
244921	Fee-for-Service	1972559706	1972559706	1	2	THAKUR, VIJAYA MD	10/23/2020	207R00000X	NA	Other	026	PHYSICIANS	79868	None	None	0	In state provider	None	840 DELBON AVE	STE A	TURLOCK	CA	95382	2005	50	06099	37.51046091	-120.8383932	Stanislaus County
244922	Fee-for-Service	1629361449	1629361449	1	1	THOMPSON, DAVID A MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	19061	13	Neurology (M.D. only)	0	In state provider	None	435 ARDEN AVENUE	SUITE 560	GLENDALE	CA	91203	1142	19	06037	34.15848148	-118.2628845	Los Angeles County
244926	Fee-for-Service	1659562650	1659562650	1	2	THIELE, JENS MD	3/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	103862	07	Dermatology	0	In state provider	None	3629 VISTA WAY	None	OCEANSIDE	CA	92056	4522	37	06073	33.1814285	-117.3093613	San Diego County
244968	Fee-for-Service	1770014292	1770014292	1	1	TEA, TOMMY MD	10/11/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	171572	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
245007	Fee-for-Service	1508354028	1508354028	1	1	TSAI, GRACE L DPM	10/20/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	345 F	SUITE 100	CHULA VISTA	CA	91910	2626	37	06073	32.64088085	-117.081699	San Diego County
245014	Fee-for-Service	1922145671	1922145671	1	1	TROITSKAIA-WILLIAMS, SVETLAN	11/19/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	81124	27	Psychiatry Neurology (D.O. only)	0	In state provider	A MD	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
245015	Fee-for-Service	1457665564	1457665564	1	1	TRAN, ANDY D MD INC	11/23/2010	207RC0200X	NA	Other	026	PHYSICIANS	54251	41	Internal Medicine	0	In state provider	None	875 BREA BLVD	None	BREA	CA	92821	2606	30	06059	33.93434103	-117.8932895	Orange County
245028	Fee-for-Service	1740625235	1740625235	1	2	TODOS PARA LA SALUD	8/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3030 N FRESNO STREET	None	FRESNO	CA	93703	1100	10	06019	36.77828036	-119.7815087	Fresno County
245069	Fee-for-Service	1508921396	1508921396	1	1	TSENG, PETER C MD	8/31/1988	207P00000X	NA	Other	026	PHYSICIANS	45459	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1720 BROOKLYN AVE	None	LOS ANGELES	CA	90033	2462	19	06037	34.040502	-118.191954	Los Angeles County
245079	Fee-for-Service	1669085296	1669085296	1	1	TIDBALL, ALEXIS LCSW	3/3/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 CLAREMONT AVE STE 1	None	STOCKTON	CA	95207	5700	39	06077	37.99861886	-121.3102123	San Joaquin County
245191	Fee-for-Service	1568655306	1568655306	1	1	TOOHEY, TARA P MD	9/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130519	36	Psychiatry	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
245192	Fee-for-Service	1104053024	1104053024	1	1	TANTISATTAMO, EKAMOL MD	10/31/2017	207R00000X	NA	Other	026	PHYSICIANS	151885	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
245242	Fee-for-Service	1013350586	1013350586	1	1	TROXELL, REGINA M MD	9/13/2018	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	157940	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
245312	Fee-for-Service	1831258441	1831258441	1	1	TSAI, JOHN YOUNG MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	88115	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
245343	Fee-for-Service	1992351803	1992351803	1	1	TAJON-SCOTT, MARIE R LMFT	11/15/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	687 UPLAND RD	None	REDWOOD CITY	CA	94062	2828	41	06081	37.47213818	-122.2520257	San Mateo County
245367	Fee-for-Service	1598082943	1598082943	1	1	TAKAKURA, AKO MD	12/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120021	18	Ophthalmology	0	In state provider	None	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
245452	Fee-for-Service	1841581022	1841581022	1	1	TARZANA TREATMENT CENTERS	11/12/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	44459 N 10TH STREET WEST	None	LANCASTER	CA	93534	3346	19	06037	34.691139	-118.1480675	Los Angeles County
245501	Fee-for-Service	1184683401	1184683401	1	1	TOTAL RENAL CARE, INC	3/1/1996	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DIALYSIS CTR	13939 E 14TH ST	STE 110	SAN LEANDRO	CA	94578	2613	01	06001	37.71377536	-122.1407447	Alameda County
245514	Fee-for-Service	1962488007	1962488007	1	9	TERI INC	2/17/1989	310500000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MONTGOMERY HOUSE	1658 MONTGOMERY DR	None	VISTA	CA	92084	7626	37	06073	33.18158129	-117.2135206	San Diego County
245577	Fee-for-Service	1649328675	1649328675	1	1	TONG, DAN H MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93560	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
245583	Fee-for-Service	1013992197	1013992197	1	1	TOCCHI, LEE P MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67857	20	Orthopedic Surgery	0	In state provider	None	370 DEL NORTE AVE	STE 201	YUBA CITY	CA	95991	4142	51	06101	39.14466521	-121.6166961	Sutter County
245586	Fee-for-Service	1568435477	1568435477	1	1	THE MILTON S HERSHEY	4/1/2003	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER	500 UNIVERSITY DR	None	HERSHEY	PA	17033	2360	00	None	40.26440258	-76.67394583	Dauphin County
245590	Fee-for-Service	1740830793	1740830793	1	1	TOPKARE HOSPICE INC	9/15/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7071 CONVOY COURT	STE 101	SAN DIEGO	CA	92111	1023	37	06073	32.83463806	-117.1643104	San Diego County
245597	Fee-for-Service	1780763201	1780763201	1	1	THOMPSON, LEROY F LMFT	12/21/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	16581 BROOKHURST	None	FOUNTAIN VALLEY	CA	92708	2344	30	06059	33.7215297	-117.9547079	Orange County
245601	Fee-for-Service	1831258441	1831258441	1	1	TSAI, JOHN YOUNG MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	88115	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
245602	Fee-for-Service	1164481081	1164481081	1	1	TOTAL RENAL CARE, INC	4/1/1997	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ALHAMBRA DIALYSIS CTR	1315 ALHAMBRA BLVD	STE 100	SACRAMENTO	CA	95816	5245	34	06067	38.568429	-121.4665605	Sacramento County
245614	Fee-for-Service	1477572865	1477572865	1	1	THALER, BRUCE J MD	9/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140361	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
245627	Fee-for-Service	1487092581	1487092581	1	1	TRUONG, CHRISTINE H	10/29/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
245640	Fee-for-Service	1205091287	1205091287	1	1	TRAN, ANN K PHD	10/12/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
245654	Fee-for-Service	1922004555	1922004555	1	1	THE CITY OF ORANGE FIRE	12/2/1994	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	DEPARTMENT	176 S ORANGE ST	None	ORANGE	CA	92866	1424	30	06059	33.78646098	-117.8520899	Orange County
245673	Fee-for-Service	1629200134	1629200134	1	1	TOTAL RENAL CARE INC	11/1/2009	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1505 WILSON TERRACE	STE 190	GLENDALE	CA	91206	4071	19	06037	34.14960934	-118.2313491	Los Angeles County
245678	Fee-for-Service	1366426702	1366426702	1	1	TRAN, PHUONGANH Q OD	5/6/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	653 CAMINO DE LOS MARES	STE 107	SAN CLEMENTE	CA	92673	2808	30	06059	33.45767098	-117.6495718	Orange County
245690	Fee-for-Service	1689665267	1689665267	1	1	TEHACHAPI HOSPITAL	3/16/2009	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	115 W E ST	None	TEHACHAPI	CA	93561	1607	15	06029	35.13009994	-118.4488237	Kern County
245691	Fee-for-Service	1275573149	1275573149	1	1	TRAN, DOMINQUE Q MD	12/1/2000	207R00000X	NA	Other	026	PHYSICIANS	64861	41	Internal Medicine	0	In state provider	None	9191 WESTMINSTER AVE	None	GARDEN GROVE	CA	92844	2751	30	06059	33.75946879	-117.9688437	Orange County
245710	Fee-for-Service	1518523380	1518523380	1	1	TRICARE HOME HEALTH LLC	11/8/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	17915 VENTURA BLVD	SUITE 204	ENCINO	CA	91316	4802	19	06037	34.16385429	-118.522817	Los Angeles County
245719	Fee-for-Service	1982018545	1982018545	1	1	TANG, MICHAEL E	6/29/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	154723	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
245723	Fee-for-Service	1184729048	1184729048	1	1	TSUDA-NGUYEN, VANESSA DO	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	8745	08	Family Practice	0	In state provider	None	441 S HAM LANE	None	LODI	CA	95242	3525	39	06077	38.12839172	-121.2883127	San Joaquin County
245729	Fee-for-Service	1720014657	1720014657	1	1	TAN, LAI W MD	4/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52139	41	Internal Medicine	0	In state provider	None	260 INTERNATIONAL CIT	None	SAN JOSE	CA	95119	1103	43	06085	37.24047903	-121.7998157	Santa Clara County
245730	Fee-for-Service	1528598901	1528598901	1	1	TROJAN EYE CENTER OPTOMETRY	12/18/2017	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	3335 S FIGUEROA ST	SUITE M	LOS ANGELES	CA	90007	3841	19	06037	34.02334742	-118.2790932	Los Angeles County
245737	Fee-for-Service	1922487578	1922487578	1	1	TRAN, KELVIN	8/25/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	17866	67	Endocrinology	0	In state provider	None	2702 LOW CT	None	FAIRFIELD	CA	94534	9771	48	06095	38.23678474	-122.0847463	Solano County
245746	Fee-for-Service	1700409992	1700409992	1	1	TIN ENTERPRISE LLC	6/12/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	678 N WILSON WAY	STE 14	STOCKTON	CA	95205	4200	39	06077	37.962954	-121.2735326	San Joaquin County
245748	Fee-for-Service	1225479561	1225479561	1	1	TERRUSA, TERI F LCSW	9/5/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER 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
245760	Fee-for-Service	1093455388	1093455388	1	1	THURSTON, KUYANN L NP	12/29/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18040 SHERMAN WAY	SUITE 304	RESEDA	CA	91335	4656	19	06037	34.20103048	-118.526787	Los Angeles County
245770	Fee-for-Service	1942589171	1942589171	1	1	TABAK, NICOLE R LMFT	10/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
245831	Fee-for-Service	1386089407	1386089407	1	1	TAHIRI HASSANI, YOUSSEF MD	8/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141420	24	Plastic Surgery	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
245856	Fee-for-Service	1407822018	1407822018	1	1	TORRES, GARCIA L E MD	12/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	35096	05	Anesthesiology	0	In state provider	None	3828 DELMAS TER	None	CULVER CITY	CA	90232	2713	19	06037	34.02308948	-118.3972101	Los Angeles County
245869	Fee-for-Service	1376787135	1376787135	1	1	TER-OGANESYAN, RAMON	12/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	95295	30	Radiology	0	In state provider	None	11370 ANDERSON	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
245873	Fee-for-Service	1568435477	1568435477	1	1	THE MILTON S HERSHEY	4/1/2003	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER	500 UNIVERSITY DR	None	HERSHEY	PA	17033	2360	00	None	40.26440258	-76.67394583	Dauphin County
245876	Fee-for-Service	1184330474	1184330474	1	1	THE BREEZY DOULA LLC	1/30/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	30	06059	0	0	None
245880	Fee-for-Service	1740830793	1740830793	1	1	TOPKARE HOSPICE INC	9/15/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7071 CONVOY COURT	STE 101	SAN DIEGO	CA	92111	1023	37	06073	32.83463806	-117.1643104	San Diego County
245912	Fee-for-Service	1114075991	1114075991	1	1	TORRES, BEVERLY V	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50490	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
245918	Fee-for-Service	1477798262	1477798262	1	1	TRAN, WESLEY H MD	9/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110511	20	Orthopedic Surgery	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
245928	Fee-for-Service	1033555354	1033555354	1	1	THOMAS, KATHERINE C MD	7/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135391	41	Internal Medicine	0	In state provider	None	4550 CALIFORNIA AVE	SUITE 500	BAKERSFIELD	CA	93309	7030	15	06029	35.367903	-119.0537145	Kern County
245942	Fee-for-Service	1811554389	1811554389	1	1	THIND, BALKARN S MD	6/28/2023	207L00000X	NA	Other	026	PHYSICIANS	181505	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
245990	Fee-for-Service	1336778182	1336778182	1	1	TRINH, CHRISTINE MD	9/25/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	186455	None	None	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
246004	Fee-for-Service	1750412300	1750412300	1	4	TAHOE FOREST HOSP DIST	4/28/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10051 LAKE BLVD	#4	TRUCKEE	CA	96161	4870	29	06057	39.32550268	-120.2025066	Nevada County
246015	Fee-for-Service	1730593096	1730593096	1	1	THOMAS, NATASHA MD	5/14/2018	207P00000X	NA	Other	026	PHYSICIANS	153333	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
246020	Fee-for-Service	1144392606	1144392606	1	1	TENG, ANDELLE L MD	7/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94822	33	Thoracic Surgery	0	In state provider	None	1505 WILSON TER	STE 200	GLENDALE	CA	91206	4073	19	06037	34.14960934	-118.2313491	Los Angeles County
246029	Fee-for-Service	1992901094	1992901094	1	1	THU, MYAING S	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
246037	Fee-for-Service	1861993412	1861993412	1	2	TRETIAK, DMITRIY A NP	6/29/2018	193400000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16237 VENTURA BLVD	None	ENCINO	CA	91436	2201	19	06037	34.15686987	-118.4871369	Los Angeles County
246038	Fee-for-Service	1144339540	1144339540	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1331 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	5410	19	06037	34.02666154	-118.4890774	Los Angeles County
246041	Fee-for-Service	1982026613	1982026613	1	1	TANG, JIM R LCSW	5/30/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
246064	Fee-for-Service	1003044876	1003044876	1	1	TRENKLE, GEOFFREY B DO	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13166	None	None	0	In state provider	None	1700 E CESAR E CHAVEZ AV	SUITE 2500	LOS ANGELES	CA	90033	2434	19	06037	34.05101259	-118.217259	Los Angeles County
246068	Fee-for-Service	1043392103	1043392103	1	1	TOSTADO, MARINA L MD	9/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75458	41	Internal Medicine	0	In state provider	None	1144 COFFEE RD	None	MODESTO	CA	95355	4205	50	06099	37.659627	-120.9756125	Stanislaus County
246075	Fee-for-Service	1134191182	1134191182	1	1	TANDO, DARLENE A LCSW	11/21/2006	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	3245 UNIVERSITY AVE	STE 1 #357	SAN DIEGO	CA	92104	2009	37	06073	32.74847353	-117.124236	San Diego County
246081	Fee-for-Service	1962625459	1962625459	1	1	TU, ZHONGHENG MD	4/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98296	08	Family Practice	0	In state provider	None	43839 15TH STREET WEST	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
246090	Fee-for-Service	1679938765	1679938765	1	1	TAUBE, ANNETTE L NP	11/2/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
246131	Fee-for-Service	1235722026	1235722026	1	1	THE CERES COMMUNITY PROJECT	9/10/2024	332U00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	7351 BODEGA AVE	None	SEBASTOPOL	CA	95472	3727	49	06097	38.40103429	-122.8272081	Sonoma County
246143	Fee-for-Service	1851836472	1851836472	1	1	TAN, MARISSA A CRNA	7/31/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
246206	Fee-for-Service	1295060440	1295060440	1	1	TAVYEV, YANA J MD	10/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109479	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
246212	Fee-for-Service	1518961846	1518961846	1	1	TRAN, ANHTUAN D	8/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	90428	41	Internal Medicine	0	In state provider	None	7400 VAN NUYS BLVD	STE 112	VAN NUYS	CA	91405	1972	19	06037	34.205454	-118.448724	Los Angeles County
246266	Fee-for-Service	1851400212	1851400212	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1021 BRIDGE ST	None	COLUSA	CA	95932	2839	06	06011	39.20424767	-122.0042833	Colusa County
246298	Fee-for-Service	1902961444	1902961444	1	1	TWAY, KENNETH P MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	39105	41	Internal Medicine	0	In state provider	None	1106 PACIFIC ST	None	SAN LUIS OBISPO	CA	93401	3302	40	06079	35.28062733	-120.6579035	San Luis Obispo County
246316	Fee-for-Service	1386104669	1386104669	1	1	THE LAKES HOME HEALTH	10/10/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	14140 VENTURA BLVD	SUITE 204	SHERMAN OAKS	CA	91423	2750	15	06029	34.14968092	-118.4413738	Los Angeles County
246323	Fee-for-Service	1316247521	1316247521	1	1	THE GASTRO GROUP INC	3/30/2011	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	None	17203 JASMINE ST	None	VICTORVILLE	CA	92395	7786	36	06071	34.47489651	-117.287046	San Bernardino County
246361	Fee-for-Service	1376043372	1376043372	1	1	THE GARDENS OF EL MONTE LLC	1/1/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5044 BUFFINGTON RD	None	EL MONTE	CA	97132	1466	19	06037	34.09345508	-118.0081827	Los Angeles County
246405	Fee-for-Service	1831458553	1831458553	1	1	TANG, MICHAEL B MD	7/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148490	05	Anesthesiology	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
246469	Fee-for-Service	1255405270	1255405270	1	1	TANG, REN A	10/14/2005	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	GOSPEL HEARING AID CNTR	93 N 14TH ST	STE 2	SAN JOSE	CA	95112	6200	43	06085	37.34380948	-121.8781739	Santa Clara County
246479	Fee-for-Service	1033515838	1033515838	1	1	TRUE CARE HOME HEALTH	5/5/2017	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	7355 TOPANGA CANYON BLVD	SUITE 221	CANOGA PARK	CA	91303	7355	19	06037	34.204383	-118.6059875	Los Angeles County
246493	Fee-for-Service	1295060440	1295060440	1	1	TAVYEV, YANA J MD	10/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109479	13	Neurology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
246524	Fee-for-Service	1386914778	1386914778	1	1	TOMKINS, MICHAEL A DO	8/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12055	01	General Practice	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
246566	Fee-for-Service	1376990655	1376990655	1	1	TABER, THOMAS DO	6/6/2020	207R00000X	NA	Other	026	PHYSICIANS	17482	41	Internal Medicine	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
246587	Fee-for-Service	1558039511	1558039511	1	1	TDH PHARMACY, INC.	10/15/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9029 MCFADDEN AVE	None	WESTMINSTER	CA	92683	6408	30	06059	33.73764245	-117.9709878	Orange County
246604	Fee-for-Service	1962488007	1962488007	1	1	TERI INC	1/25/1983	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6433 FLAMENCO ST	None	CARLSBAD	CA	92009	4314	37	06073	33.11037587	-117.2479977	San Diego County
246640	Fee-for-Service	1144471939	1144471939	2	2	THREE ANGELS MEDICAL PROFESS	10/19/2018	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	IONAL CORPORATION	180 EAST 4TH ST	SUITE B AND C	PERRIS	CA	92570	2114	33	06065	33.78239548	-117.226467	Riverside County
246686	Fee-for-Service	1316390552	1316390552	2	1	TRUE VINE PHARMACY INC	12/18/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1598 LONG BEACH BLVD	STE 102	LONG BEACH	CA	90813	2384	19	06037	33.78672562	-118.1892442	Los Angeles County
246736	Fee-for-Service	1710093976	1710093976	1	1	THOMAS, JOHN A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	929 LIPSCOMB ST	None	FORT WORTH	TX	76104	3173	00	None	32.734467	-97.33328351	Tarrant County
246745	Fee-for-Service	1528185055	1528185055	1	1	TISON MEDICAL GROUP INC	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	44211	18	Ophthalmology	0	In state provider	None	801 N TUSTIN AVE	STE 500	SANTA ANA	CA	92705	3609	30	06059	33.752286	-117.8341735	Orange County
246751	Fee-for-Service	1114200037	1114200037	1	1	TU, TIFFANY M	7/7/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
246766	Fee-for-Service	1033515838	1033515838	1	1	TRUE CARE HOME HEALTH	10/7/2019	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	7355 TOPANGA CANYON BLVD	SUITE 221	CANOGA PARK	CA	91303	7355	19	06037	34.204383	-118.6059875	Los Angeles County
246778	Fee-for-Service	1750412300	1750412300	1	7	TAHOE FOREST HOSP DIST	4/28/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CLINIC	10956 DONNER PASS RD	STE 230	TRUCKEE	CA	96161	4885	29	06057	39.32625521	-120.2012059	Nevada County
246782	Fee-for-Service	1831207869	1831207869	1	1	TANG, DANIEL S OD	1/9/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRY CENTER	5835 YORK BLVD	None	LOS ANGELES	CA	90042	2634	19	06037	34.11842874	-118.1910447	Los Angeles County
246783	Fee-for-Service	1851736938	1851736938	1	1	TRAN, THUY B MD	9/21/2022	208600000X	NA	General Surgery	026	PHYSICIANS	125362	None	None	0	In state provider	None	101 CITY DR S	# B10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
246814	Fee-for-Service	1386775054	1386775054	1	1	THIRUNAVUKKARASU,	5/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97862	41	Internal Medicine	0	In state provider	BHUVANESWARI MD	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
246825	Fee-for-Service	1639185937	1639185937	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4410 SLAUSON AVE	None	MAYWOOD	CA	90270	2932	19	06037	33.98711787	-118.1865325	Los Angeles County
246887	Fee-for-Service	1962849588	1962849588	1	1	TALMAGE, MARILYN J LMFT	9/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	534 B ST	None	SANTA ROSA	CA	95401	5211	49	06097	38.44296	-122.7177585	Sonoma County
246963	Fee-for-Service	1932588993	1932588993	1	1	TRAVEN, SOPHIA A MD	10/12/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	173285	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
246993	Fee-for-Service	1639480759	1639480759	1	1	THOMPSON, CARLIE K MD	8/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	127831	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
247027	Fee-for-Service	1871602276	1871602276	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3095 MCMURRAY DRIVE	None	ANDERSON	CA	96007	3507	45	06089	40.45604961	-122.2939037	Shasta County
247044	Fee-for-Service	1891254124	1891254124	1	1	TERNAVSKY, ALEX S RCP	6/3/2019	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
247069	Fee-for-Service	1700363306	1700363306	1	1	TAYLOR, JAMES E PT	8/28/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3400 PANAMA LANE	SUITE R	BAKERSFIELD	CA	93313	3996	15	06029	35.29601148	-119.040507	Kern County
247074	Fee-for-Service	1184709248	1184709248	1	1	TECHNOMED HOMECARE INC	11/7/2006	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	THI HOME MEDICAL EQUIPME	27188 SUN CITY BLVD	None	SUN CITY	CA	92586	5505	33	06065	33.71218208	-117.1936261	Riverside County
247076	Fee-for-Service	1124361910	1124361910	1	1	TRAN, TUNG V MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136999	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
247124	Fee-for-Service	1881899052	1881899052	1	1	TANNIS, LIANNE C	11/1/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	250 TRAVELODGE DR	None	EL CAJON	CA	92020	4126	37	06073	32.79312432	-116.980275	San Diego County
247133	Fee-for-Service	1477507879	1477507879	1	1	TUFENKIAN, DAVID A MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	58142	40	Pediatrics	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
247178	Fee-for-Service	1811979099	1811979099	1	1	TAVERNA, MICHAEL JACOB	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	400 S CLARK STREET	None	BUTTE	MT	59701	2328	00	None	46.00840837	-112.5461616	Silver Bow County
247213	Fee-for-Service	1497855159	1497855159	1	1	TSANG, MING LI	5/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96539	08	Family Practice	0	In state provider	None	909 HYDE ST	STE 432	SAN FRANCISCO	CA	94109	4822	38	06075	37.78939387	-122.4170945	San Francisco County
247266	Fee-for-Service	1912206657	1912206657	1	1	TREVINO, MELINDA D MD	11/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131056	01	General Practice	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
247278	Fee-for-Service	1104151372	1104151372	1	1	THOMAS, DALIA M LCSW	9/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	436 S MAGNOLIA AVE	STE 101, 201	SAN DIEGO	CA	92150	9015	37	06073	32.791122	-116.962417	San Diego
247283	Fee-for-Service	1487946919	1487946919	1	1	THOMPSON, RUSSELL J DC	4/27/2020	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	629 CAMINO DE LOS MARES	104	SAN CLEMENTE	CA	92673	2829	30	06059	33.45968314	-117.65198	Orange County
247316	Fee-for-Service	1821010950	1821010950	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PAHRMACY #06065	1260 W CAPITOL AVE	None	WEST SACRAMENTO	CA	95691	2719	57	06113	38.58124641	-121.5244115	Yolo County
247406	Fee-for-Service	1265874135	1265874135	1	1	TEMECULA VALLEY HOSPITALIST	12/2/2013	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP INC	31700 TEMECULA PARKWAY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
247420	Fee-for-Service	1477507879	1477507879	1	1	TUFENKIAN, DAVID A MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	58142	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
247489	Fee-for-Service	1043731052	1043731052	1	1	TLC NON-EMERGENCY MEDICAL TR	4/20/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ANSPORTATION	6235 JOSIE STREET	None	ATWATER	CA	95301	9106	24	06047	37.3103281	-120.6008106	Merced County
247491	Fee-for-Service	1932218385	1932218385	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 NORTH CHINA LAKE BLV	None	RIDGECREST	CA	93555	3544	15	06029	35.62298483	-117.6699603	Kern County
247500	Fee-for-Service	1679190656	1679190656	1	1	TAKEYASU-RAMOS, BETTY K PT	8/27/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
247537	Fee-for-Service	1932521150	1932521150	1	1	THOMAS, TERRI R LPCC	2/12/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16501 WALNUT STREET	SUITE 12	HESPERIA	CA	92345	3684	36	06071	34.42057564	-117.3026653	San Bernardino County
247589	Fee-for-Service	1831450410	1831450410	1	1	TENNANT, MEGAN A PT	6/13/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
247609	Fee-for-Service	1386396950	1386396950	1	1	TRI COUNTIES COMMUNITY ACTIO	8/19/2024	251B00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	N PARTNERSHIP	318 6TH ST	None	ORLAND	CA	95963	1226	11	06021	39.75097191	-122.1970625	Glenn County
247620	Fee-for-Service	1972833382	1972833382	1	1	TOTAL RENAL CARE INC	11/9/2010	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	228 N GARFIELD AVENUE	STE 301	MONTERY PARK	CA	91754	1709	19	06037	34.06461848	-118.1228384	Los Angeles County
247647	Fee-for-Service	1306038187	1306038187	1	1	TSANG, JANET C MD	9/1/2010	390200000X	NA	Other	026	PHYSICIANS	105048	41	Internal Medicine	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
247654	Fee-for-Service	1730369356	1730369356	1	1	THOM, FRANCES M NP	4/25/2008	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6120 VINELAND AVE	None	NORTH HOLLYWOOD	CA	91606	4914	19	06037	34.1819583	-118.3702737	Los Angeles County
247716	Fee-for-Service	1366867327	1366867327	1	1	TRAN-KIM, DIANA M T DO	6/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14124	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18210 YORBA LINDA BLVD	SUITE 404	YORBA LINDA	CA	92886	4060	30	06059	33.8883981	-117.8154098	Orange County
247724	Fee-for-Service	1033228556	1033228556	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4077 GOVERNOR DR	None	SAN DIEGO	CA	92122	2522	37	06073	32.8545342	-117.2022085	San Diego County
247756	Fee-for-Service	1619310513	1619310513	1	1	TOTAL RENAL CARE INC	4/3/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	902 BEAR MOUNTAIN RD	None	ARVIN	CA	93203	1317	15	06029	35.2091585	-118.8345735	Kern County
247761	Fee-for-Service	1760749782	1760749782	1	1	TABOR-FURMARK, KARA S MD	12/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130412	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	6968	19	06037	34.07067	-118.4432445	Los Angeles County
247783	Fee-for-Service	1215572607	1215572607	1	1	TUSAAZEMAJJA, ANDREW N PT	3/27/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	615 WEST AVE L	None	LANCASTER	CA	93545	7211	19	06037	34.6603515	-118.1419695	Los Angeles County
247791	Fee-for-Service	1205906229	1205906229	1	1	THE NEPHROLOGY GROUP, INC.	10/13/2017	207RN0300X	NA	Nephrology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	568 E HERNDON AVE	STE 201	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
247792	Fee-for-Service	1710997606	1710997606	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	21949 VENTURA BLVD	None	WOODLAND HILLS	CA	91364	1725	19	06037	34.16851593	-118.6050967	Los Angeles County
247836	Fee-for-Service	1659395671	1659395671	1	1	TONKS, ROBERT D MD	5/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	46158	20	Orthopedic Surgery	0	In state provider	None	7901 FROST STREET	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
247897	Fee-for-Service	1386396950	1386396950	1	1	TRI COUNTIES COMMUNITY ACTIO	11/12/2024	251B00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	N PARTNERSHIP	318 6TH ST	None	ORLAND	CA	95963	1226	11	06021	39.75097191	-122.1970625	Glenn County
247919	Fee-for-Service	1861741308	1861741308	1	1	THOMAS-LAYUGAN, DESIREE	6/29/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6800 INDIANA AVE	130	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
247921	Fee-for-Service	1366458663	1366458663	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE 5620	661 SWEETWATER RD	None	SPRING VALLEY	CA	91977	5628	37	06073	32.70816022	-117.0112889	San Diego County
247926	Fee-for-Service	1033554423	1033554423	1	1	TINT, DERRICK MD	1/22/2021	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	160407	None	None	0	In state provider	None	341 MAGNOLIA AVE	STE 206	CORONA	CA	92879	3332	33	06065	33.85291987	-117.5664344	Riverside County
247955	Fee-for-Service	1679960892	1679960892	1	1	TRAN, HOANG-VU MD	10/9/2023	208G00000X	NA	General Surgery	026	PHYSICIANS	187624	None	None	0	In state provider	None	3300 WEBSTER ST	STE 500	OAKLAND	CA	94609	3149	01	06001	37.82132826	-122.2621843	Alameda County
247971	Fee-for-Service	1326237819	1326237819	1	1	TRUONG, PATRICK B MD	7/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89158	10	Gastroenterology (M.D. only)	0	In state provider	None	1135 S SUNSET AVE	STE 405	WEST COVINA	CA	91790	3965	19	06037	34.06215064	-117.9453997	Los Angeles County
248050	Fee-for-Service	1770503591	1770503591	1	1	TRUPP, DIANA MD	1/1/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	50561	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
248076	Fee-for-Service	1205906229	1205906229	1	1	THE NEPHROLOGY GROUP, INC.	10/1/1994	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	568 E HERNDON AVE	STE 201	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
248085	Fee-for-Service	1023596780	1023596780	1	1	THEOS, LISA A RCP	10/4/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
248089	Fee-for-Service	1033748074	1033748074	1	1	TRAN, ERIC DO	7/13/2023	207R00000X	NA	Other	026	PHYSICIANS	21077	None	None	0	In state provider	None	9888 GENESEE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
248091	Fee-for-Service	1740778711	1740778711	1	1	TOU, EMILEY MD	6/14/2023	207L00000X	NA	Other	026	PHYSICIANS	166261	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
248109	Fee-for-Service	1306469838	1306469838	1	1	TRAN, SAMANTHA	5/7/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	None	07	Dermatology	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
248124	Fee-for-Service	1629265046	1629265046	1	1	TRIVEDI, MAYUR R MD	5/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91177	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
248142	Fee-for-Service	1407058464	1407058464	1	1	TRAN, NGOCTHUY N MD	4/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99925	41	Internal Medicine	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
248149	Fee-for-Service	1407897473	1407897473	1	1	TRUONG, PHUC HUY MD	9/30/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	36401	40	Pediatrics	0	In state provider	None	11160 WARNER AVE	STE 207	FOUNTAIN VALLEY	CA	92708	4048	30	06059	33.71630854	-117.934317	Orange County
248153	Fee-for-Service	1689754509	1689754509	1	1	TING, ANDREW R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 BROADWAY	STE 300	SEATTLE	WA	98122	4334	00	None	47.609316	-122.3207995	King County
248194	Fee-for-Service	1821033861	1821033861	1	1	TEKAUTZ, MICHAEL R MD	7/1/1984	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	42730	30	Radiology	0	In state provider	None	709 18TH ST	None	MODESTO	CA	95354	1210	50	06099	37.64364413	-120.9896383	Stanislaus County
248210	Fee-for-Service	1245904812	1245904812	1	1	TRIBBLE, RACHEL L LCSW	8/17/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	591 CAMINO DE LA REINA	SUITE 210	SAN DIEGO	CA	92108	3104	37	06073	32.76632791	-117.1616245	San Diego County
248220	Fee-for-Service	1598541435	1598541435	1	1	TUMAMBING HUGHES MARRIAGE AN	1/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	150 W FOOTHILL BLVD	A	SAN DIMAS	CA	91773	1103	19	06037	34.12480006	-117.8083927	Los Angeles County
248260	Fee-for-Service	1083173199	1083173199	1	1	THOMPSON, JANESE A MD	11/27/2023	363LX0001X	NA	Nurse Practitioner	026	PHYSICIANS	182266	None	None	0	In state provider	None	501 J ST	None	SACRAMENTO	CA	95814	2325	34	06067	38.582118	-121.499325	Sacramento County
248262	Fee-for-Service	1326237819	1326237819	1	1	TRUONG, PATRICK B MD	7/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89158	41	Internal Medicine	0	In state provider	None	1135 S SUNSET AVE	STE 405	WEST COVINA	CA	91790	3965	19	06037	34.06215064	-117.9453997	Los Angeles County
248366	Fee-for-Service	1821114828	1821114828	1	1	TARZANA TREATMENT CENTERS,IN	8/30/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	C.	18700 OXNARD STREET	None	TARZANA	CA	91356	1413	19	06037	34.18014349	-118.5410025	Los Angeles County
248401	Fee-for-Service	1023247137	1023247137	1	1	TEJADA-JOYA, ROXANA E LMFT	1/11/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1450 TREAT BLVD	STE 320	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
248411	Fee-for-Service	1629265046	1629265046	1	1	TRIVEDI, MAYUR R MD	5/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91177	10	Gastroenterology (M.D. only)	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
248432	Fee-for-Service	1407058464	1407058464	1	1	TRAN, NGOCTHUY N MD	4/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99925	40	Pediatrics	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
248438	Fee-for-Service	1508361734	1508361734	1	1	TINDELL, WILLIAM MD	4/5/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	175603	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
248474	Fee-for-Service	1811434509	1811434509	1	1	TRAGARZ, SHANNON LMFT	11/4/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	409 13TH	STE 1900	OAKLAND	CA	94612	2605	01	06001	37.80326679	-122.2707988	Alameda County
248508	Fee-for-Service	1740893304	1740893304	1	1	TAN, IRENE B OD	7/17/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1668 E 2ND ST	STE B	BEAUMONT	CA	92223	3168	33	06065	33.92359885	-116.9480354	Riverside County
248512	Fee-for-Service	1134115371	1134115371	1	1	TENG, NATLIE A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	560 N CAMINO MERCADO	STE 7	CASA GRANDE	AZ	85222	5759	00	None	32.877936	-111.691107	Pinal County
248517	Fee-for-Service	1932287695	1932287695	1	1	TE SELLE, MARIAN E MD	10/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77356	25	Physical Medicine and Rehabilitation	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
248533	Fee-for-Service	1952668238	1952668238	1	1	TANG, STEPHEN A MD	8/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128302	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
248542	Fee-for-Service	1114008067	1114008067	2	1	TEJANI, NASIR H MD	8/1/2017	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	32473	40	Pediatrics	0	In state provider	None	3325 PALO VERDE AVE	STE 203	LONG BEACH	CA	90808	4132	19	06037	33.81701249	-118.1078791	Los Angeles County
248550	Fee-for-Service	1073970687	1073970687	1	1	TORY PRESTERA MD INC.	5/3/2017	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	100 N RANCHO SANTA FE RD	126	SAN MARCOS	CA	92069	1294	37	06073	33.15125491	-117.197854	San Diego County
248574	Fee-for-Service	1275973000	1275973000	1	1	THOMPSON, MATTHEW C MD	8/2/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	133843	30	Radiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
248592	Fee-for-Service	1548265036	1548265036	1	17	TRUXTUN RADIOLOGY	2/25/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	1305 BEAR MOUNTAIN BLVD	None	ARVIN	CA	93203	1230	15	06029	35.20895551	-118.839294	Kern County
248595	Fee-for-Service	1275651515	1275651515	1	43	THE ONCOLOGY INSTITUTE CA, A	3/1/2022	207RH0000X	NA	Hematology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PE AND INNOVATION	11550 INDIAN HILLS RD	SUITE 360	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
248597	Fee-for-Service	1598887861	1598887861	1	1	TIMOTHY W GOODRICH	9/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	825 SE BISHOP BLVD	STE 601	PULLMAN	WA	99163	5517	00	None	46.71343241	-117.1699476	Whitman County
248608	Fee-for-Service	1306159686	1306159686	1	1	TRUJILLO, RAMIRO LCSW	1/5/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
248613	Fee-for-Service	1942394838	1942394838	1	1	TENNYSONSAMSON, JO E OT	2/12/2018	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	611 ABBOTT ST	100	SALINAS	CA	93901	4389	27	06053	36.66192801	-121.6413283	Monterey County
248632	Fee-for-Service	1477597714	1477597714	1	1	TRAN, THANH Q MD INC	5/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52468	13	Neurology (M.D. only)	0	In state provider	None	439 OFARRELL ST	None	SAN FRANCISCO	CA	94102	2009	38	06075	37.78589862	-122.4120158	San Francisco County
248664	Fee-for-Service	1811244197	1811244197	1	1	THOMPSON, JASON M PSYD	1/10/2019	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	630 DRAKE AVE	None	SAUSALITO	CA	94965	1107	21	06041	37.87340883	-122.515085	Marin County
248689	Fee-for-Service	1831327063	1831327063	1	1	TRISHA K ECKMAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3950 17TH ST	None	BAKER CITY	OR	97814	1300	00	None	44.79521864	-117.8498831	Baker County
248771	Fee-for-Service	1396772786	1396772786	1	1	TOLSTRUP, KRISTEN MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62057	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
248804	Fee-for-Service	1932287695	1932287695	1	1	TE SELLE, MARIAN E MD	10/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77356	36	Psychiatry	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
248806	Fee-for-Service	1821017294	1821017294	2	1	THOMAS, SHAN MD	9/8/2017	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	79405	None	None	0	In state provider	None	350 POSADA LN	STE 202	TEMPLETON	CA	93465	4059	40	06079	35.55239522	-120.7215238	San Luis Obispo County
248873	Fee-for-Service	1144516493	1144516493	1	1	TYLER, SHAWN L MD	3/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131002	41	Internal Medicine	0	In state provider	None	2200 OFARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
248881	Fee-for-Service	1548265036	1548265036	1	1	TRUXTUN RADIOLOGY	4/20/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP, LP	1817 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	5008	15	06029	35.37326659	-119.0227581	Kern County
248884	Fee-for-Service	1275651515	1275651515	1	43	THE ONCOLOGY INSTITUTE CA, A	3/1/2022	207RH0000X	NA	Hematology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PE AND INNOVATION	11550 INDIAN HILLS RD	SUITE 360	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
248906	Fee-for-Service	1013328780	1013328780	1	1	TONKIN, GABRIEL W MD	12/26/2018	207P00000X	NA	Other	026	PHYSICIANS	154171	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
248911	Fee-for-Service	1710918768	1710918768	1	1	TSE, ALICE W MD	1/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52947	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
248944	Fee-for-Service	1912273996	1912273996	1	1	THIEU, WILLIAM MD	5/8/2020	208800000X	NA	Other	026	PHYSICIANS	140895	34	Urology and Urological Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
248973	Fee-for-Service	1356746044	1356746044	2	2	TWINSRX PHARMACY INC	12/5/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2491 PACIFIC AVE	STE 1	LONG BEACH	CA	90806	2900	19	06037	33.802425	-118.193809	Los Angeles County
248980	Fee-for-Service	1790179935	1790179935	1	1	TARPLEY, JOSHUA A MD	10/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145260	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
249044	Fee-for-Service	1710998190	1710998190	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2516 JAMACHA RD	None	EL CAJON	CA	92019	4363	37	06073	32.74479792	-116.9298067	San Diego County
249048	Fee-for-Service	1912016437	1912016437	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5625	1135 AVOCADO AVE	None	EL CAJON	CA	92020	7702	37	06073	32.78017317	-116.9578444	San Diego County
249090	Fee-for-Service	1932287695	1932287695	1	1	TE SELLE, MARIAN E MD	10/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77356	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
249113	Fee-for-Service	1861620197	1861620197	1	1	TOKUTAKE, SAYURI DO	10/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10856	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
249173	Fee-for-Service	1275651515	1275651515	1	43	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0000X	NA	Hematology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	11550 INDIAN HILLS RD	SUITE 360	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
249197	Fee-for-Service	1710918768	1710918768	1	1	TSE, ALICE W MD	1/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52947	01	General Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
249221	Fee-for-Service	1710132733	1710132733	1	1	TOE, TET MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105047	41	Internal Medicine	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3194	07	06013	37.9141514	-122.0422089	Contra Costa County
249285	Fee-for-Service	1588044622	1588044622	1	1	TUVSHINTOGS, ENKHEE MD	7/20/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157564	08	Family Practice	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
249291	Fee-for-Service	1467960070	1467960070	1	1	TAVALLAEI, NIOOSHA	10/25/2023	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
249330	Fee-for-Service	1578593471	1578593471	1	1	TANTRAPHOL, MONICA S MD	5/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90457	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
249331	Fee-for-Service	1326099086	1326099086	1	1	TUTTON, SEAN M MD	11/12/2021	2085R0204X	NA	Other	026	PHYSICIANS	89331	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
249350	Fee-for-Service	1659332682	1659332682	1	1	TONTZ, WILLIAM L MD	11/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	69746	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
249389	Fee-for-Service	1508605635	1508605635	1	1	TRINITY EMERGENCY PHYSICIANS	7/1/2024	193400000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
249401	Fee-for-Service	1861620197	1861620197	1	1	TOKUTAKE, SAYURI DO	10/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10856	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
249446	Fee-for-Service	1801434824	1801434824	1	1	THERAPY CENTERS OF DR. SUSAN	2/21/2020	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	13620 LINCOLN WAY	380	AUBURN	CA	95603	3261	31	06061	38.93032866	-121.0549381	Placer County
249447	Fee-for-Service	1184071516	1184071516	1	1	TANG, ANDREW S DO	7/8/2022	2080P0204X	NA	Other	026	PHYSICIANS	19851	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
249461	Fee-for-Service	1275651515	1275651515	1	43	THE ONCOLOGY INSTITUTE CA, A	3/1/2022	207RH0000X	NA	Hematology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PE AND INNOVATION	11550 INDIAN HILLS RD	SUITE 360	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
249466	Fee-for-Service	1497389746	1497389746	1	1	TAMBA, STEVEN CNP	11/2/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
249497	Fee-for-Service	1811064710	1811064710	1	1	TALKIN, TERRY N MD	10/31/1990	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	36940	41	Internal Medicine	0	In state provider	None	10001 VENICE BLVD	None	LOS ANGELES	CA	90034	5806	19	06037	34.0228078	-118.3999707	Los Angeles County
249589	Fee-for-Service	1134513047	1134513047	1	1	TRUONG, ANDREW T MD	6/18/2019	207R00000X	NA	Other	026	PHYSICIANS	159187	41	Internal Medicine	0	In state provider	None	26800 CROWN VALLEY PKWY	STE 305, 315, 325, 330	MISSION VIEJO	CA	92691	8033	30	06059	33.56286021	-117.6673449	Orange County
249593	Fee-for-Service	1245980200	1245980200	1	1	TANG, ALLAN MD	1/10/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	189538	08	Family Practice	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
249601	Fee-for-Service	1073929782	1073929782	1	1	TUALITY MEDICAL GROUP LLC	1/10/2019	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	2	Out of state provider	None	335 SE 8TH AVENUE	None	HILLSBORO	OR	97123	4246	00	None	45.51948957	-122.9773135	Washington County
249621	Fee-for-Service	1760681050	1760681050	1	1	TAK, BERNICE PHD	9/22/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2131 ASHTON AVE	None	MENLO PARK	CA	94025	6501	41	06081	37.43205327	-122.2036961	San Mateo County
249626	Fee-for-Service	1235291758	1235291758	1	1	THEVALOJINI, THAYAPARAN	11/7/2008	207P00000X	NA	Other	026	PHYSICIANS	105046	41	Internal Medicine	0	In state provider	MD	1180 EAST SHAW	#125	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
249637	Fee-for-Service	1659332682	1659332682	1	1	TONTZ, WILLIAM L MD	11/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	69746	20	Orthopedic Surgery	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
249657	Fee-for-Service	1003293523	1003293523	1	1	TABUYO-MARTIN, ANGEL D MD	9/5/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	147327	None	None	0	In state provider	None	3301 C ST	STE 550	SACRAMENTO	CA	95816	3372	34	06067	38.579877	-121.456143	Sacramento County
249678	Fee-for-Service	1750345815	1750345815	1	1	TRIVEDI, RASMIKANT S MD	8/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	51100	05	Anesthesiology	0	In state provider	None	1145 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3528	19	06037	33.89242734	-118.2947128	Los Angeles County
249679	Fee-for-Service	1508605635	1508605635	1	1	TRINITY EMERGENCY PHYSICIANS	1/21/2025	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
249698	Fee-for-Service	1003809567	1003809567	1	1	TRIPP, COURTNEY T DO	6/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10752	None	None	0	In state provider	None	1025 N DOUTY ST	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
249704	Fee-for-Service	1578713707	1578713707	1	1	TAN, JESSICA S MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	115558	03	Allergy	0	In state provider	None	655 MARSHALL CT	None	REDWOOD CITY	CA	94063	2030	41	06081	37.48865062	-122.223886	San Mateo County
249735	Fee-for-Service	1801434824	1801434824	1	1	THERAPY CENTERS OF DR. SUSAN	2/21/2020	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	13620 LINCOLN WAY	380	AUBURN	CA	95603	3261	31	06061	38.93032866	-121.0549381	Placer County
249744	Fee-for-Service	1609049840	1609049840	1	1	TU, BRENDEN N MD	9/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103332	08	Family Practice	0	In state provider	None	2020 SUTTER PLACE	None	DAVIS	CA	95616	6217	57	06113	38.56287659	-121.7715536	Yolo County
249747	Fee-for-Service	1275651515	1275651515	1	43	THE ONCOLOGY INSTITUTE CA, A	5/20/2022	207RH0000X	NA	Hematology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PE AND INNOVATION	11550 INDIAN HILLS RD	SUITE 360	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
249755	Fee-for-Service	1699129916	1699129916	1	1	TRAN, TIMOTHY THIEN MD INC	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123698	01	General Practice	0	In state provider	None	12302 GARDEN GROVE BLVD	SUITE 7	GARDEN GROVE	CA	92843	1833	30	06059	33.77428392	-117.9181185	Orange County
249781	Fee-for-Service	1356361190	1356361190	1	1	TRENNER, DENNIS L DPM	7/1/1990	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2760 ORO DAM BLVD E	None	OROVILLE	CA	95966	5117	04	06007	39.50884022	-121.5437764	Butte County
249800	Fee-for-Service	1124336789	1124336789	1	1	TO, CHRISTINA A MD	5/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118871	41	Internal Medicine	0	In state provider	None	15243 VANOWEN ST	SUITE 210	VAN NUYS	CA	91405	3605	19	06037	34.19394848	-118.4654115	Los Angeles County
249827	Fee-for-Service	1124582424	1124582424	1	1	THE NEURON CLINIC GP	1/17/2025	2084N0400X	NA	Neurology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	44045 MARGARITA RD	STE 106	TEMECULA	CA	92592	2729	33	06065	33.48351542	-117.1027964	Riverside County
249853	Fee-for-Service	1831204825	1831204825	1	1	TSENG, LINDA MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74932	13	Neurology (M.D. only)	0	In state provider	None	16707 ARROW BLVD	None	FONTANA	CA	92335	3801	36	06071	34.09913829	-117.4394986	San Bernardino County
249868	Fee-for-Service	1407876436	1407876436	1	1	TOGIOKA, THOMAS T MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	57739	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	390 N SEPULVEDA BLVD	None	EL SEGUNDO	CA	90245	4401	19	06037	33.92077214	-118.3960953	Los Angeles County
249878	Fee-for-Service	1790189413	1790189413	1	1	TIDWELL, STACEY LCSW	6/18/2021	225XM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
249959	Fee-for-Service	1023255015	1023255015	1	1	TRIM, RYAN PHD	2/2/2010	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
249976	Fee-for-Service	1962511329	1962511329	1	1	THRIFTY DRUG STORE 5440	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	111 E AVENUE 26	None	LOS ANGELES	CA	90031	2312	19	06037	34.07653164	-118.2152045	Los Angeles County
250011	Fee-for-Service	1780983346	1780983346	1	1	TORGRIMSON, SARAH E LMFT	1/18/2021	103K00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 E COLORADO BLVD	STE 500	PASADENA	CA	91106	2380	19	06037	34.14595648	-118.1287575	Los Angeles County
250014	Fee-for-Service	1982137279	1982137279	1	1	TAREEN, SERENE MD	4/22/2024	207R00000X	NA	Other	026	PHYSICIANS	162652	41	Internal Medicine	0	In state provider	None	18200 YORBA LINDA BLVD	SUITE 250	YORBA LINDA	CA	92886	4044	30	06059	33.88842824	-117.8154698	Orange County
250060	Fee-for-Service	1326204249	1326204249	1	1	THADWAL, BALJEET S MD	8/11/2008	207L00000X	NA	Other	026	PHYSICIANS	102645	05	Anesthesiology	0	In state provider	None	2388 N CALIFORNIA	None	STOCKTON	CA	95204	5506	39	06077	37.97524442	-121.290938	San Joaquin County
250073	Fee-for-Service	1700180759	1700180759	1	1	TORRES, JESSICA M LMFT	8/26/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28100 BOUQUET CANYON RD.	SUITE 218	SANTA CLARITA	CA	91350	2009	19	06037	34.45052733	-118.497654	Los Angeles County
250082	Fee-for-Service	1407035769	1407035769	1	1	TAYLOR, JANET L	11/16/2007	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	8409 PIONEER BLVD	None	WHITTIER	CA	90606	2947	19	06037	33.968394	-118.081687	Los Angeles County
250096	Fee-for-Service	1114942018	1114942018	1	1	THOMASON, TIMOTHY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2021 N MACARTHUR BLVD	STE 150	IRVING	TX	75061	2210	00	None	32.834691	-96.95924802	Dallas County
250112	Fee-for-Service	1831296789	1831296789	1	1	TANDON, ASHISH MD	7/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51484	None	None	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
250114	Fee-for-Service	1124582424	1124582424	1	1	THE NEURON CLINIC GP	9/27/2021	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	None	44045 MARGARITA RD	STE 106	TEMECULA	CA	92592	2729	33	06065	33.48351542	-117.1027964	Riverside County
250121	Fee-for-Service	1538554159	1538554159	1	1	TSENG, JOCELYN M MD	1/28/2020	207R00000X	NA	Other	026	PHYSICIANS	146175	41	Internal Medicine	0	In state provider	None	1501 TROUSDALE DR	215	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
250124	Fee-for-Service	1518500917	1518500917	1	1	TYLER, BREANNA M	11/15/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1168 ASPEN LN	None	BANNING	CA	92220	1402	33	06065	33.93586347	-116.9154159	Riverside County
250142	Fee-for-Service	1831204825	1831204825	1	1	TSENG, LINDA MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74932	40	Pediatrics	0	In state provider	None	16707 ARROW BLVD	None	FONTANA	CA	92335	3801	36	06071	34.09913829	-117.4394986	San Bernardino County
250166	Fee-for-Service	1811183643	1811183643	1	1	TOWNS, MARK F MD	11/30/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	750 SPAANS ROAD	SUITE C, D, F	GALT	CA	95632	8609	34	06067	38.265354	-121.302423	Sacramento County
250190	Fee-for-Service	1023303294	1023303294	1	1	TEHAMA COUNTY HEALTH	4/1/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES AGENCY	1850 WALNUT STREET	None	RED BLUFF	CA	96080	3611	52	06103	40.16904822	-122.2542817	Tehama County
250219	Fee-for-Service	1174055388	1174055388	1	1	TABET, ANTHONY DO	4/13/2020	207R00000X	NA	Other	026	PHYSICIANS	16876	41	Internal Medicine	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
250232	Fee-for-Service	1649528357	1649528357	1	1	TAING, JENNIFER S NP	7/21/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
250234	Fee-for-Service	1225114713	1225114713	1	1	TAMAYO, ROBERT E OD	4/4/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3525 PACIFIC COAST HWY	STE E	TORRANCE	CA	90505	6656	19	06037	33.80337655	-118.3474795	Los Angeles County
250368	Fee-for-Service	1104935550	1104935550	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5632	9532 WINTER GARDENS BLVD	None	LAKESIDE	CA	92040	4032	37	06073	32.85065339	-116.9311976	San Diego County
250374	Fee-for-Service	1407067937	1407067937	2	1	TUPAZ HOMES LLC	5/18/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	14910 UNION AVE	None	SAN JOSE	CA	95124	4358	43	06085	37.251999	-121.9310815	Santa Clara County
250391	Fee-for-Service	1912695263	1912695263	1	1	TIBURCIO VASQUEZ HEALTH CTR	10/24/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	19400 SANTA MARIA AVENUE	ROOM P7 AND P8	CASTRO VALLEY	CA	94546	3400	01	06001	37.70465128	-122.0785627	Alameda County
250412	Fee-for-Service	1518500917	1518500917	1	1	TYLER, BREANNA M	11/15/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1168 ASPEN LN	None	BANNING	CA	92220	1402	33	06065	33.93586347	-116.9154159	Riverside County
250456	Fee-for-Service	1811183643	1811183643	1	1	TOWNS, MARK F MD	12/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100676	None	None	0	In state provider	None	750 SPAANS ROAD	SUITE C, D, F	GALT	CA	95632	8609	34	06067	38.265354	-121.302423	Sacramento County
250461	Fee-for-Service	1699754358	1699754358	2	1	TOWER NEPHROLOGY MEDICAL GR	5/19/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	OUP	8641 WILSHIRE BLVD	SUITE 300	BEVERLY HILLS	CA	90211	2921	19	06037	34.06614972	-118.3798912	Los Angeles County
250504	Fee-for-Service	1275651515	1275651515	1	10	THE ONCOLOGY INSTITUTE CA, A	6/14/2023	207RH0003X	NA	Oncology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1135 S SUNSET BLVD	SUITE 301	WEST COVINA	CA	91790	3707	19	06037	34.06215064	-117.9453997	Los Angeles County
250674	Fee-for-Service	1912695263	1912695263	1	1	TIBURCIO VASQUEZ HEALTH CTR	10/16/2024	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	19400 SANTA MARIA AVENUE	ROOM P7 AND P8	CASTRO VALLEY	CA	94546	3400	01	06001	37.70465128	-122.0785627	Alameda County
250696	Fee-for-Service	1457585697	1457585697	1	1	TURNER-LLOVERAS, DANIEL J MD	8/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121387	None	None	0	In state provider	None	215 WEST JANSS ROAD	None	THOUSAND OAK	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
250699	Fee-for-Service	1609338029	1609338029	1	1	TAN, KEVIN T MD	2/24/2024	207L00000X	NA	Other	026	PHYSICIANS	177253	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
250738	Fee-for-Service	1710661871	1710661871	1	1	TRAM HO PETERSEN INC.	7/16/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5814 VAN ALLEN WAY	SUITE 146	CARLSBAD	CA	92008	7359	37	06073	33.13600632	-117.2876273	San Diego County
250743	Fee-for-Service	1811183643	1811183643	1	1	TOWNS, MARK F MD	10/28/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	100676	-	NOT APPLICABLE	0	In state provider	None	750 SPAANS ROAD	SUITE C, D, F	GALT	CA	95632	8609	34	06067	38.265354	-121.302423	Sacramento County
250752	Fee-for-Service	1689038721	1689038721	1	1	TEKESTE, TIMNIT F MD	8/28/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	152689	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
250791	Fee-for-Service	1730204207	1730204207	1	1	TROUTMAN, WILBUR MD	11/15/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73397	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	WOMEN'S MED CTR OF LA	3660 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2653	19	06037	33.93178635	-118.2019603	Los Angeles County
250792	Fee-for-Service	1275651515	1275651515	1	10	THE ONCOLOGY INSTITUTE CA, A	8/1/2014	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	1135 S SUNSET BLVD	SUITE 301	WEST COVINA	CA	91790	3707	19	06037	34.06215064	-117.9453997	Los Angeles County
250808	Fee-for-Service	1427077569	1427077569	1	1	TRETIAK, SEAN H MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65535	05	Anesthesiology	0	In state provider	None	21235 HAWTHORNE BLVD	STE 200	TORRANCE	CA	90503	5525	19	06037	33.83505386	-118.3554946	Los Angeles County
250809	Fee-for-Service	1003996828	1003996828	1	1	THOENE, MICHAEL J MD	2/28/1983	207N00000X	NA	Dermatology	026	PHYSICIANS	25265	07	Dermatology	0	In state provider	None	514 S MAGNOLIA AVE	None	EL CAJON	CA	92020	6011	37	06073	32.79028005	-116.962414	San Diego County
250818	Fee-for-Service	1497861793	1497861793	1	1	TAK, CHONG HO MD	8/31/1990	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	49031	40	Pediatrics	0	In state provider	None	3680 E IMPERIAL HWY	STE 200	LYNWOOD	CA	90262	2663	19	06037	33.93211641	-118.2011728	Los Angeles County
250853	Fee-for-Service	1447558044	1447558044	1	1	TSAI, IRENE S MD	5/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118951	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
250867	Fee-for-Service	1982867370	1982867370	1	1	TSAO, GABRIEL J MD	5/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	111386	04	Otology, Laryngology, Rhinology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
250891	Fee-for-Service	1376611038	1376611038	1	1	TSAI, SHIU-CHI MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	38034	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	950 E ALMOND AVE	STE 101	MADERA	CA	93637	5694	20	06039	36.9454463	-120.0471689	Madera County
250917	Fee-for-Service	1851840789	1851840789	1	1	TLC PLUS HOME HEALTH INC	2/7/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	27574 COMMERCE CENTER DR	UNIT 231	TEMECULA	CA	92590	2536	33	06065	33.51295397	-117.1617678	Riverside County
250959	Fee-for-Service	1891950564	1891950564	1	1	THOMAS, SARAH LMFT	2/11/2025	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
250961	Fee-for-Service	1912695263	1912695263	1	1	TIBURCIO VASQUEZ HEALTH CTR	10/24/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	19400 SANTA MARIA AVENUE	ROOM P7 AND P8	CASTRO VALLEY	CA	94546	3400	01	06001	37.70465128	-122.0785627	Alameda County
250968	Fee-for-Service	1558326371	1558326371	1	2	TON, KIET A MD	8/1/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	130978	41	Internal Medicine	0	In state provider	None	14082 MAGNOLIA ST	109	WESTMINSTER	CA	92683	4764	30	06059	33.75832207	-117.9723348	Orange County
250983	Fee-for-Service	1992840813	1992840813	1	1	TALEGHANI, CHRISTOPHER K MD	7/1/2019	207T00000X	NA	General Surgery	026	PHYSICIANS	-	14	Neurological Surgery	2	Out of state provider	None	85 MAUI LANI PKWY	None	WAILUKU	HI	96793	2416	00	None	20.886543	-156.4911107	Maui County
250990	Fee-for-Service	1649286931	1649286931	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2310 HOMESTEAD RD	None	LOS ALTOS	CA	94024	7339	43	06085	37.33754943	-122.0672057	Santa Clara County
251028	Fee-for-Service	1619396298	1619396298	1	1	TAMINICH, RACHEL LMFT	10/23/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
251032	Fee-for-Service	1407051196	1407051196	1	1	TOPOZ, IRINA A MD	4/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
251064	Fee-for-Service	1205935012	1205935012	1	1	THE CHILDREN'S HOSPITAL OF A	12/29/2006	282NC2000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1600 7TH AVE S	None	BIRMINGHAM	AL	35233	1785	00	None	33.50351519	-86.80482824	Jefferson County
251066	Fee-for-Service	1992159149	1992159149	1	1	TOKUMITSU, SAYAKA W MD	8/25/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152195	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
251081	Fee-for-Service	1275651515	1275651515	1	10	THE ONCOLOGY INSTITUTE CA, A	10/15/2021	207RH0003X	NA	Oncology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1135 S SUNSET BLVD	SUITE 301	WEST COVINA	CA	91790	3707	19	06037	34.06215064	-117.9453997	Los Angeles County
251107	Fee-for-Service	1427117084	1427117084	1	1	TUN, KYAW K MD	11/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85428	68	Hematology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
251109	Fee-for-Service	1285665133	1285665133	1	1	TUNG, VIVIAN V MD	8/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78067	40	Pediatrics	0	In state provider	None	7300 GIRARD AVE	STE 106	LA JOLLA	CA	92037	5138	37	06073	32.83772948	-117.2716382	San Diego County
251110	Fee-for-Service	1427261437	1427261437	1	1	TONG, WILSON P MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116219	68	Hematology	0	In state provider	None	4721 DALLAS RANCH RD	None	ANTIOCH	CA	94531	8811	07	06013	37.97016362	-121.7967323	Contra Costa County
251121	Fee-for-Service	1811381858	1811381858	1	1	TORNG, PERRY DO	9/6/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16452	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
251169	Fee-for-Service	1225711765	1225711765	1	1	TANG, CHLOE CCC-SLP	1/30/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2123 S HACIENDA BLVD	None	HACIENDA HEIGHTS	CA	91745	4243	19	06037	33.99521958	-117.9685486	Los Angeles County
251184	Fee-for-Service	1841292620	1841292620	1	1	TAYLOR F REICHEL	6/24/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	520 N 3RD AVE	None	SANDPOINT	ID	83864	1507	00	None	48.27786153	-116.5503511	Bonner County
251195	Fee-for-Service	1659873990	1659873990	1	1	TUASON, ANGELICA OT	8/23/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1251 E DYER RD	SUITE 150	SANTA ANA	CA	92705	5662	30	06059	33.70870351	-117.8551005	Orange County
251204	Fee-for-Service	1639445372	1639445372	1	1	THRELKELD, ZACHARY D MD	5/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	127863	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
251261	Fee-for-Service	1477509529	1477509529	1	1	THAKUR, ANJANI K MD INC	6/16/2009	208600000X	NA	General Surgery	026	PHYSICIANS	66588	02	General Surgery	0	In state provider	None	840 DELBON AVE	None	TURLOCK	CA	95382	2005	50	06099	37.51046091	-120.8383932	Stanislaus County
251293	Fee-for-Service	1073684908	1073684908	1	1	TAHOE DOUGLAS FIRE	9/17/2012	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	1	Border provider	PROTECTION DISTRICT	193 ELKS POINT ROAD	None	ZEPHYR COVE	NV	89448	0919	00	None	38.98342082	-119.9433524	Douglas County
251319	Fee-for-Service	1881640787	1881640787	1	1	TUCH BARRY AM	10/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	27150	20	Orthopedic Surgery	0	In state provider	None	9360 N NAME UNO	STE 125	GILROY	CA	95020	3535	43	06085	37.035801	-121.569858	Santa Clara County
251333	Fee-for-Service	1376053843	1376053843	1	4	TYSON MEDICAL INC	1/16/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	RGENT CARE	630 SOUTH BRAWLEY AVE	10	BRAWLEY	CA	92227	3107	13	06025	32.97215183	-115.5425908	Imperial County
251354	Fee-for-Service	1205935012	1205935012	1	1	THE CHILDREN'S HOSPITAL OF A	8/19/2010	282NC2000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1600 7TH AVE S	None	BIRMINGHAM	AL	35233	1785	00	None	33.50351519	-86.80482824	Jefferson County
251370	Fee-for-Service	1275651515	1275651515	1	10	THE ONCOLOGY INSTITUTE CA, A	8/1/2014	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1135 S SUNSET BLVD	SUITE 301	WEST COVINA	CA	91790	3707	19	06037	34.06215064	-117.9453997	Los Angeles County
251398	Fee-for-Service	1427261437	1427261437	1	1	TONG, WILSON P MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116219	78	Neoplastic Diseases/Oncology	0	In state provider	None	4721 DALLAS RANCH RD	None	ANTIOCH	CA	94531	8811	07	06013	37.97016362	-121.7967323	Contra Costa County
251401	Fee-for-Service	1275524589	1275524589	1	1	TSUTAOKA, ELSA K MD	12/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	61609	08	Family Practice	0	In state provider	None	1111 E STANLEY BLVD	None	LIVERMORE	CA	94550	4115	01	06001	37.67881307	-121.7823992	Alameda County
251420	Fee-for-Service	1750412300	1750412300	1	3	TAHOE FOREST HOSP DIST	4/28/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	10978 DONNER PASS RD	None	TRUCKEE	CA	96160	0433	29	06057	39.32616692	-120.2026317	Nevada County
251425	Fee-for-Service	1376725168	1376725168	1	1	THRIFTY PAYLESS INC.	1/31/2008	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6495	9333 WHITTIER BLVD	None	PICO RIVERA	CA	90660	2746	19	06037	33.99907759	-118.0784107	Los Angeles County
251494	Fee-for-Service	1609162379	1609162379	1	1	TRINH, LORNA LMFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
251527	Fee-for-Service	1184058091	1184058091	1	1	TENNEY, TARA T MD	1/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136834	01	General Practice	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
251556	Fee-for-Service	1053871665	1053871665	1	1	TAKAHASHI, SAM S DO	8/22/2023	207L00000X	NA	Other	026	PHYSICIANS	20569	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
251593	Fee-for-Service	1659807717	1659807717	1	1	TAMPA SURGICAL CENTER LLC	9/24/2018	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	7640 TAMPA AVE	STE 102	RESEDA	CA	91335	1700	19	06037	34.20951144	-118.5534786	Los Angeles County
251621	Fee-for-Service	1376053843	1376053843	1	4	TYSON MEDICAL INC	1/16/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	RGENT CARE	630 SOUTH BRAWLEY AVE	10	BRAWLEY	CA	92227	3107	13	06025	32.97215183	-115.5425908	Imperial County
251691	Fee-for-Service	1942532601	1942532601	1	1	TSOU, YAO SZU MFT	5/11/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	86019	-	NOT APPLICABLE	0	In state provider	None	1340 TULLY RD	STE 301 & 304	SAN JOSE	CA	95122	3055	43	06085	37.31710924	-121.8334186	Santa Clara County
251701	Fee-for-Service	1003814211	1003814211	1	1	TREMPER,LARRY 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	1201 E SCHUSTER	STE 5 B	EL PASO	TX	79902	0000	00	None	31.77612849	-106.4886625	El Paso County
251703	Fee-for-Service	1326235433	1326235433	1	1	TRAN, THUYEN H MD	2/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80111	30	Radiology	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
251722	Fee-for-Service	1861598112	1861598112	1	1	TOWNSEND,DENISE J MD	9/30/1988	207R00000X	NA	Other	026	PHYSICIANS	64306	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	# 3600	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
251728	Fee-for-Service	1225061922	1225061922	1	1	TEELE, MIRIAM E	6/24/1997	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1127 WILSHIRE BLVD	STE 901	LOS ANGELES	CA	90017	3910	19	06037	34.05270508	-118.2641005	Los Angeles County
251763	Fee-for-Service	1649692716	1649692716	1	3	TEAM PHYSICIANS OF NORTHERN	3/9/2023	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6001 NORRIS CANYON RD	None	SAN RAMON	CA	94583	5400	07	06013	37.7755858	-121.958923	Contra Costa County
251790	Fee-for-Service	1457856387	1457856387	1	1	TRANI, MARVIN C DO	5/7/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17835	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
251793	Fee-for-Service	1104938505	1104938505	1	1	TOGAY, VAROL MD	3/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	64496	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1687 ERRINGER RD	STE 105	SIMI VALLEY	CA	93065	6509	56	06111	34.268886	-118.761426	Ventura County
251863	Fee-for-Service	1659861342	1659861342	1	1	TORRES, PAUL PT	9/1/2021	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
251874	Fee-for-Service	1184702896	1184702896	1	1	TORRES, NANCY MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	50755	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
251895	Fee-for-Service	1194139766	1194139766	1	1	TILFORD, SARAH MD	12/10/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154086	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
251901	Fee-for-Service	1790235323	1790235323	1	1	THELEN, KENDALL L NP	11/27/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
251914	Fee-for-Service	1396525564	1396525564	1	1	THARON RIVERSIDE, LLC	4/8/2025	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	10849 ARLINGTON AVENUE	None	RIVERSIDE	CA	92505	2201	33	06065	33.94495631	-117.4932302	Riverside County
251916	Fee-for-Service	1538367420	1538367420	1	1	THOMPSON, JUDI A LCSW	5/24/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
251917	Fee-for-Service	1568503639	1568503639	1	1	THIND, SURINDER S MD	1/1/1982	174400000X	NA	Other	026	PHYSICIANS	32303	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11100 WARNER AVE	STE 218	FOUNTAIN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
251934	Fee-for-Service	1316049646	1316049646	1	1	TRAN, TUYEN T OD	8/10/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2508 MISSION ST	None	SAN FRANCISCO	CA	94110	7369	38	06075	37.75682643	-122.4189251	San Francisco County
251962	Fee-for-Service	1215947247	1215947247	1	1	TANG, NATHAN H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55241	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	414 G ST	None	MARYSVILLE	CA	95901	5663	58	06115	39.13913942	-121.5934649	Yuba County
251965	Fee-for-Service	1558444695	1558444695	1	1	TRAN, QUYNH N	10/2/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5250 PHILADELPHIA ST	D	CHINO	CA	91710	2483	36	06071	34.03355477	-117.6912519	San Bernardino County
251980	Fee-for-Service	1861619314	1861619314	1	1	TURNING POINT OF CENTRAL	12/16/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA INC	14871 ROAD 192	None	PORTERVILLE	CA	93257	8975	54	06107	36.05979257	-119.1431949	Tulare County
252028	Fee-for-Service	1164981023	1164981023	1	1	TAMHANE, JAEE DO	7/1/2023	207P00000X	NA	Other	026	PHYSICIANS	20494	None	None	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
252044	Fee-for-Service	1154071348	1154071348	1	1	TENORIO, LISA A MD	8/21/2024	207P00000X	NA	Other	026	PHYSICIANS	187665	70	Clinic (mixed specialty)	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
252079	Fee-for-Service	1053779777	1053779777	1	1	TRABAZO, DAVID DO	12/3/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17094	08	Family Practice	0	In state provider	None	550 W RANCH VIEW DR	2005	ROCKLIN	CA	95765	5396	31	06061	38.83760761	-121.2972372	Placer County
252080	Fee-for-Service	1104938505	1104938505	1	1	TOGAY, VAROL MD	3/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	64496	41	Internal Medicine	0	In state provider	None	1687 ERRINGER RD	STE 105	SIMI VALLEY	CA	93065	6509	56	06111	34.268886	-118.761426	Ventura County
252125	Fee-for-Service	1558419580	1558419580	1	1	THORP, ANDREA W MD	8/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80643	40	Pediatrics	0	In state provider	None	245 TERRACINA BLVD	STE 207A	REDLANDS	CA	92373	4869	36	06071	34.03858912	-117.2066515	San Bernardino County
252152	Fee-for-Service	1114381209	1114381209	1	1	TON, ERIC H MD	5/24/2018	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
252160	Fee-for-Service	1184702896	1184702896	1	1	TORRES, NANCY MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	50755	40	Pediatrics	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
252193	Fee-for-Service	1831278969	1831278969	1	1	TAO, CHUNFUN F MD	4/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92553	41	Internal Medicine	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
252228	Fee-for-Service	1356512305	1356512305	1	1	TREGONING, STEPHEN	3/1/1999	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	5360 JACKSON DR	None	LA MESA	CA	91942	6002	37	06073	32.77680573	-117.0176327	San Diego County
252240	Fee-for-Service	1528476272	1528476272	1	1	TORRES, MASSIEL M LCSW	10/21/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
252250	Fee-for-Service	1215947247	1215947247	1	1	TANG, NATHAN H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55241	41	Internal Medicine	0	In state provider	None	414 G ST	None	MARYSVILLE	CA	95901	5663	58	06115	39.13913942	-121.5934649	Yuba County
252258	Fee-for-Service	1831680255	1831680255	1	1	TOROSYAN, NAREK H DO	9/20/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17771	None	None	0	In state provider	None	5250 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91601	3186	19	06037	34.1665161	-118.3755868	Los Angeles County
252260	Fee-for-Service	1134654361	1134654361	1	1	THOMPSON, SUSAN P NP	10/31/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
252265	Fee-for-Service	1083011670	1083011670	1	1	THE URGENT CARE AT VERMONT	4/28/2016	261QU0200X	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
252273	Fee-for-Service	1407490824	1407490824	1	1	TEVES, RICHARD NP	4/10/2024	163W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1902 ORANGE TREE LN	SUITE 200	REDLANDS	CA	92374	2888	36	06071	34.06785293	-117.2179967	San Bernardino County
252291	Fee-for-Service	1962727347	1962727347	1	1	TALAMO, THOMAS N MD	11/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129090	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
252300	Fee-for-Service	1942675038	1942675038	1	1	TF BREWER, M.D., INC.	7/14/2021	193200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	FORNIA	3415 S SEPULVEDA BLVD	STE 1122	LOS ANGELES	CA	90034	6060	19	06037	34.02086527	-118.4235306	Los Angeles County
252317	Fee-for-Service	1104813013	1104813013	1	1	TANI, JASON C MD	8/1/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	160274	None	None	0	In state provider	None	13010 HESPERIA RD	600	VICTORVILLE	CA	92395	8321	36	06071	34.48843676	-117.2909745	San Bernardino County
252319	Fee-for-Service	1184702094	1184702094	1	1	TAY, GRACE S MD	11/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	88470	02	General Surgery	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
252333	Fee-for-Service	1154071348	1154071348	1	1	TENORIO, LISA A MD	8/21/2024	207P00000X	NA	Other	026	PHYSICIANS	187665	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
252399	Fee-for-Service	1437145042	1437145042	1	1	TANG, JOHN C MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70341	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
252434	Fee-for-Service	1972161511	1972161511	1	1	TRISTAR HOME HEALTH CARE INC	3/20/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8363 RESEDA BLVD	STE 203B	NORTHRIDGE	CA	91324	4673	19	06037	34.22255941	-118.5361155	Los Angeles County
252439	Fee-for-Service	1528650330	1528650330	1	1	THE WAY OF PARADISE HOSPICE	4/21/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	14545 FRIAR STREET	STE 183	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
252442	Fee-for-Service	1548418023	1548418023	1	1	TRUONG, HENRY H OD	3/22/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5755 COTTLE ROAD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
252443	Fee-for-Service	1104825454	1104825454	1	1	TAYLOR, ARTHUR J MD	8/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2650 N TENAYA WAY	STE 301	LAS VEGAS	NV	89128	1112	00	None	36.20804839	-115.2501292	Clark County
252446	Fee-for-Service	1801157268	1801157268	1	1	TOLLES, JULIANA MD	12/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122401	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 SOUTH GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
252463	Fee-for-Service	1104935485	1104935485	1	1	THRIFTY PAYLESS INC	4/6/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1601 23RD ST	None	BAKERSFIELD	CA	93301	4035	15	06029	35.38002941	-119.0205461	Kern County
252490	Fee-for-Service	1689172173	1689172173	1	1	TREANOR, MICHAEL PHD	2/6/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	6968	19	06037	34.07067	-118.4432445	Los Angeles County
252508	Fee-for-Service	1871110932	1871110932	1	1	THE FRESNO CENTER	7/28/2020	1041C0700X	NA	Mental Health Outpatient Services	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	4861 E KINGS CANYON RD	None	FRESNO	CA	93727	3811	10	06019	36.7360374	-119.7332482	Fresno County
252545	Fee-for-Service	1093246670	1093246670	1	1	THATIKUNTA, PRATEEK MD	8/11/2023	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	158382	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
252551	Fee-for-Service	1184825135	1184825135	1	1	TRITTO, APRIL T MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119743	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
252552	Fee-for-Service	1083011670	1083011670	1	1	THE URGENT CARE AT VERMONT	4/28/2016	261QU0200X	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
252560	Fee-for-Service	1336210319	1336210319	1	1	TRAN, DOAN-TRANG T MD	9/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73844	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
252561	Fee-for-Service	1033268388	1033268388	1	1	TRAN, KHOA B MD	9/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90753	34	Urology and Urological Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
252562	Fee-for-Service	1649615071	1649615071	1	1	TRAN, AMY H MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137426	41	Internal Medicine	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
252588	Fee-for-Service	1942675038	1942675038	1	1	TF BREWER, M.D., INC.	1/3/2023	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	FORNIA	3415 S SEPULVEDA BLVD	STE 1122	LOS ANGELES	CA	90034	6060	19	06037	34.02086527	-118.4235306	Los Angeles County
252613	Fee-for-Service	1114959509	1114959509	1	1	TABORGA, CELSO F MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	80337	41	Internal Medicine	0	In state provider	None	1280 CENTRAL BLVD	STE D	BRENTWOOD	CA	94513	2205	07	06013	37.9394976	-121.6978566	Contra Costa County
252621	Fee-for-Service	1518287960	1518287960	1	1	TSUKAMOTO, MICHELLE M DO	8/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11245	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
252629	Fee-for-Service	1962488007	1962488007	1	8	TERI INC	4/29/1985	310500000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	VISTA HOUSE	1768 MONTE MAR RD	None	VISTA	CA	92084	3636	37	06073	33.21935032	-117.2110185	San Diego County
252632	Fee-for-Service	1386030955	1386030955	1	2	TANGSOMBATVISIT, STEPHANIE	5/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146823	None	None	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
252650	Fee-for-Service	1518915693	1518915693	1	1	TAYLOR, DOUGLAS M DPM	4/29/2008	213EP1101X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	13847 E 14TH STREET	STE 110 A	SAN LEANDRO	CA	94578	2632	01	06001	37.71457844	-122.1418551	Alameda County
252691	Fee-for-Service	1588658280	1588658280	1	1	THOMAS, ANNE S MD	2/1/2000	207L00000X	NA	Other	026	PHYSICIANS	69831	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
252700	Fee-for-Service	1639233935	1639233935	1	1	THE CHILDRENS CLINIC	8/15/1999	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	455 E COLUMBIA ST	None	LONG BEACH	CA	90806	2755	19	06037	33.80900524	-118.1874314	Los Angeles County
252708	Fee-for-Service	1801922729	1801922729	1	1	TANG, ROBERT MD	2/28/1986	207R00000X	NA	Other	026	PHYSICIANS	53548	01	General Practice	0	In state provider	None	2251 HAWTHORNE ST	None	SACRAMENTO	CA	95815	2958	34	06067	38.607948	-121.4587935	Sacramento County
252727	Fee-for-Service	1528650330	1528650330	1	1	THE WAY OF PARADISE HOSPICE	4/21/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	14545 FRIAR STREET	STE 183	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
252759	Fee-for-Service	1649649419	1649649419	1	2	TEEN, JASSAMINE LCSW	4/27/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
252772	Fee-for-Service	1154683118	1154683118	1	1	TEN HOLT, RENSINA NP	8/2/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
252776	Fee-for-Service	1841352044	1841352044	1	1	TORRE, JANIS E LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
252825	Fee-for-Service	1962971515	1962971515	1	1	THURMAN, SABRINA L LCSW	11/13/2023	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
252826	Fee-for-Service	1659468445	1659468445	1	1	TRAN, LOAN T MD CORP	11/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	60907	18	Ophthalmology	0	In state provider	None	9143 E VALLEY BLVD	STE 102	ROSEMEAD	CA	91770	1991	19	06037	34.08096534	-118.0700742	Los Angeles County
252840	Fee-for-Service	1114362894	1114362894	1	1	TIMBOE, JENNA K MD	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134953	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
252848	Fee-for-Service	1336210319	1336210319	1	1	TRAN, DOAN-TRANG T MD	9/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73844	10	Gastroenterology (M.D. only)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
252850	Fee-for-Service	1881703239	1881703239	1	1	THRIFTY PAYLESS INC	12/13/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5872	5574 E KINGS CANYON RD	None	FRESNO	CA	93727	4526	10	06019	36.734724	-119.7006975	Fresno County
252855	Fee-for-Service	1851396717	1851396717	1	1	TAYLOR-ALBERT, ELIZABETH MD	10/10/2019	207RR0500X	NA	Other	026	PHYSICIANS	160430	83	Rheumatology	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
252877	Fee-for-Service	1942675038	1942675038	1	1	TF BREWER, M.D., INC.	2/23/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	FORNIA	3415 S SEPULVEDA BLVD	STE 1122	LOS ANGELES	CA	90034	6060	19	06037	34.02086527	-118.4235306	Los Angeles County
252899	Fee-for-Service	1003015215	1003015215	1	1	TIN, MAUNG M MD	12/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105297	38	Geriatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
252909	Fee-for-Service	1841348737	1841348737	1	1	THOMAS, SONYA, W MD	4/30/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	55155	08	Family Practice	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
252923	Fee-for-Service	1962488007	1962488007	1	4	TERI INC	4/29/1985	310500000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	GRACE HOUSE	2507 HIBISCUS AVE	None	VISTA	CA	92081	4605	37	06073	33.15858343	-117.2187414	San Diego County
252928	Fee-for-Service	1891843736	1891843736	1	1	TU, ERIK S MD	2/22/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	97776	18	Ophthalmology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
252945	Fee-for-Service	1871903310	1871903310	1	1	TRAN, MINH H MD	7/31/2018	207L00000X	NA	Other	026	PHYSICIANS	147724	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
252956	Fee-for-Service	1548265036	1548265036	1	6	TRUXTUN RADIOLOGY	5/17/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	9330 STOCKDALE HWY	STE 100	BAKERSFIELD	CA	93311	3615	15	06029	35.35452946	-119.106351	Kern County
252983	Fee-for-Service	1639233935	1639233935	1	1	THE CHILDRENS CLINIC	8/15/1999	261QC1500X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	455 E COLUMBIA ST	None	LONG BEACH	CA	90806	2755	19	06037	33.80900524	-118.1874314	Los Angeles County
252998	Fee-for-Service	1801922729	1801922729	1	1	TANG, ROBERT MD	2/28/1986	207R00000X	NA	Other	026	PHYSICIANS	53548	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2251 HAWTHORNE ST	None	SACRAMENTO	CA	95815	2958	34	06067	38.607948	-121.4587935	Sacramento County
253021	Fee-for-Service	1194970293	1194970293	1	1	TURULLOLS, SYLVIA D MD	2/28/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	150776	None	None	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
253033	Fee-for-Service	1568662369	1568662369	1	1	TOULABI, BABAK MD	12/11/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	131277	30	Radiology	0	In state provider	None	2365 QUIMBY ROAD	STE 100	SAN JOSE	CA	95122	1337	43	06085	37.325106	-121.8094335	Santa Clara County
253049	Fee-for-Service	1477075158	1477075158	1	1	TEKESTE, DEJEN CRNA	8/6/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
253055	Fee-for-Service	1295962934	1295962934	1	1	THOMPSON, HOLLY M MD	9/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	116285	42	Nuclear Medicine	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
253119	Fee-for-Service	1487031803	1487031803	1	1	TRAN, DUC M DO	7/12/2019	390200000X	NA	Other	026	PHYSICIANS	17303	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
253127	Fee-for-Service	1114362894	1114362894	1	1	TIMBOE, JENNA K MD	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134953	40	Pediatrics	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
253138	Fee-for-Service	1770776981	1770776981	1	1	TRAN, MINH Q MD INC	10/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95464	14	Neurological Surgery	0	In state provider	None	14501 MAGNOLIA ST	STE 102	WESTMINSTER	CA	92683	5542	30	06059	33.75188963	-117.9723601	Orange County
253163	Fee-for-Service	1942675038	1942675038	1	1	TF BREWER, M.D., INC.	2/23/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FORNIA	3415 S SEPULVEDA BLVD	STE 1122	LOS ANGELES	CA	90034	6060	19	06037	34.02086527	-118.4235306	Los Angeles County
253164	Fee-for-Service	1023082153	1023082153	1	1	TIDOW-KEBRITCHI, SUSANNE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2160 S 1ST AVE	None	MAYWOOD	IL	60153	3328	00	None	41.86025379	-87.83381752	Cook County
253169	Fee-for-Service	1093276198	1093276198	1	1	THAI, JUSTIN C MD	9/21/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	177462	None	None	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
253206	Fee-for-Service	1962870907	1962870907	1	1	TELFER, ALBERT NP	2/17/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	126 AVOCADO AVE	STE 205	PERRIS	CA	92571	2605	33	06065	33.8102395	-117.2244465	Riverside County
253213	Fee-for-Service	1275058448	1275058448	1	1	TRINIDAD, DANICA F NP	12/13/2019	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1211 W LA PALMA AVE	STE 207	ANAHEIM	CA	92801	2139	30	06059	33.84718298	-117.933758	Orange County
253229	Fee-for-Service	1649367921	1649367921	1	1	TRAN, DAI L MD	7/10/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	83981	18	Ophthalmology	0	In state provider	None	1148 E HOLT AVE	None	POMONA	CA	91767	5827	19	06037	34.06287974	-117.7275052	Los Angeles County
253245	Fee-for-Service	1417311739	1417311739	1	1	TSUKAMOTO, MICHELLE R MD	10/14/2019	207R00000X	NA	Other	026	PHYSICIANS	153398	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
253261	Fee-for-Service	1306427752	1306427752	1	1	THEMIS HOME HEALTH, INC.	11/21/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	427 W. COLORADO ST.	SUITE 102C	GLENDALE	CA	91204	1583	19	06037	34.1425505	-118.262142	Los Angeles County
253283	Fee-for-Service	1497714927	1497714927	1	1	TOOMA, RAJA S MD	5/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36223	66	Emergency Medicine (Urgent Care)	0	In state provider	None	24853 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	6102	33	06065	33.91718453	-117.228627	Riverside County
253284	Fee-for-Service	1801922729	1801922729	1	1	TANG, ROBERT MD	2/28/1986	207R00000X	NA	Other	026	PHYSICIANS	53548	41	Internal Medicine	0	In state provider	None	2251 HAWTHORNE ST	None	SACRAMENTO	CA	95815	2958	34	06067	38.607948	-121.4587935	Sacramento County
253289	Fee-for-Service	1669524013	1669524013	1	1	TANTON, ELIZABETH A NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4700 SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
253304	Fee-for-Service	1285626184	1285626184	1	1	TIMOTHY M CASEY MD	1/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 CHICAGO AVE	None	MINNEAPOLIS	MN	55404	4518	00	None	44.95666589	-93.26255996	Hennepin County
253340	Fee-for-Service	1255059630	1255059630	1	1	TIAN, XIN YUAN OD	9/30/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	388 9TH STREET	SUITE 157	OAKLAND	CA	94607	4290	01	06001	37.80019425	-122.2715222	Alameda County
253391	Fee-for-Service	1285712356	1285712356	1	1	TALOMA, LUDWIGA T MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55969	41	Internal Medicine	0	In state provider	None	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
253415	Fee-for-Service	1548325855	1548325855	1	1	TRANG, TUNG T MD	2/8/2015	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	108204	84	Surgery-Head and Neck	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4108	15	06029	35.382555	-118.970757	Kern County
253439	Fee-for-Service	1730159716	1730159716	1	1	TYSCH, SHERRI R DO	3/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	5794	40	Pediatrics	0	In state provider	None	612 E JANSS ROAD	None	THOUSAND OAKS	CA	91360	5113	56	06111	34.19957051	-118.8666284	Ventura County
253452	Fee-for-Service	1942675038	1942675038	1	1	TF BREWER, M.D., INC.	7/19/2021	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	FORNIA	3415 S SEPULVEDA BLVD	STE 1122	LOS ANGELES	CA	90034	6060	19	06037	34.02086527	-118.4235306	Los Angeles County
253460	Fee-for-Service	1922236165	1922236165	1	1	TONG, ROBERT L MD	6/14/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	113897	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
253520	Fee-for-Service	1952364937	1952364937	1	1	TOTAL RENAL CARE INC	8/25/1989	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	WALNUT CREEK DIALYSIS	404 N WIGET LN	None	WALNUT CREEK	CA	94598	2408	07	06013	37.92944835	-122.0288255	Contra Costa County
253537	Fee-for-Service	1518929108	1518929108	1	1	TSCHETTER, CLIFFORD N MD	5/31/1985	207ZC0500X	NA	Other	026	PHYSICIANS	4300	22	Pathology (M.D. only)	0	In state provider	None	353 30TH ST	None	OAKLAND	CA	94609	3402	01	06001	37.81875726	-122.2635923	Alameda County
253547	Fee-for-Service	1689235111	1689235111	1	1	TEMPELIS, COLIN K PT	4/28/2022	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
253551	Fee-for-Service	1376575985	1376575985	1	1	TRAM, THONG D DO	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7856	41	Internal Medicine	0	In state provider	None	1600 CREEKSIDE DR	#2800	FOLSOM	CA	95630	3486	34	06067	38.669994	-121.147488	Sacramento County
253576	Fee-for-Service	1326116716	1326116716	1	1	TANGAAN, MONICO	2/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	STE 304	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
253624	Fee-for-Service	1639228570	1639228570	1	1	TOY, STEPHEN D 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
253632	Fee-for-Service	1639102510	1639102510	1	1	THOMAS WILLIAM SMITH, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1712 E 23RD AVE	None	HUTCHINSON	KS	67502	1114	00	None	38.07953411	-97.89161962	Reno County
253645	Fee-for-Service	1881238178	1881238178	1	1	TAPCHOM, ANGE B CRNA	3/10/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
253682	Fee-for-Service	1033178876	1033178876	1	1	TRAYLOR, AMATER Z JR MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32496	18	Ophthalmology	0	In state provider	None	5682 ADELINE ST	None	OAKLAND	CA	94608	2804	01	06001	37.84149803	-122.2742749	Alameda County
253704	Fee-for-Service	1548325855	1548325855	1	1	TRANG, TUNG T MD	2/8/2015	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	108204	04	Otology, Laryngology, Rhinology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4108	15	06029	35.382555	-118.970757	Kern County
253730	Fee-for-Service	1053736975	1053736975	1	1	THE WEITCHPEC GROUP	4/8/2015	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	9567 ARROW ROUTE	SUITE L	RANCHO CUCAMONGA	CA	91730	4550	36	06071	34.09927854	-117.5968935	San Bernardino County
253740	Fee-for-Service	1942675038	1942675038	1	1	TF BREWER, M.D., INC.	2/23/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	47	Miscellaneous	0	In state provider	FORNIA	3415 S SEPULVEDA BLVD	STE 1122	LOS ANGELES	CA	90034	6060	19	06037	34.02086527	-118.4235306	Los Angeles County
253753	Fee-for-Service	1629145503	1629145503	1	1	THOMPSON, JOSEPH C JR MD	10/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	48303	22	Pathology (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
253764	Fee-for-Service	1700924248	1700924248	1	1	TONGSON-IGNACIO, JANE E	5/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88855	22	Pathology (M.D. only)	0	In state provider	MD	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
253787	Fee-for-Service	1912606690	1912606690	1	1	TAHMINA HAQ MD	5/2/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	631 S BROOKHURST ST	STE. 214	ANAHEIM	CA	92804	3510	30	06059	33.823647	-117.9589675	Orange County
253836	Fee-for-Service	1487997888	1487997888	1	1	THIDA M THANT	2/3/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
253983	Fee-for-Service	1396130209	1396130209	1	1	TAYLOR, JAMES P MD	8/1/2022	208600000X	NA	General Surgery	026	PHYSICIANS	175763	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
254020	Fee-for-Service	1417920299	1417920299	1	1	THIND, SATSIMRAN S DO	8/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9389	05	Anesthesiology	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
254022	Fee-for-Service	1184702961	1184702961	1	1	TERRAZAS, YVES B MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71783	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
254039	Fee-for-Service	1588773931	1588773931	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8245 N LAKE BLVD	None	KINGS BEACH	CA	96143	0000	31	06061	39.23757948	-120.027681	Placer County
254075	Fee-for-Service	1912606690	1912606690	1	1	TAHMINA HAQ MD	5/2/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	631 S BROOKHURST ST	STE. 214	ANAHEIM	CA	92804	3510	30	06059	33.823647	-117.9589675	Orange County
254076	Fee-for-Service	1184826364	1184826364	1	1	TING, JENNIFER G MD	4/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134140	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2200 OFARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
254107	Fee-for-Service	1992968648	1992968648	1	1	TAKAYAMA, CHRISTIAN M MD	2/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111163	08	Family Practice	0	In state provider	None	1499 W 1ST ST	None	SAN PEDRO	CA	90732	3255	19	06037	33.74333957	-118.3093406	Los Angeles County
254139	Fee-for-Service	1003393216	1003393216	1	1	TAICH, LIOR B MD	4/6/2023	208800000X	NA	Other	026	PHYSICIANS	167387	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
254140	Fee-for-Service	1407934995	1407934995	1	1	TSANG, HUNG H MD	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	71832	42	Nuclear Medicine	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
254193	Fee-for-Service	1811235161	1811235161	1	1	TOTAL RENAL CARE INC	10/30/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1936 E 1ST STREET	None	LOS ANGELES	CA	90033	3413	19	06037	34.04596927	-118.2162133	Los Angeles County
254200	Fee-for-Service	1417344383	1417344383	1	1	TEVES, KATHLEEN M MD	4/4/2018	208M00000X	NA	Other	026	PHYSICIANS	145332	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
254226	Fee-for-Service	1104557719	1104557719	1	1	TSE, GABRIEL Y MD	7/23/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	176948	40	Pediatrics	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
254247	Fee-for-Service	1336863497	1336863497	1	1	THOMAS, BRANDON OT	9/26/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3002 DOW AVE STE 114	None	TUSTIN	CA	92780	7247	30	06059	33.70954889	-117.8043627	Orange County
254249	Fee-for-Service	1235107566	1235107566	1	6	THE REGENTS OF THE UNIVERSIT	2/19/2019	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2020 SANTA MONICA BLVD	SUITE 600	SANTA MONICA	CA	90404	2131	19	06037	34.02901811	-118.4795396	Los Angeles County
254252	Fee-for-Service	1043398662	1043398662	1	1	TSUNEHARA, SCOTT T MD	1/28/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79175	41	Internal Medicine	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
254267	Fee-for-Service	1508278359	1508278359	1	2	THE ROADS FOUNDATION	10/12/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	4800 E LOS COYOTES DIAGO	None	LONG BEACH	CA	90815	2897	19	06037	33.79304077	-118.1378147	Los Angeles County
254297	Fee-for-Service	1295263283	1295263283	1	1	TOTAL RENAL CARE INC	3/18/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4930 PARAMOUNT BLVD	None	LAKEWOOD	CA	90712	2904	19	06037	33.848028	-118.1598515	Los Angeles County
254341	Fee-for-Service	1538119540	1538119540	1	1	TIRANDAZ, MEHRAN MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85399	30	Radiology	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 103	GARDEN GROVE	CA	92843	1915	30	06059	33.77450141	-117.9123364	Orange County
254347	Fee-for-Service	1932490281	1932490281	1	1	TAYLOR GOOT, M.D.	4/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2719	00	None	35.08771808	-106.6192188	Bernalillo County
254364	Fee-for-Service	1275693400	1275693400	1	1	TAPSON, VICTOR F MD	1/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127944	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
254436	Fee-for-Service	1992356877	1992356877	1	1	TOWNE, SHADYA LCSW	11/16/2023	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
254514	Fee-for-Service	1649308610	1649308610	1	1	TINSON, GERALDINE LCSW	3/7/2025	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
254520	Fee-for-Service	1811359342	1811359342	1	1	THOMPSON, RODERICK M MD	11/24/2019	207R00000X	NA	Other	026	PHYSICIANS	150518	41	Internal Medicine	0	In state provider	None	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	38	06075	37.76850146	-122.3949365	San Francisco County
254539	Fee-for-Service	1235107566	1235107566	1	6	THE REGENTS OF THE UNIVERSIT	2/19/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	83	Rheumatology	0	In state provider	None	2020 SANTA MONICA BLVD	SUITE 600	SANTA MONICA	CA	90404	2131	19	06037	34.02901811	-118.4795396	Los Angeles County
254549	Fee-for-Service	1508278359	1508278359	1	2	THE ROADS FOUNDATION	10/12/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	4800 E LOS COYOTES DIAGO	None	LONG BEACH	CA	90815	2897	19	06037	33.79304077	-118.1378147	Los Angeles County
254564	Fee-for-Service	1235107566	1235107566	1	2	THE REGENTS OF THE UNIVERSIT	4/19/2019	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	UCLA-DMPG-GASTROENTEROLO	100 MEDICAL PLAZA STE 70	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
254577	Fee-for-Service	1225147689	1225147689	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05574	11350 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	3631	19	06037	34.18665433	-118.3787332	Los Angeles County
254580	Fee-for-Service	1316382377	1316382377	1	1	TRAN, MARK D MD	2/3/2018	390200000X	NA	Other	026	PHYSICIANS	136346	30	Radiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
254607	Fee-for-Service	1841211968	1841211968	1	1	TOMONGIN, CHRISTOPHER A	6/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87100	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
254649	Fee-for-Service	1275693400	1275693400	1	1	TAPSON, VICTOR F MD	1/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127944	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
254666	Fee-for-Service	1962168369	1962168369	1	1	TRANSPLANT GENOMICS, INC.	6/5/2023	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	18000 W 99TH ST STE 100	None	LENEXA	KS	66219	1233	00	None	38.94987391	-94.79342414	Johnson County
254680	Fee-for-Service	1407084098	1407084098	1	1	TANKSLEY, SIMON G MD	1/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144412	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
254700	Fee-for-Service	1083630099	1083630099	1	1	TANG, THU T MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	55777	30	Radiology	0	In state provider	None	25455 BARTON RD	STE 107B	LOMA LINDA	CA	92354	3139	36	06071	34.04805253	-117.249534	San Bernardino County
254745	Fee-for-Service	1801991963	1801991963	1	1	TICHENOR LOWMAN MILLER	2/28/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	MEDICAL GROUP, INC	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
254803	Fee-for-Service	1396085536	1396085536	1	1	TOGETHER HOSPICE CARE LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7771 UNIVERSITY AVE	None	LA MESA	CA	91942	4950	37	06073	32.76215266	-117.0300807	San Diego County
254807	Fee-for-Service	1447704168	1447704168	1	1	TRINH, LILLIAN OD	2/1/2019	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	767 N HILL ST	STE 200	LOS ANGELES	CA	90012	2365	19	06037	34.06255157	-118.2397077	Los Angeles County
254825	Fee-for-Service	1235107566	1235107566	1	6	THE REGENTS OF THE UNIVERSIT	2/19/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2020 SANTA MONICA BLVD	SUITE 600	SANTA MONICA	CA	90404	2131	19	06037	34.02901811	-118.4795396	Los Angeles County
254837	Fee-for-Service	1669642385	1669642385	1	1	TAKETANI, TAMARA N MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	101084	40	Pediatrics	0	In state provider	None	5333 HOLLISTER AVE	STE 250	SANTA BARBARA	CA	93111	2466	42	06083	34.43491982	-119.8105484	Santa Barbara County
254848	Fee-for-Service	1932559200	1932559200	1	1	TAKAMURA, KOHTAROH B DO	9/11/2019	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
254853	Fee-for-Service	1235107566	1235107566	1	2	THE REGENTS OF THE UNIVERSIT	1/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	UCLA-DMPG-GASTROENTEROLO	100 MEDICAL PLAZA STE 70	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
254876	Fee-for-Service	1134201270	1134201270	1	1	THOMAS SCOTT GALLACHER MD	1/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
254887	Fee-for-Service	1235107566	1235107566	1	7	THE REGENTS OF THE UNIVERSIT	6/28/2019	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
254909	Fee-for-Service	1255372769	1255372769	1	1	TREHAN, YOGESH MD	4/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	67477	41	Internal Medicine	0	In state provider	None	100 CORTONA WAY	STE 140	BRENTWOOD	CA	94513	7112	07	06013	37.92663446	-121.7366493	Contra Costa County
254919	Fee-for-Service	1184083008	1184083008	1	1	TURNER-JOHNSON, STEPHANIE S	2/20/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
254963	Fee-for-Service	1891131421	1891131421	1	1	TU, POWEN MD	7/20/2019	207U00000X	NA	Other	026	PHYSICIANS	137485	42	Nuclear Medicine	0	In state provider	None	250 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
254968	Fee-for-Service	1811071889	1811071889	1	1	TODESTAYLOR, NANCY R MD	12/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45528	07	Dermatology	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
254972	Fee-for-Service	1669771036	1669771036	1	1	TSAO, JYEMING M MD	6/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122111	13	Neurology (M.D. only)	0	In state provider	None	751 SOUTH BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
255068	Fee-for-Service	1376053843	1376053843	1	2	TYSON MEDICAL INC	7/10/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	RGENT CARE	2026 N IMPERIAL AVE	STE C	EL CENTRO	CA	92243	1607	13	06025	32.81256347	-115.5700202	Imperial County
255086	Fee-for-Service	1962599589	1962599589	1	1	TOWNSEND, JANICE E MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68528	None	None	0	In state provider	None	4652 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.0980897	-118.2906693	Los Angeles County
255088	Fee-for-Service	1396085536	1396085536	1	1	TOGETHER HOSPICE CARE LLC	10/12/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7771 UNIVERSITY AVE	None	LA MESA	CA	91942	4950	37	06073	32.76215266	-117.0300807	San Diego County
255113	Fee-for-Service	1235107566	1235107566	1	6	THE REGENTS OF THE UNIVERSIT	2/19/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	2020 SANTA MONICA BLVD	SUITE 600	SANTA MONICA	CA	90404	2131	19	06037	34.02901811	-118.4795396	Los Angeles County
255117	Fee-for-Service	1568766442	1568766442	1	1	TAY-KELLEY, SIOK-HIAN NP	7/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
255143	Fee-for-Service	1053740225	1053740225	1	1	TAM-SUAREZ, PEONY C OD	1/3/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
255167	Fee-for-Service	1154467181	1154467181	1	3	THE HUNTINGTON MEDICAL FOUND	4/13/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	65 NORTH MADISON AVE	STE 800	PASADENA	CA	91101	2038	19	06037	34.14705803	-118.1384317	Los Angeles County
255179	Fee-for-Service	1235107566	1235107566	1	7	THE REGENTS OF THE UNIVERSIT	6/28/2019	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
255184	Fee-for-Service	1437254943	1437254943	1	1	TURK, ARTHUR MD	11/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	17845	03	Allergy	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
255199	Fee-for-Service	1255372769	1255372769	1	1	TREHAN, YOGESH MD	4/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	67477	66	Emergency Medicine (Urgent Care)	0	In state provider	None	100 CORTONA WAY	STE 140	BRENTWOOD	CA	94513	7112	07	06013	37.92663446	-121.7366493	Contra Costa County
255215	Fee-for-Service	1164771747	1164771747	1	1	THE ACHIEVABLE FOUNDATION	4/6/2017	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	5901 GREEN VALLEY CIRCLE	STE 405	CULVER CITY	CA	90230	6971	19	06037	33.98409358	-118.3923715	Los Angeles County
255267	Fee-for-Service	1629129358	1629129358	1	1	TO, AMY R OD	1/27/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 CALIFORNIA STREET	None	REDLANDS	CA	92374	2910	36	06071	34.07159807	-117.2263378	San Bernardino County
255293	Fee-for-Service	1922097500	1922097500	1	1	TRI-CITY IMMEDIATE CARE	4/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	OB-GYN MED GRP INC	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
255341	Fee-for-Service	1770594186	1770594186	1	1	THOMPSON,WILLIAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2347 E GALA ST	None	MERIDIAN	ID	83642	0000	00	None	43.58853	-116.3657565	Ada County
255413	Fee-for-Service	1366789018	1366789018	1	1	TELEHEALTHDOCS MEDICAL	1/13/2017	171W00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CORPORATION	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
255422	Fee-for-Service	1346532405	1346532405	1	1	TORNAI, CATHERINE A LMFT	7/26/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1885 LUNDY AVE	SUITE 223	SAN JOSE	CA	95131	1888	43	06085	37.39329538	-121.8907367	Santa Clara County
255472	Fee-for-Service	1366707325	1366707325	1	1	TU, KHOA M MD	12/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130861	66	Emergency Medicine (Urgent Care)	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
255489	Fee-for-Service	1477591055	1477591055	1	1	THE MOSES H CONE MEM	4/16/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1200 N ELM ST	None	GREENSBORO	NC	27401	1004	00	None	36.090747	-79.7877135	Guilford County
255504	Fee-for-Service	1164771747	1164771747	1	1	THE ACHIEVABLE FOUNDATION	11/1/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	5901 GREEN VALLEY CIRCLE	STE 405	CULVER CITY	CA	90230	6971	19	06037	33.98409358	-118.3923715	Los Angeles County
255510	Fee-for-Service	1124673652	1124673652	1	1	TREASURES WITHIN FAMILY COUN	7/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SELING, INC.	1921 S CATALINA AVE	SUITE 1	REDONDO BEACH	CA	90277	5516	19	06037	33.81545027	-118.3866495	Los Angeles County
255529	Fee-for-Service	1952410375	1952410375	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	57701 29 PALMS HIGHWAY	None	YUCCA VALLEY	CA	92284	3066	36	06071	34.12600242	-116.4057678	San Bernardino County
255534	Fee-for-Service	1699708610	1699708610	1	1	THREEWITT, TANYA A MD	4/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73909	08	Family Practice	0	In state provider	None	5161 CLAYTON RD	STE F	CONCORD	CA	94521	3157	07	06013	37.95582533	-121.967442	Contra Costa County
255582	Fee-for-Service	1922097500	1922097500	1	1	TRI-CITY IMMEDIATE CARE	4/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	OB-GYN MED GRP INC	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
255635	Fee-for-Service	1306469739	1306469739	1	1	TEJEDA ACEVEDO, RIGOBERTO M	3/19/2024	207R00000X	NA	Other	026	PHYSICIANS	189664	None	None	0	In state provider	D	9939 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.91571158	-117.4549231	Riverside County
255642	Fee-for-Service	1770695470	1770695470	1	1	TOMLIN, DEAN F MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68527	08	Family Practice	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
255701	Fee-for-Service	1366789018	1366789018	1	1	TELEHEALTHDOCS MEDICAL	3/23/2023	171W00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
255744	Fee-for-Service	1225071384	1225071384	1	1	TSAO, JONOTHAN DO	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	6926	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
255760	Fee-for-Service	1760700207	1760700207	1	1	TOBIIT INC	4/4/2011	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	111438	08	Family Practice	0	In state provider	None	349 S MONROE ST	STE 40	SAN JOSE	CA	95128	2010	43	06085	37.32218021	-121.9433358	Santa Clara County
255776	Fee-for-Service	1477591055	1477591055	1	1	THE MOSES H CONE MEM	4/16/2007	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1200 N ELM ST	None	GREENSBORO	NC	27401	1004	00	None	36.090747	-79.7877135	Guilford County
255791	Fee-for-Service	1164771747	1164771747	1	1	THE ACHIEVABLE FOUNDATION	11/1/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	5901 GREEN VALLEY CIRCLE	STE 405	CULVER CITY	CA	90230	6971	19	06037	33.98409358	-118.3923715	Los Angeles County
255816	Fee-for-Service	1841465986	1841465986	1	1	TAYANI, RAMIN MD INC	3/1/2011	207W00000X	NA	Ophthalmology	026	PHYSICIANS	69679	18	Ophthalmology	0	In state provider	None	653 CAMINO DE LOS MARES	STE 107	SAN CLEMENTE	CA	92673	2808	30	06059	33.45767098	-117.6495718	Orange County
255848	Fee-for-Service	1902561632	1902561632	1	1	THOMAS, JAZMYNE J LCSW	1/11/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8962 ARLINGDALE WAY	None	SPRING VALLEY	CA	91977	3353	37	06073	32.73353399	-117.008238	San Diego County
255877	Fee-for-Service	1013152990	1013152990	1	1	THE MOTHER ROSE MANOR	3/11/2008	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	ADMINISTRATOR	628 WEST 52ND PLACE	None	LOS ANGELES	CA	90037	3706	19	06037	33.99496006	-118.2852022	Los Angeles County
255885	Fee-for-Service	1124013917	1124013917	1	1	TOWNSLEY,JAMES C	2/1/2001	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1245 WILSHIRE BLVD	STE 603	LOS ANGELES	CA	90017	4806	19	06037	34.05362775	-118.2661889	Los Angeles County
255913	Fee-for-Service	1740705268	1740705268	1	1	TRUJEQUE, DESIREE E LMFT	3/1/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	111353	-	NOT APPLICABLE	0	In state provider	None	4388 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3565	30	06059	33.80294702	-118.0565421	Orange County
255936	Fee-for-Service	1831159003	1831159003	1	1	THE DEPARTMENT OF PSYCHIATRY	1/27/2022	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
255988	Fee-for-Service	1366789018	1366789018	1	1	TELEHEALTHDOCS MEDICAL	1/13/2017	171W00000X	NA	Other	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	CORPORATION	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
256024	Fee-for-Service	1992882807	1992882807	1	1	THOR, ANN D MD	2/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	22	Pathology (M.D. only)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
256035	Fee-for-Service	1417303140	1417303140	1	1	THOMPSON, HEATHER L	6/16/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
256039	Fee-for-Service	1073888764	1073888764	1	1	TORSHIZY, HAMIDREZA MD	7/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107170	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
256054	Fee-for-Service	1235523291	1235523291	1	1	TRAN, VU A MD	7/23/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	160226	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
256059	Fee-for-Service	1457918559	1457918559	1	1	TRUONG, ALEXANDER H MD	10/9/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	176831	None	None	0	In state provider	None	15975 HARBOR BOULEVARD	None	FOUNTAIN VALLEY	CA	92708	1303	30	06059	33.73140379	-117.9200162	Orange County
256136	Fee-for-Service	1770043119	1770043119	1	1	TIRET, SEAN M MD	7/1/2022	207P00000X	NA	Other	026	PHYSICIANS	176632	None	None	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
256138	Fee-for-Service	1396854675	1396854675	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05705	14629 7TH ST	None	VICTORVILLE	CA	92395	4214	36	06071	34.51685949	-117.3125486	San Bernardino County
256158	Fee-for-Service	1245392018	1245392018	1	1	TAN, PHILIP M LAC	9/10/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	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
256163	Fee-for-Service	1376513119	1376513119	1	1	TREWELLA, AMY C MD	5/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	99176	08	Family Practice	0	In state provider	None	211 13TH STREET	None	RAMONA	CA	92065	2711	37	06073	33.04020023	-116.8739786	San Diego County
256186	Fee-for-Service	1679192934	1679192934	1	1	TONG, TSZ MAN DO	10/13/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21538	None	None	0	In state provider	None	19333 BEAR VALLEY ROAD	SUITE 106	APPLE VALLEY	CA	92308	5149	36	06071	34.47104148	-117.2413863	San Bernardino County
256220	Fee-for-Service	1831159003	1831159003	1	1	THE DEPARTMENT OF PSYCHIATRY	10/25/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
256246	Fee-for-Service	1649389164	1649389164	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1020 AL TAHOE BLVD	None	SOUTH LAKE TAHOE	CA	96150	4501	09	06017	38.93428347	-119.9763495	El Dorado County
256267	Fee-for-Service	1396260170	1396260170	1	1	TAHERI, NAHID K	12/11/2017	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	11550 INDIAN HILLS ROAD	STE 210	MISSION HILLS	CA	91345	1202	19	06037	34.28024575	-118.4588775	Los Angeles County
256277	Fee-for-Service	1366789018	1366789018	1	1	TELEHEALTHDOCS MEDICAL	1/13/2017	171W00000X	NA	Other	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	CORPORATION	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
256326	Fee-for-Service	1598272718	1598272718	1	1	TANG, LAURA K	4/2/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	280 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
256334	Fee-for-Service	1235356437	1235356437	1	1	TOPA TOPA OPTOMETRY INC	8/1/2001	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1211 MARICOPA HWY	SUITE 101	OJAI	CA	93023	3165	56	06111	34.44201622	-119.2632073	Ventura County
256403	Fee-for-Service	1942233127	1942233127	1	1	TOURTELLOTTE, WARREN G MD	2/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146145	22	Pathology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	RM 3719	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
256409	Fee-for-Service	1477617314	1477617314	1	1	THOMAS, GIGI P MD	12/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73883	25	Physical Medicine and Rehabilitation	0	In state provider	None	730 MAGNOLIA AVE	None	CORONA	CA	92879	3117	33	06065	33.85878701	-117.5544725	Riverside County
256410	Fee-for-Service	1245212505	1245212505	1	1	TOLENTINO, MILAGROS D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	31830	02	General Surgery	0	In state provider	None	15666 18TH AVE	None	CLEARLAKE	CA	95422	0000	17	06033	38.93616777	-122.619287	Lake County
256426	Fee-for-Service	1578835021	1578835021	1	1	TYE, JONATHAN J MD APC	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1250 S SUNSET	SUITE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
256472	Fee-for-Service	1780174011	1780174011	1	1	TRIPSAS, CHRISTINA K MD	4/18/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	174510	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
256514	Fee-for-Service	1740403054	1740403054	1	1	TOTAL NUTRITION THERAPY	10/29/2002	332BP3500X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	16644 E JOHNSON DR	SUITE B	CITY OF INDUSTRY	CA	91745	2412	19	06037	34.0027685	-117.9459317	Los Angeles County
256520	Fee-for-Service	1831159003	1831159003	1	1	THE DEPARTMENT OF PSYCHIATRY	4/19/2021	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
256534	Fee-for-Service	1396193389	1396193389	1	1	TSENG, JOSHUA	8/10/2020	208600000X	NA	General Surgery	026	PHYSICIANS	141586	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
256559	Fee-for-Service	1437413705	1437413705	1	1	TURRIAGO, JONATHAN T DO	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14590	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1300 N VERMONT AVENUE	SUITE 307	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
256564	Fee-for-Service	1366789018	1366789018	1	1	TELEHEALTHDOCS MEDICAL	6/28/2024	171W00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
256589	Fee-for-Service	1528080041	1528080041	1	1	TETTEH, NII-ARYEE E MD	2/20/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76579	None	None	0	In state provider	INC	340 4TH AVE	STE 10	CHULA VISTA	CA	91910	3813	37	06073	32.63831293	-117.0833536	San Diego County
256602	Fee-for-Service	1043447790	1043447790	1	1	TRAVIS OLIVES	1/16/2018	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	1829	00	None	44.97241797	-93.26300044	Hennepin County
256614	Fee-for-Service	1811000656	1811000656	1	1	THADANI, RESHMA MD	5/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90054	40	Pediatrics	0	In state provider	None	1300 BANCROFT AVE	STE 204	SAN LEANDRO	CA	94577	5147	01	06001	37.72690979	-122.1477291	Alameda County
256618	Fee-for-Service	1013384411	1013384411	1	1	TRANQUILITY CARE INC	5/3/2019	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1812 CRATER STREET	None	SIMI VALLEY	CA	93063	3125	56	06111	34.26952458	-118.7322979	Ventura County
256619	Fee-for-Service	1962488007	1962488007	1	2	TERI INC	1/25/1983	310500000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	VIA RIO HOUSE	1262 VIA ENCINOS DR	None	FALLBROOK	CA	92028	9302	37	06073	33.32738805	-117.2318169	San Diego County
256629	Fee-for-Service	1346202843	1346202843	1	2	TMI PATHOLOGY ASSOCIATES	2/17/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	14850 ROSCOE BLVD	None	PANORAMA CITY	CA	91403	4618	19	06037	34.22145548	-118.4566005	Los Angeles County
256632	Fee-for-Service	1861501231	1861501231	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05480	23 PENINSULA CTR	None	ROLLING HILLS EST	CA	90274	3506	19	06037	33.77513263	-118.3757485	Los Angeles County
256650	Fee-for-Service	1659539153	1659539153	2	1	TOPPUR RAMANAKUMAR, AJAY K	6/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124907	06	Cardiovascular Disease (M.D. only)	0	In state provider	MD	415 E HARDING WAY	#D	STOCKTON	CA	95204	6118	39	06077	37.96819912	-121.2900761	San Joaquin County
256692	Fee-for-Service	1457428344	1457428344	1	1	TURAY, STEPHEN B DO	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8170	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
256700	Fee-for-Service	1245212505	1245212505	1	1	TOLENTINO, MILAGROS D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	31830	01	General Practice	0	In state provider	None	15666 18TH AVE	None	CLEARLAKE	CA	95422	0000	17	06033	38.93616777	-122.619287	Lake County
256711	Fee-for-Service	1851514855	1851514855	1	1	THORNE, WILLES 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	945 S OREM BLVD	None	OREM	UT	84058	5011	00	None	40.27974717	-111.6897542	Utah County
256716	Fee-for-Service	1578835021	1578835021	1	1	TYE, JONATHAN J MD APC	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1250 S SUNSET	SUITE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
256750	Fee-for-Service	1427133628	1427133628	1	1	TONKOVICH, JOELLE A LCSW	10/13/2015	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3990 OLD TOWN AVENUE	SUITE B-100	SAN DIEGO	CA	92110	2930	37	06073	32.75011358	-117.1915672	San Diego County
256758	Fee-for-Service	1780174011	1780174011	1	1	TRIPSAS, CHRISTINA K MD	4/18/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	174510	41	Internal Medicine	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
256783	Fee-for-Service	1063580280	1063580280	1	1	TJIO, ANTHONY H MD	1/16/1981	207P00000X	NA	Other	026	PHYSICIANS	30648	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2489 TAPO ST	None	SIMI VALLEY	CA	93063	2453	56	06111	34.280505	-118.7089775	Ventura County
256799	Fee-for-Service	1801957667	1801957667	1	1	TAHOE FOREST HOSP DIST	3/15/1996	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	1	Border provider	INCLINE VILLAGE HLTH CTR	880 ALDER AVE	None	INCLINE VLG	NV	89451	8215	00	None	39.25092003	-119.9543846	Washoe County
256800	Fee-for-Service	1831159003	1831159003	1	1	THE DEPARTMENT OF PSYCHIATRY	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	48	Unknown	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
256838	Fee-for-Service	1821080144	1821080144	1	1	TIRDEL, GREGORY B MD	2/8/2015	207RC0200X	NA	Other	026	PHYSICIANS	69661	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10956 DONNER PASS RD	STE 260	TRUCKEE	CA	96161	4871	29	06057	39.32625521	-120.2012059	Nevada County
256856	Fee-for-Service	1366789018	1366789018	1	1	TELEHEALTHDOCS MEDICAL	1/17/2023	171W00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
256863	Fee-for-Service	1154624187	1154624187	1	1	TOLES, KARA A MD	9/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128628	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
256874	Fee-for-Service	1942366471	1942366471	1	1	TAYLOR, ANDREW G MD	4/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103445	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
256956	Fee-for-Service	1932101953	1932101953	1	1	TAVERNIER, LAURA A MD	2/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	77131	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3300 RENNER DR	None	FORTUNA	CA	95540	3120	12	06023	40.58243651	-124.135992	Humboldt County
256978	Fee-for-Service	1780826941	1780826941	1	1	TAKEUCHI, ASIA M MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114272	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
256983	Fee-for-Service	1205945680	1205945680	1	1	THRIFTY PAYLESS INC	3/1/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6405 EL CAJON BLVD	None	SAN DIEGO	CA	92115	2646	37	06073	32.76511149	-117.0605707	San Diego County
256988	Fee-for-Service	1104867167	1104867167	1	1	THE FORT HAMILTON HOSPITAL	3/25/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	630 EATON AVE	None	HAMILTON	OH	45013	2767	00	None	39.41555012	-84.57394329	Butler County
256993	Fee-for-Service	1891927752	1891927752	1	1	THOMAS SAADEH M.D.	6/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	115 AIRPORT RD	None	SULPHUR SPGS	TX	75482	2105	00	None	33.15631021	-95.60008732	Hopkins County
257017	Fee-for-Service	1104138775	1104138775	1	1	TILLUCKDHARRY, NATASHA S MD	1/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124303	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
257071	Fee-for-Service	1063580280	1063580280	1	1	TJIO, ANTHONY H MD	1/16/1981	207P00000X	NA	Other	026	PHYSICIANS	30648	40	Pediatrics	0	In state provider	None	2489 TAPO ST	None	SIMI VALLEY	CA	93063	2453	56	06111	34.280505	-118.7089775	Ventura County
257087	Fee-for-Service	1679678502	1679678502	1	1	TIRADO, CINTHIA MD	11/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118777	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
257097	Fee-for-Service	1841595238	1841595238	1	1	TNT PHARMACY CORPORATION	4/13/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	705 W. LA VETA AVENUE	#110A	ORANGE	CA	92868	4447	30	06059	33.78062272	-117.8600738	Orange County
257111	Fee-for-Service	1437147295	1437147295	1	1	TAVARES, JOAQUIM S MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	5701 W CHARLESTON BLVD	STE 100	LAS VEGAS	NV	89146	1256	00	None	36.15908651	-115.219719	Clark County
257143	Fee-for-Service	1366789018	1366789018	1	1	TELEHEALTHDOCS MEDICAL	1/13/2017	171W00000X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	CORPORATION	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
257163	Fee-for-Service	1679290720	1679290720	1	1	TABAR, ARIELLE NICOLE PT	10/31/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1222 W COLONY RD	STE 130	RIPON	CA	95366	9480	39	06077	37.75395862	-121.136171	San Joaquin County
257165	Fee-for-Service	1750931853	1750931853	1	1	TROGDON, VANESSA CO	7/17/2020	222Z00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	1355 BESSIE AVE	None	TRACY	CA	95376	3415	39	06077	37.74282451	-121.4330827	San Joaquin County
257225	Fee-for-Service	1790176204	1790176204	1	1	TODARO, LAURA C CNM	8/16/2017	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
257243	Fee-for-Service	1982702619	1982702619	1	1	THOMAS D FAIRBAIRN MD	10/31/2013	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
257245	Fee-for-Service	1932101953	1932101953	1	1	TAVERNIER, LAURA A MD	2/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	77131	01	General Practice	0	In state provider	None	3300 RENNER DR	None	FORTUNA	CA	95540	3120	12	06023	40.58243651	-124.135992	Humboldt County
257264	Fee-for-Service	1245779669	1245779669	1	1	TSUKAHARA, LOUISE M NP	3/27/2017	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
257270	Fee-for-Service	1376757468	1376757468	1	1	TRAN, NHAT H MD	8/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104438	25	Physical Medicine and Rehabilitation	0	In state provider	None	2488 N CALIFORNIA ST	None	STOCKTON	CA	95204	5508	39	06077	37.97587328	-121.2911856	San Joaquin County
257278	Fee-for-Service	1104867167	1104867167	1	1	THE FORT HAMILTON HOSPITAL	3/25/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	630 EATON AVE	None	HAMILTON	OH	45013	2767	00	None	39.41555012	-84.57394329	Butler County
257323	Fee-for-Service	1992705990	1992705990	1	1	TERZ, JOSE J MD	2/8/2015	208600000X	NA	General Surgery	026	PHYSICIANS	21984	78	Neoplastic Diseases/Oncology	0	In state provider	None	1910 ROYALTY DR	None	POMONA	CA	91767	3021	19	06037	34.07871356	-117.7454184	Los Angeles County
257334	Fee-for-Service	1194742809	1194742809	2	1	THE SCOOTER STRE-SF LLC	3/12/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	THE SCOOTER STORE	1300 INDUSTRIAL RD	UNIT #20	SAN CARLOS	CA	94070	4130	41	06081	37.50136918	-122.2457819	San Mateo County
257341	Fee-for-Service	1871947390	1871947390	1	1	TOMICH, SAMUEL W MD	5/29/2020	207R00000X	NA	Other	026	PHYSICIANS	156900	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	CARDIOLOGY DEPARTMENT	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
257345	Fee-for-Service	1881078251	1881078251	1	1	TAMRAZIAN, ERIC MD	4/24/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	150492	13	Neurology (M.D. only)	0	In state provider	None	13355 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5802	19	06037	33.91091877	-118.3527745	Los Angeles County
257357	Fee-for-Service	1962947341	1962947341	1	1	TSAI, ANH N CCC-SLP	3/23/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	16800 ASTON	STE 175	IRVINE	CA	92606	4820	30	06059	33.70035445	-117.8435881	Orange County
257360	Fee-for-Service	1992927248	1992927248	1	1	TANG, LAWTON W MD	1/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	104375	24	Plastic Surgery	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
257372	Fee-for-Service	1609819887	1609819887	1	1	TABIB, SHAHRAM M MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69677	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
257384	Fee-for-Service	1154825156	1154825156	1	1	TAN, MERRICK MD	9/15/2023	207L00000X	NA	Other	026	PHYSICIANS	165891	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
257393	Fee-for-Service	1578515847	1578515847	1	1	TAVITIAN, ARMINEH MD INC	6/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	74699	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1500 S CENTRAL AVE	STE 200	GLENDALE	CA	91204	3853	19	06037	34.12736888	-118.257777	Los Angeles County
257398	Fee-for-Service	1437147295	1437147295	1	1	TAVARES, JOAQUIM S MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	5701 W CHARLESTON BLVD	STE 100	LAS VEGAS	NV	89146	1256	00	None	36.15908651	-115.219719	Clark County
257429	Fee-for-Service	1235248634	1235248634	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #6001	571 BELLEVUE RD	None	ATWATER	CA	95301	2928	24	06047	37.36048553	-120.597876	Merced County
257431	Fee-for-Service	1407054430	1407054430	1	1	TSAI, JEROME MD	8/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	93757	30	Radiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
257498	Fee-for-Service	1245267152	1245267152	1	1	TURNER, BARBARA J MD	12/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156550	41	Internal Medicine	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
257507	Fee-for-Service	1508278359	1508278359	1	1	THE ROADS FOUNDATION	1/11/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INC	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	19	06037	33.89475493	-118.2080292	Los Angeles County
257539	Fee-for-Service	1558518464	1558518464	1	1	TELLES, SARAH E MD	9/12/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	81293	36	Psychiatry	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
257588	Fee-for-Service	1306990817	1306990817	2	1	TUAZON, LUZCEL G MD	3/23/2021	207R00000X	NA	Other	026	PHYSICIANS	171390	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
257613	Fee-for-Service	1992705990	1992705990	1	1	TERZ, JOSE J MD	2/8/2015	208600000X	NA	General Surgery	026	PHYSICIANS	21984	01	General Practice	0	In state provider	None	1910 ROYALTY DR	None	POMONA	CA	91767	3021	19	06037	34.07871356	-117.7454184	Los Angeles County
257685	Fee-for-Service	1437147295	1437147295	1	1	TAVARES, JOAQUIM S MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	1	Border provider	None	5701 W CHARLESTON BLVD	STE 100	LAS VEGAS	NV	89146	1256	00	None	36.15908651	-115.219719	Clark County
257697	Fee-for-Service	1104997022	1104997022	1	1	THOMPSON, NOLAN H MD	12/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	54128	36	Psychiatry	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
257698	Fee-for-Service	1992169957	1992169957	1	1	TEDALDI, MICHAEL W MD	8/3/2020	207R00000X	NA	Other	026	PHYSICIANS	153708	41	Internal Medicine	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
257703	Fee-for-Service	1205390911	1205390911	1	1	TENTLER, MATTHEW LMFT	9/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1200 PASEO CAMARILLO	155	CAMARILLO	CA	93010	6050	56	06111	34.22097448	-119.054079	Ventura County
257711	Fee-for-Service	1841309127	1841309127	1	1	THRIFTY DRUG STORE 5609	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	9450 LAS TUNAS DR	None	TEMPLE CITY	CA	91780	2138	19	06037	34.10611324	-118.0648337	Los Angeles County
257729	Fee-for-Service	1295149946	1295149946	1	1	THONGKHAM, JAYLONG W MD	6/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154599	05	Anesthesiology	0	In state provider	None	1400 EAST CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
257793	Fee-for-Service	1508278359	1508278359	1	1	THE ROADS FOUNDATION	8/1/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	19	06037	33.89475493	-118.2080292	Los Angeles County
257892	Fee-for-Service	1386138972	1386138972	1	1	TIPPUR, ANKITA H MD	11/28/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	175064	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
257895	Fee-for-Service	1548429533	1548429533	1	1	TAYLOR, ERIN P LMFT	7/6/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
257899	Fee-for-Service	1265509129	1265509129	1	1	TILLES, IRA H MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81641	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
257906	Fee-for-Service	1831324235	1831324235	1	1	TONER, REBECCA A LMFT	9/20/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1133 HIGH ST	STE C	AUBURN	CA	95603	5152	31	06061	38.89754086	-121.0711279	Placer County
257933	Fee-for-Service	1548265036	1548265036	1	11	TRUXTUN RADIOLOGY	2/20/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	6310 LAKE ISABELLA BLVD	None	LAKE ISABELLA	CA	93240	9222	15	06029	35.62730892	-118.4737749	Kern County
257945	Fee-for-Service	1194937326	1194937326	1	1	THURMAN, ANDRAUS S MD	3/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89135	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
257976	Fee-for-Service	1750460887	1750460887	1	1	TORREST, MICHAEL A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37208	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2540 EAST ST	None	CONCORD	CA	94520	1906	07	06013	37.98292379	-122.0341876	Contra Costa County
257984	Fee-for-Service	1538484936	1538484936	2	1	THAPAMAGAR, SUMAN B MD	7/3/2019	207RP1001X	NA	Pulmonology	026	PHYSICIANS	142825	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
258029	Fee-for-Service	1972894707	1972894707	1	1	TRUONG, JOHN MD	7/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123151	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
258038	Fee-for-Service	1770744351	1770744351	1	1	TODMAN, MICHELE S MD	2/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119700	18	Ophthalmology	0	In state provider	None	1001 RIVERSIDE AVENUE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
258045	Fee-for-Service	1780047779	1780047779	1	1	TSAO, LULU R MD	9/7/2021	207RA0201X	NA	Other	026	PHYSICIANS	152982	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
258060	Fee-for-Service	1639378078	1639378078	1	1	TARLOV, NICHOLAS MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	98972	14	Neurological Surgery	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
258070	Fee-for-Service	1063858967	1063858967	1	1	TONGCHINSUB, PAMELA P MD	11/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134511	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
258080	Fee-for-Service	1508278359	1508278359	1	1	THE ROADS FOUNDATION	8/1/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	19	06037	33.89475493	-118.2080292	Los Angeles County
258091	Fee-for-Service	1720240526	1720240526	1	1	TANG, STEPHANIE L DO	12/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10727	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	3075	19	06037	34.06633051	-118.4452686	Los Angeles County
258103	Fee-for-Service	1821025313	1821025313	1	1	TRIMZI, MATEEN H MD	12/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93138	41	Internal Medicine	0	In state provider	None	11234 ANDERSON ST	STE 1405	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
258105	Fee-for-Service	1700820305	1700820305	1	1	TRIFUNOVIC, ROBERT D MD	3/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65362	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2023 MISSION AVE	STE 1-A	OCEANSIDE	CA	92054	2324	37	06073	33.20443651	-117.3638361	San Diego County
258114	Fee-for-Service	1609961671	1609961671	1	1	THOMAS, DONALD D MD	12/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	64730	33	Thoracic Surgery	0	In state provider	None	24411 HEALTH CENTER DR	STE 680	LAGUNA HILLS	CA	92653	3692	30	06059	33.6087201	-117.7076948	Orange County
258127	Fee-for-Service	1952337719	1952337719	1	1	TERRAZZINO, JOSEPH MD	3/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	75356	25	Physical Medicine and Rehabilitation	0	In state provider	None	25775 MCBEAN PKWY	STE 216	VALENCIA	CA	91355	3703	19	06037	34.40042013	-118.5511416	Los Angeles County
258141	Fee-for-Service	1184818684	1184818684	1	1	TOLAN, AMY M MD	8/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	103257	02	General Surgery	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
258207	Fee-for-Service	1093824336	1093824336	1	1	THRIFY PAYLESS INC	10/31/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID # 6353	432 N MAIN ST	None	ALTURAS	CA	96101	3458	25	06049	41.48807479	-120.542498	Modoc County
258209	Fee-for-Service	1447549522	1447549522	1	1	TAUNYA MATHEWS BOYKINS	4/1/2011	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	10628 MORNING RIDGE DR	None	MORENO VALLEY	CA	92557	4205	33	06065	33.96652211	-117.2308797	Riverside County
258254	Fee-for-Service	1396011409	1396011409	1	1	TANG, MONICA C MD	7/2/2019	207K00000X	NA	Other	026	PHYSICIANS	162324	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
258271	Fee-for-Service	1538484936	1538484936	2	1	THAPAMAGAR, SUMAN B MD	7/3/2019	207RP1001X	NA	Pulmonology	026	PHYSICIANS	142825	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
258319	Fee-for-Service	1992991236	1992991236	1	1	TELICHOWSKA, MONIKA PHD	5/15/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1902 WEBSTER ST	None	SAN FRANCISCO	CA	94115	5800	38	06075	37.78836821	-122.432005	San Francisco County
258341	Fee-for-Service	1578962312	1578962312	1	1	TRUBATISKY, ALEXANDRIA M NP	9/21/2021	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5000 W SUNSET BLVD	FL 4	LOS ANGELES	CA	90027	5861	19	06037	34.0981066	-118.2986382	Los Angeles County
258357	Fee-for-Service	1841449485	1841449485	1	1	TILGHMAN, MYRES W MD	12/7/2010	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	96339	77	Infectious Disease	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
258414	Fee-for-Service	1952337719	1952337719	1	1	TERRAZZINO, JOSEPH MD	3/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	75356	41	Internal Medicine	0	In state provider	None	25775 MCBEAN PKWY	STE 216	VALENCIA	CA	91355	3703	19	06037	34.40042013	-118.5511416	Los Angeles County
258461	Fee-for-Service	1073581385	1073581385	1	1	TENNANT, GREGORY S DO	5/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9121	20	Orthopedic Surgery	0	In state provider	None	10522 KATELLA AVE	None	ANAHEIM	CA	92804	6528	30	06059	33.80292253	-117.9496575	Orange County
258467	Fee-for-Service	1992032577	1992032577	1	1	TAHA, AMMAR MD	12/11/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	158239	None	None	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
258484	Fee-for-Service	1598859100	1598859100	1	3	TOM H PIATT MD INC	4/14/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	5921 CLARK RD	STE C	PARADISE	CA	95969	4832	04	06007	39.75770331	-121.6070477	Butte County
258498	Fee-for-Service	1447549522	1447549522	1	1	TAUNYA MATHEWS BOYKINS	4/1/2011	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	10628 MORNING RIDGE DR	None	MORENO VALLEY	CA	92557	4205	33	06065	33.96652211	-117.2308797	Riverside County
258517	Fee-for-Service	1790863553	1790863553	1	1	TANAKA, STEPHEN C MD	11/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	48300	18	Ophthalmology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
258543	Fee-for-Service	1396011409	1396011409	1	1	TANG, MONICA C MD	7/2/2019	207K00000X	NA	Other	026	PHYSICIANS	162324	03	Allergy	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
258617	Fee-for-Service	1518919562	1518919562	1	1	TANG, KELVIN K OD	9/3/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
258661	Fee-for-Service	1710072558	1710072558	1	1	TORRANCE CARE CENTER WEST	11/1/2000	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	4333 TORRANCE BLVD	None	TORRANCE	CA	90503	4401	19	06037	33.83759353	-118.360089	Los Angeles County
258664	Fee-for-Service	1811990625	1811990625	1	1	TRAQUAIR, PHILIP S MD	6/14/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163136	None	None	0	In state provider	None	755 UNIVERSITY AVE	None	SACRAMENTO	CA	95825	6708	34	06067	38.565378	-121.419567	Sacramento County
258685	Fee-for-Service	1134698095	1134698095	1	1	TAASAN, PHOEBE MARIE OT	5/20/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
258736	Fee-for-Service	1053872184	1053872184	1	1	TOTH, TYLER R MD	4/4/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	181192	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
258766	Fee-for-Service	1356881452	1356881452	1	1	TRIPET, MICHAEL R LMFT	6/26/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
258769	Fee-for-Service	1588072730	1588072730	1	1	TSANG, SANDY DO	2/8/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16619	08	Family Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
258792	Fee-for-Service	1518015478	1518015478	1	1	TONG, TEDDY YF MD	12/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	64330	18	Ophthalmology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
258813	Fee-for-Service	1215113444	1215113444	1	1	THE ALLIANCE FOR COMMUNITY W	1/28/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	E	3209 GALINDO STREET	None	OAKLAND	CA	94601	2507	01	06001	37.78673159	-122.2212171	Alameda County
258838	Fee-for-Service	1568605608	1568605608	1	1	TRAN, ALBERT MD	10/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113825	05	Anesthesiology	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
258847	Fee-for-Service	1134534738	1134534738	1	1	TAY, WESLEY M MD	6/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142002	01	General Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
258856	Fee-for-Service	1891037479	1891037479	1	1	TILLMAN, RACHEL L LPCC	11/27/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
258867	Fee-for-Service	1629515705	1629515705	1	5	TWO CHAIRS BEHAVIORAL HEALTH	8/7/2020	101YP2500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
258873	Fee-for-Service	1043507015	1043507015	1	1	TING, KEVIN S MD	9/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141799	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
258876	Fee-for-Service	1013015445	1013015445	1	1	TREMOULET, ADRIANA H MD	2/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76788	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
258892	Fee-for-Service	1669998845	1669998845	1	1	THE LOS ANGELES FREE CLINIC	11/14/2018	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	19	06037	34.07607952	-118.373418	Los Angeles County
258928	Fee-for-Service	1598787400	1598787400	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05593	13905 AMAR RD	None	LA PUENTE	CA	91746	1670	19	06037	34.05316569	-117.9737442	Los Angeles County
258940	Fee-for-Service	1750762787	1750762787	1	1	TESKE, GLADYS M LCSW	7/9/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1550 SUPERIOR AVE	None	COSTA MESA	CA	92627	3653	30	06059	33.63305341	-117.9266303	Orange County
258958	Fee-for-Service	1982682647	1982682647	1	1	THEOPHILUS E OWAN	3/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1380 E MEDICAL CENTER DR	None	ST GEORGE	UT	84790	2123	00	None	37.097622	-113.553828	Washington County
258967	Fee-for-Service	1043745821	1043745821	1	1	TOPALJEKIAN, PUZANT MD	6/28/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164802	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
259019	Fee-for-Service	1891244802	1891244802	1	1	TAMIS, RUTH C	1/6/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
259045	Fee-for-Service	1154811271	1154811271	1	1	TAVANAEI, MARYAM	8/9/2023	207RN0300X	NA	Nephrology	026	PHYSICIANS	173242	None	None	0	In state provider	None	12660 RIVERSIDE DR	STE 225	NORTH HOLLYWOOD	CA	91607	3429	19	06037	34.1575795	-118.409499	Los Angeles County
259065	Fee-for-Service	1174527881	1174527881	1	1	TIMM, JENNA A MD	9/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90933	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
259104	Fee-for-Service	1194157339	1194157339	1	1	TREITL, DANIELA E MD	7/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155022	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
259120	Fee-for-Service	1093249252	1093249252	1	1	TARR, ADELINE T DO	12/11/2020	207R00000X	NA	Other	026	PHYSICIANS	18238	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
259156	Fee-for-Service	1629515705	1629515705	1	5	TWO CHAIRS BEHAVIORAL HEALTH	7/29/2020	101YP2500X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
259199	Fee-for-Service	1598109928	1598109928	1	1	TOFFEL, MELISSA E MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13961	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
259200	Fee-for-Service	1740701481	1740701481	1	1	TOUBIA, ELIAS A	9/28/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1481 E PLAZA BOULEVARD	None	NATIONAL CITY	CA	91950	3613	37	06073	32.6768163	-117.0909096	San Diego County
259202	Fee-for-Service	1710989330	1710989330	1	1	TORRANCE MEMORIAL	11/1/1993	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL CENTER	3121 SKYPARK DR	STE 3124	TORRANCE	CA	90505	5005	19	06037	33.80723077	-118.3417423	Los Angeles County
259250	Fee-for-Service	1073576153	1073576153	1	1	TOTAL RENAL CARE, INC	12/1/1998	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	PREMIER DIALYSIS CENTER	7612 ATLANTIC AVE	None	CUDAHY	CA	90201	5020	19	06037	33.96685949	-118.1871941	Los Angeles County
259262	Fee-for-Service	1568926764	1568926764	1	1	TURNER, DESMOND D RCP	3/1/2019	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
259366	Fee-for-Service	1316203722	1316203722	1	1	TONG, CHING LICK MD	10/7/2019	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	163201	84	Surgery-Head and Neck	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
259383	Fee-for-Service	1063874345	1063874345	1	1	TRUONG-N, KHOA MD	7/1/2021	207L00000X	NA	Other	026	PHYSICIANS	151055	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
259408	Fee-for-Service	1003111642	1003111642	1	1	TENG, SHENDEE MD	7/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83798	None	None	0	In state provider	None	15031 RINALDI STREET	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
259431	Fee-for-Service	1427274638	1427274638	1	1	TREHAN, YOGESH MD INC	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67477	66	Emergency Medicine (Urgent Care)	0	In state provider	None	100 CORTONA WAY	STE 140	BRENTWOOD	CA	94513	7112	07	06013	37.92663446	-121.7366493	Contra Costa County
259451	Fee-for-Service	1629515705	1629515705	1	5	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
259462	Fee-for-Service	1346330248	1346330248	1	1	THURMAN, JOSHUA M MD	8/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	45	Nephrology (Renal-Kidney)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
259520	Fee-for-Service	1952358632	1952358632	1	1	TRIFFON, DOUGLAS W MD	12/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	44525	41	Internal Medicine	0	In state provider	None	5565 GROSSMONT CENTER DR	STE 2	LA MESA	CA	91942	3037	37	06073	32.77978322	-117.0094766	San Diego County
259543	Fee-for-Service	1780203430	1780203430	1	1	THOMPSON, HALEY L MD	1/30/2024	207PP0204X	NA	Other	026	PHYSICIANS	185763	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
259568	Fee-for-Service	1699715672	1699715672	1	1	TAN, LEON L MD	12/1/1995	2084N0402X	NA	Neurology	026	PHYSICIANS	33939	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
259677	Fee-for-Service	1285091090	1285091090	1	1	THOMAS, KRISTINA MD	7/31/2024	390200000X	NA	Other	026	PHYSICIANS	181109	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
259683	Fee-for-Service	1477091809	1477091809	1	1	TORRES, ANTHONY	4/21/2021	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	454 ORANGE STREET	4H	REDLANDS	CA	92374	0000	36	06071	34.059429	-117.1825505	San Bernardino County
259720	Fee-for-Service	1427274638	1427274638	1	1	TREHAN, YOGESH MD INC	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67477	41	Internal Medicine	0	In state provider	None	100 CORTONA WAY	STE 140	BRENTWOOD	CA	94513	7112	07	06013	37.92663446	-121.7366493	Contra Costa County
259726	Fee-for-Service	1558655126	1558655126	1	1	TRAN, HUNG Q MD	10/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
259727	Fee-for-Service	1164943163	1164943163	1	1	TANVIR, ANUM DO	7/22/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16807	08	Family Practice	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
259732	Fee-for-Service	1629515705	1629515705	1	5	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	GROUP, A PSYCHOLOGY COR	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
259749	Fee-for-Service	1194323402	1194323402	1	1	TIGHE, KELLETT J LMFT	12/14/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
259785	Fee-for-Service	1578630471	1578630471	1	1	TAN, MICHAEL C MD	1/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66942	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
259811	Fee-for-Service	1952358632	1952358632	1	1	TRIFFON, DOUGLAS W MD	12/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	44525	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5565 GROSSMONT CENTER DR	STE 2	LA MESA	CA	91942	3037	37	06073	32.77978322	-117.0094766	San Diego County
259819	Fee-for-Service	1245349604	1245349604	1	1	THRIFTY PAYLESS INC	4/16/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	959 CRENSHAW BLVD	None	LOS ANGELES	CA	90019	1938	19	06037	34.05502709	-118.3228367	Los Angeles County
259820	Fee-for-Service	1619036209	1619036209	1	1	TA, VUONG PHUC MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66612	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
259823	Fee-for-Service	1962780551	1962780551	1	1	THOMPSON, JOSEPH S MD	5/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	842 E MAIN ST	None	MEDFORD	OR	97504	7134	00	None	42.32787853	-122.863311	Jackson County
259854	Fee-for-Service	1699715672	1699715672	1	1	TAN, LEON L MD	12/1/1995	2084N0402X	NA	Neurology	026	PHYSICIANS	33939	79	Neurology-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
259864	Fee-for-Service	1417957697	1417957697	1	1	TAN, LORENA H MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	61352	08	Family Practice	0	In state provider	None	5555 W LAS POSITAS BLVD	None	PLEASANTON	CA	94588	4000	01	06001	37.69212528	-121.8803442	Alameda County
259868	Fee-for-Service	1538216130	1538216130	1	1	TUNG, EMILY Y OD	10/22/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5755 COTTLE ROAD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
259871	Fee-for-Service	1770570566	1770570566	1	1	TAYLOR, NATHAN L MD	2/19/2019	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	128084	20	Orthopedic Surgery	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
259891	Fee-for-Service	1053657684	1053657684	1	1	TAN, MAYBEL M MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126350	41	Internal Medicine	0	In state provider	None	9808 VENICE BLVD	PENTHOUSE	CULVER CITY	CA	90232	2732	19	06037	34.0236396	-118.3980847	Los Angeles County
259908	Fee-for-Service	1023127453	1023127453	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6034	1730 S MAIN ST	None	WILLITS	CA	95490	4405	23	06045	39.39023887	-123.3466711	Mendocino County
259916	Fee-for-Service	1013026467	1013026467	1	1	THRIFTY PAYLESS INC	7/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5729	1688 N PERRIS BLVD	None	PERRIS	CA	92571	4709	33	06065	33.802488	-117.2262385	Riverside County
259945	Fee-for-Service	1821202227	1821202227	1	1	TURNING POINT OF CENTRAL	6/19/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA INC	1100 UNION AVE	None	BAKERSFIELD	CA	93307	1051	15	06029	35.36762397	-119.0028315	Kern County
259949	Fee-for-Service	1962600239	1962600239	1	1	TOMCHICK, SCOTT A	11/14/2011	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
260035	Fee-for-Service	1013603463	1013603463	1	1	TICAS, LUZ	10/11/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
260085	Fee-for-Service	1447725338	1447725338	1	1	TSAI, REBECCA MD	5/3/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	183843	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
260087	Fee-for-Service	1720094022	1720094022	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	980 FLORIN RD	None	SACRAMENTO	CA	95831	3515	34	06067	38.493828	-121.5229545	Sacramento County
260089	Fee-for-Service	1194999854	1194999854	1	1	TRAINEDES, SHANNON N CRNA	7/12/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
260112	Fee-for-Service	1033122254	1033122254	1	1	TSUSHIMA, GREGORY MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62277	02	General Surgery	0	In state provider	None	8635 W 3RD ST	None	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
260141	Fee-for-Service	1699715672	1699715672	1	1	TAN, LEON L MD	12/1/1995	2084N0402X	NA	Neurology	026	PHYSICIANS	33939	13	Neurology (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
260152	Fee-for-Service	1992734701	1992734701	1	1	TRAUGHBER, CHRISTOPHER MD	3/19/2025	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	42264	-	NOT APPLICABLE	0	In state provider	None	1647 WEST ANAHEIM STREET	None	HARBOR CITY	CA	90710	3213	19	06037	33.78621735	-118.3058946	Los Angeles County
260158	Fee-for-Service	1770570566	1770570566	1	1	TAYLOR, NATHAN L MD	2/19/2019	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	128084	46	Hand Surgery	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
260179	Fee-for-Service	1053657684	1053657684	1	1	TAN, MAYBEL M MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126350	45	Nephrology (Renal-Kidney)	0	In state provider	None	9808 VENICE BLVD	PENTHOUSE	CULVER CITY	CA	90232	2732	19	06037	34.0236396	-118.3980847	Los Angeles County
260184	Fee-for-Service	1538562202	1538562202	1	1	TAGLIA, CHRISTOPHER R MD	6/27/2020	208600000X	NA	General Surgery	026	PHYSICIANS	134209	02	General Surgery	0	In state provider	None	136 N 3RD ST	None	LOMPOC	CA	93436	7002	42	06083	34.64013944	-120.4451768	Santa Barbara County
260223	Fee-for-Service	1437187234	1437187234	1	1	TRAN, TRAM T MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64862	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
260285	Fee-for-Service	1033668652	1033668652	1	1	THRIFTY PAYLESS INC	8/28/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	28995 NEWPORT ROAD	None	MENIFEE	CA	92584	8069	33	06065	33.68497147	-117.1544445	Riverside County
260350	Fee-for-Service	1932318599	1932318599	1	1	THOMAS BADIN MD, INC	2/4/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	801 N TUSTIN AVE	SUITE 703	SANTA ANA	CA	92705	3612	30	06059	33.752286	-117.8341735	Orange County
260415	Fee-for-Service	1053842971	1053842971	1	1	TAYLOR, GRACE MD	10/1/2023	207P00000X	NA	Other	026	PHYSICIANS	161070	None	None	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
260444	Fee-for-Service	1053447532	1053447532	1	1	TULLY, GRIFFETH W MD	4/18/1996	207PE0004X	NA	Other	026	PHYSICIANS	60035	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
260487	Fee-for-Service	1629218334	1629218334	1	1	TRAN, LY O CRNA	4/22/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
260511	Fee-for-Service	1437187234	1437187234	1	1	TRAN, TRAM T MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64862	10	Gastroenterology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
260595	Fee-for-Service	1124508940	1124508940	1	1	TAMAYO, MARIAH	8/26/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1515 WEST CAMBRIDGE AVE	None	VISALIA	CA	93277	4513	54	06107	36.314496	-119.307951	Tulare County
260614	Fee-for-Service	1740368554	1740368554	1	1	TREMAYNE, PAULA S DO	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8495	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
260618	Fee-for-Service	1902954993	1902954993	1	1	TONG, ERIC M MD	10/27/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67726	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
260640	Fee-for-Service	1548308315	1548308315	1	1	THIARA, VIRPAL KAUR MD	6/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94823	41	Internal Medicine	0	In state provider	None	726 4TH STREET	None	MARYSVILLE	CA	95992	5656	58	06115	39.13872267	-121.5944372	Yuba County
260655	Fee-for-Service	1669738464	1669738464	1	1	TSAI, ICHEN MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128554	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
260664	Fee-for-Service	1922189471	1922189471	1	1	TAKAO, KEVIN PT	5/13/2020	174400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6759 SIERRA CT	SUITE A	DUBLIN	CA	94568	2670	01	06001	37.70825702	-121.9144925	Alameda County
260668	Fee-for-Service	1326068131	1326068131	1	1	TINSLEY,CYNTHIA H MD	11/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	85914	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
260676	Fee-for-Service	1497389746	1497389746	1	2	TAMBA, STEVEN NP	1/17/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95012488	-	NOT APPLICABLE	0	In state provider	None	600 W SANTA ANA BLVD	SUITE 107 108 109 110	SANTA ANA	CA	92701	4558	30	06059	33.74804119	-117.874111	Orange County
260682	Fee-for-Service	1427373323	1427373323	1	1	TAN, ECHO E MD	11/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118776	13	Neurology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
260711	Fee-for-Service	1437163227	1437163227	1	1	TAKEMOTO, GREG S M D	11/7/1994	207R00000X	NA	Other	026	PHYSICIANS	77070	01	General Practice	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
260716	Fee-for-Service	1518617992	1518617992	1	1	TAN, EDWARD A	4/3/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
260767	Fee-for-Service	1457604035	1457604035	1	1	THOMPSON, CATHERINE N LMFT	5/4/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
260789	Fee-for-Service	1649626433	1649626433	1	1	TIGRANYAN, SHUSHAN PSYD	12/12/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	9324 W STOCKTON BLVD	None	ELK GROVE	CA	95758	8012	34	06067	38.418309	-121.3939665	Sacramento County
260791	Fee-for-Service	1891826772	1891826772	1	1	TABBAH, MOHAMMAD J MD	7/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156135	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
260815	Fee-for-Service	1689933590	1689933590	1	1	TUCHAN PINEDA, GRISELDA J LM	12/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	2820 SOUTH VERMONT AVENU	16	LOS ANGELES	CA	90007	2291	19	06037	34.028991	-118.291524	Los Angeles County
260818	Fee-for-Service	1528072543	1528072543	1	1	TONG, TOMMY R MD	10/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	70961	22	Pathology (M.D. only)	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
260863	Fee-for-Service	1700417953	1700417953	1	1	TAYLOR-KETCHAM, NATALIE PT	4/9/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1610 ARDEN WAY	SUITE 195	SACRAMENTO	CA	95815	4035	34	06067	38.598597	-121.42863	Sacramento County
260883	Fee-for-Service	1124508940	1124508940	1	1	TAMAYO, MARIAH	8/26/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1515 WEST CAMBRIDGE AVE	None	VISALIA	CA	93277	4513	54	06107	36.314496	-119.307951	Tulare County
260927	Fee-for-Service	1134141047	1134141047	1	1	THRIFTY DRUG STORE 5656	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	8694 LAKE MURRAY BLVD	None	SAN DIEGO	CA	92119	2828	37	06073	32.80147304	-117.0117449	San Diego County
260931	Fee-for-Service	1104216597	1104216597	1	1	TIEU, RYAN LCSW	7/31/2024	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
260955	Fee-for-Service	1124379698	1124379698	1	1	THROWER, NATASHA N MD	10/31/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	168720	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
260960	Fee-for-Service	1396453460	1396453460	1	1	TORIO, BREANNE AU	7/8/2024	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
260969	Fee-for-Service	1154561298	1154561298	1	1	THOBANI, SALIMA A MD	10/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	105230	03	Allergy	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
260999	Fee-for-Service	1386057495	1386057495	1	1	TURNER, CHELSEA R LCSW	7/12/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
261016	Fee-for-Service	1679816201	1679816201	1	1	TEMECULA VALLEY HOSPITAL INC	11/12/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
261022	Fee-for-Service	1942235668	1942235668	1	1	TAYLOR,VANESSA M DPM	5/8/2000	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	CHINO HILLS PODIATRY GRP	5827 PINE AVE	BLDG 12 UNIT A	CHINO HILLS	CA	91709	6534	36	06071	33.94745656	-117.6777147	San Bernardino County
261044	Fee-for-Service	1265509186	1265509186	1	1	THOMPSON, BRIAN E MD	9/1/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	58579	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
261059	Fee-for-Service	1023767589	1023767589	1	1	TCT CARE INC	1/13/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	9009 MCFADDEN AVE	None	WESTMINSTER	CA	92683	6408	30	06059	33.73761316	-117.971121	Orange County
261074	Fee-for-Service	1871548388	1871548388	1	1	TAY, ABAS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	35954	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	25 N 14TH ST	STE 840	SAN JOSE	CA	95112	6215	43	06085	37.34293357	-121.8775187	Santa Clara County
261079	Fee-for-Service	1891826772	1891826772	1	1	TABBAH, MOHAMMAD J MD	7/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156135	10	Gastroenterology (M.D. only)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
261134	Fee-for-Service	1952665036	1952665036	1	1	TEK, ROTANA S DO	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13698	41	Internal Medicine	0	In state provider	None	341 E MAIN STREET	None	SAN JACINTO	CA	92583	4231	33	06065	33.78391437	-116.9562698	Riverside County
261138	Fee-for-Service	1306921069	1306921069	1	1	TABASSUM, ALAM MD	3/13/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	55784	01	General Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
261140	Fee-for-Service	1871350793	1871350793	1	1	TROTTIER, AUDREY LMFT	2/6/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
261154	Fee-for-Service	1750674834	1750674834	1	1	TEPP0NE-MARTIN, OXANA L CRNA	1/16/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6601 WHITE FEATHER ROAD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
261163	Fee-for-Service	1417430760	1417430760	1	1	TRAN, PETER P	4/2/2020	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	14221 EUCLID ST	SUITE F	GARDEN GROVE	CA	92843	4991	30	06059	33.757191	-117.937638	Orange County
261214	Fee-for-Service	1790896710	1790896710	1	1	THE HEALTH CARE AUTHORITY	12/29/2012	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FOR MEDICAL WEST	995 9TH AVENUE SW	None	BESSEMER	AL	35022	4527	00	None	33.37296685	-86.99179095	Jefferson County
261215	Fee-for-Service	1245735125	1245735125	1	1	TSAI, CYNTHIA MD	6/15/2021	207R00000X	NA	Other	026	PHYSICIANS	165307	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
261246	Fee-for-Service	1427018993	1427018993	1	1	TRAN, DOUGLAS A MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42263	04	Otology, Laryngology, Rhinology	0	In state provider	A PROFESSIONAL CORP	10760 WARNER AVE	STE 101	FOUNTAIN VALLEY	CA	92708	3852	30	06059	33.71627097	-117.9410205	Orange County
261305	Fee-for-Service	1679816201	1679816201	1	1	TEMECULA VALLEY HOSPITAL INC	11/12/2013	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
261322	Fee-for-Service	1255681011	1255681011	1	1	TOTAL RENAL CARE INC	12/1/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	19222 PIONEER BLVD	STE 101	CERRITOS	CA	90703	6603	19	06037	33.85561436	-118.08199	Los Angeles County
261327	Fee-for-Service	1851655005	1851655005	1	1	THOMPSON, MAXWELL E MD	6/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	128618	05	Anesthesiology	0	In state provider	None	955 BLANCO CIRCLE	None	SALINAS	CA	93901	4452	27	06053	36.65564507	-121.6367659	Monterey County
261335	Fee-for-Service	1265509186	1265509186	1	1	THOMPSON, BRIAN E MD	9/1/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	58579	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
261340	Fee-for-Service	1245648922	1245648922	1	1	TIDWELL, JUSTIN T NP	9/11/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
261347	Fee-for-Service	1255351755	1255351755	1	1	TESLUK, GREGORY C	3/31/1987	207W00000X	NA	Ophthalmology	026	PHYSICIANS	41824	18	Ophthalmology	0	In state provider	None	400 E ORANGEBURG AVE	None	MODESTO	CA	95350	5342	50	06099	37.66360555	-120.9877687	Stanislaus County
261350	Fee-for-Service	1942239785	1942239785	1	1	TAKII, BRUCE PT	9/23/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	337 S. 10TH STREET	G	TAFT	CA	93268	3300	15	06029	35.13716256	-119.4651601	Kern County
261361	Fee-for-Service	1871548388	1871548388	1	1	TAY, ABAS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	35954	41	Internal Medicine	0	In state provider	None	25 N 14TH ST	STE 840	SAN JOSE	CA	95112	6215	43	06085	37.34293357	-121.8775187	Santa Clara County
261416	Fee-for-Service	1760910467	1760910467	1	1	TOME, LUCIA MD	10/21/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157266	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
261428	Fee-for-Service	1811037369	1811037369	1	1	TRAN, NGUYEN P MD	9/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89653	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
261438	Fee-for-Service	1982076477	1982076477	1	1	TYUS, AMY A LMFT	5/30/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
261464	Fee-for-Service	1699979229	1699979229	1	1	TU, THUC B MD	3/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84863	41	Internal Medicine	0	In state provider	None	2785 PACIFIC AVE	STE A	LONG BEACH	CA	90806	2612	19	06037	33.807861	-118.193748	Los Angeles County
261471	Fee-for-Service	1649626011	1649626011	1	1	TRAN, THANG D MD	7/15/2019	207LP3000X	NA	Other	026	PHYSICIANS	141165	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
261495	Fee-for-Service	1992930465	1992930465	1	1	TRAN, DAVID N	5/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114274	None	None	0	In state provider	None	23845 MCBEAN PARKWAY	None	VALENCIA	CA	91355	2011	19	06037	34.39696803	-118.5525278	Los Angeles County
261502	Fee-for-Service	1790896710	1790896710	1	1	THE HEALTH CARE AUTHORITY	12/29/2012	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FOR MEDICAL WEST	995 9TH AVENUE SW	None	BESSEMER	AL	35022	4527	00	None	33.37296685	-86.99179095	Jefferson County
261518	Fee-for-Service	1225063795	1225063795	1	1	TORDILLA, F OMAR B MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	88578	01	General Practice	0	In state provider	None	225 EAST 2ND AVE	None	ESCONDIDO	CA	92025	4249	37	06073	33.12175817	-117.0787555	San Diego County
261525	Fee-for-Service	1780783332	1780783332	1	1	TAMELA VANDERAARDE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	BENEFIS HEALTHCARE	1101 26TH ST	None	GREAT FALLS	MT	59405	0000	00	None	47.491965	-111.2617215	Cascade County
261527	Fee-for-Service	1295814960	1295814960	3	1	TTT HEALTHCARE INC	5/12/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	616 N. GARFIELD AVE	101	MONTEREY PARK	CA	91754	1153	19	06037	34.06916465	-118.1229039	Los Angeles County
261533	Fee-for-Service	1427018993	1427018993	1	1	TRAN, DOUGLAS A MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42263	84	Surgery-Head and Neck	0	In state provider	A PROFESSIONAL CORP	10760 WARNER AVE	STE 101	FOUNTAIN VALLEY	CA	92708	3852	30	06059	33.71627097	-117.9410205	Orange County
261626	Fee-for-Service	1205910494	1205910494	1	1	TOWN, SHEILA M MD	11/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	31844	18	Ophthalmology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
261718	Fee-for-Service	1538692215	1538692215	1	1	TRAN, DAVID T DO	10/8/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18773	None	None	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
261724	Fee-for-Service	1104892611	1104892611	1	1	TRABUCCO, ARNALDO F MD	10/26/2020	208800000X	NA	Other	026	PHYSICIANS	167841	34	Urology and Urological Surgery	0	In state provider	None	2517 CANAL ST	STE 1	MERCED	CA	95340	2898	24	06047	37.30980519	-120.4785636	Merced County
261751	Fee-for-Service	1699979229	1699979229	1	1	TU, THUC B MD	3/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84863	45	Nephrology (Renal-Kidney)	0	In state provider	None	2785 PACIFIC AVE	STE A	LONG BEACH	CA	90806	2612	19	06037	33.807861	-118.193748	Los Angeles County
261798	Fee-for-Service	1356683494	1356683494	1	1	TIWANA, JASLEEN K MD	2/19/2024	207R00000X	NA	Other	026	PHYSICIANS	167933	None	None	0	In state provider	None	2700 F ST	100	BAKERSFIELD	CA	93301	1849	15	06029	35.384184	-119.023442	Kern County
261804	Fee-for-Service	1700931706	1700931706	2	1	TEAGLE, DONALD E OD	10/31/1993	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1321 GLENDALE GALLERIA	None	GLENDALE	CA	91210	1400	19	06037	34.144848	-118.2596735	Los Angeles County
261816	Fee-for-Service	1205298908	1205298908	1	1	TIOLECO, MARY H DO	11/15/2018	390200000X	NA	Other	026	PHYSICIANS	15900	08	Family Practice	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.2206967	-118.5342638	Los Angeles County
261902	Fee-for-Service	1952009250	1952009250	1	1	TCARES LLC	3/16/2023	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	820 BOWEN CT	None	YUBA CITY	CA	95993	8882	51	06101	39.13550217	-121.6509639	Sutter County
261912	Fee-for-Service	1356379002	1356379002	1	1	TEITEL, DAVID F MD	1/1/1982	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	42831	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
261920	Fee-for-Service	1841785771	1841785771	1	1	TARN, FRANK DO	8/31/2023	207P00000X	NA	Other	026	PHYSICIANS	21010	None	None	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
261998	Fee-for-Service	1508907023	1508907023	1	1	THAKER, KARTIK MD INC	2/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	45557	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3650 SOUTH ST	STE 210	LAKEWOOD	CA	90712	1527	19	06037	33.86019847	-118.149255	Los Angeles County
262040	Fee-for-Service	1598908873	1598908873	1	1	TRAN, BILL C MD	10/21/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	122729	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
262055	Fee-for-Service	1184643546	1184643546	1	1	THOMAS H SCOTT, DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 PARKLAND DR	None	DERRY	NH	03038	2746	00	None	42.87620843	-71.3168876	Rockingham County
262090	Fee-for-Service	1962488007	1962488007	1	7	TERI INC	1/25/1983	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ANZA HOUSE	1736 ANZA AVE	None	VISTA	CA	92084	3235	37	06073	33.22617897	-117.2326501	San Diego County
262137	Fee-for-Service	1720657471	1720657471	1	1	TAKETA, TAYLOR A CCC-SLP	11/8/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	27192 NEWPORT ROAD	SUITE 1	MENIFEE	CA	92584	7387	33	06065	33.68506045	-117.1855215	Riverside County
262179	Fee-for-Service	1285743708	1285743708	1	1	THRIFTY PAYLESS INC	2/23/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	49060 ROAD 426	None	OAKHURST	CA	93644	8546	20	06039	37.33195138	-119.6510765	Madera County
262200	Fee-for-Service	1356379002	1356379002	1	1	TEITEL, DAVID F MD	1/1/1982	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	42831	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
262217	Fee-for-Service	1093336711	1093336711	1	1	THOM, DESEAN D MD	12/2/2021	207L00000X	NA	Other	026	PHYSICIANS	163482	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
262288	Fee-for-Service	1508907023	1508907023	1	1	THAKER, KARTIK MD INC	2/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	45557	41	Internal Medicine	0	In state provider	None	3650 SOUTH ST	STE 210	LAKEWOOD	CA	90712	1527	19	06037	33.86019847	-118.149255	Los Angeles County
262295	Fee-for-Service	1124065164	1124065164	1	1	TAY, BOBBY MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	80047	20	Orthopedic Surgery	0	In state provider	None	400 PARNASSUS AVE	# A632	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
262297	Fee-for-Service	1134682552	1134682552	1	1	TRAN, MY TUYET MD	12/29/2023	207P00000X	NA	Other	026	PHYSICIANS	178920	None	None	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
262399	Fee-for-Service	1912930900	1912930900	1	1	THOUSAND OAKS PATHOLOGY	3/30/2007	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	ASSOCIATES INC	351 ROLLING OAKS DR	STE 100	THOUSAND OAKS	CA	91361	1276	56	06111	34.17437329	-118.8712248	Ventura County
262516	Fee-for-Service	1467957720	1467957720	1	1	THAKER, NIKKI DO	5/21/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20129	None	None	0	In state provider	None	421 NUT TREE RD	None	VACAVILLE	CA	95687	3508	48	06095	38.36441975	-121.9525909	Solano County
262544	Fee-for-Service	1972843415	1972843415	1	1	TRAN, LIEN-KHUONG P MD	5/1/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	182666	None	None	0	In state provider	None	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	33	06065	33.90290859	-117.4941562	Riverside County
262551	Fee-for-Service	1982861126	1982861126	1	1	TRAN, MAIANH T CNM	4/27/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
262574	Fee-for-Service	1508907023	1508907023	1	1	THAKER, KARTIK MD INC	2/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	45557	01	General Practice	0	In state provider	None	3650 SOUTH ST	STE 210	LAKEWOOD	CA	90712	1527	19	06037	33.86019847	-118.149255	Los Angeles County
262593	Fee-for-Service	1770905945	1770905945	1	1	THINH DUY MAI M.D., A.P.C.	1/14/2021	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	61 VICTORY LN	STE. A	LOS GATOS	CA	95030	5920	43	06085	37.22441264	-121.9836902	Santa Clara County
262610	Fee-for-Service	1023209004	1023209004	1	1	TESTARD, AARON R LMFT	5/10/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3021 TELEGRAPH AVE	SUITE C	BERKELEY	CA	94705	2072	01	06001	37.855386	-122.259851	Alameda County
262657	Fee-for-Service	1598259194	1598259194	1	1	TIFFANY BAUTISTA	11/23/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	888 SWIFT BLVD	None	RICHLAND	WA	99352	3514	00	None	46.28046647	-119.28231	Benton County
262659	Fee-for-Service	1023287679	1023287679	1	1	T H E CLINIC AT RUTH	2/1/2008	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	TEMPLE HEALTH CENTER	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	1104	19	06037	34.016157	-118.3088825	Los Angeles County
262725	Fee-for-Service	1649794116	1649794116	1	1	TAPIA, MATTHEW LMFT	9/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
262741	Fee-for-Service	1851663744	1851663744	1	1	TONEKABONI, MARYAM S MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	118665	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
262758	Fee-for-Service	1871577890	1871577890	1	1	TAKASH, THOMAS J MD	4/28/2022	207L00000X	NA	Other	026	PHYSICIANS	64633	None	None	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
262774	Fee-for-Service	1164432803	1164432803	1	1	TRAN, YOUNG T MD	7/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66589	02	General Surgery	0	In state provider	None	17170 COLIMA RD	STE D	HACIENDA HEIGHTS	CA	91745	6771	19	06037	33.9907128	-117.9325812	Los Angeles County
262825	Fee-for-Service	1467476614	1467476614	1	1	TRAN, THUYHAN T MD	10/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90056	41	Internal Medicine	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
262866	Fee-for-Service	1205816113	1205816113	1	1	TAMKIN, GARY W MD	1/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	78338	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
262897	Fee-for-Service	1295718054	1295718054	1	1	TRINH, TRONG DO	9/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7445	08	Family Practice	0	In state provider	None	525 W ACACIA ST	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
262918	Fee-for-Service	1164823993	1164823993	1	1	THOMAS, MONICA H LCSW	6/30/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	600 N MOUNTAIN AVE	STE B 106	UPLAND	CA	91786	4359	36	06071	34.10094187	-117.6700806	San Bernardino County
262934	Fee-for-Service	1346478831	1346478831	1	1	TREVATHAN, ELIZABETH T MD	6/17/2019	208M00000X	NA	Other	026	PHYSICIANS	115832	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
262939	Fee-for-Service	1740475201	1740475201	1	1	TANG, JAMES C MD	1/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99603	30	Radiology	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
262947	Fee-for-Service	1023287679	1023287679	1	1	T H E CLINIC AT RUTH	2/1/2008	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	TEMPLE HEALTH CENTER	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	1104	19	06037	34.016157	-118.3088825	Los Angeles County
262971	Fee-for-Service	1871847186	1871847186	1	1	TULLY, PATRICE A MD	2/23/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	146948	None	None	0	In state provider	None	1520 SAN PABLO ST	STE 1300	LOS ANGELES	CA	90033	5312	19	06037	34.06269295	-118.2030006	Los Angeles County
262983	Fee-for-Service	1790741171	1790741171	1	1	TELLE, TODD R MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	86846	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
263012	Fee-for-Service	1346286721	1346286721	1	1	TRAN, ROGER N MD	12/5/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	85461	08	Family Practice	0	In state provider	None	23321 EL TORO ROAD	STE H	LAKE FOREST	CA	92630	4892	30	06059	33.62411283	-117.6963344	Orange County
263021	Fee-for-Service	1588773006	1588773006	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	30222 CROWN VALLEY PKWY	None	LAGUNA NIGUEL	CA	92677	2332	30	06059	33.52399633	-117.7143119	Orange County
263023	Fee-for-Service	1750503926	1750503926	1	1	TOUEG, MIRIAM M	10/6/2017	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
263041	Fee-for-Service	1871114082	1871114082	1	1	TRAFFAS, MARK PT	2/22/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
263087	Fee-for-Service	1982977765	1982977765	1	1	TRIKA MEDICAL INC	12/4/2012	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	18095 HWY 18	STE B	APPLE VALLEY	CA	92307	2189	36	06071	34.54025876	-117.2693057	San Bernardino County
263142	Fee-for-Service	1184649790	1184649790	1	1	TOYAMA, AKIRA CRNA	9/30/1990	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
263159	Fee-for-Service	1174598122	1174598122	1	1	TSUJIMOTO, KAREN L MD	4/30/1991	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	72609	77	Infectious Disease	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
263175	Fee-for-Service	1194146431	1194146431	1	1	TARIQ, AFNAN R MD	4/4/2024	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	130907	None	None	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
263187	Fee-for-Service	1295718054	1295718054	1	1	TRINH, TRONG DO	9/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7445	66	Emergency Medicine (Urgent Care)	0	In state provider	None	525 W ACACIA ST	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
263209	Fee-for-Service	1366753600	1366753600	1	1	TRAN, DUC A MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136796	25	Physical Medicine and Rehabilitation	0	In state provider	None	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
263234	Fee-for-Service	1023287679	1023287679	1	1	T H E CLINIC AT RUTH	2/1/2008	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	TEMPLE HEALTH CENTER	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	1104	19	06037	34.016157	-118.3088825	Los Angeles County
263247	Fee-for-Service	1013531110	1013531110	1	1	TSAI, MARGARET PT	1/27/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
263248	Fee-for-Service	1467425223	1467425223	1	1	TIET, JENNY-QUYEN OD	8/7/2000	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	17251 FOOTHILL BLVD	None	FONTANA	CA	92335	9044	36	06071	34.10656453	-117.428166	San Bernardino County
263252	Fee-for-Service	1598573974	1598573974	1	1	THOMPSON, ELLA	1/17/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
263255	Fee-for-Service	1821708439	1821708439	1	1	TOP RANK DIAGNOSTIC LAB LLC	6/17/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	22875 SAVI RANCH PKWY	UNIT B	YORBA LINDA	CA	92887	4617	30	06059	33.87553981	-117.7379673	Orange County
263304	Fee-for-Service	1346286721	1346286721	1	1	TRAN, ROGER N MD	12/5/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	85461	38	Geriatrics	0	In state provider	None	23321 EL TORO ROAD	STE H	LAKE FOREST	CA	92630	4892	30	06059	33.62411283	-117.6963344	Orange County
263315	Fee-for-Service	1962488007	1962488007	1	6	TERI INC	8/9/1989	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ORIENTE HOUSE	3081 ORIENTE DR	None	VISTA	CA	92084	1423	37	06073	33.25030395	-117.2364864	San Diego County
263376	Fee-for-Service	1982977765	1982977765	1	1	TRIKA MEDICAL INC	12/4/2012	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	18095 HWY 18	STE B	APPLE VALLEY	CA	92307	2189	36	06071	34.54025876	-117.2693057	San Bernardino County
263396	Fee-for-Service	1407388903	1407388903	1	1	TRAN, ADRIENNE MD	10/18/2021	207R00000X	NA	Other	026	PHYSICIANS	173284	None	None	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
263446	Fee-for-Service	1174598122	1174598122	1	1	TSUJIMOTO, KAREN L MD	4/30/1991	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	72609	41	Internal Medicine	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
263487	Fee-for-Service	1730298167	1730298167	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5735	24829 DEL PRADO	None	DANA POINT	CA	92629	2852	30	06059	33.46647676	-117.6953307	Orange County
263500	Fee-for-Service	1952357717	1952357717	1	1	TISMINEZKY, BERNARDO MD	12/5/2019	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
263501	Fee-for-Service	1003261595	1003261595	1	1	TSUDA, PAIGE MD	7/20/2020	207L00000X	NA	Other	026	PHYSICIANS	150978	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
263521	Fee-for-Service	1023287679	1023287679	1	1	T H E CLINIC AT RUTH	3/24/2008	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	TEMPLE HEALTH CENTER	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	1104	19	06037	34.016157	-118.3088825	Los Angeles County
263544	Fee-for-Service	1265729826	1265729826	1	1	TRINITY PHARMACY INC	1/9/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1335 S GRAND AVENUE	None	GLENDORA	CA	91740	5046	19	06037	34.11465572	-117.8727594	Los Angeles County
263577	Fee-for-Service	1669530069	1669530069	1	1	THE READING HOSPITAL MED CTR	3/12/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	SIXTH AVENUE & SPRUCE ST	None	WEST READING	PA	19611	6052	00	None	40.332429	-75.9499785	Berks County
263600	Fee-for-Service	1740741560	1740741560	1	1	TER HAAR, CHARLOTTE M MD	7/31/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	183786	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
263623	Fee-for-Service	1295166965	1295166965	1	1	TOTAL RENAL CARE INC	7/2/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3001 HEALTH CARE WAY	BLDG 200	MODESTO	CA	95356	8503	50	06099	37.70867855	-121.0523055	Stanislaus County
263647	Fee-for-Service	1922089408	1922089408	1	1	TAYLOR, SANDRA J MD	4/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	84688	02	General Surgery	0	In state provider	None	2158 JEAN AVENUE	None	SOUTH LAKE TAHOE	CA	96150	3412	09	06017	38.91508934	-119.9978421	El Dorado County
263680	Fee-for-Service	1093075723	1093075723	1	1	TORRES, IKADEAN P LMFT	9/26/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
263698	Fee-for-Service	1407244213	1407244213	1	1	TORRES, PATRICIA LMFT	11/14/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	415 KNOLLCREST DR	STE 101	REDDING	CA	96002	0181	45	06089	40.57267376	-122.3643496	Shasta County
263761	Fee-for-Service	1477263986	1477263986	1	1	TRAN, HIEU NP	10/12/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
263766	Fee-for-Service	1235607870	1235607870	1	1	THAPLIYAL, AMRIT P LMFT	12/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
263785	Fee-for-Service	1063521417	1063521417	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05902	666 CONCAR DR	None	SAN MATEO	CA	94402	2622	41	06081	37.55485482	-122.3046012	San Mateo County
263791	Fee-for-Service	1205068863	1205068863	1	1	TAPPEN, DANA M	10/5/2009	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 WEST 6TH ST	SUITE 111	LOS ANGELES	CA	90017	1823	19	06037	34.05416748	-118.2622848	Los Angeles County
263834	Fee-for-Service	1689134736	1689134736	1	1	TIMKIN, BORA MD	6/9/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	178654	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
263856	Fee-for-Service	1376562686	1376562686	1	1	TOM, JENNIFER V MD	3/23/2023	261QU0200X	NA	Other	026	PHYSICIANS	179310	None	None	0	In state provider	None	100 S. SAN MATEO DR.	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
263869	Fee-for-Service	1740241157	1740241157	1	1	TEMPLE, WILLIAM W MD	2/8/2015	207ZP0102X	NA	Other	026	PHYSICIANS	36059	22	Pathology (M.D. only)	0	In state provider	None	2231 S WESTERN AVE	None	LOS ANGELES	CA	90018	1302	19	06037	34.03512469	-118.3090138	Los Angeles County
263921	Fee-for-Service	1194458059	1194458059	1	1	TEHACHAPI ADHC INC	7/26/2023	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	123 W. F STREET	None	TEHACHAPI	CA	93561	1613	15	06029	35.13120671	-118.4489752	Kern County
263942	Fee-for-Service	1336210137	1336210137	1	1	TRAN, CINDY S MD	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92128	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
263943	Fee-for-Service	1497833040	1497833040	1	1	TENN, GORDON K MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	25021	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
263955	Fee-for-Service	1780633610	1780633610	1	1	TIMOTHY GOVAERTS	5/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1750 E KEN PRATT BLVD	None	LONGMONT	CO	80504	5311	00	None	40.16034936	-105.0585093	Boulder County
263960	Fee-for-Service	1962660563	1962660563	1	1	TAYLOR-SNEL, MARCELLA A LCSW	9/22/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
264102	Fee-for-Service	1578942892	1578942892	1	1	THIESEN, JORDAN D DO	8/1/2018	207P00000X	NA	Other	026	PHYSICIANS	16372	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
264145	Fee-for-Service	1114358116	1114358116	1	1	TORRES, YARELY	5/16/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29995 TECHNOLOGY DR	103	MURRIETA	CA	92563	2633	33	06065	33.56041691	-117.1370428	Riverside County
264164	Fee-for-Service	1093385320	1093385320	1	1	TARZANA POST ACUTE, LLC	7/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5650 RESEDA BLVD	None	TARZANA	CA	91356	2230	19	06037	34.17395562	-118.5359786	Los Angeles County
264173	Fee-for-Service	1780282418	1780282418	1	1	TULARE HEALTHCARE & WELLNESS	10/11/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER LP	680 E MERRITT AVE	None	TULARE	CA	93274	2135	54	06107	36.22209621	-119.3382598	Tulare County
264189	Fee-for-Service	1649293150	1649293150	1	2	THOMAS, GEORGE P MD	9/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	35801	41	Internal Medicine	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
264212	Fee-for-Service	1861569733	1861569733	1	1	TERRELL, JOHN MD	4/1/1994	207W00000X	NA	Ophthalmology	026	PHYSICIANS	73284	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	ROOM 1-340	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
264215	Fee-for-Service	1174632509	1174632509	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5685	72253 29 PALMS HWY	None	TWENTYNINE PALMS	CA	92277	2417	36	06071	34.13542451	-116.0868015	San Bernardino County
264222	Fee-for-Service	1225044514	1225044514	1	1	THRIFTY PAYLESS INC	2/21/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 N CANON DR	None	BEVERLY HILLS	CA	90210	4705	19	06037	34.0697895	-118.400055	Los Angeles County
264284	Fee-for-Service	1235248295	1235248295	1	1	TANOURA, TAD T MD	8/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	67703	None	None	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
264341	Fee-for-Service	1467530246	1467530246	1	1	TSE, WILSON M W MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72904	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
264355	Fee-for-Service	1891838462	1891838462	1	1	TRAN, JULIE A OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 BREA MALL	None	BREA	CA	92821	5717	30	06059	33.91462708	-117.8886521	Orange County
264471	Fee-for-Service	1376860346	1376860346	1	1	TUMBAGA, GLORIA M MD	3/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121308	02	General Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
264483	Fee-for-Service	1215957436	1215957436	1	1	TRAINOR, LAUREN M DO	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	5396	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
264495	Fee-for-Service	1780336479	1780336479	1	1	TOPS MEDICAL CENTER, INC.	9/19/2022	213EG0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4835 VAN NUYS BLVD STE 1	None	SHERMAN OAKS	CA	91403	2136	19	06037	34.1587068	-118.4487394	Los Angeles County
264539	Fee-for-Service	1003906553	1003906553	1	1	TESFAY, ZELALEM MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	76854	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7126 PACIFIC BLVD	STE B	HUNTINGTON PARK	CA	90255	4775	19	06037	33.97476423	-118.2251554	Los Angeles County
264577	Fee-for-Service	1033184668	1033184668	1	1	THOMAS PAINTER MD	1/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3457 5TH AVE	None	PITTSBURGH	PA	15213	3204	00	None	40.44003598	-79.9609513	Allegheny County
264603	Fee-for-Service	1124221726	1124221726	1	1	TAKSALI, SUDEEP MD	12/18/2007	204D00000X	NA	Other	026	PHYSICIANS	100328	20	Orthopedic Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
264627	Fee-for-Service	1467530246	1467530246	1	1	TSE, WILSON M W MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72904	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
264643	Fee-for-Service	1134157860	1134157860	1	1	TANAKA, NILS JOHN MD	11/30/1991	207P00000X	NA	Other	026	PHYSICIANS	57654	01	General Practice	0	In state provider	None	13300 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5805	19	06037	33.91165585	-118.3524538	Los Angeles County
264656	Fee-for-Service	1952433187	1952433187	1	1	TRIMBLE, CHRISTINA M LMFT	9/20/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	222 CHURCH ST	B	NEVADA CITY	CA	95959	2505	29	06057	39.26361433	-121.0182708	Nevada County
264697	Fee-for-Service	1710271697	1710271697	1	1	TABY, RODOLPHE MD	6/16/2021	207Q00000X	NA	Adult Primary Care	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
264769	Fee-for-Service	1215957436	1215957436	1	1	TRAINOR, LAUREN M DO	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	5396	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
264788	Fee-for-Service	1215045968	1215045968	1	1	TAHERI TAFRESHI, ANOSHIRAVAN	9/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77810	36	Psychiatry	0	In state provider	MD	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
264796	Fee-for-Service	1982695300	1982695300	1	1	THINH, TRUONG VAN MD	5/5/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	39826	01	General Practice	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
264821	Fee-for-Service	1831398759	1831398759	1	1	TSANG, KEITH MD	5/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116147	None	None	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
264826	Fee-for-Service	1518019140	1518019140	1	1	TRAN, QUAN M OD	11/16/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	305 N MAIN ST	None	SANTA ANA	CA	92701	4852	30	06059	33.7472043	-117.8675716	Orange County
264833	Fee-for-Service	1437233418	1437233418	1	1	TERESZKIEWICZ, CAROL MD	1/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	57267	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
264865	Fee-for-Service	1700046364	1700046364	1	1	TARUNA RALHAN MD	2/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 W THOMAS RD	None	PHOENIX	AZ	85013	3742	00	None	33.480864	-112.0795155	Maricopa County
264880	Fee-for-Service	1194884759	1194884759	1	1	TAKEHARA, MICHAEL A MD	1/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	62290	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
264898	Fee-for-Service	1427492891	1427492891	1	1	TRAN, VIVIAN M MD	12/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132706	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
264928	Fee-for-Service	1134157860	1134157860	1	1	TANAKA, NILS JOHN MD	11/30/1991	207P00000X	NA	Other	026	PHYSICIANS	57654	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13300 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5805	19	06037	33.91165585	-118.3524538	Los Angeles County
264968	Fee-for-Service	1316397003	1316397003	1	1	THORNLEY, CAITLIN J MD	4/25/2023	208600000X	NA	General Surgery	026	PHYSICIANS	185715	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
265013	Fee-for-Service	1740818012	1740818012	1	1	TIZCARENO, YOLANDA NP	6/27/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
265021	Fee-for-Service	1275102865	1275102865	1	1	THREE OLIVES HOME HEALTH	5/10/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CORP	6949 RESEDA BLVD	UNIT 201A	RESEDA	CA	91335	8537	19	06037	34.19712	-118.536077	Los Angeles County
265057	Fee-for-Service	1265073068	1265073068	2	1	TRANSITCARE	10/1/2023	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TATION	6470 FOOTHILL BLVD	UNIT A	TUJUNGA	CA	91042	2729	19	06037	34.24452205	-118.2728144	Los Angeles County
265083	Fee-for-Service	1982695300	1982695300	1	1	THINH, TRUONG VAN MD	5/5/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	39826	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
265122	Fee-for-Service	1902838352	1902838352	1	2	TAHOE CARSON RADIOLOGY LOOS	8/27/2023	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	1	Border provider	None	2874 N CARSON STREET,	SUITE 300	CARSON CITY	NV	89706	1683	00	None	39.185271	-119.7710595	Consolidated Municipality of Carson City
265135	Fee-for-Service	1013910900	1013910900	1	1	TRADONSKY, STEVEN MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	53852	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
265166	Fee-for-Service	1194884759	1194884759	1	1	TAKEHARA, MICHAEL A MD	1/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	62290	83	Rheumatology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
265189	Fee-for-Service	1891007084	1891007084	1	1	TRINH, TIFFANY T MD	9/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120697	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
265208	Fee-for-Service	1821040320	1821040320	1	1	TERDIMAN, JONATHAN MD	10/1/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	70554	10	Gastroenterology (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
265216	Fee-for-Service	1184227944	1184227944	1	1	TRIZA SOLUTIONS LLC	3/18/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	859 CORPORATE WAY	None	FREMONT	CA	94539	6115	01	06001	37.49838204	-121.929212	Alameda County
265257	Fee-for-Service	1992993141	1992993141	1	2	TERESA ELAINE SHARBER	8/24/2017	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	118 PINETREE DRIVE	None	PERRIS	CA	92571	2681	33	06065	33.8090187	-117.2235068	Riverside County
265267	Fee-for-Service	1902984545	1902984545	1	1	TSEN, CAROLINE MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85972	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
265295	Fee-for-Service	1144218272	1144218272	1	1	TESKE, DOUGLAS W. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	555 S 18TH ST	None	COLUMBUS	OH	43205	2654	00	None	39.95323846	-82.9765048	Franklin County
265379	Fee-for-Service	1629215520	1629215520	1	1	TAM, JAMES K MD	7/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106111	None	None	0	In state provider	None	751 SOUTH BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
265422	Fee-for-Service	1013910900	1013910900	1	1	TRADONSKY, STEVEN MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	53852	20	Orthopedic Surgery	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
265450	Fee-for-Service	1710369293	1710369293	1	1	TISCHLER, SAMUEL DPM	1/11/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
265454	Fee-for-Service	1811375272	1811375272	1	1	TRAN, CHRISTINA T DO	8/2/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15141	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
265479	Fee-for-Service	1275263469	1275263469	1	1	TUUNGAFASI, EUNICE H NP	1/31/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
265495	Fee-for-Service	1821040320	1821040320	1	1	TERDIMAN, JONATHAN MD	10/1/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	70554	41	Internal Medicine	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
265505	Fee-for-Service	1528162989	1528162989	1	1	TAYLOR, MELISSA A DO	6/26/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7112	08	Family Practice	0	In state provider	None	1901 TOWN AND COUNTRY DR	SUITE 104	NORCO	CA	92860	3611	33	06065	33.92721419	-117.561448	Riverside County
265531	Fee-for-Service	1457379034	1457379034	1	2	TURNURE MEDICAL GROUP INC	3/15/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	2288 AUBURN BLVD	STE 104	SACRAMENTO	CA	95821	1618	34	06067	38.625345	-121.4114985	Sacramento County
265543	Fee-for-Service	1992993141	1992993141	1	2	TERESA ELAINE SHARBER	8/24/2017	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	118 PINETREE DRIVE	None	PERRIS	CA	92571	2681	33	06065	33.8090187	-117.2235068	Riverside County
265596	Fee-for-Service	1942023189	1942023189	1	1	TOKIC, BEGO OT	2/26/2025	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	805 E WALNUT AVE	None	LOMPOC	CA	93436	7027	42	06083	34.64061286	-120.4487303	Santa Barbara County
265617	Fee-for-Service	1740385111	1740385111	1	1	TOTAL RENAL CARE, INC	1/12/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	125 CORPORATE PL	STE C	VALLEJO	CA	94590	6921	48	06095	38.09460847	-122.2483788	Solano County
265618	Fee-for-Service	1073004958	1073004958	1	1	TOUSSI, ATRIN MD	10/17/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	180124	07	Dermatology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
265619	Fee-for-Service	1346380870	1346380870	1	1	THE BROOKDALE HOSPITAL	11/28/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDCIAL CENTER	ONE BROOKDALE PLAZA	None	BROOKLYN	NY	11212	3198	00	None	40.654503	-73.9124325	Kings County
265645	Fee-for-Service	1659655496	1659655496	1	1	TSAO, DANIELLE J OD	10/31/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 S ATLANTIC BLVD	STE A	MONTEREY PARK	CA	91754	3872	19	06037	34.05627946	-118.1347926	Los Angeles County
265654	Fee-for-Service	1083903124	1083903124	1	1	TORRANCE HEALTH ASSOCIATION	2/10/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	824 E CARSON ST	SUITE 203	CARSON	CA	90745	2262	19	06037	33.83159904	-118.2605506	Los Angeles County
265667	Fee-for-Service	1174511448	1174511448	1	1	TRACY, MARTHA MD	3/27/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	31246	78	Neoplastic Diseases/Oncology	0	In state provider	None	3001 COLBY ST	None	BERKELEY	CA	94705	2039	01	06001	37.85496934	-122.2575642	Alameda County
265668	Fee-for-Service	1710955539	1710955539	1	1	TABIBIAN, BEHNAM S MD	5/10/2021	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	61974	None	None	0	In state provider	None	1700 CESAR E CHAVEZ AVE	STE 2200	LOS ANGELES	CA	90033	2476	19	06037	34.05101259	-118.217259	Los Angeles County
265683	Fee-for-Service	1093160897	1093160897	1	1	TORRES, YAHANNA MD	8/1/2021	207R00000X	NA	Other	026	PHYSICIANS	173870	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
265701	Fee-for-Service	1962870907	1962870907	1	2	TELFER, ALBERT NP	6/27/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95002211	-	NOT APPLICABLE	0	In state provider	None	43485 HOLLYHOCK ST	None	INDIO	CA	92201	1976	33	06065	33.73268124	-116.2444907	Riverside County
265735	Fee-for-Service	1366544629	1366544629	1	1	TANG, GEORGE MD	7/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	78792	20	Orthopedic Surgery	0	In state provider	None	10 CONGRESS ST	STE 103	PASADENA	CA	91105	3027	19	06037	34.13396893	-118.1528162	Los Angeles County
265749	Fee-for-Service	1962660803	1962660803	1	1	TAINTER, CHRISTOPHER R MD	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131390	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
265752	Fee-for-Service	1265433965	1265433965	1	1	TYE, KENNETH MD INC	10/16/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	32035	30	Radiology	0	In state provider	None	1250 S SUNSET AVE	STE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
265756	Fee-for-Service	1962488007	1962488007	1	11	TERI INC	7/29/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6205 ALVERTON DR	None	CARLSBAD	CA	92009	3061	37	06073	33.12697247	-117.2610133	San Diego County
265817	Fee-for-Service	1629332671	1629332671	1	1	TECKCHANDANI, SHWETA A DO	10/21/2019	390200000X	NA	Other	026	PHYSICIANS	13390	13	Neurology (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
265874	Fee-for-Service	1538344452	1538344452	1	1	TAN, JOANNE E LMFT	5/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
265902	Fee-for-Service	1346380870	1346380870	1	1	THE BROOKDALE HOSPITAL	11/28/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDCIAL CENTER	ONE BROOKDALE PLAZA	None	BROOKLYN	NY	11212	3198	00	None	40.654503	-73.9124325	Kings County
265935	Fee-for-Service	1780734350	1780734350	1	1	THOMPSON, KENDRA B PT	9/11/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3180 ARDEN WY	None	SACRAMENTO	CA	95825	3701	34	06067	38.595528	-121.3903395	Sacramento County
265955	Fee-for-Service	1174511448	1174511448	1	1	TRACY, MARTHA MD	3/27/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	31246	41	Internal Medicine	0	In state provider	None	3001 COLBY ST	None	BERKELEY	CA	94705	2039	01	06001	37.85496934	-122.2575642	Alameda County
265962	Fee-for-Service	1356645865	1356645865	1	1	THAI, NINA N CRNA	5/10/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	207 W LEGION	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
265992	Fee-for-Service	1942680814	1942680814	1	1	TEHRANI, MICHAEL MD APC	12/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128457	41	Internal Medicine	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
266040	Fee-for-Service	1265433965	1265433965	1	1	TYE, KENNETH MD INC	10/16/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	32035	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1250 S SUNSET AVE	STE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
266117	Fee-for-Service	1770551731	1770551731	1	1	TSAI, AN SHYANG MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31773	40	Pediatrics	0	In state provider	None	7501 HOSPITAL DR	STE 206	SACRAMENTO	CA	95823	5405	34	06067	38.464776	-121.416912	Sacramento County
266177	Fee-for-Service	1790879286	1790879286	1	1	TEITELBAUM, MICHELE LMFT	9/27/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 N PACIFIC COAST HWY	200	REDONDO BEACH	CA	90277	2162	19	06037	33.85464152	-118.3902749	Los Angeles County
266192	Fee-for-Service	1912606690	1912606690	1	2	TAHMINA HAQ MD	11/5/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	515 S BEACH BLVD	C	ANAHEIM	CA	92804	1812	30	06059	33.82559703	-117.9934832	Orange County
266246	Fee-for-Service	1952023418	1952023418	1	1	TOEWS, CATHERINE PT	12/14/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	17270 BEAR VALLEY RD	STE 105	VICTORVILLE	CA	92395	7751	36	06071	34.47103946	-117.2849598	San Bernardino County
266256	Fee-for-Service	1578540936	1578540936	1	1	THOMPSON, STEVEN 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	2200 E SHOW LOW LAKE RD	None	SHOW LOW	AZ	85901	7831	00	None	34.202988	-110.0176695	Navajo County
266316	Fee-for-Service	1407017247	1407017247	1	1	TERRIEN, BRIAN D MD	10/17/2019	207L00000X	NA	Other	026	PHYSICIANS	158978	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
266320	Fee-for-Service	1730244203	1730244203	1	1	TROMBINO, LORRAINE	12/19/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
266323	Fee-for-Service	1265433965	1265433965	1	1	TYE, KENNETH MD INC	10/16/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	32035	41	Internal Medicine	0	In state provider	None	1250 S SUNSET AVE	STE 202	WEST COVINA	CA	91790	3962	19	06037	34.0610671	-117.9463685	Los Angeles County
266331	Fee-for-Service	1356738462	1356738462	1	1	TORBA, DANIEL G MD	2/15/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	155239	08	Family Practice	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
266336	Fee-for-Service	1467461061	1467461061	1	1	TRAN, LAWRENCE T MD	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	87064	41	Internal Medicine	0	In state provider	None	24411 HEALTH CENTER DR	STE 680	LAGUNA HILLS	CA	92653	3692	30	06059	33.6087201	-117.7076948	Orange County
266340	Fee-for-Service	1154859916	1154859916	1	1	TAYLOR, CRISTI LMFT	9/16/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	401 VERNON ST	B	ROSEVILLE	CA	95678	2600	31	06061	38.74793156	-121.2853565	Placer County
266367	Fee-for-Service	1013370238	1013370238	1	1	TOROSIS, MICHELE L MD	6/14/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	150979	None	None	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
266389	Fee-for-Service	1407625858	1407625858	1	1	TELETHERAPEUTICS HEALTH CALI	7/22/2024	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	FORNIA CORP	710 RIMPAU AVE	STE 102	CORONA	CA	92879	5723	33	06065	33.87375	-117.5526465	Riverside County
266434	Fee-for-Service	1194783548	1194783548	1	1	THOMAS, DANIEL S MD	6/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	52883	24	Plastic Surgery	0	In state provider	None	619 W EAST AVE	None	CHICO	CA	95926	7201	04	06007	39.75055922	-121.8716897	Butte County
266476	Fee-for-Service	1912606690	1912606690	1	2	TAHMINA HAQ MD	11/5/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	515 S BEACH BLVD	C	ANAHEIM	CA	92804	1812	30	06059	33.82559703	-117.9934832	Orange County
266482	Fee-for-Service	1891959367	1891959367	1	1	TING, SARAH S OD	4/17/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8250 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5427	19	06037	34.22078654	-118.4326211	Los Angeles County
266487	Fee-for-Service	1891807673	1891807673	1	1	TOMASSIAN, KREKOR A MD	7/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40035	01	General Practice	0	In state provider	None	415 W ALOSTA AVE	STE 201	GLENDORA	CA	91740	4335	19	06037	34.1288673	-117.8699632	Los Angeles County
266514	Fee-for-Service	1841398518	1841398518	1	1	TAN, JAMES H MD	1/27/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	59404	08	Family Practice	0	In state provider	None	5615 SCOTTS VALLEY DR	None	SCOTTS VALLEY	CA	95066	3492	44	06087	37.06232425	-122.0064552	Santa Cruz County
266538	Fee-for-Service	1265541692	1265541692	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1151 CRESTON RD	None	PASO ROBLES	CA	93446	3031	40	06079	35.62302625	-120.6615665	San Luis Obispo County
266577	Fee-for-Service	1649382714	1649382714	1	1	THYNE, SHANNON MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62123	40	Pediatrics	0	In state provider	None	1001 POTRERO AVE	RM 6E	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
266598	Fee-for-Service	1881688950	1881688950	1	1	TRAN, DON D MD	2/1/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41328	41	Internal Medicine	0	In state provider	None	25 N 14TH STREET	STE 780	SAN JOSE	CA	95112	6215	43	06085	37.34293357	-121.8775187	Santa Clara County
266612	Fee-for-Service	1801549100	1801549100	1	1	TOSCANO, YESSENIA L CNP	8/2/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1207 E FLORIDA AVE	None	HEMET	CA	92543	4513	33	06065	33.74753552	-116.9593245	Riverside County
266622	Fee-for-Service	1528144433	1528144433	1	1	TAYLOR, TASHA K MD	3/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	82187	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
266627	Fee-for-Service	1265484240	1265484240	1	1	THACH, ANDREA M MD	10/31/1985	207R00000X	NA	Other	026	PHYSICIANS	53457	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
266674	Fee-for-Service	1407625858	1407625858	1	1	TELETHERAPEUTICS HEALTH CALI	7/22/2024	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	FORNIA CORP	710 RIMPAU AVE	STE 102	CORONA	CA	92879	5723	33	06065	33.87375	-117.5526465	Riverside County
266722	Fee-for-Service	1639762644	1639762644	1	1	TABARES, REBECCA NP	1/1/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
266735	Fee-for-Service	1417110412	1417110412	1	1	TONYA MIKO ENOMOTO, 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	3181 SW SAM JACKSON PARK	None	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
266759	Fee-for-Service	1811952054	1811952054	1	1	THEODORE, PIERRE R MD	8/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86700	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
266773	Fee-for-Service	1891807673	1891807673	1	1	TOMASSIAN, KREKOR A MD	7/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40035	08	Family Practice	0	In state provider	None	415 W ALOSTA AVE	STE 201	GLENDORA	CA	91740	4335	19	06037	34.1288673	-117.8699632	Los Angeles County
266812	Fee-for-Service	1497436042	1497436042	1	1	TSE, WAI LAN PT	8/7/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	275 W HOSPITALITY LN	103	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
266827	Fee-for-Service	1124643564	1124643564	1	1	TRAN, HEATHER DPM	10/7/2024	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5565 GROSSMONT CENTER DR	SUITE 510	LA MESA	CA	91942	3024	37	06073	32.77978322	-117.0094766	San Diego County
266835	Fee-for-Service	1215357983	1215357983	1	1	TRUONG, KIM B MD	7/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141548	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
266854	Fee-for-Service	1811195456	1811195456	1	1	TRAN, SCOTT L	10/18/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12801 CROSSROADS PKWY SO	None	CITY OF INDUSTRY	CA	91746	3502	19	06037	34.0289395	-118.024533	Los Angeles County
266855	Fee-for-Service	1275204638	1275204638	1	1	TING, JAVI S CNP	11/18/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	987 E HILLSDALE BLVD	None	FOSTER CITY	CA	94404	2112	41	06081	37.55686846	-122.273705	San Mateo County
266933	Fee-for-Service	1659805778	1659805778	1	1	THE 7 C'S HOSPICE, INC	11/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	190 SIERRA COURT	SUITE B-109	PALMDALE	CA	93550	7618	19	06037	34.64013337	-118.1280539	Los Angeles County
266975	Fee-for-Service	1831115807	1831115807	1	1	THOMAS, JEFFREY L MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67160	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
266989	Fee-for-Service	1336176312	1336176312	1	1	TAYLOR, CECILLE G MD INC	3/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	67853	18	Ophthalmology	0	In state provider	None	1561 CREECKSIDE DR	STE 160	FOLSOM	CA	95630	3495	34	06067	38.668032	-121.150188	Sacramento County
267007	Fee-for-Service	1093973018	1093973018	1	1	TINIO, STEPHEN P MD	6/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103256	08	Family Practice	0	In state provider	None	3132 WEST MARCH LANE	STE 5	STOCKTON	CA	95219	2354	39	06077	37.9839146	-121.3516231	San Joaquin County
267048	Fee-for-Service	1447518964	1447518964	1	1	TSUKIMOTO, MITSUHIKO MD	6/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129205	40	Pediatrics	0	In state provider	None	25845 BARTON RD	SUITE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
267050	Fee-for-Service	1194758235	1194758235	1	1	TALAT SAIFEE MD	9/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	42230	40	Pediatrics	0	In state provider	A MEDICAL CORPORATION	2211 W MAGNOLIA BLVD	STE 210	BURBANK	CA	91506	1771	19	06037	34.1728873	-118.3320905	Los Angeles County
267054	Fee-for-Service	1396994778	1396994778	1	1	TSAI, STEVE F MD	11/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88038	22	Pathology (M.D. only)	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
267057	Fee-for-Service	1528300217	1528300217	1	1	TRUONG, MINH H LCSW	12/7/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CSW	875 RIDGEWAY STREET	None	MORRO BAY	CA	93442	9998	40	06079	35.35940696	-120.8422596	San Luis Obispo County
267060	Fee-for-Service	1841292257	1841292257	1	1	TAO, JEREMIAH P MD	7/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99982	18	Ophthalmology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
267095	Fee-for-Service	1346283835	1346283835	1	1	TRACY, RYAN P MD	1/6/2021	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	83635	None	None	0	In state provider	None	2299 BACON ST	STE 7	CONCORD	CA	94520	2046	07	06013	37.98199042	-122.0349518	Contra Costa County
267132	Fee-for-Service	1295713543	1295713543	1	1	TRUSE, BRYSON 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	4892 N STONE AVE	None	TUCSON	AZ	85704	5761	00	None	32.295168	-110.970315	Pima County
267183	Fee-for-Service	1396705018	1396705018	1	1	TREDAL,M STEVEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	333 NORTH SMITH AVE	None	ST PAUL	MN	55102	0000	00	None	44.94251219	-93.1074995	Ramsey County
267185	Fee-for-Service	1427483452	1427483452	1	1	TIU, JANUARY NP	7/16/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
267197	Fee-for-Service	1902370075	1902370075	1	1	TRUONG, JULIE NP	2/8/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
267204	Fee-for-Service	1750825154	1750825154	1	1	TANIGUCHI, STACY M PSY	7/28/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	28816	-	NOT APPLICABLE	0	In state provider	None	730 POLK ST	4TH FLOOR	SAN FRANCISCO	CA	94109	7813	38	06075	37.78379532	-122.4192766	San Francisco County
267209	Fee-for-Service	1851706220	1851706220	1	1	TRAN, NGOC MD	8/9/2023	207ZP0102X	NA	Other	026	PHYSICIANS	148483	None	None	0	In state provider	None	2621 10TH	None	BERKELEY	CA	94710	2674	01	06001	37.85811852	-122.2898175	Alameda County
267210	Fee-for-Service	1477978708	1477978708	1	1	TRAUTH, ERIC LMFT	6/12/2019	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
267217	Fee-for-Service	1659805778	1659805778	1	1	THE 7 C'S HOSPICE, INC	11/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	190 SIERRA COURT	SUITE B-109	PALMDALE	CA	93550	7618	19	06037	34.64013337	-118.1280539	Los Angeles County
267245	Fee-for-Service	1407317076	1407317076	1	1	TOMAJAN, MEGAN K MD	9/6/2022	207R00000X	NA	Other	026	PHYSICIANS	180510	None	None	0	In state provider	None	1020 29TH STREET	SUITE 570	SACRAMENTO	CA	95816	5125	34	06067	38.572803	-121.4685	Sacramento County
267264	Fee-for-Service	1669468435	1669468435	2	1	THOMAS SHILTON CORP	1/19/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	90 N ASHWOOD	SUITE B	VENTURA	CA	93003	1810	56	06111	34.27593896	-119.2394708	Ventura County
267299	Fee-for-Service	1154732451	1154732451	1	1	TRINH, SUSAN MD	6/28/2018	390200000X	NA	Other	026	PHYSICIANS	154642	05	Anesthesiology	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
267400	Fee-for-Service	1154316180	1154316180	1	1	TORRES, ROLAND A MD	11/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	53137	14	Neurological Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
267462	Fee-for-Service	1063610400	1063610400	1	1	TAGAMI, LORI S	9/14/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9353 IMPERIAL HIGHWAY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
267479	Fee-for-Service	1285849521	1285849521	1	1	TA, LIEM P DO	4/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10001	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
267495	Fee-for-Service	1427049162	1427049162	1	1	TACATA, FELISA P MD	11/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94819	36	Psychiatry	0	In state provider	None	2081 ARENA BLVD	SUITE 160	SACRAMENTO	CA	95834	2309	34	06067	38.647737	-121.510467	Sacramento County
267533	Fee-for-Service	1487722732	1487722732	1	1	TRAN, STEVE M MD	4/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	64217	45	Nephrology (Renal-Kidney)	0	In state provider	None	26800 CROWN VALLEY PKWY	None	MISSION VIEJO	CA	92691	6330	30	06059	33.56286021	-117.6673449	Orange County
267553	Fee-for-Service	1073758249	1073758249	1	1	THE VILLAGE PROJECT, INCORPO	12/12/2024	251S00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	RATED	1069 BROADWAY AVE	SUITE 201	SEASIDE	CA	93955	4996	27	06053	36.6091585	-121.8437505	Monterey County
267574	Fee-for-Service	1710096144	1710096144	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5692	27177 HWY 189	STE E	BLUE JAY	CA	92317	0000	36	06071	34.24567419	-117.2110003	San Bernardino County
267580	Fee-for-Service	1891055075	1891055075	1	1	TALREJA, NEHA MD	4/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141471	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
267609	Fee-for-Service	1891892675	1891892675	1	1	TROUNG, KEVIN A MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	83027	66	Emergency Medicine (Urgent Care)	0	In state provider	None	210 W SAN BERNARDINO DR	None	COVINA	CA	91723	1515	19	06037	34.088004	-117.893475	Los Angeles County
267643	Fee-for-Service	1679513253	1679513253	1	1	TIGNO, DONNA D MD	7/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68689	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	350 30TH ST	STE 520	OAKLAND	CA	94609	3426	01	06001	37.81892183	-122.2640154	Alameda County
267650	Fee-for-Service	1720653553	1720653553	1	1	THE TEEN PROJECT, INC.	2/3/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	20302 FLANAGAN ROAD	None	TRABUCO CANYON	CA	92679	0975	30	06059	33.66733437	-117.5843214	Orange County
267742	Fee-for-Service	1619343357	1619343357	1	1	TALAMI INTERNATIONAL INC	9/21/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	505 N MOLLISON AVE	SUITE 102	EL CAJON	CA	92021	6159	37	06073	32.80048689	-116.9509459	San Diego County
267749	Fee-for-Service	1982973582	1982973582	1	1	TAVEROS, MEL C R MD	5/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139158	40	Pediatrics	0	In state provider	None	420 34TH STREET	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
267767	Fee-for-Service	1467030221	1467030221	1	1	TSAI, HSIN HSIANG C MD	11/22/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	13355 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5802	19	06037	33.91091877	-118.3527745	Los Angeles County
267784	Fee-for-Service	1316255094	1316255094	1	1	TRAN, LINDA B MD	7/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118778	41	Internal Medicine	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
267822	Fee-for-Service	1174619282	1174619282	1	1	TRUONG, REX H MD	12/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80200	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
267846	Fee-for-Service	1477800753	1477800753	1	1	TOP IMAGING, INC.	1/5/2023	261QR0200X	NA	Mammography/MRI Provider	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	13091 KERRY ST	None	GARDEN GROVE	CA	92844	1638	30	06059	33.77278603	-117.9589987	Orange County
267854	Fee-for-Service	1063587616	1063587616	1	1	THIARA, ARVINDER K MD	2/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97774	40	Pediatrics	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
267860	Fee-for-Service	1548265036	1548265036	1	9	TRUXTUN RADIOLOGY	2/12/2019	261QR0200X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP LP	301 BRUNDAGE LANE	None	BAKERSFIELD	CA	93304	3248	15	06029	35.35386839	-119.0055269	Kern County
267861	Fee-for-Service	1245620384	1245620384	1	1	THRIVE AND SHINE SPEECH THER	12/10/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	APY, INC.	292 S LA CIENEGA BLVD	#250	BEVERLY HILLS	CA	90211	3330	19	06037	34.06283371	-118.3761195	Los Angeles County
267872	Fee-for-Service	1134355126	1134355126	1	1	TENNANT, RICHARD S MD	2/16/2022	207R00000X	NA	Other	026	PHYSICIANS	114468	None	None	0	In state provider	None	27235 TOURNEY	2500	VALENCIA	CA	91355	5908	19	06037	34.41755702	-118.5772646	Los Angeles County
267874	Fee-for-Service	1255495552	1255495552	1	1	THE CHILDRENS CLINIC	7/1/2005	261QC1500X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	1057 PINE AVE	None	LONG BEACH	CA	90813	3118	19	06037	33.7801197	-118.1924041	Los Angeles County
267936	Fee-for-Service	1821017294	1821017294	2	2	THOMAS, SHAN MD	1/16/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	None	None	0	In state provider	None	292 POSADA LN	None	TEMPLETON	CA	93465	4054	40	06079	35.5531447	-120.7214979	San Luis Obispo County
267967	Fee-for-Service	1962579524	1962579524	1	1	TERRA, MARY I LCSW	10/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	24310	-	NOT APPLICABLE	0	In state provider	None	2001 THE ALAMEDA	None	SAN JOSE	CA	95126	1136	43	06085	37.34293689	-121.9270392	Santa Clara County
268004	Fee-for-Service	1013276575	1013276575	1	1	TIENG, ANDREA MD INC	9/25/2013	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	106477	10	Gastroenterology (M.D. only)	0	In state provider	None	10408 INDUSTRIAL CIRCLE	None	REDLANDS	CA	92374	4548	36	06071	34.06469012	-117.2361582	San Bernardino County
268010	Fee-for-Service	1689702755	1689702755	1	1	TROTTER, BROCK E LCSW	11/19/2019	163WP0807X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
268050	Fee-for-Service	1275909434	1275909434	1	1	TWO ZEDS MEDICAL CORPORATION	4/4/2025	207P00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3830 VALLEY CENTRE DR	SUITE 702	SAN DIEGO	CA	92130	3320	37	06073	32.93777252	-117.2318423	San Diego County
268054	Fee-for-Service	1003835679	1003835679	1	1	TEE, NORA K MD	1/12/2012	207R00000X	NA	Other	026	PHYSICIANS	53201	41	Internal Medicine	0	In state provider	KA WOO MEDICAL CLINIC	841 W VALLEY BLVD	STE 107	ALHAMBRA	CA	91803	3251	19	06037	34.07803221	-118.1327862	Los Angeles County
268088	Fee-for-Service	1376053843	1376053843	1	3	TYSON MEDICAL INC	12/24/2024	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	RGENT CARE	1044 CHERRY VALLEY BLVD	SUITE 430	CALIMESA	CA	92320	2247	33	06065	33.96519906	-117.0382461	Riverside County
268115	Fee-for-Service	1215919550	1215919550	1	1	TRACY, KEVIN A MD	6/30/1985	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	55177	40	Pediatrics	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
268128	Fee-for-Service	1649473794	1649473794	1	1	TAZEN, SIRINAN MD	9/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125220	13	Neurology (M.D. only)	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
268148	Fee-for-Service	1881954501	1881954501	1	1	THEISEN, JEREMY D MD	2/2/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183849	None	None	0	In state provider	None	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
268161	Fee-for-Service	1255495552	1255495552	1	1	THE CHILDRENS CLINIC	7/1/2005	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SERVING CHILDREN & THEIR	1057 PINE AVE	None	LONG BEACH	CA	90813	3118	19	06037	33.7801197	-118.1924041	Los Angeles County
268171	Fee-for-Service	1609162379	1609162379	1	2	TRINH, LORNA LMFT	11/20/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	256 CAJON ST	E	REDLANDS	CA	92373	5278	36	06071	34.05204454	-117.1802319	San Bernardino County
268176	Fee-for-Service	1427005339	1427005339	1	1	TAVAKOL, MOHAMMAD MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	51473	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 N NAME UNO	None	GILROY	CA	95020	3528	43	06085	37.03498475	-121.5729235	Santa Clara County
268179	Fee-for-Service	1881192417	1881192417	1	1	TANEDO, RONALDO CNP	1/23/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3930 4TH AVE	STE 300	SAN DIEGO	CA	92103	3119	37	06073	32.74892723	-117.1616459	San Diego County
268266	Fee-for-Service	1205395431	1205395431	1	1	TRAN, TRI M MD	5/26/2022	390200000X	NA	Other	026	PHYSICIANS	177025	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
268271	Fee-for-Service	1629515705	1629515705	1	8	TWO CHAIRS BEHAVIORAL HEALTH	10/25/2023	101YP2500X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	GROUP, A PSYCHOLOGY COR	801 S GRAND STREET	SUITE 780	LOS ANGELES	CA	90017	8590	19	06037	34.04532806	-118.258462	Los Angeles County
268317	Fee-for-Service	1497118822	1497118822	1	1	TRAN, ELIZA T DO	10/17/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16560	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
268333	Fee-for-Service	1275909434	1275909434	1	1	TWO ZEDS MEDICAL CORPORATION	5/17/2019	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3830 VALLEY CENTRE DR	SUITE 702	SAN DIEGO	CA	92130	3320	37	06073	32.93777252	-117.2318423	San Diego County
268342	Fee-for-Service	1366635526	1366635526	1	1	TAKLA, LA TANYA A	7/1/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	901 MCHENRY AVE STE	I	MODESTO	CA	95350	5416	50	06099	37.655694	-120.993837	Stanislaus County
268354	Fee-for-Service	1376745315	1376745315	1	1	TONG, JONATHAN L MD CORP	12/23/1999	207L00000X	NA	Other	026	PHYSICIANS	62923	05	Anesthesiology	0	In state provider	None	9920 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.7016655	-117.955521	Orange County
268397	Fee-for-Service	1295204451	1295204451	1	1	TESSA BARROWS, MARRIAGE & FA	3/11/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MILY THERAPIST, PC	2800 PLEASANT HILL RD	280	PLEASANT HILL	CA	94523	2003	07	06013	37.95774955	-122.0922963	Contra Costa County
268433	Fee-for-Service	1912073099	1912073099	1	1	TANG, HOUCHIN	2/22/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
268443	Fee-for-Service	1871566406	1871566406	1	1	TEKIN, UYGUR N MD	3/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52029	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1004 FOWLER WAY	STE 4	PLACERVILLE	CA	95667	5746	09	06017	38.72683597	-120.7921028	El Dorado County
268453	Fee-for-Service	1841268547	1841268547	1	1	TARK, ERNEST III MD	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	64242	None	None	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
268489	Fee-for-Service	1194794602	1194794602	1	1	TRIPATHY, DEBASISH MD	12/31/1990	207RH0003X	NA	Oncology	026	PHYSICIANS	46248	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	# A502	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
268548	Fee-for-Service	1619474178	1619474178	1	1	TRAN, ZACHARY MD	11/9/2020	2086S0120X	NA	General Surgery	026	PHYSICIANS	164030	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
268562	Fee-for-Service	1598392177	1598392177	1	1	TSENG, ANGELA DO	12/15/2023	390200000X	NA	Other	026	PHYSICIANS	19719	None	None	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
268570	Fee-for-Service	1629515705	1629515705	1	8	TWO CHAIRS BEHAVIORAL HEALTH	8/16/2021	101YP2500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	801 S GRAND STREET	SUITE 780	LOS ANGELES	CA	90017	8590	19	06037	34.04532806	-118.258462	Los Angeles County
268592	Fee-for-Service	1841401213	1841401213	1	1	TUPAZ HOMES LLC	6/2/1997	310500000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	308 MARTI WAY	None	SAN JOSE	CA	95136	2135	43	06085	37.27235899	-121.8453964	Santa Clara County
268616	Fee-for-Service	1750929428	1750929428	1	1	TEAMONE HOME HEALTH INC	12/2/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 166	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
268644	Fee-for-Service	1013373166	1013373166	1	1	TOLLIVER, KENNEICE LMFT	3/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
268715	Fee-for-Service	1891088704	1891088704	1	1	TARANTINO, TARA L DO	9/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13976	None	None	0	In state provider	None	401 GREGORY LN	STE 104	PLEASANT HILL	CA	94523	2851	07	06013	37.94798358	-122.073455	Contra Costa County
268721	Fee-for-Service	1205964376	1205964376	1	1	TUN, TIN MD INC	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	51476	41	Internal Medicine	0	In state provider	None	1031 E LATHAM AVE	SUITE 1	HEMET	CA	92543	4425	33	06065	33.7493735	-116.961021	Riverside County
268773	Fee-for-Service	1013244235	1013244235	1	1	THARANI, TANINDER K MD	10/24/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	109480	-	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
268800	Fee-for-Service	1962488007	1962488007	1	5	TERI INC	8/25/1992	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MARSHALL HOUSE	758 S MELROSE DR	None	VISTA	CA	92081	6714	37	06073	33.18374021	-117.2524483	San Diego County
268816	Fee-for-Service	1275612285	1275612285	1	1	TAKACS, FRANK A MD	4/28/1999	207L00000X	NA	Other	026	PHYSICIANS	31245	05	Anesthesiology	0	In state provider	None	23625 HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
268840	Fee-for-Service	1629515705	1629515705	1	8	TWO CHAIRS BEHAVIORAL HEALTH	8/19/2021	101YP2500X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	801 S GRAND STREET	SUITE 780	LOS ANGELES	CA	90017	8590	19	06037	34.04532806	-118.258462	Los Angeles County
268844	Fee-for-Service	1063583094	1063583094	1	1	TAGAYUN, ROXANNE S MD	3/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61722	05	Anesthesiology	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
268859	Fee-for-Service	1306363668	1306363668	1	1	THOMPSON-HOSKINS, TENESHA A	7/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	RVICES	69730 HIGHWAY 111 UNDEFI	SUITE 210	RANCHO MIRAGE	CA	92270	2869	33	06065	33.7728798	-116.4474207	Riverside County
268921	Fee-for-Service	1972792406	1972792406	1	1	TSAI, ELIZABETH	6/13/2024	207L00000X	NA	Other	026	PHYSICIANS	103114	05	Anesthesiology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
268924	Fee-for-Service	1629770078	1629770078	1	1	THOMAS, VOCHERI M DOULA	8/25/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
268965	Fee-for-Service	1174143473	1174143473	1	1	TRUSTED ANESTHESIA PARTNERS,	6/2/2020	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	INC.	4060 EAST WHITTIER BOULE	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
268973	Fee-for-Service	1649513409	1649513409	1	1	TOMPKINS, JOSHUA C MD	6/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131509	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
268995	Fee-for-Service	1053848317	1053848317	1	1	THOMAS, KATHERINE F MD	11/27/2023	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	158019	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
269034	Fee-for-Service	1205924040	1205924040	1	1	TRINH, TUAN Q MD	4/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91305	41	Internal Medicine	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
269041	Fee-for-Service	1811200470	1811200470	1	1	TRIBUZI, LAURA E MD	2/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125455	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
269115	Fee-for-Service	1982047213	1982047213	1	1	THOTA, SUPRAJA D MD	5/4/2017	207R00000X	NA	Other	026	PHYSICIANS	133646	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
269137	Fee-for-Service	1629515705	1629515705	1	8	TWO CHAIRS BEHAVIORAL HEALTH	8/16/2021	101YP2500X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	801 S GRAND STREET	SUITE 780	LOS ANGELES	CA	90017	8590	19	06037	34.04532806	-118.258462	Los Angeles County
269154	Fee-for-Service	1083753602	1083753602	1	1	TAN, KHEK-TECK MD	5/17/2023	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	62270	None	None	0	In state provider	None	8320 LINCOLN BLVD.	103A	LOS ANGELES	CA	90045	2465	19	06037	33.9620531	-118.4211442	Los Angeles County
269194	Fee-for-Service	1053738484	1053738484	1	1	TRINH, CHRISTINA M OD	12/1/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
269222	Fee-for-Service	1841836244	1841836244	1	1	TICHACEK, MARY NP	12/5/2024	163W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15260 VENTURA BLVD	1200	SHERMAN OAKS	CA	91403	5307	19	06037	34.15370926	-118.4656644	Los Angeles County
269244	Fee-for-Service	1174143473	1174143473	1	1	TRUSTED ANESTHESIA PARTNERS,	6/2/2020	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC.	4060 EAST WHITTIER BOULE	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
269254	Fee-for-Service	1922188572	1922188572	1	1	TALWAR, RAMAN K MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	40062	02	General Surgery	0	In state provider	None	38656 MEDICAL CENTER DR	STE A	PALMDALE	CA	93551	4483	19	06037	34.58533737	-118.1437927	Los Angeles County
269309	Fee-for-Service	1790940203	1790940203	1	1	TUCKER, JESSICA C MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10950	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
269391	Fee-for-Service	1932199049	1932199049	1	1	TIAN, DI MD	9/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55403	22	Pathology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
269434	Fee-for-Service	1326308404	1326308404	1	1	TONG, ANGELA	6/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
269453	Fee-for-Service	1124384110	1124384110	1	2	TORBATI, ALI A MD	9/20/2018	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	133799	None	None	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
269487	Fee-for-Service	1386690592	1386690592	1	1	THUAN VU MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11800 ASTORIA BLVD	None	HOUSTON	TX	77089	6041	00	None	29.5835234	-95.20877661	Harris County
269534	Fee-for-Service	1922183342	1922183342	1	1	TRAN, SCOTT (PHONG) H MD	10/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79531	41	Internal Medicine	0	In state provider	None	9876 KATELLA AVE	None	ANAHEIM	CA	92804	6418	30	06059	33.80305103	-117.9606595	Orange County
269537	Fee-for-Service	1013975705	1013975705	1	1	TIHAN, TARIK MD	10/4/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50987	22	Pathology (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
269552	Fee-for-Service	1578853297	1578853297	1	1	THIARA, RANDEEP S MD	6/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126888	None	None	0	In state provider	None	6001 NORRIS CANYON RD	None	SAN RAMON	CA	94583	5400	07	06013	37.7755858	-121.958923	Contra Costa County
269569	Fee-for-Service	1356377469	1356377469	1	1	THURMAN, LOUISE MD	8/9/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	69460	None	None	0	In state provider	None	3558 ROUND BARN BLVD	None	SANTA ROSA	CA	95403	1780	49	06097	38.47617	-122.7235455	Sonoma County
269596	Fee-for-Service	1770605115	1770605115	1	1	TRUONG P NGUYEN CHIROPRACTIC	3/12/2018	111NR0400X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	IROPRACTIC CENTER	8907 WARNER AVENUE	250	HUNTINGTON BEACH	CA	92647	5083	30	06059	33.71589787	-117.9728562	Orange County
269601	Fee-for-Service	1043530777	1043530777	1	1	TSAI, FRANK F MD	8/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130661	18	Ophthalmology	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
269671	Fee-for-Service	1043521255	1043521255	1	1	THALLAPANENI, RAMBABU MD	10/1/2023	208M00000X	NA	Other	026	PHYSICIANS	177570	None	None	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
269804	Fee-for-Service	1629065792	1629065792	1	1	TRAN, DIEM N OD	5/5/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6731 WESTMINSTER BLVD	STE 102	WESTMINSTER	CA	92683	3792	30	06059	33.75912651	-118.010655	Orange County
269808	Fee-for-Service	1154580348	1154580348	1	1	TRI-CITY PETCT LLC	6/28/2010	261QR0200X	NA	Mammography/MRI Provider	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	902 SYCAMORE AVE	SUITE 120	VISTA	CA	92081	7879	30	06059	33.16083881	-117.2197986	San Diego County
269816	Fee-for-Service	1013975705	1013975705	1	1	TIHAN, TARIK MD	10/4/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50987	90	Pathology-Forensic	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
269817	Fee-for-Service	1497905889	1497905889	1	1	TARCATU, DANA L MD	9/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109446	01	General Practice	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
269838	Fee-for-Service	1417035007	1417035007	1	1	TAYLOR, DERRICK D MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	41902	02	General Surgery	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
269842	Fee-for-Service	1093858086	1093858086	1	1	TANA MEDICAL SUPPLIES	9/24/2007	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TANA MEDICAL SUPPLIES	1828 S WESTERN AVE	SUITE 7	LOS ANGELES	CA	90006	5808	19	06037	34.04079509	-118.3089792	Los Angeles County
269851	Fee-for-Service	1851372189	1851372189	1	1	TSO, VIVIAN H MD	4/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	77695	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
269985	Fee-for-Service	1649622960	1649622960	1	1	TRAN, GREGORY M PT	10/8/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
269991	Fee-for-Service	1942369566	1942369566	1	1	TURNER, MICHELE M MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	56301	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
270078	Fee-for-Service	1972620078	1972620078	1	1	TAYLOR, DERYL W LMFT	2/1/2024	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
270096	Fee-for-Service	1346322567	1346322567	1	1	TAIRA, AL V MD	7/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111479	78	Neoplastic Diseases/Oncology	0	In state provider	None	100 S. SAN MATEO DRIVE	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
270142	Fee-for-Service	1083118871	1083118871	1	1	TRAN, ANH DO	1/17/2022	390200000X	NA	Other	026	PHYSICIANS	17637	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
270158	Fee-for-Service	1265721393	1265721393	1	1	TRINITY WOMENS HEALTH INC	4/12/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	25485 MEDICAL CENTER DR	SUITE 200	MURRIETA	CA	92562	6927	33	06065	33.55785761	-117.1842222	Riverside County
270168	Fee-for-Service	1013266543	1013266543	1	1	TURNER, RICHARD S LMFT	7/9/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
270197	Fee-for-Service	1922211937	1922211937	1	1	TAUBMAN, SHOSHANA B PHD	10/23/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3551 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
270209	Fee-for-Service	1790787265	1790787265	2	1	TNL PHARMACY CORPORATION	3/4/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HONG'S PHARMACY	8883 WESTMINSTER AVE	None	GARDEN GROVE	CA	92844	2608	30	06059	33.75942652	-117.974097	Orange County
270240	Fee-for-Service	1457536757	1457536757	1	1	TER-POGHOSYAN, ZARINE MD INC	6/17/2014	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	101387	None	None	0	In state provider	None	12507 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	3135	19	06037	34.18670353	-118.405791	Los Angeles County
270245	Fee-for-Service	1093966012	1093966012	1	1	TOWNER, GRACIELLA L	8/10/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
270256	Fee-for-Service	1912606690	1912606690	1	3	TAHMINA HAQ MD	12/20/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	17822 BEACH BLVD	201	HUNTINGTON BEACH	CA	92647	7185	30	06059	33.70331388	-117.9890471	Orange County
270311	Fee-for-Service	1588611826	1588611826	1	1	TAKLA, FAYEZ S MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67660	05	Anesthesiology	0	In state provider	None	9212 MIRA ESTE CT	STE 204	SAN DIEGO	CA	92126	6337	37	06073	32.88927901	-117.1482338	San Diego County
270320	Fee-for-Service	1629071352	1629071352	1	1	THERATECH INC	1/16/2013	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1109 MYATT BLVD	None	MADISON	TN	37115	2453	00	None	36.28217912	-86.69063364	Davidson County
270368	Fee-for-Service	1174849996	1174849996	1	1	TRAN, ERIC K MD	2/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146177	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 SOUTH GRAND AVENUE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
270375	Fee-for-Service	1598227134	1598227134	1	1	TRAN, TRUNG A	4/30/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	16575 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	2337	30	06059	33.7218603	-117.9547079	Orange County
270386	Fee-for-Service	1649455544	1649455544	1	1	THU, KHIN M MD	1/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101140	41	Internal Medicine	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6253	07	06013	37.98252	-121.8030615	Contra Costa County
270428	Fee-for-Service	1992199558	1992199558	1	1	TENOLD, MATTHEW E MD	8/17/2021	207RH0003X	NA	Oncology	026	PHYSICIANS	146826	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
270491	Fee-for-Service	1679146146	1679146146	1	1	TOMLINSON, KRISTI A LCSW	11/28/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2309 PACIFIC COAST	STE 202	HERMOSA BEACH	CA	90254	2751	19	06037	33.87101437	-118.3948248	Los Angeles County
270503	Fee-for-Service	1992981401	1992981401	1	1	THIEL, ANKE-JULIANA	4/9/2020	133V00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	LNESS	570 NEVADA ST	UNIT F	REDLANDS	CA	92373	2342	36	06071	34.060464	-117.217422	San Bernardino County
270531	Fee-for-Service	1912606690	1912606690	1	3	TAHMINA HAQ MD	12/20/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	17822 BEACH BLVD	201	HUNTINGTON BEACH	CA	92647	7185	30	06059	33.70331388	-117.9890471	Orange County
270591	Fee-for-Service	1497907836	1497907836	1	1	TANENBAUM, ANDREA M LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
270651	Fee-for-Service	1013315779	1013315779	1	1	TOWERS, KATHERINE CNM	5/18/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
270665	Fee-for-Service	1528394202	1528394202	1	1	TABARAEE, EHSAN MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114899	None	None	0	In state provider	None	609 E ORANGEBURG AVE	SUITE 201	MODESTO	CA	95350	5512	50	06099	37.66364947	-120.9857985	Stanislaus County
270719	Fee-for-Service	1518931450	1518931450	1	1	TAMPOYA, FLORENCIA T MD	8/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	47994	01	General Practice	0	In state provider	None	9710 19TH ST	None	RANCHO CUCAMONGA	CA	91737	3538	36	06071	34.13274747	-117.593073	San Bernardino County
270739	Fee-for-Service	1033228481	1033228481	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5510	5520 WOODRUFF AVE	None	LAKEWOOD	CA	90713	1535	19	06037	33.857541	-118.1170425	Los Angeles County
270744	Fee-for-Service	1730776261	1730776261	2	2	TESSA'S PLACE INC	2/10/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	25982 VIA MAREJADA	None	MISSION VIEJO	CA	92691	5611	30	06059	33.58589157	-117.6705994	Orange County
270759	Fee-for-Service	1912074923	1912074923	1	1	TENG, JAMES C MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73491	05	Anesthesiology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
270866	Fee-for-Service	1457619884	1457619884	1	1	THOMAS EVAN WATTS	4/10/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
270870	Fee-for-Service	1306045703	1306045703	1	1	TANG, RAYMOND S MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	94473	10	Gastroenterology (M.D. only)	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
270943	Fee-for-Service	1588051288	1588051288	1	1	TANGO, JENNIFER M MD	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144419	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
270996	Fee-for-Service	1518931450	1518931450	1	1	TAMPOYA, FLORENCIA T MD	8/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	47994	08	Family Practice	0	In state provider	None	9710 19TH ST	None	RANCHO CUCAMONGA	CA	91737	3538	36	06071	34.13274747	-117.593073	San Bernardino County
270997	Fee-for-Service	1730211301	1730211301	1	1	TENN, DAVID T MD	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	52045	-	NOT APPLICABLE	0	In state provider	None	235 E NOBLE AVE	None	VISALIA	CA	93277	2727	54	06107	36.326232	-119.2903695	Tulare County
270999	Fee-for-Service	1457549107	1457549107	1	1	TAN, MARIA N MD	10/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	101565	40	Pediatrics	0	In state provider	None	2580 SR MARY COLUMBA DR	None	RED BLUFF	CA	96080	4327	52	06103	40.14842672	-122.2180085	Tehama County
271018	Fee-for-Service	1982922910	1982922910	1	1	TUMYAN, LUSINE MD	5/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	98676	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	8344	19	06037	34.06373445	-118.443537	Los Angeles County
271112	Fee-for-Service	1770874794	1770874794	1	1	TOLEN, JENNIFER A MD	3/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123732	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
271113	Fee-for-Service	1992725808	1992725808	1	1	TANEL, RONN E MD	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67277	40	Pediatrics	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
271128	Fee-for-Service	1063731297	1063731297	1	1	TUSTISON, KIMBERLY S MD	7/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131535	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	555 TECHEVAH DR	3W105	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
271143	Fee-for-Service	1043228026	1043228026	1	1	TEJAL J BHOJAK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3811 OHARA ST	None	PITTSBURGH	PA	15213	2593	00	None	40.44350017	-79.95952606	Allegheny County
271150	Fee-for-Service	1497772321	1497772321	1	1	TEMPORINI, HUMBERTO D MD	11/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52387	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
271221	Fee-for-Service	1720310329	1720310329	1	1	TU-CHAN, ADELYN P DO	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13083	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
271223	Fee-for-Service	1659710606	1659710606	1	1	TURQUEZA, ARTHUR J MFT	10/26/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	87968	-	NOT APPLICABLE	0	In state provider	None	165 CLAY ST	None	SALINAS	CA	93901	2509	27	06053	36.67006578	-121.6591741	Monterey County
271290	Fee-for-Service	1598954026	1598954026	1	1	TRAN, CAROLINE L MD	9/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102784	05	Anesthesiology	0	In state provider	None	27401 LOS ALTOS	SUITE 180	MISSION VIEJO	CA	92691	8012	30	06059	33.56489118	-117.665546	Orange County
271297	Fee-for-Service	1407020076	1407020076	1	1	TAHRAWI, FADI T MD	7/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9365	05	Anesthesiology	0	In state provider	None	6969 BROCKTON AVE	SUITE B	RIVERSIDE	CA	92506	3813	33	06065	33.94701	-117.396786	Riverside County
271329	Fee-for-Service	1922649938	1922649938	1	1	TOTAL RENAL CARE INC	4/10/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1601 RAIDERS WAY	None	OXNARD	CA	93033	5620	56	06111	34.1717005	-119.1613725	Ventura County
271367	Fee-for-Service	1700026531	1700026531	1	1	TAMRAKAR, LINA MD	3/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120695	41	Internal Medicine	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
271408	Fee-for-Service	1851751564	1851751564	1	1	TKO MEDICAL CORPORATION	4/12/2017	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2305 E ASHLAN AVE	None	FRESNO	CA	93726	3102	10	06019	36.79418749	-119.7834795	Fresno County
271425	Fee-for-Service	1497772321	1497772321	1	1	TEMPORINI, HUMBERTO D MD	11/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52387	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
271459	Fee-for-Service	1508392887	1508392887	1	1	TU, JOANNA H MD	1/6/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	157956	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
271519	Fee-for-Service	1164433777	1164433777	1	1	TOWBIN, MARTIN E MD	4/1/2002	207P00000X	NA	Other	026	PHYSICIANS	34258	66	Emergency Medicine (Urgent Care)	0	In state provider	None	914 PINE ST	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
271534	Fee-for-Service	1699155002	1699155002	1	1	TRAN, KIEN MD	6/4/2021	207R00000X	NA	Other	026	PHYSICIANS	171888	None	None	0	In state provider	None	3320 LOS COYOTES DIAGONA	#120	LONG BEACH	CA	90808	3936	19	06037	33.8173793	-118.1104908	Los Angeles County
271591	Fee-for-Service	1003033655	1003033655	1	1	TRIMEX MED DISTRIBUTORS	6/17/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TRIMEX MED DISTRIBUTORS	2631 W MANCHESTER BLVD	None	INGLEWOOD	CA	90305	2433	19	06037	33.96006846	-118.3229955	Los Angeles County
271592	Fee-for-Service	1144659913	1144659913	1	1	THOK, JULIE J NP	12/12/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
271621	Fee-for-Service	1780660324	1780660324	1	1	TZENG, DAVID Z MD	6/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81243	41	Internal Medicine	0	In state provider	None	2825 S ST	None	SACRAMENTO	CA	95816	7319	34	06067	38.564163	-121.4726085	Sacramento County
271652	Fee-for-Service	1841064524	1841064524	1	1	TOVAR, ULISES PT	2/8/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1400 S MERCEY SPRINGS RD	STE I	LOS BANOS	CA	93635	4928	24	06047	37.054854	-120.835392	Merced County
271664	Fee-for-Service	1285630202	1285630202	1	1	TAN, JESSE W MD	6/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	68881	None	None	0	In state provider	None	2865 ATLANTIC AVE	SUITE 225	LONG BEACH	CA	90806	1707	19	06037	33.809418	-118.185058	Los Angeles County
271672	Fee-for-Service	1841300621	1841300621	1	1	THRIFTY PAYLESS INC	1/1/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6276	17441 MAIN ST	None	HESPERIA	CA	92345	6268	36	06071	34.41870169	-117.2824823	San Bernardino County
271681	Fee-for-Service	1013944545	1013944545	1	1	THOMAS P WORLEY III MD	12/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2240 SUTHERLAND AVE	STE 104	KNOXVILLE	TN	37919	2333	00	None	35.95707787	-83.95193291	Knox County
271723	Fee-for-Service	1356521579	1356521579	1	1	TEACHER, TERESA E LCSW	9/15/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15455 SAN FERNANDO MISSO	#300	MISSION HILLS	CA	91345	1353	19	06037	34.27194157	-118.469079	Los Angeles County
271774	Fee-for-Service	1962579029	1962579029	1	1	TEMPLE UNIVERSITY HOSP	8/29/2006	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3401 N BROAD ST	None	PHILADELPHIA	PA	19140	5103	00	None	40.00596888	-75.151912	Philadelphia County
271810	Fee-for-Service	1144521063	1144521063	1	1	TAULBEE, REBECCA T NP	8/31/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
271829	Fee-for-Service	1437135266	1437135266	1	1	TRAN, QUY N MD	6/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92414	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
271838	Fee-for-Service	1649259243	1649259243	1	1	TORRENTE, SANDRA L MD	4/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54544	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
271851	Fee-for-Service	1033184890	1033184890	1	1	TERPENNING, MARILOU MD	8/2/1999	207RH0003X	NA	Oncology	026	PHYSICIANS	39425	41	Internal Medicine	0	In state provider	None	2021 SANTA MONICA BLVD	SUITE 400E	SANTA MONICA	CA	90404	2103	19	06037	34.02922048	-118.4793681	Los Angeles County
271891	Fee-for-Service	1922170406	1922170406	1	1	TRAN, TIMOTHY C MD	1/1/1999	207R00000X	NA	Other	026	PHYSICIANS	66986	41	Internal Medicine	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
271899	Fee-for-Service	1326141441	1326141441	1	1	TAKAO, CHERYL M MD	5/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79646	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
271915	Fee-for-Service	1700931706	1700931706	2	2	TEAGLE, DONALD E OD	8/2/2016	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1306 GLENDALE GALLERIA	None	GLENDALE	CA	91210	1400	19	06037	34.144848	-118.2596735	Los Angeles County
271921	Fee-for-Service	1922070770	1922070770	1	1	TELLEZ, DAVID W MD	9/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS ROAD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
271970	Fee-for-Service	1639663784	1639663784	1	1	TSANG, DENNIS MD	10/3/2023	207R00000X	NA	Other	026	PHYSICIANS	163952	None	None	0	In state provider	None	800 S FAIRMONT ST	STE 310	PASADENA	CA	91105	3153	19	06037	34.13193177	-118.1517805	Los Angeles County
271976	Fee-for-Service	1851449664	1851449664	1	1	TEOH, JO-ANNE H MD	11/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92739	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
271983	Fee-for-Service	1902892102	1902892102	1	1	TAYLOR, MICHAEL A MD	7/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83022	30	Radiology	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
272037	Fee-for-Service	1689807992	1689807992	1	1	TAFTI, MONA A MD	6/26/2015	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	115557	30	Radiology	0	In state provider	None	612 W DUARTE RD	SUITE 101	ARCADIA	CA	91007	9220	19	06037	34.12647805	-118.051994	Los Angeles County
272050	Fee-for-Service	1962579029	1962579029	1	1	TEMPLE UNIVERSITY HOSP	8/29/2006	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3401 N BROAD ST	None	PHILADELPHIA	PA	19140	5103	00	None	40.00596888	-75.151912	Philadelphia County
272070	Fee-for-Service	1285994244	1285994244	1	1	TIET, TAM MD	7/21/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	132568	01	General Practice	0	In state provider	None	3883 AIRWAY DRIVE	120, 165, 201, 202, 203	SACRAMENTO	CA	95403	1678	49	06097	38.483226	-122.739705	Sonoma County
272124	Fee-for-Service	1033184890	1033184890	1	1	TERPENNING, MARILOU MD	8/2/1999	207RH0003X	NA	Oncology	026	PHYSICIANS	39425	68	Hematology	0	In state provider	None	2021 SANTA MONICA BLVD	SUITE 400E	SANTA MONICA	CA	90404	2103	19	06037	34.02922048	-118.4793681	Los Angeles County
272161	Fee-for-Service	1003052739	1003052739	1	1	TRAN, NGOC TRAM G DO	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12130	45	Nephrology (Renal-Kidney)	0	In state provider	None	3610 ATLANTIC AVE	None	LONG BEACH	CA	90807	3418	19	06037	33.822621	-118.185002	Los Angeles County
272175	Fee-for-Service	1326141441	1326141441	1	1	TAKAO, CHERYL M MD	5/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79646	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
272216	Fee-for-Service	1679036289	1679036289	1	1	TOULOUMDJIAN, AREK A MD	5/10/2022	207R00000X	NA	Other	026	PHYSICIANS	177197	None	None	0	In state provider	None	70077 RAMON RD	None	RANCHO MIRAGE	CA	92270	5201	33	06065	33.81587854	-116.4396933	Riverside County
272249	Fee-for-Service	1831692573	1831692573	1	1	THE PRACTICE COUNSELING SERV	2/6/2019	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ICES LICENSED CLINICAL S	1000 TEXAS ST	STE D	FAIRFIELD	CA	94533	5700	48	06095	38.24926548	-122.046354	Solano County
272257	Fee-for-Service	1558366021	1558366021	1	1	TRAN, HONG-NHUNG MD	1/20/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	98143	None	None	0	In state provider	None	1820 41ST AVE	STE D	CAPITOLA	CA	95010	2516	44	06087	36.975573	-121.964832	Santa Cruz County
272258	Fee-for-Service	1356407340	1356407340	1	1	TESMAN, JOHN R MD	9/18/2018	207P00000X	NA	Other	026	PHYSICIANS	68726	70	Clinic (mixed specialty)	0	In state provider	None	2705 LOMA VISTA RD	206	VENTURA	CA	93003	1581	56	06111	34.27504051	-119.2600018	Ventura County
272276	Fee-for-Service	1366971376	1366971376	1	1	TSYTSIKOVA, LYUBOV V MD	11/22/2022	207L00000X	NA	Other	026	PHYSICIANS	175536	None	None	0	In state provider	None	1595 SOQUEL DR	STE 230	SANTA CRUZ	CA	95065	1719	44	06087	36.98879599	-121.9826354	Santa Cruz County
272322	Fee-for-Service	1134656010	1134656010	1	1	TOH, MUN KEONG JOSHUA LMFT	8/13/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39350 CIVIC CENTER DR	None	FREMONT	CA	94538	2343	01	06001	37.55399458	-121.9756047	Alameda County
272337	Fee-for-Service	1639618481	1639618481	1	1	TET TOE MD, INC	5/22/2017	261QP2300X	NA	Other	026	PHYSICIANS	105047	41	Internal Medicine	0	In state provider	None	1580 CREEKSIDE DR	STE 130	FOLSOM	CA	95630	3886	34	06067	38.668914	-121.148028	Sacramento County
272365	Fee-for-Service	1073926945	1073926945	1	1	TOOMARI, NOJAN DO INC	4/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11162	None	None	0	In state provider	None	18200 VENTURA BLVD	None	TARZANA	CA	91356	4229	19	06037	34.16598839	-118.5291213	Los Angeles County
272408	Fee-for-Service	1770087728	1770087728	1	1	TAHMASIAN, MARTIK MD	10/2/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191714	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
272434	Fee-for-Service	1003052739	1003052739	1	1	TRAN, NGOC TRAM G DO	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12130	41	Internal Medicine	0	In state provider	None	3610 ATLANTIC AVE	None	LONG BEACH	CA	90807	3418	19	06037	33.822621	-118.185002	Los Angeles County
272457	Fee-for-Service	1912943655	1912943655	1	1	TAO, ERIC M MD	8/31/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	54435	None	None	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
272472	Fee-for-Service	1851300719	1851300719	1	1	TOMLINSON, IMAMU O MD	5/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85080	08	Family Practice	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
272496	Fee-for-Service	1891916367	1891916367	1	1	TAMUNANG, GODWILL T	10/4/2007	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	KIMBO MED DISTRIBUTOR	407 N AVALON BLVD	None	WILMINGTON	CA	90744	5803	19	06037	33.77445607	-118.262037	Los Angeles County
272500	Fee-for-Service	1861462525	1861462525	1	1	THOMAS, KARIN E MD	10/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65219	18	Ophthalmology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
272509	Fee-for-Service	1629382270	1629382270	1	1	TENDER LUVIN CARE MEDICAL	2/24/2012	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	SOCIAL WORKER AGENCY INC	400 CORPORATE POINT	STE 300	CULVER CITY	CA	90230	7615	19	06037	33.988765	-118.3842122	Los Angeles County
272543	Fee-for-Service	1619455631	1619455631	1	1	TOM, CRYSTAL K OD	9/16/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1845 W REDLANDS BLVD	101	REDLANDS	CA	92373	3124	36	06071	34.06287653	-117.215955	San Bernardino County
272558	Fee-for-Service	1689163180	1689163180	1	1	TRENT PETERSON	1/12/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1003 WILLOW CREEK RD	None	PRESCOTT	AZ	86301	1641	00	None	34.558992	-112.481901	Yavapai County
272591	Fee-for-Service	1508909516	1508909516	1	1	TA, DONG Q DC	7/1/2001	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	2248 S GAREY AVE	None	POMONA	CA	91766	5616	19	06037	34.03057911	-117.7490309	Los Angeles County
272689	Fee-for-Service	1366646952	1366646952	1	1	TOUMA, MARLIN MD	5/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116472	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
272783	Fee-for-Service	1780194779	1780194779	1	1	TRAN, HENRY LCSW	7/29/2024	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
272796	Fee-for-Service	1326197815	1326197815	1	1	TSOU, AMY Y PHD	7/5/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
272823	Fee-for-Service	1295855484	1295855484	1	1	TRUONG, LE A OD	12/14/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
272830	Fee-for-Service	1093825770	1093825770	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5693	2025 E WASHINGTON ST	None	COLTON	CA	92324	4704	36	06071	34.050627	-117.2921535	San Bernardino County
272861	Fee-for-Service	1558856971	1558856971	1	1	TRAN, PHOENIX M OD	9/16/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1739 W. AVENUE J	None	LANCASTER	CA	93534	2839	19	06037	34.6894773	-118.1626235	Los Angeles County
272933	Fee-for-Service	1467638114	1467638114	1	1	TABIBZADEH, KAMROOZ H MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	57734	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6618 VAN NUYS BLVD	None	VAN NUYS	CA	91405	4617	19	06037	34.19123738	-118.4487091	Los Angeles County
273007	Fee-for-Service	1891717765	1891717765	1	1	TODD SPENCER M D MEDICAL	3/16/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
273012	Fee-for-Service	1285749762	1285749762	1	1	TUCKER-HARRIS, SHIRLEY	8/1/1989	207R00000X	NA	Other	026	PHYSICIANS	46545	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
273047	Fee-for-Service	1942211339	1942211339	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5701	700 E REDLANDS BLVD	STE A	REDLANDS	CA	92373	6168	36	06071	34.04750423	-117.1691726	San Bernardino County
273074	Fee-for-Service	1568501674	1568501674	1	1	TAMIMI, ZIAD A MD	8/23/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	28773	08	Family Practice	0	In state provider	None	450 FOURTH AVE.	STE 408	CHULA VISTA	CA	91910	4430	37	06073	32.63513513	-117.0820663	San Diego County
273099	Fee-for-Service	1073616025	1073616025	1	1	TROLAN, THERESE S MD	2/21/2006	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	61013	40	Pediatrics	0	In state provider	None	1820 41ST AVE	STE D	CAPITOLA	CA	95010	2516	44	06087	36.975573	-121.964832	Santa Cruz County
273127	Fee-for-Service	1720267743	1720267743	1	1	TOMINAGA, GAIL T MD INC	2/19/2008	2086S0127X	NA	General Surgery	026	PHYSICIANS	57834	02	General Surgery	0	In state provider	None	9888 GENESEE AVE	LJ-601	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
273193	Fee-for-Service	1437237062	1437237062	1	1	TAN, LILY M MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62835	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	450 SUTTER ST	RM 916	SAN FRANCISCO	CA	94108	3911	38	06075	37.78934929	-122.4077786	San Francisco County
273205	Fee-for-Service	1750303103	1750303103	1	1	TEJEDA, DAVID MD	4/30/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	64599	40	Pediatrics	0	In state provider	None	3801 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1625	38	06075	37.78707021	-122.4555217	San Francisco County
273206	Fee-for-Service	1619920055	1619920055	1	1	TODD THOMPSON, MARCIA A LCSW	5/28/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
273221	Fee-for-Service	1215481809	1215481809	1	1	TORRANCE VISION CENTER AN	6/12/2017	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC PRACTICE INC	2396 CRENSHAW BLVD	STE C	TORRANCE	CA	90501	3336	19	06037	33.82224412	-118.328446	Los Angeles County
273265	Fee-for-Service	1558526137	1558526137	1	1	TRAN, BUI MD	8/29/2023	207L00000X	NA	Other	026	PHYSICIANS	185498	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
273290	Fee-for-Service	1043693211	1043693211	1	1	TADEO, TANIA B LMFT	8/11/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3400 CENTRAL AVE	SUITE 215	RIVERSIDE	CA	92506	2175	33	06065	33.95355249	-117.385407	Riverside County
273321	Fee-for-Service	1871076265	1871076265	1	1	TORRES, JESSICA	9/25/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	151 N SUNRISE AVE	SUITE 1105	ROSEVILLE	CA	95661	2924	31	06061	38.74746043	-121.2655348	Placer County
273329	Fee-for-Service	1912233545	1912233545	1	1	TONG, HUI Q PHD	11/8/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
273353	Fee-for-Service	1922053271	1922053271	1	1	TOMASZEWSKI FARIAS, SARAH	8/22/2002	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4900 BROADWAY	None	SACRAMENTO	CA	95820	1532	34	06067	38.546091	-121.447305	Sacramento County
273385	Fee-for-Service	1851953335	1851953335	1	1	TRAN, LEYNA P NP	5/2/2024	207Q00000X	NA	Adult Primary Care	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1310 STEWART DR	STE 301	ORANGE	CA	92868	3854	30	06059	33.78236048	-117.8664975	Orange County
273401	Fee-for-Service	1366561433	1366561433	1	1	TREJO, JACQUELINE V MD FACOG	11/4/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	87206	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
273410	Fee-for-Service	1962424077	1962424077	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1500 NORTHGATE MALL	None	SAN RAFAEL	CA	94903	3671	21	06041	38.00378637	-122.543312	Marin County
273488	Fee-for-Service	1831263110	1831263110	2	1	TOBII DYNAVOX LLC	2/12/2018	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	2100 WHARTON STREET	SUITE 400	PITTSBURGH	PA	15203	1942	00	None	40.43025433	-79.97538707	Allegheny County
273575	Fee-for-Service	1508123217	1508123217	1	1	TAKATORI, NANAE MD	9/18/2018	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	126593	10	Gastroenterology (M.D. only)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
273583	Fee-for-Service	1548255896	1548255896	1	1	TAM, MAY C SD	4/1/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	525 W MAIN ST	STE 2	EL CENTRO	CA	92243	7906	13	06025	32.79280049	-115.555473	Imperial County
273622	Fee-for-Service	1801852702	1801852702	1	1	TURK, JOSEPH P MD	11/20/2018	207XS0114X	NA	Orthopedic Surgery	026	PHYSICIANS	90754	20	Orthopedic Surgery	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
273632	Fee-for-Service	1891163499	1891163499	1	1	TUNG, VICRUMDEEP MD	4/4/2018	208600000X	NA	General Surgery	026	PHYSICIANS	147448	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
273665	Fee-for-Service	1104288182	1104288182	1	1	TRAN, JOHN P DO	9/16/2019	207R00000X	NA	Other	026	PHYSICIANS	16057	41	Internal Medicine	0	In state provider	None	20101 LAKE CHABOT RD	4TH FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
273719	Fee-for-Service	1184985871	1184985871	1	1	TROUNG, MY-LE MD INC	6/25/2012	207L00000X	NA	Other	026	PHYSICIANS	63412	05	Anesthesiology	0	In state provider	None	9920 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.7016655	-117.955521	Orange County
273728	Fee-for-Service	1396199378	1396199378	1	1	THAYER, ROBERT DO	1/23/2020	207R00000X	NA	Other	026	PHYSICIANS	17097	41	Internal Medicine	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6098	19	06037	34.0956033	-118.2916918	Los Angeles County
273730	Fee-for-Service	1780926048	1780926048	1	1	TJAJADI, MATTHEW S MD	7/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147839	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
273756	Fee-for-Service	1609461003	1609461003	1	1	THIRD OPTOMETRIC CARE OF CAL	6/26/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15333 CULVER DR	SUITE 690	IRVINE	CA	92604	7143	30	06059	33.69534179	-117.7972555	Orange County
273779	Fee-for-Service	1861690299	1861690299	1	1	TAN, BELINDA H MD	9/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	100913	07	Dermatology	0	In state provider	None	165 SAINT DOMINICS DR	STE 140	MANTECA	CA	95337	7802	39	06077	37.79882972	-121.2447835	San Joaquin County
273842	Fee-for-Service	1952713851	1952713851	1	1	TILLY, JOLINE J MD	5/5/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	94824	66	Emergency Medicine (Urgent Care)	0	In state provider	None	32341 COAST HWY	None	LAGUNA BEACH	CA	92651	6701	30	06059	33.49286069	-117.7351651	Orange County
273884	Fee-for-Service	1114424777	1114424777	1	1	TAN, NICHOLAS S MD	8/15/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	21378	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
273957	Fee-for-Service	1770194680	1770194680	1	1	THOSAR, SHALMALI S	7/1/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	29650 BRADLEY RD	None	MENIFEE	CA	92586	6521	33	06065	33.6899672	-117.1885767	Riverside County
273960	Fee-for-Service	1255971271	1255971271	1	1	TESFAYE, YOHANA PT	4/20/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
274102	Fee-for-Service	1215355748	1215355748	1	1	TANG, DENNIS M MD	9/1/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	167806	04	Otology, Laryngology, Rhinology	0	In state provider	None	8631 W THIRD STREET	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
274133	Fee-for-Service	1760891725	1760891725	1	1	TROUTNER, HEIDI J LCSW	7/28/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
274174	Fee-for-Service	1497960181	1497960181	1	1	TRUONG, JACQUELINE OD	6/16/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ASSOCIATES INC	15070 SUMMIT AVE	STE 400	FONTANA	CA	92336	5387	36	06071	34.14947209	-117.4750579	San Bernardino County
274248	Fee-for-Service	1295122984	1295122984	1	1	THAI, JESSICA NP	11/2/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
274323	Fee-for-Service	1104975788	1104975788	1	1	TRAPSE, FELIX M JR MD	7/16/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	97600	08	Family Practice	0	In state provider	None	1028 N CHERRY STREET	None	TULARE	CA	93274	2212	54	06107	36.22252514	-119.3375885	Tulare County
274334	Fee-for-Service	1114285814	1114285814	1	1	THOMPSON, CHARLOS	10/9/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
274377	Fee-for-Service	1326192816	1326192816	1	1	THOMAS, GREGORY W MD	1/1/1987	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	46138	08	Family Practice	0	In state provider	None	100 E LOCUST AVE	None	LOMPOC	CA	93436	7845	42	06083	34.63249447	-120.4580104	Santa Barbara County
274378	Fee-for-Service	1366547689	1366547689	1	1	THAI, GABY T MD	12/1/1997	2084N0400X	NA	Neurology	026	PHYSICIANS	80338	13	Neurology (M.D. only)	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
274386	Fee-for-Service	1336345222	1336345222	1	1	TOTAL HEALTH DIABETES LLC	7/11/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	2500 MAITLAND CENTER PKW	SUITE 311	MAITLAND	FL	32751	7293	00	None	28.63422918	-81.39486766	Orange County
274391	Fee-for-Service	1508819152	1508819152	1	1	TANNOUS, JOSEPH A MD	8/13/2008	207R00000X	NA	Other	026	PHYSICIANS	94352	41	Internal Medicine	0	In state provider	None	1180 E SHAW AVE	#125	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
274397	Fee-for-Service	1205460292	1205460292	1	1	TRUONG, RONALD L CRNA	5/28/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
274408	Fee-for-Service	1518980283	1518980283	1	1	TAI, CHAU Y MD	7/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95375	24	Plastic Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
274413	Fee-for-Service	1164603064	1164603064	1	1	TAI, DENICE K MD	8/5/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	97952	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
274424	Fee-for-Service	1659504124	1659504124	1	1	THANG DINH NGUYEN, MD A MEDI	10/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	76049	None	None	0	In state provider	CAL CORPORATION	18111 BROOKHURST ST	STE 6700	FOUNTAIN VALLEY	CA	92708	7516	30	06059	33.70027259	-117.9544055	Orange County
274482	Fee-for-Service	1013962067	1013962067	1	2	TOWER IMAGING MEDICAL	9/13/2005	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	INC	2202 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	5706	19	06037	34.03277088	-118.4813792	Los Angeles County
274483	Fee-for-Service	1013363522	1013363522	1	1	THE J. MOSS FOUNDATION	12/27/2018	101Y00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	10620 TREENA ST	230	SAN DIEGO	CA	92131	1140	37	06073	32.91067106	-117.1138546	San Diego County
274497	Fee-for-Service	1073680898	1073680898	1	1	TONG, MY-DIEM MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65140	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
274498	Fee-for-Service	1518059799	1518059799	1	1	TOLEDO, ABEL C MD	7/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	67360	08	Family Practice	0	In state provider	None	300 OXFORD STREET	SUITE 110	CHULA VISTA	CA	91911	3117	37	06073	32.61026802	-117.0678151	San Diego County
274517	Fee-for-Service	1578883385	1578883385	1	1	TRAN, RICHARD T T	7/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126250	41	Internal Medicine	0	In state provider	None	555 WASHINGTON ST	None	SAN DIEGO	CA	92103	2289	37	06073	32.74986289	-117.1599343	San Diego County
274531	Fee-for-Service	1619426004	1619426004	1	1	TEMBONICARABALLO, NATALIA OD	10/24/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	392 S GLASSELL STREET	SUITE 101	ORANGE	CA	92866	1920	30	06059	33.782679	-117.853146	Orange County
274564	Fee-for-Service	1437269297	1437269297	1	1	THRIFTY PAYLESS INC	1/1/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5862	1210 N BLACKSTONE AVE	None	FRESNO	CA	93703	3606	10	06019	36.758097	-119.790561	Fresno County
274584	Fee-for-Service	1982660502	1982660502	1	1	TANG, NHIEP MD	5/1/1983	208800000X	NA	Other	026	PHYSICIANS	37133	34	Urology and Urological Surgery	0	In state provider	None	1155 W CENTRAL AVE	STE 108	SANTA ANA	CA	92707	3100	30	06059	33.71259106	-117.8843848	Orange County
274651	Fee-for-Service	1154422533	1154422533	1	1	TACDOL, RENA A MD	4/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	96693	08	Family Practice	0	In state provider	None	901 NEVIN AVENUE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
274725	Fee-for-Service	1437179744	1437179744	1	1	TREECE, MICHAEL S MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	55157	40	Pediatrics	0	In state provider	None	1580 VALENCIA ST	STE 506	SAN FRANCISCO	CA	94110	4418	38	06075	37.74746923	-122.4202583	San Francisco County
274761	Fee-for-Service	1518059799	1518059799	1	1	TOLEDO, ABEL C MD	7/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	67360	01	General Practice	0	In state provider	None	300 OXFORD STREET	SUITE 110	CHULA VISTA	CA	91911	3117	37	06073	32.61026802	-117.0678151	San Diego County
274832	Fee-for-Service	1144307075	1144307075	1	1	TREJO, CATHERINE MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	45249	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
274916	Fee-for-Service	1558413351	1558413351	1	1	TANG, HONG-ZHUAN MD	8/15/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66170	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
274919	Fee-for-Service	1619471802	1619471802	1	1	THE LOS ANGELES FREE CLINIC	3/23/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	137 N VIRGIL AVE	None	LOS ANGELES	CA	90004	4811	19	06037	34.07457287	-118.2868414	Los Angeles County
274928	Fee-for-Service	1033120332	1033120332	1	1	THRIFTY PAYLESS INC	2/15/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 CHINA GRADE LOOP	None	BAKERSFIELD	CA	93308	1739	15	06029	35.42675859	-119.0206444	Kern County
274934	Fee-for-Service	1235979733	1235979733	1	1	TRAN, BRENDA OD	6/21/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	625 W 9TH ST	None	SAN PEDRO	CA	90731	3107	19	06037	33.73602552	-118.2906945	Los Angeles County
274946	Fee-for-Service	1861430605	1861430605	1	1	THOMAS B FERRARA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MINNESOTA NEONATAL	2545 CHICAGO AVE	SUITE 512	MINNEAPOLIS	MN	55404	4518	00	None	44.955792	-93.26257049	Hennepin County
274953	Fee-for-Service	1669581096	1669581096	1	1	THRIFY PAYLESS INC	4/6/1999	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #5796	707 W LACEY BLVD	None	HANFORD	CA	93230	4326	16	06031	36.3279927	-119.6557596	Kings County
275125	Fee-for-Service	1013074236	1013074236	1	1	TORREY, ROBERT R JR MD	12/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	34160	34	Urology and Urological Surgery	0	In state provider	INC	345 TERRACINA BLVD	None	REDLANDS	CA	92373	4829	36	06071	34.03724677	-117.2046271	San Bernardino County
275144	Fee-for-Service	1548506579	1548506579	1	1	TIFFANY-ROBERTS, KARA E LMFT	9/25/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 MAGNOLIA AVENUE	SUITE 1F	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
275178	Fee-for-Service	1558413351	1558413351	1	1	TANG, HONG-ZHUAN MD	8/15/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66170	01	General Practice	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
275181	Fee-for-Service	1619471802	1619471802	1	1	THE LOS ANGELES FREE CLINIC	3/1/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	137 N VIRGIL AVE	None	LOS ANGELES	CA	90004	4811	19	06037	34.07457287	-118.2868414	Los Angeles County
275192	Fee-for-Service	1639610983	1639610983	1	1	TRAPANA, EVAN J MD	7/18/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	177013	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
275207	Fee-for-Service	1174719470	1174719470	1	1	TATIANA AGABEKIAN	10/1/2020	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
275252	Fee-for-Service	1538896857	1538896857	1	1	TOKAR, EPHRAIM LMFT	10/13/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
275273	Fee-for-Service	1568801033	1568801033	1	1	TRAN, QUANG D DO MD	7/1/2017	390200000X	NA	Other	026	PHYSICIANS	13862	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
275298	Fee-for-Service	1346359775	1346359775	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12897 HARBOR BLVD	None	GARDEN GROVE	CA	92840	5808	30	06059	33.77560269	-117.9181851	Orange County
275335	Fee-for-Service	1205219706	1205219706	1	1	TAN, JENNIFER DO	11/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	14113	41	Internal Medicine	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
275393	Fee-for-Service	1366124448	1366124448	1	1	TRAN, HAN T CRNA	9/20/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
275416	Fee-for-Service	1750518577	1750518577	1	1	TAI, CHAU MD PC	5/20/2009	2082S0105X	NA	General Surgery	026	PHYSICIANS	95375	24	Plastic Surgery	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
275433	Fee-for-Service	1871671966	1871671966	1	1	TELLES, TRACEY L MD	6/19/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84645	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
275439	Fee-for-Service	1619471802	1619471802	1	1	THE LOS ANGELES FREE CLINIC	4/13/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	137 N VIRGIL AVE	None	LOS ANGELES	CA	90004	4811	19	06037	34.07457287	-118.2868414	Los Angeles County
275467	Fee-for-Service	1487767190	1487767190	1	1	TRAN, DAN B MD	1/27/2021	174400000X	NA	Other	026	PHYSICIANS	83738	None	None	0	In state provider	None	4300 LONG BEACH BLVD	SUITE 400	LONG BEACH	CA	90807	2008	19	06037	33.83662572	-118.1900605	Los Angeles County
275495	Fee-for-Service	1235206350	1235206350	1	1	TANNER, J LANE MD	12/5/1986	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	28611	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	# M696	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
275524	Fee-for-Service	1295962686	1295962686	1	1	TANAKA, MARY MD	8/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116057	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
275575	Fee-for-Service	1265035406	1265035406	1	1	TOLBERT, ARTHUR D LMFT	5/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 CLAREMONT AVE STE 1	None	STOCKTON	CA	95207	5700	39	06077	37.99861886	-121.3102123	San Joaquin County
275601	Fee-for-Service	1922612225	1922612225	1	1	TOPANGA HOME HEALTH CARE INC	6/15/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5311 TOPANGA CANYON BLVD	STE 309	WOODLAND HILLS	CA	91364	1754	19	06037	34.166313	-118.6059365	Los Angeles County
275659	Fee-for-Service	1043255391	1043255391	1	1	TEITGE, STEFAN R MD	2/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81967	66	Emergency Medicine (Urgent Care)	0	In state provider	None	345 S HALCYON RD	None	ARROYO GRANDE	CA	93420	3896	40	06079	35.113419	-120.5915945	San Luis Obispo County
275671	Fee-for-Service	1811458375	1811458375	1	1	TRUMBLE, DIANA K MD	6/17/2022	207P00000X	NA	Other	026	PHYSICIANS	177185	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
275683	Fee-for-Service	1770523797	1770523797	1	1	TRUONG, FRANK T MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	63830	08	Family Practice	0	In state provider	None	1085 N HARBOR BLVD	None	ANAHEIM	CA	92801	2417	30	06059	33.85017	-117.924238	Orange County
275695	Fee-for-Service	1619471802	1619471802	1	1	THE LOS ANGELES FREE CLINIC	4/13/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	137 N VIRGIL AVE	None	LOS ANGELES	CA	90004	4811	19	06037	34.07457287	-118.2868414	Los Angeles County
275707	Fee-for-Service	1386108959	1386108959	1	1	TRUONG, HANG T RCP	2/24/2019	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
275755	Fee-for-Service	1811412661	1811412661	1	1	TOMSAN, HANNA MD	5/11/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176109	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
275852	Fee-for-Service	1508488891	1508488891	1	1	TADEVOSYAN, ARMINE NP	9/22/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16101 VENTURA	SUITE 300	ENCINO	CA	91436	2500	19	06037	34.15646951	-118.4842635	Los Angeles County
275891	Fee-for-Service	1811006240	1811006240	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05771	131 W MAIN ST	None	VENTURA	CA	93001	2509	56	06111	34.28137086	-119.303094	Ventura County
275897	Fee-for-Service	1194803270	1194803270	1	1	THAN, THAN MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65810	41	Internal Medicine	0	In state provider	None	5601 DEER VALLEY RD	None	ANTIOCH	CA	94531	8577	07	06013	37.9518204	-121.7780768	Contra Costa County
275934	Fee-for-Service	1508686510	1508686510	1	1	TRUE NORTH COUNSELING INC	1/15/2025	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2331 HONOLULU AVE	SUITE G	MONTROSE	CA	91020	1844	19	06037	34.20604709	-118.2293958	Los Angeles County
275936	Fee-for-Service	1629515705	1629515705	1	4	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	GROUP, A PSYCHOLOGY COR	333 BRADFORD	STE 270	REDWOOD CITY	CA	94063	1571	41	06081	37.48799425	-122.2320157	San Mateo County
275953	Fee-for-Service	1518137561	1518137561	1	1	THOMAS, CARMEN R LMFT	5/21/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	980 W 17TH ST	SUITE C	SANTA ANA	CA	92706	3554	30	06059	33.75994454	-117.8770455	Orange County
275998	Fee-for-Service	1982127452	1982127452	1	1	TIAN, MIAO	2/5/2024	207ZP0102X	NA	Other	026	PHYSICIANS	166044	None	None	0	In state provider	None	4301 NORTHSTAR WAY	None	MODESTO	CA	95356	9535	50	06099	0	0	None
276088	Fee-for-Service	1144302654	1144302654	1	1	TIEU, VINNIE V	7/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4275 E CONCOURS DR	STE 100	ONTARIO	CA	91764	4930	36	06071	34.074981	-117.5592735	San Bernardino County
276092	Fee-for-Service	1780372011	1780372011	1	1	TELNET-RX SPECIALTIES INC.	5/31/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2353 FOOTHILL BLVD	None	LA VERNE	CA	91750	3027	19	06037	34.11176256	-117.7599665	Los Angeles County
276106	Fee-for-Service	1194251199	1194251199	1	1	TAKAKURA, WILL MD	7/2/2020	207R00000X	NA	Other	026	PHYSICIANS	160782	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
276117	Fee-for-Service	1235152489	1235152489	1	1	TUNZI, MARC MD	12/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	56059	08	Family Practice	0	In state provider	None	1330 NATIVIDAD RD	None	SALINAS	CA	93906	3101	27	06053	36.696996	-121.633173	Monterey County
276145	Fee-for-Service	1861697450	1861697450	1	1	TAKAYAMA, JOHN MD	1/30/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	67205	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	# M696	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
276189	Fee-for-Service	1629515705	1629515705	1	4	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	333 BRADFORD	STE 270	REDWOOD CITY	CA	94063	1571	41	06081	37.48799425	-122.2320157	San Mateo County
276191	Fee-for-Service	1568562825	1568562825	1	1	TOMESCU, ANDREEA H LMFT	2/6/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	45445 PORTOLA AVE	SUITE 1	PALM DESERT	CA	92260	4844	33	06065	33.7186073	-116.3737698	Riverside County
276202	Fee-for-Service	1801938592	1801938592	1	1	TOWN CENTER MED GRP INC	2/28/1997	207VX0000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4082 E WHITTIER BLVD	STE 102	LOS ANGELES	CA	90023	2258	19	06037	34.02389953	-118.183464	Los Angeles County
276267	Fee-for-Service	1134876204	1134876204	1	1	TYRREL, INC.	9/13/2022	208M00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
276299	Fee-for-Service	1548242589	1548242589	1	1	TAGGARD, DEREK A MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80229	89	Surgery-Traumatic	0	In state provider	PROFESSIONAL CORPORATION	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
276327	Fee-for-Service	1376618363	1376618363	1	2	TANENBAUM, BARTON MD	3/1/2000	208800000X	NA	Other	026	PHYSICIANS	19250	34	Urology and Urological Surgery	0	In state provider	None	201 S ALVARADO ST	STE 215	LOS ANGELES	CA	90057	2388	19	06037	34.06417777	-118.2719543	Los Angeles County
276437	Fee-for-Service	1053694810	1053694810	1	1	TROMBLEY, STEPHEN L LMFT	4/26/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2214 FIFTH AVE	None	SAN DIEGO	CA	92101	2104	37	06073	32.72859436	-117.160304	San Diego County
276441	Fee-for-Service	1629515705	1629515705	1	4	TWO CHAIRS BEHAVIORAL HEALTH	6/15/2020	101YP2500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	333 BRADFORD	STE 270	REDWOOD CITY	CA	94063	1571	41	06081	37.48799425	-122.2320157	San Mateo County
276459	Fee-for-Service	1649908369	1649908369	1	1	TANAFRANCA, DIANNE M NP	5/3/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
276576	Fee-for-Service	1942586433	1942586433	1	1	TROCHE PEREZ, MARIA D NP	10/15/2020	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
276611	Fee-for-Service	1669890737	1669890737	1	1	TSING, PAMELA J MD	8/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141794	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
276675	Fee-for-Service	1528049897	1528049897	1	1	TSENG, JERRY T MD	3/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76391	41	Internal Medicine	0	In state provider	None	11420 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
276691	Fee-for-Service	1629515705	1629515705	1	4	TWO CHAIRS BEHAVIORAL HEALTH	12/20/2021	101YP2500X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	GROUP, A PSYCHOLOGY COR	333 BRADFORD	STE 270	REDWOOD CITY	CA	94063	1571	41	06081	37.48799425	-122.2320157	San Mateo County
276692	Fee-for-Service	1043507643	1043507643	1	1	TAN, CALVIN E S OD	8/31/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
276704	Fee-for-Service	1295056802	1295056802	1	1	TAN, LEE A MD	9/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149102	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
276710	Fee-for-Service	1821674367	1821674367	1	1	TRAN, JONATHAN K MD	9/27/2024	207R00000X	NA	Other	026	PHYSICIANS	186916	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
276750	Fee-for-Service	1396233375	1396233375	1	1	TORRES MENDOZA, JOCELYN LCS	12/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
276755	Fee-for-Service	1417115239	1417115239	1	1	TEAUSANT, ALICIA M DPM	2/7/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
276760	Fee-for-Service	1114147592	1114147592	1	1	TORRES, FRANKLIN K MD	2/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102285	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1902 FULLERTON AVE	1ST FLR	CORONA	CA	92881	3105	33	06065	33.85828347	-117.5503481	Riverside County
276787	Fee-for-Service	1386878262	1386878262	1	1	THLICK, JU-EN C MD	9/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120968	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
276794	Fee-for-Service	1700123023	1700123023	1	1	THOMPSON, JOHNY L LMFT	8/13/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15455 SAN FERNANDO MISSO	#300	MISSION HILLS	CA	91345	1353	19	06037	34.27194157	-118.469079	Los Angeles County
276796	Fee-for-Service	1861990335	1861990335	1	1	THERAPATH PARTNERS, LLC	4/28/2023	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	545 45TH ST	FL 7	NEW YORK	NY	10036	3409	00	None	40.762422	-73.9958625	New York County
276799	Fee-for-Service	1043919798	1043919798	1	1	TAYLOR ALMQUIST LICENSED CLI	9/1/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NICAL SOCIAL WORKER INC	473 E CARNEGIE DRIVE	SUITE 200	SAN BERNARDINO	CA	92408	4207	36	06071	34.0683677	-117.2746246	San Bernardino County
276810	Fee-for-Service	1780711531	1780711531	1	1	TALEBI, TONY N MD	7/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	84204	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
276811	Fee-for-Service	1003353087	1003353087	1	1	TAMBINI, PAUL LCSW	10/3/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	520 CHADBOURNE RD	None	FAIRFIELD	CA	94534	0000	48	06095	38.235248	-122.0817079	Solano County
276817	Fee-for-Service	1396718615	1396718615	1	1	TARTAR, V MARIE MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	68806	30	Radiology	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
276830	Fee-for-Service	1689109217	1689109217	1	1	TURNER, JAMES M MD	9/16/2023	207RE0101X	NA	Endocrinology	026	PHYSICIANS	186927	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
276872	Fee-for-Service	1053723437	1053723437	1	1	TAN, JOSHUA T DO MD	9/6/2018	207R00000X	NA	Other	026	PHYSICIANS	16356	41	Internal Medicine	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
276925	Fee-for-Service	1487639795	1487639795	1	1	TUSCANO, JOSEPH M MD	1/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	69025	68	Hematology	0	In state provider	None	2525 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
276936	Fee-for-Service	1043761141	1043761141	1	1	THEBO, RYAN D CNP	11/15/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	683 LOMAS SANTA FE DR	None	SOLANA BEACH	CA	92075	1412	37	06073	32.99596006	-117.2594441	San Diego County
276946	Fee-for-Service	1689013468	1689013468	1	1	THOMSON, SAMANTHA L MD	9/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149038	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8631 W 3RD ST	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
276970	Fee-for-Service	1922561356	1922561356	1	1	TORRES, JOSEFINA MD	8/29/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178171	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
276993	Fee-for-Service	1215183496	1215183496	1	1	THRIFTY PAYLESS INC.	10/16/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #04212	955 STONY POINT RD.	None	SANTA ROSA	CA	95407	4728	49	06097	38.426355	-122.7419235	Sonoma County
276994	Fee-for-Service	1851623326	1851623326	1	1	THIESSEN, CHONNIE S LMFT	8/29/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST 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
277009	Fee-for-Service	1114147592	1114147592	1	1	TORRES, FRANKLIN K MD	2/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102285	02	General Surgery	0	In state provider	None	1902 FULLERTON AVE	1ST FLR	CORONA	CA	92881	3105	33	06065	33.85828347	-117.5503481	Riverside County
277037	Fee-for-Service	1205945664	1205945664	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE 5833	531 FIVE CITIES DR	None	PISMO BEACH	CA	93449	3007	40	06079	35.13609383	-120.6242627	San Luis Obispo County
277043	Fee-for-Service	1407282247	1407282247	1	1	TWIN TOWN CORPORATION	11/19/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	705 W LA VETA AVENUE	STE 208	ORANGE	CA	92868	4448	30	06059	33.78062272	-117.8600738	Orange County
277069	Fee-for-Service	1902908577	1902908577	1	1	TSAI, LINDA DO	7/21/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	9200	None	None	0	In state provider	None	1 WASHINGTON SQ	None	SAN JOSE	CA	95192	0037	43	06085	37.335654	-121.8822075	Santa Clara County
277072	Fee-for-Service	1912902602	1912902602	1	1	TAN, CHRISTOPHER A MD	7/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70509	40	Pediatrics	0	In state provider	None	2801 ATLANTIC AVE	FL 3	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
277110	Fee-for-Service	1700902798	1700902798	1	1	TARZANA TREATMENT CENTERS, I	8/30/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	44447 N 10TH STREET WEST	BUILDING A	LANCASTER	CA	93534	3324	19	06037	34.69104127	-118.1480655	Los Angeles County
277133	Fee-for-Service	1821251554	1821251554	1	1	THRASHER, ELLEN D PHD	4/6/2010	103TC0700X	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
277197	Fee-for-Service	1689170698	1689170698	1	1	TO, SINDY B	11/8/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15272 SUMMIT AVE	None	FONTANA	CA	92336	0231	36	06071	34.152624	-117.4724415	San Bernardino County
277218	Fee-for-Service	1053476044	1053476044	1	1	TADOKORO, BENJAMIN H LCSW	7/3/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM DR	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
277221	Fee-for-Service	1245243716	1245243716	1	1	THAKUR, DINESHKUMAR M MD	6/24/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	50275	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
277245	Fee-for-Service	1588836886	1588836886	1	1	TAMBE, KENNETH A	5/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	101 H ST	SUITE E	ARCATA	CA	95521	6695	12	06023	40.86155786	-124.0888153	Humboldt County
277282	Fee-for-Service	1477744639	1477744639	1	1	TYLER, MARISA P NP	6/24/2019	261QF0050X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
277288	Fee-for-Service	1770302218	1770302218	1	1	TORRES, MICHAEL ANDREW L PT	10/21/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3400 8TH STREET	STE 108	NATIONAL CITY	CA	91950	3167	37	06073	32.68571247	-117.0716254	San Diego County
277341	Fee-for-Service	1023225372	1023225372	1	1	TRU-HEALTH, INC	4/25/2006	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2324 LEVER BLVD	None	STOCKTON	CA	95206	2900	39	06077	37.92504969	-121.2978194	San Joaquin County
277368	Fee-for-Service	1912442062	1912442062	1	1	TARLEY DIALYSIS LLC	10/25/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1320 EL CAPITAN DR	SUITE 210	DANVILLE	CA	94526	6258	07	06013	37.78476866	-121.9658691	Contra Costa County
277376	Fee-for-Service	1265471841	1265471841	1	1	TAN, HONGJING MD	11/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129563	25	Physical Medicine and Rehabilitation	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
277382	Fee-for-Service	1407059066	1407059066	1	1	TAYLOR, JENNIE W MD	7/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131751	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
277411	Fee-for-Service	1679151039	1679151039	1	1	THOMASON, NICOLE C MD	9/3/2024	208M00000X	NA	Other	026	PHYSICIANS	None	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
277414	Fee-for-Service	1013370097	1013370097	1	1	TONG, SCHUYLER R MD	8/1/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	150876	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
277447	Fee-for-Service	1952860751	1952860751	1	1	TADROS, DANIEL	8/23/2022	390200000X	NA	Other	026	PHYSICIANS	177537	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
277570	Fee-for-Service	1780615880	1780615880	1	1	THE HEALTH CARE LTD	1/21/2007	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1313 HERMANN DR	None	HOUSTON	TX	77004	7005	00	None	29.72231143	-95.38786621	Harris County
277584	Fee-for-Service	1972086882	1972086882	1	1	TAGALOA-TULIFAU FOOT AND ANK	9/29/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	LE CENTER, INC.	5220 CLARK AVE	SUITE. 315	LAKEWOOD	CA	90712	2635	19	06037	33.8527092	-118.1337623	Los Angeles County
277601	Fee-for-Service	1730195025	1730195025	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5644	535 ROBINSON AVE	None	SAN DIEGO	CA	92103	4209	37	06073	32.74690054	-117.15996	San Diego County
277621	Fee-for-Service	1275514069	1275514069	1	1	TRAN, THANG D MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	81642	41	Internal Medicine	0	In state provider	None	2060 ABORN RD	STE 125	SAN JOSE	CA	95121	1586	43	06085	37.3114718	-121.8072775	Santa Clara County
277627	Fee-for-Service	1407059066	1407059066	1	1	TAYLOR, JENNIE W MD	7/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131751	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
277700	Fee-for-Service	1568983690	1568983690	1	1	TANEJA, ANJALI DO	11/15/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	22090	None	None	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
277727	Fee-for-Service	1336796457	1336796457	1	1	TA, KATHLEEN LCSW	11/19/2024	101YM0800X	NA	Other	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
277755	Fee-for-Service	1831166685	1831166685	1	1	THOMAS H. ON, 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	1625 E NORTHERN AVE	STE # 103	PHOENIX	AZ	85020	0000	00	None	33.554709	-112.0467375	Maricopa County
277762	Fee-for-Service	1780792234	1780792234	1	1	TEVENDALE, ROBERT W MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65065	08	Family Practice	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
277815	Fee-for-Service	1780615880	1780615880	1	1	THE HEALTH CARE LTD	1/21/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1313 HERMANN DR	None	HOUSTON	TX	77004	7005	00	None	29.72231143	-95.38786621	Harris County
277869	Fee-for-Service	1275514069	1275514069	1	1	TRAN, THANG D MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	81642	01	General Practice	0	In state provider	None	2060 ABORN RD	STE 125	SAN JOSE	CA	95121	1586	43	06085	37.3114718	-121.8072775	Santa Clara County
277930	Fee-for-Service	1902060015	1902060015	1	1	TENKEI, TIMEA LMFT	8/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	850 3RD ST	None	SANTA ROSA	CA	95404	4529	49	06097	38.441781	-122.7083265	Sonoma County
277949	Fee-for-Service	1154398337	1154398337	1	1	TALLE, ARMAN 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 S DOBSON RD	STE 209	MESA	AZ	85202	4753	00	None	33.387444	-111.876894	Maricopa County
277970	Fee-for-Service	1346462223	1346462223	1	1	TEHRANI, ROUZBEH MD	8/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112548	41	Internal Medicine	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
278007	Fee-for-Service	1760602320	1760602320	1	1	TILS, INC	3/9/2001	302R00000X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	GLENOAKS ADULT DAY HLTH	3201 N GLENOAKS BLVD	None	BURBANK	CA	91504	2009	19	06037	34.20551184	-118.3390364	Los Angeles County
278024	Fee-for-Service	1679812838	1679812838	1	1	TUONG, WILLIAM MD	9/14/2020	207R00000X	NA	Other	026	PHYSICIANS	144485	41	Internal Medicine	0	In state provider	None	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	19	06037	34.06704253	-118.3835029	Los Angeles County
278030	Fee-for-Service	1306854708	1306854708	1	1	TORRANO, ROBERT T MD	6/30/1988	207K00000X	NA	Other	026	PHYSICIANS	57939	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
278043	Fee-for-Service	1104917723	1104917723	1	1	TALLEY, ROBERT B JR MD	9/13/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	56990	10	Gastroenterology (M.D. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
278064	Fee-for-Service	1700902798	1700902798	1	4	TARZANA TREATMENT CENTERS, I	1/15/2025	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NC.	44447 10TH ST	BUILDING D	LANCASTER	CA	93534	3324	19	06037	34.69104127	-118.1480655	Los Angeles County
278074	Fee-for-Service	1962430835	1962430835	1	1	TAYLOR, BRUCE K MD	7/12/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	50150	20	Orthopedic Surgery	0	In state provider	None	2528 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	52	06103	40.14932543	-122.2191932	Tehama County
278083	Fee-for-Service	1194764720	1194764720	1	1	TANAKA, ROBERT M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35094	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
278168	Fee-for-Service	1811055007	1811055007	1	1	TAKAHASHI ERNEST KO	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 O ST	STE 102	SACRAMENTO	CA	95814	5327	34	06067	38.576592	-121.5036045	Sacramento County
278186	Fee-for-Service	1477731677	1477731677	1	1	TSAI, JOANNA D MD	6/16/2017	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	101756	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1310 SAN BERNARDINO RD	SUITE 201	UPLAND	CA	91786	4985	36	06071	34.10260261	-117.6332582	San Bernardino County
278223	Fee-for-Service	1689041253	1689041253	1	2	TELSER, KATHLEEN E	6/24/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1910 HUNTINGTON DRIVE	18	SOUTH PASADENA	CA	91030	4886	19	06037	34.10428151	-118.143801	Los Angeles County
278229	Fee-for-Service	1932627411	1932627411	1	1	TIDRICK, KATHERINE E LMFT	2/11/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
278258	Fee-for-Service	1669495487	1669495487	1	1	TAKAHASHI, AILEEN MD	8/7/2024	208600000X	NA	General Surgery	026	PHYSICIANS	63724	02	General Surgery	0	In state provider	None	23451 MADISON	300	TORRANCE	CA	90505	4737	19	06037	33.81197627	-118.3478154	Los Angeles County
278269	Fee-for-Service	1144711797	1144711797	1	1	TANG, FELICIA MD	11/17/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	163886	None	None	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300 & 230	SACRAMENTO	CA	95816	5238	34	06067	38.570076	-121.4657145	Sacramento County
278273	Fee-for-Service	1669488953	1669488953	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12059 CENTRAL AVE	None	CHINO	CA	91710	1908	36	06071	34.034247	-117.689373	San Bernardino County
278289	Fee-for-Service	1730776261	1730776261	2	1	TESSA'S PLACE INC	8/26/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	26075 ARCADA DRIVE	None	MISSION VIEJO	CA	92691	4804	30	06059	33.60630279	-117.6752123	Orange County
278313	Fee-for-Service	1851835177	1851835177	1	1	THE MITRY GROUP INC	11/5/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	145 E DUARTE RD	SUITE D	ARCADIA	CA	91006	3993	19	06037	34.13029985	-118.0260173	Los Angeles County
278390	Fee-for-Service	1134476237	1134476237	1	1	THE AMBIENT HOSPICE INC	6/24/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6350 LAUREL CANYON BLVD	SUITE 330	NORTH HOLLYWOOD	CA	91606	3224	19	06037	34.18640491	-118.3964824	Los Angeles County
278462	Fee-for-Service	1881921104	1881921104	1	1	TARAPORE, PHIROZ E MD	6/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107586	14	Neurological Surgery	0	In state provider	None	1001 POTRERO AVENUE	RM 4M39	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
278494	Fee-for-Service	1841378544	1841378544	1	1	TORREBLANCA, ANTONIA MD	9/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83469	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
278512	Fee-for-Service	1538542808	1538542808	1	1	THE ALEF GROUP LTD	7/9/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	77-711 FLORA ROAD	SUITE 204	PALM DESERT	CA	92211	4110	33	06065	33.76856549	-116.3075194	Riverside County
278624	Fee-for-Service	1649389172	1649389172	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1526 PALOS VERDES MALL	None	WALNUT CREEK	CA	94597	2229	07	06013	37.92505481	-122.0878984	Contra Costa County
278629	Fee-for-Service	1134476237	1134476237	1	1	THE AMBIENT HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6350 LAUREL CANYON BLVD	SUITE 330	NORTH HOLLYWOOD	CA	91606	3224	19	06037	34.18640491	-118.3964824	Los Angeles County
278630	Fee-for-Service	1518114834	1518114834	1	1	TRAN, TRISHA T OD	5/20/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	850 S ATLANTIC BLVD	SUITE 301	MONTEREY PARK	CA	91754	6710	19	06037	34.05097684	-118.1379979	Los Angeles County
278654	Fee-for-Service	1851466627	1851466627	1	1	TRETTIN, GAIL P	6/11/2004	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	191 BURTON MESA BLVD	STE B	LOMPOC	CA	93436	1400	42	06083	34.70401649	-120.4647615	Santa Barbara County
278664	Fee-for-Service	1376690024	1376690024	1	1	TRUONG, KENNETH T MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7327	41	Internal Medicine	0	In state provider	PAC ASIAN MEDICAL CENTER	33509 WESTERN AVE	None	UNION CITY	CA	94587	3203	01	06001	37.59233528	-122.0347014	Alameda County
278676	Fee-for-Service	1972614378	1972614378	1	1	TSCHUMPER, BRIAN A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
278681	Fee-for-Service	1417230293	1417230293	1	1	TEA, VERONICA K OD	5/9/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2601 E MAIN ST	None	VENTURA	CA	93003	2801	56	06111	34.27443821	-119.2609368	Ventura County
278700	Fee-for-Service	1780744979	1780744979	1	1	TRAN, LOI V DO	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7326	41	Internal Medicine	0	In state provider	ATTN MGA OFFICE	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
278710	Fee-for-Service	1952535494	1952535494	1	1	TERMEER, JENNIFER L MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114997	None	None	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
278729	Fee-for-Service	1417145798	1417145798	1	1	THOMAS, NICOLE DO	2/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9147	02	General Surgery	0	In state provider	None	800 E WASHINGTON BLVD	None	CRESCENT CITY	CA	95531	8359	08	06015	41.77272521	-124.1940494	Del Norte County
278776	Fee-for-Service	1659489755	1659489755	1	1	TOMLINSON, JAMES S MD	10/1/1998	2086X0206X	NA	General Surgery	026	PHYSICIANS	62837	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
278795	Fee-for-Service	1134190234	1134190234	1	1	TRAN, LILIAN B MD	9/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	69137	40	Pediatrics	0	In state provider	None	29472 AVE DE LAS BANDERA	None	RANCHO SANTA MARG	CA	92688	2651	30	06059	33.620238	-117.610578	Orange County
278827	Fee-for-Service	1154468924	1154468924	1	1	THU, AUNG MD INC	11/17/2010	173000000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	245 N LAURSEN ST	None	HEMET	CA	92543	4437	33	06065	33.750954	-116.960839	Riverside County
278854	Fee-for-Service	1164531505	1164531505	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	968 MURRIETA BLVD	None	LIVERMORE	CA	94550	4063	01	06001	37.67590463	-121.7849602	Alameda County
278862	Fee-for-Service	1578033692	1578033692	1	1	TRUSTING CARE HOME HEALTH	4/27/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	7590 N GLENOAKS BLVD	STE 105	BURBANK	CA	91504	1011	19	06037	34.20858506	-118.3436243	Los Angeles County
278873	Fee-for-Service	1619087475	1619087475	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1808 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	5610	19	06037	34.03004271	-118.4848154	Los Angeles County
278887	Fee-for-Service	1790962660	1790962660	1	1	THRIFTY PAYLESS INC	7/3/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #6549	11200 OLIVE DR	None	BAKERSFIELD	CA	93312	5840	15	06029	35.41981448	-119.127087	Kern County
279022	Fee-for-Service	1932111879	1932111879	1	1	TEELA, JAMES E DPM	4/20/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1332 WEST HERDON AVE	SUITE 100	FRESNO	CA	93711	7118	10	06019	36.83737137	-119.8148304	Fresno County
279031	Fee-for-Service	1134190234	1134190234	1	1	TRAN, LILIAN B MD	9/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	69137	41	Internal Medicine	0	In state provider	None	29472 AVE DE LAS BANDERA	None	RANCHO SANTA MARG	CA	92688	2651	30	06059	33.620238	-117.610578	Orange County
279098	Fee-for-Service	1316563976	1316563976	1	2	TELE-ICU INC	3/24/2023	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2623 SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	19	06037	33.98921547	-118.2242565	Los Angeles County
279238	Fee-for-Service	1508970245	1508970245	1	1	TOM YI DO PROFESSIONAL	10/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	7811	None	None	0	In state provider	None	127 N MADISON	#107	PASADENA	CA	91101	1750	19	06037	34.148223	-118.1384475	Los Angeles County
279256	Fee-for-Service	1760150601	1760150601	1	1	THORNTON, MATTHEW OD	8/26/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27335 TOURNEY RD	STE 180	SANTA CLARITA	CA	91355	2204	19	06037	34.41919917	-118.5789065	Los Angeles County
279304	Fee-for-Service	1841828134	1841828134	1	1	TITUS, ERRON W MD	7/5/2023	207ZP0105X	NA	Other	026	PHYSICIANS	185269	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
279328	Fee-for-Service	1336163575	1336163575	1	1	THEIN, DAVID K MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69707	None	None	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
279329	Fee-for-Service	1063688802	1063688802	1	1	TALAMANTES, EFRAIN MD	5/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109825	41	Internal Medicine	0	In state provider	None	1680 EAST 120 STREET	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
279347	Fee-for-Service	1942645171	1942645171	1	1	TRUONG, VUANH N MD	4/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134632	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
279367	Fee-for-Service	1881896850	1881896850	1	1	TAKASE-SANCHEZ, MICHELLE M	11/10/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	92628	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MD	147 N BRENT STREET	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
279381	Fee-for-Service	1669462883	1669462883	1	1	THOMPSON, SHARRON MD	3/26/2024	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	55454	25	Physical Medicine and Rehabilitation	0	In state provider	None	69780 STELLAR DR	SUITE A	RANCHO MIRAGE	CA	92270	2954	33	06065	33.76299197	-116.444597	Riverside County
279386	Fee-for-Service	1912018789	1912018789	1	1	TON, THOMAS T MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78428	01	General Practice	0	In state provider	None	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	4200	30	06059	33.77387145	-117.9966555	Orange County
279429	Fee-for-Service	1699880781	1699880781	1	1	TURNER, ELIZABETH E MD	1/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77908	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
279440	Fee-for-Service	1942446554	1942446554	1	1	TORNQUIST, STACI C LCSW	9/21/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	30300 CAMINO CAPISTRANO	None	SAN JUAN CAPISTRA	CA	92675	1304	30	06059	33.5230101	-117.6683028	Orange County
279467	Fee-for-Service	1700902798	1700902798	1	3	TARZANA TREATMENT CENTERS, I	11/10/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	44447 N 10TH STREET	BUILDING B	LANCASTER	CA	93534	3324	19	06037	34.69104127	-118.1480655	Los Angeles County
279540	Fee-for-Service	1932104601	1932104601	1	1	TAYLOR, DAVID R MD INC	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	31310	07	Dermatology	0	In state provider	None	5640 N FRESNO ST	STE 110	FRESNO	CA	93710	6098	10	06019	36.820296	-119.781292	Fresno County
279630	Fee-for-Service	1114167145	1114167145	1	1	TOTAL RENAL CARE INC	7/29/2010	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	1	Border provider	None	2230 N ELDORADO AVE	None	KLAMATH FALLS	OR	97601	6418	00	None	42.2480397	-121.7869476	Klamath County
279650	Fee-for-Service	1891752457	1891752457	1	1	TAYLOR, ERIC W. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3260 PROVIDENCE DR	STE 422	ANCHORAGE	AK	99508	4604	00	None	61.18848	-149.8197555	Municipality of Anchorage
279665	Fee-for-Service	1245259241	1245259241	1	1	TURKOT, LIANA MD	6/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77984	41	Internal Medicine	0	In state provider	None	2660 W COVELL BLVD	None	DAVIS	CA	95616	5645	57	06113	38.56101005	-121.7821776	Yolo County
279707	Fee-for-Service	1659029973	1659029973	1	1	THERAPY TODAY, LICENSED MAR	2/9/2024	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	315 ARDEN AVE	1	GLENDALE	CA	91203	1191	19	06037	34.15852735	-118.2587759	Los Angeles County
279743	Fee-for-Service	1376560128	1376560128	1	1	TUN, HKUN 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	6367 E TANQUE VERDE RD	STE 200	TUCSON	AZ	85715	3832	00	None	32.24619	-110.8571535	Pima County
279759	Fee-for-Service	1447704929	1447704929	1	1	THRIVE NC PHYSICAL THERAPY	1/1/2017	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	569 SEARLS AVE	None	NEVADA CITY	CA	95959	3063	29	06057	39.25239536	-121.023735	Nevada County
279760	Fee-for-Service	1619597127	1619597127	1	1	TURNQUEST, ANDRE MD	5/29/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
279762	Fee-for-Service	1508897463	1508897463	1	1	TARZANA ANESTHESIA MEDICAL	11/12/2009	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	18321 CLARK STREET	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
279815	Fee-for-Service	1700884038	1700884038	1	1	TARPE, GULNARA DO	11/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10838	08	Family Practice	0	In state provider	None	1301 SHOREWAY RD	SUITE 100	BELMONT	CA	94002	4110	41	06081	37.5239043	-122.2667778	San Mateo County
279844	Fee-for-Service	1376613067	1376613067	1	1	THE NEW BEGINNING FELLOWSHIP	12/21/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	TER	16581 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	2344	30	06059	33.7215297	-117.9547079	Orange County
279848	Fee-for-Service	1720095235	1720095235	1	1	TINER, CHRISTOPHER K MD	7/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	87203	24	Plastic Surgery	0	In state provider	None	300 WEST HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
279891	Fee-for-Service	1891383188	1891383188	1	1	TERRA VISTA COUNSELING	8/19/2024	251S00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	12139 MT. VERNON AVE	104	GRAND TERRACE	CA	92313	5748	36	06071	34.033185	-117.313583	San Bernardino County
279904	Fee-for-Service	1922582568	1922582568	1	1	TRANQUILITY HOMES INC	6/25/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1670 MEMORY LANE	None	PORTERVILLE	CA	93257	1332	54	06107	36.07763952	-119.0545335	Tulare County
279925	Fee-for-Service	1528285848	1528285848	1	1	TAJIK, ALI R MD INC	1/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79426	None	None	0	In state provider	None	3400 W BALL RD	STE 207	ANAHEIM	CA	92804	3737	30	06059	33.81724472	-118.0083216	Orange County
279931	Fee-for-Service	1407858178	1407858178	1	1	TAGDIRI, KEVEN MD	11/1/1989	207R00000X	NA	Other	026	PHYSICIANS	47779	41	Internal Medicine	0	In state provider	None	4401 MANCHESTER AVE	STE 103	ENCINITAS	CA	92024	4938	37	06073	33.03569437	-117.2393042	San Diego County
279964	Fee-for-Service	1497109995	1497109995	1	1	THUESON, JOHN H DO	7/24/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	17713	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
279989	Fee-for-Service	1194834523	1194834523	1	1	THRIFTY PAYLESS, INC.	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05184	2505 MT. VERNON AVE.	None	BAKERSFIELD	CA	93306	3199	15	06029	35.39081371	-118.9673655	Kern County
280003	Fee-for-Service	1225563299	1225563299	1	1	TSANG, JONATHAN CHUN MING M	9/10/2020	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	157766	36	Psychiatry	0	In state provider	D	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
280026	Fee-for-Service	1891182663	1891182663	1	1	THOMAS, DANA LMFT	4/14/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1347 GRANT ST	None	RED BLUFF	CA	96080	2366	52	06103	40.18355103	-122.2401731	Tehama County
280046	Fee-for-Service	1700884038	1700884038	1	1	TARPE, GULNARA DO	11/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10838	01	General Practice	0	In state provider	None	1301 SHOREWAY RD	SUITE 100	BELMONT	CA	94002	4110	41	06081	37.5239043	-122.2667778	San Mateo County
280175	Fee-for-Service	1447612676	1447612676	1	1	TORRES BARBA, DAVID MD	1/7/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	151578	41	Internal Medicine	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
280180	Fee-for-Service	1396211538	1396211538	1	1	TYRELL, JACQUELINE R CCC-SLP	9/2/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5340 ELVAS AVE.	300	SACRAMENTO	CA	95819	2391	34	06067	38.574819	-121.434867	Sacramento County
280231	Fee-for-Service	1366831505	1366831505	1	1	TORDECILLA, ABIGAIL M PT	8/29/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
280284	Fee-for-Service	1861497588	1861497588	1	1	THOMAS M KNUTSON M.D.	3/7/2016	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
280312	Fee-for-Service	1619504081	1619504081	1	1	TRAN, STEPHANIE T OD	6/17/2021	390200000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4300 LONG BEACH BLVD	SUITE 400	LONG BEACH	CA	90807	2008	19	06037	33.83662572	-118.1900605	Los Angeles County
280326	Fee-for-Service	1518979731	1518979731	1	1	TABIBZADEH, SEPEHR MD	5/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88467	05	Anesthesiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
280330	Fee-for-Service	1407965874	1407965874	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #05748	1825 E CHAPMAN AVE	None	ORANGE	CA	92867	7774	30	06059	33.78786046	-117.8344305	Orange County
280371	Fee-for-Service	1760485221	1760485221	1	1	TRI-STATE MEMORIAL HOSPITAL	6/12/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1221 HIGHLAND AVE	None	CLARKSTON	WA	99403	2829	00	None	46.40360847	-117.054558	Asotin County
280429	Fee-for-Service	1790209849	1790209849	1	1	TARPEY, BRIANNA G LMFT	7/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	409 13TH	STE 1900	OAKLAND	CA	94612	2605	01	06001	37.80326679	-122.2707988	Alameda County
280449	Fee-for-Service	1821225228	1821225228	1	1	THRASH, CHRISTOPHER J MD	2/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114998	40	Pediatrics	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
280501	Fee-for-Service	1376706259	1376706259	1	1	TOMIC, MARY M MD	9/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	101137	22	Pathology (M.D. only)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
280643	Fee-for-Service	1184910390	1184910390	1	1	THOMAS, GISHA MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129457	None	None	0	In state provider	None	770 MASON STREET	None	VACAVILLE	CA	95668	4646	48	06095	38.35504697	-121.983852	Solano County
280646	Fee-for-Service	1255303301	1255303301	1	1	TIMOTHY BAX	2/9/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	217 W CATALDO AVE	None	SPOKANE	WA	99201	2217	00	None	47.665782	-117.4152105	Spokane County
280668	Fee-for-Service	1851561807	1851561807	1	1	TATULIAN, KARMEN S MD	4/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101992	01	General Practice	0	In state provider	None	9375 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1418	19	06037	34.2395322	-118.3939944	Los Angeles County
280671	Fee-for-Service	1821225228	1821225228	1	1	THRASH, CHRISTOPHER J MD	2/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114998	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
280703	Fee-for-Service	1487958815	1487958815	1	1	TORABI, ALIREZA	2/23/2018	207ZP0102X	NA	Other	026	PHYSICIANS	133795	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	2625 COFFEE RD	STE S	MODESTO	CA	95355	2050	50	06099	37.67888506	-120.9759048	Stanislaus County
280737	Fee-for-Service	1568115681	1568115681	1	1	TELECLINIC LLC	2/4/2022	347C00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	11417 BERNARDO CT	204	SAN DIEGO	CA	92127	1639	37	06073	33.02158933	-117.0834832	San Diego County
280778	Fee-for-Service	1427515584	1427515584	1	1	TONECK, LAUREN E NP	12/24/2020	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
280783	Fee-for-Service	1033228440	1033228440	1	1	THRIFTY DRUG STORE 5749	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	801 N EL CAMINO REAL	None	SAN CLEMENTE	CA	92672	4649	30	06059	33.43042508	-117.6191634	Orange County
280802	Fee-for-Service	1942319462	1942319462	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1356 WEST AVENUE J	None	LANCASTER	CA	93534	4134	19	06037	34.68940254	-118.156221	Los Angeles County
280809	Fee-for-Service	1811151228	1811151228	1	1	TRAN, HA N MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115068	45	Nephrology (Renal-Kidney)	0	In state provider	None	725 WELCH ROAD	MC5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
280860	Fee-for-Service	1700313160	1700313160	1	1	TRAN, PHUC D DO	5/13/2020	207R00000X	NA	Other	026	PHYSICIANS	17973	41	Internal Medicine	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
280878	Fee-for-Service	1578911608	1578911608	1	1	THRIFTY PAYLESS INC	4/20/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9700 PANAMA LANE	None	BAKERSFIELD	CA	93311	9745	15	06029	35.29620946	-119.110824	Kern County
280924	Fee-for-Service	1568431310	1568431310	1	1	THE REGENTS OF THE UNIVERSIT	11/6/1992	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	200 UCLA MEDICAL PLZ	BLDG 465	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
280931	Fee-for-Service	1548702319	1548702319	1	1	TANGONAN, KEVIN DO	12/13/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15061	08	Family Practice	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
280972	Fee-for-Service	1881707743	1881707743	1	1	THUSU, KAJORI G MD	5/13/2016	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	61326	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	888 N ALTA AVE	None	DINUBA	CA	93618	3001	54	06107	36.552825	-119.395071	Tulare County
280980	Fee-for-Service	1891871315	1891871315	1	1	TSANG, WILLIAM C MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	39739	41	Internal Medicine	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
280996	Fee-for-Service	1063149623	1063149623	1	1	TRINITY COUNSELING SERVICES	5/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	OF CALIFORNIA INC.	7545 IRVINE CENTER DR	200	IRVINE	CA	92618	2932	30	06059	33.662781	-117.75096	Orange County
281028	Fee-for-Service	1811151228	1811151228	1	1	TRAN, HA N MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115068	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
281042	Fee-for-Service	1538749742	1538749742	1	1	THIND, JASMINE NP	3/18/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
281121	Fee-for-Service	1831259472	1831259472	2	1	TIN RX THE INDEPENDENT	10/15/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	NETWORK INC	7885 HWY 99E	None	LOS MOLINOS	CA	96055	9782	52	06103	40.02543	-122.099856	Tehama County
281123	Fee-for-Service	1770519373	1770519373	1	1	TOFT, KENNETH M MD	3/1/1999	207P00000X	NA	Other	026	PHYSICIANS	55090	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
281155	Fee-for-Service	1578958575	1578958575	1	1	TAYLOR, JORDAN S MD	11/17/2022	208600000X	NA	General Surgery	026	PHYSICIANS	151209	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
281176	Fee-for-Service	1801344049	1801344049	1	1	THRIVE HOME HEALTH CARE INC	12/20/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8920 EMERALD PARK DR	STE D1	ELK GROVE	CA	95624	2380	34	06067	38.405295	-121.37067	Sacramento County
281189	Fee-for-Service	1801991740	1801991740	1	1	TEREGIS, GREGORY C MD	3/8/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76107	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
281192	Fee-for-Service	1881707743	1881707743	1	1	THUSU, KAJORI G MD	5/13/2016	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	61326	40	Pediatrics	0	In state provider	None	888 N ALTA AVE	None	DINUBA	CA	93618	3001	54	06107	36.552825	-119.395071	Tulare County
281221	Fee-for-Service	1740851419	1740851419	1	1	TREE OF LIFE HOME HEALTH CAR	6/26/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6356 VAN NUYS BLVD	STE 229	VAN NUYS	CA	91401	2743	19	06037	34.185861	-118.4487045	Los Angeles County
281231	Fee-for-Service	1255593968	1255593968	1	1	TSAI, SALINA D MD	5/27/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	151848	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
281238	Fee-for-Service	1003925439	1003925439	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE 5848	1780 ROBERTSON BLVD	None	CHOWCHILLA	CA	93610	9016	20	06039	37.11149131	-120.2735832	Madera County
281251	Fee-for-Service	1205967569	1205967569	1	1	TRIVEDI, KETAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2700 E BROAD ST	None	MANSFIELD	TX	76063	0000	00	None	32.56919125	-97.09562468	Tarrant County
281373	Fee-for-Service	1194050328	1194050328	1	1	THOMPSON, BENJAMIN J MD	12/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
281377	Fee-for-Service	1447338348	1447338348	1	1	TANALSKI, RYK GRAF MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	57655	05	Anesthesiology	0	In state provider	MOUNT ZION HOSPITAL	1600 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3010	38	06075	37.78475261	-122.43973	San Francisco County
281403	Fee-for-Service	1801991740	1801991740	1	1	TEREGIS, GREGORY C MD	3/8/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76107	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
281487	Fee-for-Service	1043692569	1043692569	1	1	TRANSIT SOLUTIONS INC.	3/28/2019	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	20475 YELLOW BRICK RD.	SUITE 3A	WALNUT	CA	91789	2929	19	06037	33.99908823	-117.8583089	Los Angeles County
281512	Fee-for-Service	1366580052	1366580052	1	1	TEMPLE GARDEN HOMES #5	3/8/2006	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	10202 GREEN ST	None	TEMPLE CITY	CA	91780	3336	19	06037	34.09709635	-118.045504	Los Angeles County
281567	Fee-for-Service	1376261743	1376261743	1	1	TAYLOR-SPENCER, TORRI NP	1/12/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8355 CHURCH ST	None	GILROY	CA	95020	4406	43	06085	37.01873743	-121.5768381	Santa Clara County
281613	Fee-for-Service	1972523587	1972523587	1	1	TILLISCH, JAN H MD	1/1/1995	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	20497	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	# 32220	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
281658	Fee-for-Service	1073078473	1073078473	1	1	TRAUMA LIFE CARE MEDICAL TRA	6/11/2020	3416L0300X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	NSPORT INC	3637 MISSION AVE	SUITE 4 & 5	CARMICHAEL	CA	95608	2946	34	06067	38.631564	-121.355874	Sacramento County
281659	Fee-for-Service	1720492713	1720492713	1	1	TOVIAN, ZEV S MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143227	08	Family Practice	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
281681	Fee-for-Service	1558312868	1558312868	1	1	TRIPURANENI, PRABHAKAR	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	38065	42	Nuclear Medicine	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
281686	Fee-for-Service	1295837359	1295837359	1	1	TRAUTWEIN, RACHEL E MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82268	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
281710	Fee-for-Service	1003248105	1003248105	1	1	TAHOORI, ARMIN MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134534	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
281733	Fee-for-Service	1033543533	1033543533	1	1	TIEMPO, STEPHANIE B NP	9/29/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1441 EASTLAKE AVENUE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
281743	Fee-for-Service	1669733747	1669733747	1	1	TEITELBAUM, MARC H	10/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	921 THE ALAMEDA	228	BERKELEY	CA	94707	2311	01	06001	37.89086106	-122.2769457	Alameda County
281817	Fee-for-Service	1609844414	1609844414	1	1	TSAY, CHI L MD PC	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	37476	05	Anesthesiology	0	In state provider	None	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
281866	Fee-for-Service	1437491511	1437491511	1	1	TSENG, DAVID H MD	8/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149249	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
281902	Fee-for-Service	1851464168	1851464168	1	1	TRAN, TUAN Q MD	2/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74835	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
281907	Fee-for-Service	1154908127	1154908127	1	1	TRAN, NGHI T MD	4/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	183190	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
281920	Fee-for-Service	1578922092	1578922092	1	1	TOOMEY, CHRISTOPHER MD	5/18/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	151210	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
281928	Fee-for-Service	1578748653	1578748653	1	1	TERRELL, MERCEDES R	6/14/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1900 DRESDEN	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
281968	Fee-for-Service	1568494763	1568494763	1	1	TSANG, STEPHEN M MD	2/11/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	69792	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	445 W EATON AVE	None	TRACY	CA	95376	3420	39	06077	37.743354	-121.432495	San Joaquin County
281979	Fee-for-Service	1396292603	1396292603	1	1	TRESGALLO PARES, RUBEN MD	9/25/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	184415	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
282065	Fee-for-Service	1730266966	1730266966	1	1	TSAI, DIANE C MD	1/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86931	78	Neoplastic Diseases/Oncology	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
282068	Fee-for-Service	1144352840	1144352840	1	1	TRIEBWASSER, HARVEY S MD	10/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	20277	40	Pediatrics	0	In state provider	None	1201 WEST LA VETA AVENUE	None	ORANGE	CA	92868	3835	30	06059	33.78034779	-117.8655767	Orange County
282146	Fee-for-Service	1063943439	1063943439	1	1	TAM, ANDREW W MD	8/16/2023	208800000X	NA	Other	026	PHYSICIANS	186025	None	None	0	In state provider	None	20101 LAKE CHABOT RD	4TH FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
282198	Fee-for-Service	1508450966	1508450966	1	1	TOBIAS, PERLEE C NP	9/9/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3535 WEST COMMONWEALTH A	None	FULLERTON	CA	92833	2821	30	06059	33.8700505	-117.9749565	Orange County
282252	Fee-for-Service	1346413036	1346413036	1	1	TUNGA, SURESH	2/26/2025	207LP3000X	NA	Other	026	PHYSICIANS	112873	05	Anesthesiology	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
282278	Fee-for-Service	1740338706	1740338706	1	1	TSUNG, PATRICIA A MD	7/1/1998	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	64462	25	Physical Medicine and Rehabilitation	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
282285	Fee-for-Service	1033566963	1033566963	1	1	TAYLOR, RACHEL LCSW	8/5/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
282341	Fee-for-Service	1316268519	1316268519	1	1	TAGHAVI, CYRUS E MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119827	20	Orthopedic Surgery	0	In state provider	None	1955 CITRACADO PKWY	STE 200	ESCONDIDO	CA	92029	4112	37	06073	33.11301099	-117.1202081	San Diego County
282383	Fee-for-Service	1700995230	1700995230	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE #5996	1050 N WILSON WAY	None	STOCKTON	CA	95205	4218	39	06077	37.96659579	-121.2744069	San Joaquin County
282428	Fee-for-Service	1285139170	1285139170	1	1	TAHATA, SHAWN MD	12/22/2023	207SG0201X	NA	Other	026	PHYSICIANS	174662	None	None	0	In state provider	None	2350 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3305	38	06075	37.78305866	-122.4421313	San Francisco County
282429	Fee-for-Service	1629150990	1629150990	1	1	TROIANO, KELLY A MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74950	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
282431	Fee-for-Service	1770061780	1770061780	1	1	TRAN, SOPHIA OD	1/28/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	563 N MOUTAIN AVE	None	UPLAND	CA	91786	5016	36	06071	34.100505	-117.6703307	San Bernardino County
282440	Fee-for-Service	1669009791	1669009791	1	1	THEIS, DUSTIN I DPM	1/31/2024	390200000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1580 CREEKSIDE DR	STE 100	FOLSOM	CA	95630	3886	34	06067	38.668914	-121.148028	Sacramento County
282491	Fee-for-Service	1376834143	1376834143	1	2	TRUONG, MICHAEL MD	10/2/2023	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	124243	None	None	0	In state provider	None	1200 N. TUSTIN AVE	#130	SANTA ANA	CA	92705	3508	30	06059	33.75564579	-117.8342574	Orange County
282504	Fee-for-Service	1497729321	1497729321	1	1	TANGUM,R MICHAEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1015 NW 22ND AVE	None	PORTLAND	OR	97210	3025	00	None	45.53024175	-122.6966202	Multnomah County
282517	Fee-for-Service	1972706281	1972706281	1	1	TAYLOR, GREGORY L MD II	9/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	98429	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
282538	Fee-for-Service	1134680267	1134680267	1	1	TSAO, SHARLENE MD	6/14/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19508	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
282564	Fee-for-Service	1407449580	1407449580	1	1	THV HOSPICE SERVICES INC.	9/18/2024	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	622 34TH ST	None	BAKERSFIELD	CA	93301	2208	15	06029	35.39051453	-119.009079	Kern County
282571	Fee-for-Service	1760560536	1760560536	1	1	TSAI, SHIRLEY S MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70650	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
282575	Fee-for-Service	1487816146	1487816146	1	2	TONKABONI, DARIUSH H MD	7/25/2017	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	101281	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
282576	Fee-for-Service	1891105177	1891105177	1	1	TANK, RIKIN H MD	7/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139868	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
282591	Fee-for-Service	1548485733	1548485733	1	1	TRAN, TIEN H DO	7/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10713	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
282634	Fee-for-Service	1770080541	1770080541	1	1	TSAI, LESTER MD	9/1/2021	207R00000X	NA	Other	026	PHYSICIANS	165394	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
282651	Fee-for-Service	1538644521	1538644521	1	1	TIIDEBERG, MICHAEL NP	4/15/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1525 W FLORIDA AVE	STE D	HEMET	CA	92543	3869	33	06065	33.7473507	-116.9878543	Riverside County
282698	Fee-for-Service	1952409609	1952409609	1	1	THIELING, CRAIG A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 3RD AVE SE	None	MAGEE	MS	39111	3665	00	None	31.871115	-89.72853648	Simpson County
282714	Fee-for-Service	1972706281	1972706281	1	1	TAYLOR, GREGORY L MD II	9/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	98429	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
282725	Fee-for-Service	1346491529	1346491529	1	1	TEAMM TRANZ INC.	7/22/2010	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TEAMM TRANZ INC.	673 ORCHID DRIVE	None	S SAN FRANCISCO	CA	94080	2257	41	06081	37.66259766	-122.4477838	San Mateo County
282748	Fee-for-Service	1578542957	1578542957	1	1	TANG, VINCENT C MD	10/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88190	None	None	0	In state provider	None	555 7TH AVE	None	BARSTOW	CA	92311	3043	36	06071	34.894062	-117.0196215	San Bernardino County
282763	Fee-for-Service	1821318130	1821318130	1	1	TRAN, QUY T MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114595	None	None	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
282804	Fee-for-Service	1467748855	1467748855	1	1	TAYLOR, KRISTIN N MD	7/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135672	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
282846	Fee-for-Service	1841300050	1841300050	1	1	TANDON, ABHISHEK MD	9/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103629	41	Internal Medicine	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
282873	Fee-for-Service	1780211540	1780211540	1	1	TABARES, DIEGO S MD	12/27/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178902	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
282880	Fee-for-Service	1528158953	1528158953	1	1	TAK, ANDREW J MD	6/1/2002	207R00000X	NA	Other	026	PHYSICIANS	78315	41	Internal Medicine	0	In state provider	None	500 UNIVERSITY AVE	None	SACRAMENTO	CA	95825	6504	34	06067	38.568402	-121.418019	Sacramento County
282905	Fee-for-Service	1720094014	1720094014	1	1	THRIFTY PAYLESS INC	11/18/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID # 6432	7211 ELK GROVE BLVD	None	ELK GROVE	CA	95758	5500	34	06067	38.409831	-121.4184915	Sacramento County
282945	Fee-for-Service	1720168982	1720168982	1	1	TROLLOPE, MICHAEL L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	24012	02	General Surgery	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
282994	Fee-for-Service	1629532262	1629532262	1	1	TSOU, TIFFANY	4/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
283000	Fee-for-Service	1881836682	1881836682	1	1	THOMAS, PATRICK S JR MD	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115559	36	Psychiatry	0	In state provider	None	760 WESTWOOD BLVD	None	LOS ANGELES	CA	90095	0001	19	06037	34.07067	-118.4432445	Los Angeles County
283103	Fee-for-Service	1396992129	1396992129	1	1	TAFOYA, SAMPAGUITA-INEZ P MD	1/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	105262	05	Anesthesiology	0	In state provider	None	2425 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2215	34	06067	38.553012	-121.45545	Sacramento County
283164	Fee-for-Service	1760474894	1760474894	1	1	TUFFANELLI, LUCIA R MD	12/31/1989	207N00000X	NA	Dermatology	026	PHYSICIANS	53460	07	Dermatology	0	In state provider	None	450 SUTTER ST	RM 1306	SAN FRANCISCO	CA	94108	4002	38	06075	37.78934929	-122.4077786	San Francisco County
283191	Fee-for-Service	1407380512	1407380512	1	1	TAYLOR, MARIO A MD	7/20/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	176199	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
283219	Fee-for-Service	1700067295	1700067295	1	1	TAKHAR, JASPREET K MD	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99170	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
283228	Fee-for-Service	1790901346	1790901346	1	1	TUCKER, BRYAN E LMFT	5/22/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1544 B STREET	STE 2	HAYWARD	CA	94541	3041	01	06001	37.67895193	-122.0732246	Alameda County
283237	Fee-for-Service	1720306772	1720306772	1	1	TAM, MICHAEL S MD	9/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	109153	02	General Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
283278	Fee-for-Service	1770718728	1770718728	1	1	TURNER, MARISA N MD	11/1/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	107660	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	FLOOR 2	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
283285	Fee-for-Service	1639176803	1639176803	1	1	TERKONDA, RAJ P MD	7/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	81638	04	Otology, Laryngology, Rhinology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
283297	Fee-for-Service	1710163274	1710163274	1	1	TING, SUE MD	12/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149880	01	General Practice	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
283372	Fee-for-Service	1154468924	1154468924	1	3	THU, AUNG MD INC	11/17/2010	173000000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	600 N 13TH AVE	STE 150	UPLAND	CA	91786	1900	36	06071	34.10113004	-117.6336234	San Bernardino County
283396	Fee-for-Service	1417551169	1417551169	1	1	THOMAS, SAMANTHA N NP	8/2/2021	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
283443	Fee-for-Service	1265516231	1265516231	1	1	TUCKER, GLORIA A MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	66238	01	General Practice	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
283482	Fee-for-Service	1457552275	1457552275	1	1	TOMASIN, JAMES V PT	12/28/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2321 COURT ST	None	REDDING	CA	96001	2527	45	06089	40.57520454	-122.3925566	Shasta County
283509	Fee-for-Service	1558785493	1558785493	1	1	TRUONG, HIEN N NP	6/26/2018	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
283545	Fee-for-Service	1992332118	1992332118	1	1	TARPLEY, MALIA MD	7/8/2024	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
283558	Fee-for-Service	1194743864	1194743864	1	1	TSI, SY MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74951	34	Urology and Urological Surgery	0	In state provider	None	3900 SHERMAN DR	STE E	RIVERSIDE	CA	92503	4005	33	06065	33.92756479	-117.4375031	Riverside County
283573	Fee-for-Service	1548302144	1548302144	1	1	TORMED WOMENS MED GRP IN	1/1/1979	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3400 LOMITA BLVD	STE 602	TORRANCE	CA	90505	4984	19	06037	33.81309744	-118.3448635	Los Angeles County
283585	Fee-for-Service	1093943136	1093943136	1	1	TSANG, BETTY MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120969	40	Pediatrics	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
283586	Fee-for-Service	1477508869	1477508869	1	1	TSE, PEGGY P MD	7/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	78170	40	Pediatrics	0	In state provider	None	16300 SAND CANYON AVE	STE 311	IRVINE	CA	92618	3703	30	06059	33.66115075	-117.7742405	Orange County
283661	Fee-for-Service	1316034192	1316034192	1	1	TONG, LI LI MD	11/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78975	41	Internal Medicine	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
283691	Fee-for-Service	1346272531	1346272531	1	1	TED MIHOK, ANTHONY POGGI	3/24/2004	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	POGGIO ANTHONY GEN PTR	223 PLAZA PROF BLDG	None	EL CERRITO	CA	94530	0000	07	06013	37.89831601	-122.3001181	Contra Costa County
283704	Fee-for-Service	1134203110	1134203110	1	1	TOTH, THOMAS L MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68775	01	General Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
283744	Fee-for-Service	1942319363	1942319363	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	735 E ALTADENA DR	None	ALTADENA	CA	91001	2302	19	06037	34.1900252	-118.1326109	Los Angeles County
283762	Fee-for-Service	1720258585	1720258585	1	1	TAROUMIAN, SARA MD	1/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117228	83	Rheumatology	0	In state provider	None	215 PESETAS	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
283767	Fee-for-Service	1801429402	1801429402	1	1	TAI, KATHERINE W OD	7/1/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	138 N MILPITAS BLVD	None	MILPITAS	CA	95035	4401	43	06085	37.43348259	-121.8999829	Santa Clara County
283769	Fee-for-Service	1801855747	1801855747	1	1	TROPP, RORY MD	1/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 SOUTH AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
283797	Fee-for-Service	1003186685	1003186685	1	1	THOMAS, ASHLEY N LMFT	9/7/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	837 3RD ST	None	EUREKA	CA	95501	0511	12	06023	40.80417466	-124.1627039	Humboldt County
283845	Fee-for-Service	1316034192	1316034192	1	1	TONG, LI LI MD	11/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78975	45	Nephrology (Renal-Kidney)	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
283907	Fee-for-Service	1801999107	1801999107	1	1	TSOU, ROBERT M MD	3/6/2019	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	41287	None	None	0	In state provider	ER	15963 QUANTICO RD	SUITE B	APPLE VALLEY	CA	92307	1301	36	06071	34.54122514	-117.2706519	San Bernardino County
283998	Fee-for-Service	1023077450	1023077450	1	2	TANK, DAYALAL D MD	8/4/2016	2084P0800X	NA	Psychiatry	026	PHYSICIANS	53624	36	Psychiatry	0	In state provider	None	933 S SUNSET AVE	STE 105	WEST COVINA	CA	91790	3410	19	06037	34.06428275	-117.9432037	Los Angeles County
284104	Fee-for-Service	1265751150	1265751150	1	1	TATINENY, KALYAN C MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	3001 ST ROSE PARKWAY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
284124	Fee-for-Service	1043552185	1043552185	1	1	TRAN, QUYNH C T MD	5/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141167	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
284160	Fee-for-Service	1447051255	1447051255	1	1	TOLEDO, REYNA	4/29/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	44	06087	0	0	None
284185	Fee-for-Service	1881011138	1881011138	1	1	TANAKA, SHO MD	8/13/2021	207L00000X	NA	Other	026	PHYSICIANS	171692	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
284190	Fee-for-Service	1821107210	1821107210	1	1	THRIFTY PAYLESS INC	12/23/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	RITE AID #6121	1329 US HIGHWAY 395 N	STE 1	GARDNERVILLE	NV	89410	5303	00	None	38.9352894	-119.7382348	Douglas County
284233	Fee-for-Service	1962737908	1962737908	1	1	TRINH, PHAT T DO	11/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	14350	05	Anesthesiology	0	In state provider	None	1800 NORTH CALIFORNIA ST	STE 1	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
284290	Fee-for-Service	1568560100	1568560100	1	1	THORNE, KATHERINE D PT	5/8/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1060 CAMERADO DRIVE	None	CAMERON PARK	CA	95682	7600	09	06017	38.6856171	-120.9860614	El Dorado County
284298	Fee-for-Service	1831411818	1831411818	1	1	TEJEDA ALVARADO, MARISOL N L	4/27/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CSW	615 WEST AVE L	None	LANCASTER	CA	93545	7211	19	06037	34.6603515	-118.1419695	Los Angeles County
284441	Fee-for-Service	1497866545	1497866545	1	1	THREE RIVERS OPTOMETRIC	8/1/2002	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	1245 THARP RD	None	YUBA CITY	CA	95993	2647	51	06101	39.14499709	-121.6484309	Sutter County
284481	Fee-for-Service	1659842102	1659842102	1	1	TAYLOR-SALERY, APRIL D LMFT	2/18/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6777 N. WILLOW AVE.	None	FRESNO	CA	93710	5900	10	06019	36.83465436	-119.7311422	Fresno County
284484	Fee-for-Service	1538311402	1538311402	1	1	TSE, JASON	2/8/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	50 E FOOTHILL BLVD	STE 100	ARCADIA	CA	91006	2314	19	06037	34.15096965	-118.0295442	Los Angeles County
284531	Fee-for-Service	1770178758	1770178758	1	1	TAPP, AMANDA NP	4/12/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
284532	Fee-for-Service	1013109826	1013109826	1	1	TREADWAY, RONALD B LMFT	4/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
284545	Fee-for-Service	1619560166	1619560166	1	1	THE ROOT NETWORK, A LICENSED	3/3/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CLINICAL SOCIAL WORKER	2990 INLAND EMPIRE BLVD	105	ONTARIO	CA	91764	4899	36	06071	34.069824	-117.5873175	San Bernardino County
284555	Fee-for-Service	1699884049	1699884049	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20572 HOMESTEAD RD	None	CUPERTINO	CA	95014	0432	43	06085	37.33746397	-122.0334809	Santa Clara County
284557	Fee-for-Service	1669669354	1669669354	1	1	TANG, CHRISTOPHER M MD	1/24/2008	207R00000X	NA	Other	026	PHYSICIANS	98921	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
284612	Fee-for-Service	1851326425	1851326425	1	1	TALMI, DANIT MD	4/4/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	158883	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
284644	Fee-for-Service	1972590495	1972590495	1	1	TEAGLE, LINDA A MD	3/20/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	66866	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	777 KNOWLES DR	STE 7	LOS GATOS	CA	95032	1417	43	06085	37.26160688	-121.9683379	Santa Clara County
284726	Fee-for-Service	1235497249	1235497249	1	1	TUAN, AUGUST S MD	9/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	113566	30	Radiology	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
284771	Fee-for-Service	1699270181	1699270181	1	1	TUR, JAMES B MD	9/6/2023	207R00000X	NA	Other	026	PHYSICIANS	164179	None	None	0	In state provider	None	152 PIONEER LANE	A-H	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
284779	Fee-for-Service	1770534182	1770534182	1	1	TSAI, VIVIAN W MD	5/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82245	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
284781	Fee-for-Service	1124424411	1124424411	1	1	TRUE CARE HOSPICE SOUTHERN	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA INC	7355 TOPANGA CANYON BLVD	SUITE 201	CANOGA PARK	CA	91303	1244	19	06037	34.204383	-118.6059875	Los Angeles County
284798	Fee-for-Service	1518932094	1518932094	1	1	TRI-STATE ORTHOPEDIC	11/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	1	Border provider	INSTITUTE	2000 HIGHWAY 95	STE 200	BULLHEAD CITY	AZ	86442	6057	00	None	35.11494	-114.5975085	Mohave County
284819	Fee-for-Service	1629128285	1629128285	1	1	TIWARI, RAJENDRA K MD	3/1/1983	193400000X	NA	Other	026	PHYSICIANS	26099	14	Neurological Surgery	0	In state provider	None	1500 S CENTRAL AVE	STE 314	GLENDALE	CA	91204	2573	19	06037	34.12736888	-118.257777	Los Angeles County
284865	Fee-for-Service	1669092383	1669092383	1	1	TOBAR, MARIA MD	11/1/2023	207P00000X	NA	Other	026	PHYSICIANS	190162	None	None	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
284947	Fee-for-Service	1124424411	1124424411	1	1	TRUE CARE HOSPICE SOUTHERN	1/31/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA INC	7355 TOPANGA CANYON BLVD	SUITE 201	CANOGA PARK	CA	91303	1244	19	06037	34.204383	-118.6059875	Los Angeles County
284950	Fee-for-Service	1588868020	1588868020	1	1	TARAKJI, AHMAD M MD	2/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115098	02	General Surgery	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
285114	Fee-for-Service	1588868020	1588868020	1	1	TARAKJI, AHMAD M MD	2/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115098	33	Thoracic Surgery	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
285119	Fee-for-Service	1902342611	1902342611	1	1	TRAN TA INC	5/28/2024	193400000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4240 KEARNY MESA RD	101	SAN DIEGO	CA	92111	3769	37	06073	32.81857281	-117.1491983	San Diego County
285136	Fee-for-Service	1114647179	1114647179	1	1	THOMAS, JOSLYN P NP	7/1/2023	363L00000X	NA	Nurse Practitioner	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
285214	Fee-for-Service	1033792882	1033792882	1	1	TAN, ALEXANDER L PHD	5/20/2021	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
285234	Fee-for-Service	1144472168	1144472168	1	1	TOZZI, FEDERICO MD	4/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138294	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
285296	Fee-for-Service	1891157459	1891157459	1	1	TIMBOL, CHRISTIAN R MD	2/8/2020	207P00000X	NA	Other	026	PHYSICIANS	165190	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
285306	Fee-for-Service	1083752810	1083752810	1	1	TEMPLE GARDEN HOMES #3	2/17/1998	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9556 BROADWAY	None	TEMPLE CITY	CA	91780	3135	19	06037	34.10031447	-118.0605254	Los Angeles County
285361	Fee-for-Service	1306843255	1306843255	1	1	TAM, BENJAMIN C MD	6/30/1995	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	77807	20	Orthopedic Surgery	0	In state provider	None	500 N GARFIELD AVE	STE 204	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
285394	Fee-for-Service	1154510386	1154510386	1	1	THONG, LINH L MD	6/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10894	41	Internal Medicine	0	In state provider	None	1310 W STEWART DR	STE 607	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
285415	Fee-for-Service	1386070159	1386070159	1	1	TEKETEL, TEWODROS W MD	9/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128719	41	Internal Medicine	0	In state provider	None	1301 PINOLE VALLEY RD	None	PINOLE	CA	94564	1384	07	06013	37.9991883	-122.2867117	Contra Costa County
285569	Fee-for-Service	1033572995	1033572995	1	1	TAYLOR, DAVID S MD	10/15/2020	208M00000X	NA	Other	026	PHYSICIANS	169407	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
285596	Fee-for-Service	1376640227	1376640227	1	1	TANG, ROBERT C MD	6/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	79602	41	Internal Medicine	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
285656	Fee-for-Service	1801278254	1801278254	1	1	TORRES, MARCELLA V MD	9/11/2017	390200000X	NA	Other	026	PHYSICIANS	145925	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
285730	Fee-for-Service	1003822305	1003822305	1	1	THRIFTY DRUG STORE 5615	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY PAYLESS INC	507 TELEGRAPH CANYON RD	None	CHULA VISTA	CA	91910	6436	37	06073	32.62859648	-117.0410715	San Diego County
285749	Fee-for-Service	1548221989	1548221989	1	1	TOTAL RENAL CARE, INC	4/1/1997	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CHICO DIALYSIS CTR	530 COHASSET RD	None	CHICO	CA	95926	2212	04	06007	39.75152454	-121.848976	Butte County
285752	Fee-for-Service	1376640227	1376640227	1	1	TANG, ROBERT C MD	6/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	79602	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
285778	Fee-for-Service	1174633846	1174633846	1	1	THRIFTY PAYLESS INC	5/10/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6001 COFFEE RD	None	BAKERSFIELD	CA	93308	9414	15	06029	35.41302	-119.092367	Kern County
285805	Fee-for-Service	1124513437	1124513437	1	1	TRAN, DONG M MD	7/19/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165253	None	None	0	In state provider	None	14135 MAIN ST	301	HESPERIA	CA	92345	8092	36	06071	34.42669852	-117.354483	San Bernardino County
285814	Fee-for-Service	1083903124	1083903124	1	2	TORRANCE HEALTH ASSOCIATION	10/20/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2841 LOMITA BLVD	SUITE 235	TORRANCE	CA	90505	5111	19	06037	33.80997064	-118.3374754	Los Angeles County
285887	Fee-for-Service	1205876943	1205876943	1	1	TIMOTHY PAINTER M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7600 BEECHNUT ST	None	HOUSTON	TX	77074	4302	00	None	29.69169348	-95.521563	Harris County
285888	Fee-for-Service	1609294503	1609294503	1	1	TELA, JORDANOS D LMFT	4/25/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
285903	Fee-for-Service	1053365007	1053365007	1	1	TOMASIN, JOHN D MD	5/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	60256	20	Orthopedic Surgery	0	In state provider	None	1310 PRENTICE DR	STE G	HEALDSBURG	CA	95448	5005	49	06097	38.626578	-122.8666945	Sonoma County
285916	Fee-for-Service	1750408381	1750408381	1	1	TAHIR, FARHAN MD	1/11/2024	207RR0500X	NA	Other	026	PHYSICIANS	161749	None	None	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
285936	Fee-for-Service	1033452768	1033452768	1	1	TRAN, MINHCHI MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133546	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
285962	Fee-for-Service	1366633067	1366633067	1	1	TRAN, KHAI Q MD	2/4/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	100786	08	Family Practice	0	In state provider	None	15068 MORAN ST	None	WESTMINSTER	CA	92683	6505	30	06059	33.7434963	-117.9672691	Orange County
285971	Fee-for-Service	1588709992	1588709992	1	1	TAHERPOUR, PARVIZ MD INC	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	28671	01	General Practice	0	In state provider	TEMPLE MEDICAL CENTER	124 N VIGNES ST	None	LOS ANGELES	CA	90012	4030	19	06037	34.04912701	-118.2337626	Los Angeles County
285990	Fee-for-Service	1902210586	1902210586	1	1	TIMENOVICH, MICHELINA L OD	10/19/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2850 N OXNARD BLVD	None	OXNARD	CA	93036	5443	56	06111	34.24320639	-119.178392	Ventura County
286040	Fee-for-Service	1164934642	1164934642	1	1	TABEL, BRITTNEY LCSW	11/15/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
286076	Fee-for-Service	1235577214	1235577214	1	1	TABATA, SIERA L	6/1/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
286107	Fee-for-Service	1235150814	1235150814	1	1	TROJAN, MATTHEW R MD	2/8/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	2	Out of state provider	None	3311 RIVER BEND DR	STE 300	SPRINGFIELD	OR	97477	8800	00	None	44.08199228	-123.0283538	Lane County
286111	Fee-for-Service	1407880594	1407880594	1	1	THEODORE ALLAN STERN MD	2/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	55 FRUIT ST	None	BOSTON	MA	02114	2621	00	None	42.363216	-71.0687745	Suffolk County
286123	Fee-for-Service	1588709992	1588709992	1	1	TAHERPOUR, PARVIZ MD INC	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	28671	08	Family Practice	0	In state provider	TEMPLE MEDICAL CENTER	124 N VIGNES ST	None	LOS ANGELES	CA	90012	4030	19	06037	34.04912701	-118.2337626	Los Angeles County
286162	Fee-for-Service	1720713001	1720713001	1	1	TZ MEDICAL MONITORING SOLUTI	4/9/2023	293D00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	2	Out of state provider	ONS LLC	20497 SW TETON AVE	B	TUALATIN	OR	97062	8812	00	None	45.372258	-122.782079	Washington County
286163	Fee-for-Service	1063988830	1063988830	1	1	THILL, NATALIE LCSW	2/20/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
286191	Fee-for-Service	1235680851	1235680851	1	1	THE SPEECH ACADEMY, INC.	4/15/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	190 S ORCHARD AVE	C200	VACAVILLE	CA	95688	3647	48	06095	38.358945	-122.004786	Solano County
286246	Fee-for-Service	1104803097	1104803097	1	1	TING, GEORGE O MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29368	45	Nephrology (Renal-Kidney)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
286274	Fee-for-Service	1679982649	1679982649	1	1	TRUESDELL, LYNDA K PHD	8/10/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7700 IRVINE CENTER DR	STE 800	IRVINE	CA	92618	3047	30	06059	33.65876225	-117.7500004	Orange County
286277	Fee-for-Service	1235485400	1235485400	1	1	TRIVEDI, RANAK B PHD	10/1/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
286392	Fee-for-Service	1750529707	1750529707	1	1	THRIFTY PAYLESS INC	3/13/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID PHARMACY #06526	3101 GREEN VALLEY RD	None	CAMERON PARK	CA	95682	7647	09	06017	38.69893593	-120.996284	El Dorado County
286401	Fee-for-Service	1346483609	1346483609	1	1	TATE, JOANN E OT	11/19/2018	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
286423	Fee-for-Service	1043482433	1043482433	1	1	TOTAL CONTACT MEDICAL INC	4/15/2008	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	D ORTHOTICS	8201 SANTA FE SPRINGS RD	None	WHITTIER	CA	90606	2718	19	06037	33.96638696	-118.0432953	Los Angeles County
286471	Fee-for-Service	1093950594	1093950594	1	1	TAHOUR, DAVID P MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	112390	30	Radiology	0	In state provider	None	2865 ATLANTIC AVE	SUITE 104	LONG BEACH	CA	90806	7406	19	06037	33.809418	-118.185058	Los Angeles County
286487	Fee-for-Service	1407281223	1407281223	1	1	TEMECULA VALLEY EMERGENCY PH	10/14/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	YSICIANS	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
286495	Fee-for-Service	1376526020	1376526020	1	1	THORNHILL, REX E DPM	7/1/1989	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	806 9TH ST	STE 2C	PASO ROBLES	CA	93446	2567	40	06079	35.62363097	-120.6895907	San Luis Obispo County
286502	Fee-for-Service	1972780120	1972780120	1	1	TSAI, FRANKLIN C MD	4/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	93562	41	Internal Medicine	0	In state provider	None	10862 CALLE VERDE	STE 593	LA MESA	CA	91941	7340	37	06073	32.74823231	-116.9602609	San Diego County
286506	Fee-for-Service	1497436653	1497436653	1	1	TAN, CAROLINE CRNA	2/28/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
286521	Fee-for-Service	1508914409	1508914409	1	1	TSAY, CASSIDY C MD	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60497	41	Internal Medicine	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
286524	Fee-for-Service	1063717429	1063717429	1	1	TERSINE, TINA CRNA	12/14/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
286525	Fee-for-Service	1447443346	1447443346	1	1	TIET, BENJAMIN MD	3/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99095	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
286571	Fee-for-Service	1376556639	1376556639	1	1	TAZEAU, YVETTE N PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2550 SAMARITAN DR	STE E	SAN JOSE	CA	95124	4104	43	06085	37.25247449	-121.9502479	Santa Clara County
286636	Fee-for-Service	1205076593	1205076593	1	1	TALBERT SURGICAL ASSOCIATES	6/21/2010	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	7677 CENTER AVE	STE 104	HUNTINGTON BEACH	CA	92647	3030	30	06059	33.736257	-117.995535	Orange County
286651	Fee-for-Service	1598169864	1598169864	1	1	THRIVE HOME HEALTH INC	7/6/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	10523 BURBANK BLVD	SUITE 202	NORTH HOLLYWOOD	CA	91601	2237	19	06037	34.17216449	-118.36017	Los Angeles County
286714	Fee-for-Service	1669987913	1669987913	1	1	TENDER LOVING HOSPICE CARE	12/16/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	2500 E FOOTHILL BLVD	SUITE 204	PASADENA	CA	91107	3455	19	06037	34.14979547	-118.097982	Los Angeles County
286717	Fee-for-Service	1013942358	1013942358	1	1	TELLA, PRABHAV 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	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
286735	Fee-for-Service	1346328903	1346328903	1	1	TAKEUCHI, KARA M MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	61535	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
286794	Fee-for-Service	1467424671	1467424671	1	1	TRIPP, MICHAEL S MD	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119983	66	Emergency Medicine (Urgent Care)	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
286812	Fee-for-Service	1932755907	1932755907	1	1	THE LOS ANGELES FREE CLINIC	3/1/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6636 SELMA AVE	None	LOS ANGELES	CA	90028	7115	19	06037	34.09968596	-118.3344841	Los Angeles County
286814	Fee-for-Service	1023687365	1023687365	1	1	TEE, CHRISTIN J MD	8/29/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	4300 ROSE DR	None	YORBA LINDA	CA	92886	2026	30	06059	33.89815111	-117.8419708	Orange County
286821	Fee-for-Service	1427204759	1427204759	1	1	TZOU, DAVID T MD	3/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137612	34	Urology and Urological Surgery	0	In state provider	None	1001 POTRERO AVE	ROOM 3A20	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
286854	Fee-for-Service	1669987913	1669987913	1	1	TENDER LOVING HOSPICE CARE	12/16/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	2500 E FOOTHILL BLVD	SUITE 204	PASADENA	CA	91107	3455	19	06037	34.14979547	-118.097982	Los Angeles County
286857	Fee-for-Service	1962852871	1962852871	1	1	THERKELSEN, KATE E	6/14/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	153847	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
286869	Fee-for-Service	1194819458	1194819458	1	1	TOURNAY, ANNE E MD	8/15/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	51284	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	# 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
286933	Fee-for-Service	1467424671	1467424671	1	1	TRIPP, MICHAEL S MD	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119983	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
286952	Fee-for-Service	1932755907	1932755907	1	1	THE LOS ANGELES FREE CLINIC	9/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6636 SELMA AVE	None	LOS ANGELES	CA	90028	7115	19	06037	34.09968596	-118.3344841	Los Angeles County
286972	Fee-for-Service	1013962067	1013962067	1	3	TOWER IMAGING MEDICAL	4/21/2006	2085N0700X	NA	MRI Provider	022	PHYSICIANS GROUP	-	31	Roentgenology, Radiology (M.D. only)	0	In state provider	INC	23929 MCBEAN PKWY	None	VALENCIA	CA	91355	4466	19	06037	34.39588575	-118.5538975	Los Angeles County
287001	Fee-for-Service	1023749371	1023749371	1	1	TALAL MD INC	9/23/2022	207RC0200X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1303 HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
287002	Fee-for-Service	1093733909	1093733909	1	1	TREMMEL, JENNIFER A MD	9/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82309	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
287010	Fee-for-Service	1194819458	1194819458	1	1	TOURNAY, ANNE E MD	8/15/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	51284	79	Neurology-Child	0	In state provider	None	10833 LE CONTE AVE	# 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
287054	Fee-for-Service	1558470989	1558470989	1	1	THRIFTY DRUG STORE 5485	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	888 LINCOLN BLVD	None	VENICE	CA	90291	2866	19	06037	33.99851035	-118.4619444	Los Angeles County
287058	Fee-for-Service	1407923220	1407923220	1	1	TAN, ANTONIUS Y MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	31770	05	Anesthesiology	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
287073	Fee-for-Service	1467424671	1467424671	1	1	TRIPP, MICHAEL S MD	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119983	41	Internal Medicine	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
287092	Fee-for-Service	1932755907	1932755907	1	1	THE LOS ANGELES FREE CLINIC	9/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6636 SELMA AVE	None	LOS ANGELES	CA	90028	7115	19	06037	34.09968596	-118.3344841	Los Angeles County
287093	Fee-for-Service	1003027491	1003027491	2	1	TUPAZ HOMES LLC	6/19/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1602 ORCHARD VIEW DR	None	SAN JOSE	CA	95124	6424	43	06085	37.23448203	-121.9038378	Santa Clara County
287180	Fee-for-Service	1336372549	1336372549	1	1	TONG, JUSTIN W MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115041	41	Internal Medicine	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
287188	Fee-for-Service	1952661027	1952661027	1	2	TRINH VU, MD., INC.	5/16/2023	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1545 SAINT MARKS PLAZA	SUITE 3	STOCKTON	CA	95207	6114	39	06077	37.98892524	-121.3254177	San Joaquin County
287203	Fee-for-Service	1902881469	1902881469	1	1	TESSIER, DERON J MD	12/14/2007	208600000X	NA	General Surgery	026	PHYSICIANS	99173	02	General Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
287264	Fee-for-Service	1508173261	1508173261	1	1	TUASON, MARY S MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118336	41	Internal Medicine	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
287282	Fee-for-Service	1134379183	1134379183	1	1	TUAN V. PHAN, M.D. INC.	8/4/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51069	08	Family Practice	0	In state provider	None	1569 LEXANN AVE	STE 120	SAN JOSE	CA	95121	1793	43	06085	37.30790568	-121.8141983	Santa Clara County
287285	Fee-for-Service	1578096400	1578096400	1	1	TATSUYAMA, CHRISTIE L CRNA	8/8/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
287302	Fee-for-Service	1982960027	1982960027	1	1	TU, STEVEN S MD	7/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128710	05	Anesthesiology	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
287374	Fee-for-Service	1619596897	1619596897	1	1	TENG, JOSEPH T MD	9/1/2023	207R00000X	NA	Other	026	PHYSICIANS	21523	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
287390	Fee-for-Service	1285962134	1285962134	1	1	TAYLOR, JACQUELINE LCSW	3/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14021 AMARGOSA RD	SUITE 100	VICTORVILLE	CA	92392	6404	36	06071	34.50419053	-117.3300794	San Bernardino County
287418	Fee-for-Service	1558470898	1558470898	1	1	THRIFTY PAYLESS INC	5/31/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RITE AID #6480	5350 SHASTA DAM BLVD	None	SHASTA LAKE	CA	96019	9402	45	06089	40.6801535	-122.35158	Shasta County
287427	Fee-for-Service	1649412735	1649412735	1	1	TAPIA, VIRIDIANA J MD	2/1/2022	207L00000X	NA	Other	026	PHYSICIANS	176031	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
287517	Fee-for-Service	1730932443	1730932443	1	1	THU MINH VU MD INC	7/15/2024	261QP2300X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	14571 MAGNOLIA ST	SUITE 106	WESTMINSTER	CA	92683	5575	30	06059	33.75097286	-117.9723502	Orange County
287580	Fee-for-Service	1447781901	1447781901	1	1	THAI, JASON MD	12/8/2023	207L00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
287632	Fee-for-Service	1346594884	1346594884	1	1	TANOUYE, RUTH S	3/7/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	14011 PARK AVE	None	VICTORVILLE	CA	92392	2413	36	06071	34.505647	-117.3265457	San Bernardino County
287682	Fee-for-Service	1417237827	1417237827	1	1	TRIVEDI, REENA D MD	1/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120263	36	Psychiatry	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
287705	Fee-for-Service	1124262860	1124262860	1	1	TURAKHIA, AALOK B MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129859	30	Radiology	0	In state provider	None	300 PASTEUR DR	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
287728	Fee-for-Service	1629245840	1629245840	1	1	TAYLOR, ROBERT M MD	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97954	41	Internal Medicine	0	In state provider	None	2333 BUCHANAN STREET	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
287772	Fee-for-Service	1780736033	1780736033	1	1	TRUMM, ROBERT OD	9/30/1993	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
287806	Fee-for-Service	1952508244	1952508244	1	1	TROST, JONATHAN D LMFT	9/7/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
287829	Fee-for-Service	1235107566	1235107566	1	4	THE REGENTS OF THE UNIVERSIT	7/30/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
287855	Fee-for-Service	1295809929	1295809929	1	1	THOMAS, JODY D PHD	2/14/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
287913	Fee-for-Service	1356510002	1356510002	1	1	TOFIYES, INC.	3/3/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	REHOBOT DISCOUNT MED SUP	577 NORTH D STREET	STE 106	SAN BERNARDINO	CA	92401	1326	36	06071	34.109613	-117.291874	San Bernardino County
287955	Fee-for-Service	1588671176	1588671176	1	1	TORRALBA, KARINA M MD	1/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	73731	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	STE 1000	LOS ANGELES	CA	90033	5312	19	06037	34.06269295	-118.2030006	Los Angeles County
287989	Fee-for-Service	1093890766	1093890766	1	1	THOMAS, SCOTT A DO	3/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8590	05	Anesthesiology	0	In state provider	None	425 W JUNIPERO ST	STE 3	SANTA BARBARA	CA	93105	4294	42	06083	34.42973253	-119.7249544	Santa Barbara County
288005	Fee-for-Service	1801037858	1801037858	1	1	TOLEDO, ABEL C MD INC	4/13/2009	261QP2300X	NA	Other	026	PHYSICIANS	67360	01	General Practice	0	In state provider	None	330 OXFORD STREET	SUITE 110	CHULA VISTA	CA	91911	3117	37	06073	32.60985611	-117.0691868	San Diego County
288046	Fee-for-Service	1386941912	1386941912	1	1	TROVATO MEDICAL GROUP INC	8/22/2011	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	DOCTORS EXPRESS OF	5763 STEVENSON BLVD	None	NEWARK	CA	94560	5301	01	06001	37.51974756	-121.9902619	Alameda County
288082	Fee-for-Service	1588671176	1588671176	1	1	TORRALBA, KARINA M MD	1/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	73731	83	Rheumatology	0	In state provider	None	1520 SAN PABLO ST	STE 1000	LOS ANGELES	CA	90033	5312	19	06037	34.06269295	-118.2030006	Los Angeles County
288086	Fee-for-Service	1972086882	1972086882	1	2	TAGALOA-TULIFAU FOOT AND ANK	10/2/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	LE CENTER, INC.	23517 MAIN ST	SUITE 105	CARSON	CA	90745	5236	19	06037	33.81129174	-118.2756933	Los Angeles County
288114	Fee-for-Service	1245432855	1245432855	1	1	TRINITY COUNTY BEHAVIORAL	3/27/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	HEALTH SERVICES	1450 MAIN STREET	None	WEAVERVILLE	CA	96093	0000	53	06105	40.72339821	-122.9297505	Trinity County
288132	Fee-for-Service	1689680100	1689680100	1	1	TUN, PEGGY	1/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	27696	None	None	0	In state provider	None	2660 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4315	43	06085	37.36653288	-122.0778348	Santa Clara County
288162	Fee-for-Service	1063716462	1063716462	1	1	TAYLOR, KATE B PHD	7/27/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD BLVD	None	LOS ANGELES	CA	90095	8631	19	06037	34.07067	-118.4432445	Los Angeles County
288163	Fee-for-Service	1629201793	1629201793	1	1	TRETOLA, MARY R LMFT	9/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1451 RIMPAU AVE	STE 215	CORONA	CA	92879	0000	33	06065	33.86546916	-117.5455079	Riverside County
288166	Fee-for-Service	1386941912	1386941912	1	1	TROVATO MEDICAL GROUP INC	8/22/2011	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	DOCTORS EXPRESS OF	5763 STEVENSON BLVD	None	NEWARK	CA	94560	5301	01	06001	37.51974756	-121.9902619	Alameda County
288213	Fee-for-Service	1316958630	1316958630	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PAYLESS DRUG STORE 5836	2410 S BROADWAY	None	SANTA MARIA	CA	93454	7818	42	06083	34.91610002	-120.4358467	Santa Barbara County
288214	Fee-for-Service	1013031541	1013031541	1	1	TRADITION ONE	2/8/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4104, 4114, 4124 DELTA S	None	SAN DIEGO	CA	92113	4113	37	06073	32.68880664	-117.1053879	San Diego County
288247	Fee-for-Service	1225086028	1225086028	1	1	TEMPE ST LUKES HOSP	7/21/2000	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1500 S MILL AVE	None	TEMPE	AZ	85281	6699	00	None	33.41223	-111.9402765	Maricopa County
288259	Fee-for-Service	1972162576	1972162576	1	1	TSANG, MAN CARINA LCSW	7/3/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2357 RALSTON DR	None	SAN JOSE	CA	95148	4036	43	06085	37.31424668	-121.799332	Santa Clara County
288265	Fee-for-Service	1104056092	1104056092	1	1	THOMAS, DANIELLE J DO	9/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2825 EAST BARNETT ROAD	None	MEDFORD	OR	97504	8332	00	None	42.31650147	-122.8306005	Jackson County
288274	Fee-for-Service	1154350155	1154350155	1	1	THEODOSOPOULOS, PHILIP MD	7/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	64860	14	Neurological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
288363	Fee-for-Service	1225086028	1225086028	1	1	TEMPE ST LUKES HOSP	7/21/2000	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1500 S MILL AVE	None	TEMPE	AZ	85281	6699	00	None	33.41223	-111.9402765	Maricopa County
288381	Fee-for-Service	1104056092	1104056092	1	1	THOMAS, DANIELLE J DO	9/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2825 EAST BARNETT ROAD	None	MEDFORD	OR	97504	8332	00	None	42.31650147	-122.8306005	Jackson County
288480	Fee-for-Service	1609458587	1609458587	1	1	TATE, KAREN E MD	3/21/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184730	08	Family Practice	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
288536	Fee-for-Service	1881884955	1881884955	1	1	TAKANO, SCOTT L MD	7/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1720 CESAR CHAVEZ	None	LOS ANGELES	CA	90033	2462	19	06037	34.04925	-118.2177405	Los Angeles County
288542	Fee-for-Service	1659807378	1659807378	1	1	TURK, TAMMY H LMFT	7/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	419 W FOOTHILL BLVD	None	MONROVIA	CA	91016	2025	19	06037	34.15128951	-118.008477	Los Angeles County
288559	Fee-for-Service	1902196355	1902196355	1	1	TOTAL RENAL CARE INC	7/1/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	100 S SAN MATEO DRIVE	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
288567	Fee-for-Service	1710182845	1710182845	1	1	THORNTON, LINDA S LCSW	6/18/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER 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
288745	Fee-for-Service	1760591283	1760591283	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	THRIFTY DRUG STORE #5508	15924 BELLFLOWER BLVD	None	BELLFLOWER	CA	90706	4602	19	06037	33.88849403	-118.125258	Los Angeles County
288751	Fee-for-Service	1417581349	1417581349	1	1	TAULA-FILEMU, DOROTHY P CNP	3/28/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	19121 BEACH BLVD	None	HUNTINGTON BEACH	CA	92648	2307	30	06059	33.685155	-117.988868	Orange County
288793	Fee-for-Service	1952185332	1952185332	1	1	TELLEZ GUERRERO, DANIEL N DO	2/17/2025	390200000X	NA	Other	026	PHYSICIANS	23401	08	Family Practice	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
288813	Fee-for-Service	1265274278	1265274278	1	1	TINOCO, BEATRIZ BIRTH DOULA	6/11/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	41	06081	0	0	None
288842	Fee-for-Service	1689170516	1689170516	1	1	TALLAM, NITIN P MD	11/8/2022	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	175972	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
288852	Fee-for-Service	1306180146	1306180146	1	1	THU, YE MD	11/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134154	77	Infectious Disease	0	In state provider	None	510 DOYLE PARK DR	None	SANTA ROSA	CA	95405	4570	49	06097	38.442618	-122.6984265	Sonoma County
288872	Fee-for-Service	1942348115	1942348115	1	1	THOMPSON, ERIC D LMFT	5/3/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
288880	Fee-for-Service	1912311861	1912311861	1	1	TOPRANI, SHEELA MD	7/1/2021	390200000X	NA	Other	026	PHYSICIANS	163110	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
288905	Fee-for-Service	1336250935	1336250935	1	1	TAYLOR, ERIC A MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84111	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
288923	Fee-for-Service	1164500773	1164500773	2	1	TRAN, TOAN H MD	5/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	37620	01	General Practice	0	In state provider	None	4545 GEORGETOWN PLACE	STE C16	STOCKTON	CA	95207	6230	39	06077	37.98906659	-121.3134248	San Joaquin County
288954	Fee-for-Service	1306180146	1306180146	1	1	THU, YE MD	11/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134154	41	Internal Medicine	0	In state provider	None	510 DOYLE PARK DR	None	SANTA ROSA	CA	95405	4570	49	06097	38.442618	-122.6984265	Sonoma County
288981	Fee-for-Service	1861587073	1861587073	1	2	TAO T. NGUYEN MD, INC	5/15/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	6043 ATLANTIC BLVD.	None	MAYWOOD	CA	90270	3118	19	06037	33.98403374	-118.1861291	Los Angeles County
289000	Fee-for-Service	1851478713	1851478713	1	1	THAYER, KIMBERLY S MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60138	34	Urology and Urological Surgery	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
289011	Fee-for-Service	1881165942	1881165942	1	1	TAGUINOD, EUGENE V RCP	1/25/2024	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
289059	Fee-for-Service	1497847560	1497847560	1	1	TAN, SOON-MIN MD	5/16/2005	207RR0500X	NA	Other	026	PHYSICIANS	66493	41	Internal Medicine	0	In state provider	ARTHRITIS & RHEUMATOLOGY	488 E SANTA CLARA ST	STE 104	ARCADIA	CA	91006	7231	19	06037	34.14235063	-118.0211625	Los Angeles County
289066	Fee-for-Service	1922341205	1922341205	1	1	TSAI, STEVEN C MD	6/29/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	134439	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
289102	Fee-for-Service	1508828856	1508828856	1	1	TANTAMJARIK, SRIVIMOL MD	11/11/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	31595	None	None	0	In state provider	None	1919 N FAIRVIEW ST	STE 218	SANTA ANA	CA	92706	2245	30	06059	33.76258416	-117.9028357	Orange County
289108	Fee-for-Service	1811503675	1811503675	1	1	TONNU, CAMTU NP	12/5/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25431 CABOT RD	STE 118	LAGUNA HILLS	CA	92653	5527	30	06059	33.59115448	-117.6744575	Orange County
289111	Fee-for-Service	1861415390	1861415390	1	1	TA, VIET D MD	8/1/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	69957	08	Family Practice	0	In state provider	None	15576 MAIN ST	None	HESPERIA	CA	92345	3482	36	06071	34.42464781	-117.322468	San Bernardino County
289131	Fee-for-Service	1760642417	1760642417	1	1	TRUTANIC, JULIE R DO	10/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11227	08	Family Practice	0	In state provider	None	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
289148	Fee-for-Service	1154731693	1154731693	1	1	THIRI, NAY N MD	12/21/2017	207R00000X	NA	Other	026	PHYSICIANS	150767	41	Internal Medicine	0	In state provider	None	6555 COYLE AVENUE	SUITE 280	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
289161	Fee-for-Service	1497847560	1497847560	1	1	TAN, SOON-MIN MD	5/16/2005	207RR0500X	NA	Other	026	PHYSICIANS	66493	83	Rheumatology	0	In state provider	ARTHRITIS & RHEUMATOLOGY	488 E SANTA CLARA ST	STE 104	ARCADIA	CA	91006	7231	19	06037	34.14235063	-118.0211625	Los Angeles County
289164	Fee-for-Service	1881191591	1881191591	1	1	TIPTON, LAUREN A MD	4/14/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	166413	None	None	0	In state provider	None	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
289168	Fee-for-Service	1306963400	1306963400	1	1	THOMSON, PATE D MD	6/26/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	11964	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
289170	Fee-for-Service	1922341205	1922341205	1	1	TSAI, STEVEN C MD	6/29/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	134439	68	Hematology	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
289405	Fee-for-Service	1710111950	1710111950	1	1	TRINITY CARE PHARMA INC	7/31/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	TRINITY CARE RX	8381 KATELLA AVE	STE O	STANTON	CA	90680	3246	30	06059	33.8030105	-117.98613	Orange County
289418	Fee-for-Service	1346481256	1346481256	1	1	THEMAN, TODD A MD	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137182	24	Plastic Surgery	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
289429	Fee-for-Service	1164408969	1164408969	1	1	TASHKIN, JONATHAN S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CAREPOINT PC	2550 S PARKER RD	STE 206	AURORA	CO	80014	1679	00	None	39.670515	-104.8642785	Arapahoe County
289438	Fee-for-Service	1730776261	1730776261	2	3	TESSA'S PLACE INC	4/16/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	25321 DE SALLE ST	None	LAGUNA HILLS	CA	92653	5049	30	06059	33.59468979	-117.6856134	Orange County
289445	Fee-for-Service	1871911081	1871911081	1	1	TERCA, DAVID A MD	7/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
289448	Fee-for-Service	1477229656	1477229656	1	1	TRUE HANDS HOME HEALTH INC	3/22/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8953 WOODMAN AVE	STE 106	ARLETA	CA	91331	8001	19	06037	34.23249056	-118.4383491	Los Angeles County
289478	Fee-for-Service	1760921423	1760921423	1	1	TRINITY MEDICAL PC	8/4/2017	193400000X	NA	Other	026	PHYSICIANS	80383	01	General Practice	0	In state provider	None	70O RIVER DR	None	FORT BRAGG	CA	95437	5403	23	06045	39.43094317	-123.8012048	Mendocino County
289489	Fee-for-Service	1265992606	1265992606	1	1	TRAN, KATHERINE M MD	7/1/2022	207P00000X	NA	Other	026	PHYSICIANS	179752	None	None	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
289495	Fee-for-Service	1932165263	1932165263	1	1	TO, STEPHEN YAN C MD	12/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75106	30	Radiology	0	In state provider	None	18200 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4216	19	06037	34.22074797	-118.5301877	Los Angeles County
289508	Fee-for-Service	1194977074	1194977074	1	1	TAYLOR, CECILLE G MD INC	6/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	67853	18	Ophthalmology	0	In state provider	None	1615 CREEKSIDE DR	STE 110	FOLSOM	CA	95630	3491	34	06067	38.670813	-121.148046	Sacramento County
289516	Fee-for-Service	1932667433	1932667433	1	1	TOPANGA PLACE INC	9/16/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	22124 VENTURA BLVD	None	WOODLAND HILLS	CA	91364	1660	19	06037	34.16858395	-118.6090245	Los Angeles County
289565	Fee-for-Service	1730817313	1730817313	1	1	TARIN, AISHA NP	3/22/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2915 TELEGRAPH AVENUE	SUITE 101	BERKELEY	CA	94705	2069	01	06001	37.85719633	-122.2595246	Alameda County
289635	Fee-for-Service	1861854135	1861854135	1	1	TANG, ANNIE MD	7/17/2023	2086X0206X	NA	General Surgery	026	PHYSICIANS	152196	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
289645	Fee-for-Service	1437579786	1437579786	1	1	TIDWELL, GRACE R MD	12/19/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	160389	-	NOT APPLICABLE	0	In state provider	None	3550 Q ST	STE 101	BAKERSFIELD	CA	93301	1645	15	06029	35.391978	-119.0105025	Kern County
289653	Fee-for-Service	1194787770	1194787770	1	1	TANDON, MEENA MD	3/31/1989	207ZC0500X	NA	Other	026	PHYSICIANS	43622	22	Pathology (M.D. only)	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
289662	Fee-for-Service	1205517166	1205517166	1	1	THE BEE MEDICAL SUPPLIES	11/12/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	11082 COLOMA RD	10	RANCHO CORDOVA	CA	95670	2875	34	06067	38.617317	-121.272642	Sacramento County
289711	Fee-for-Service	1013942648	1013942648	1	1	TEISCH, JOEL A MD	1/1/1982	207N00000X	NA	Dermatology	026	PHYSICIANS	11837	07	Dermatology	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
289769	Fee-for-Service	1356429419	1356429419	1	1	TOM, RANDALL K DPM	5/10/2004	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
289771	Fee-for-Service	1649699737	1649699737	1	1	TAYLOR, DOUGLAS F DO	3/22/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	18505	None	None	0	In state provider	None	1000 TRANCAS ST	SUITE 1	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
289794	Fee-for-Service	1124045778	1124045778	1	1	TAMER, MOUSSA P MD	4/23/1999	174400000X	NA	Other	026	PHYSICIANS	67142	None	None	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
289824	Fee-for-Service	1376559666	1376559666	1	1	THRIFTY PAYLESS INC	2/21/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8985 MIRA MESA BLVD	None	SAN DIEGO	CA	92126	2716	37	06073	32.91497667	-117.1312697	San Diego County
289880	Fee-for-Service	1962519652	1962519652	1	1	TSUCHIYA, PAMELA Y MD	11/30/1993	207W00000X	NA	Ophthalmology	026	PHYSICIANS	74382	18	Ophthalmology	0	In state provider	None	1617 SAINT MARKS PLZ	STE D	STOCKTON	CA	95207	6423	39	06077	37.98864819	-121.3268062	San Joaquin County
289907	Fee-for-Service	1548655673	1548655673	1	1	TOLUCA SPEECH AND LANGUAGE I	11/20/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3808 W RIVERSIDE DR.	405	BURBANK	CA	91505	4339	19	06037	34.15252315	-118.3412174	Los Angeles County
289921	Fee-for-Service	1558650945	1558650945	1	1	THOMPSON, CHRISTOPHER F MD	8/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	116862	04	Otology, Laryngology, Rhinology	0	In state provider	None	26726 CROWN VALLEY PKWY	SUITE 200	MISSION VIEJO	CA	92691	8003	30	06059	33.56385623	-117.6639538	Orange County
289965	Fee-for-Service	1063636223	1063636223	1	1	TRI-CITY HEALTH CENTER	12/22/2004	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	LIBERTY	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
289972	Fee-for-Service	1245248848	1245248848	1	1	TSENG, YANG-CHERN MD	6/22/2012	207L00000X	NA	Other	026	PHYSICIANS	41269	08	Family Practice	0	In state provider	None	100 S RAYMOND AVENUE	None	ALHAMBRA	CA	91801	3166	19	06037	34.09027878	-118.1450083	Los Angeles County
289974	Fee-for-Service	1003976325	1003976325	1	1	TEICHNER, RODNEY L MD	9/1/2001	207L00000X	NA	Other	026	PHYSICIANS	86205	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
289992	Fee-for-Service	1699183673	1699183673	1	1	TRAJANO, CHARMINE D OD	2/22/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	890 EASTLAKE PARKWAY	SUITE 102	CHULA VISTA	CA	91914	4521	37	06073	32.65223126	-116.9677279	San Diego County
290006	Fee-for-Service	1194170399	1194170399	1	1	TALEB, AHMED MD	12/13/2024	207R00000X	NA	Other	026	PHYSICIANS	182738	41	Internal Medicine	0	In state provider	None	6601 WHITE FEATHER ROAD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
290009	Fee-for-Service	1033468053	1033468053	1	1	TUCHMAN, ELANI PSYD	11/2/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	23822 VALENCIA BLVD	207	VALENCIA	CA	91355	5302	19	06037	34.41372708	-118.5513626	Los Angeles County
290035	Fee-for-Service	1669407268	1669407268	1	1	TOHM, DONALD G MD	2/8/2015	207W00000X	NA	Ophthalmology	026	PHYSICIANS	55650	18	Ophthalmology	0	In state provider	WESTCHESTER EYE MED CLIN	1701 26TH ST	None	BAKERSFIELD	CA	93301	2803	15	06029	35.3828695	-119.021481	Kern County
290036	Fee-for-Service	1245248848	1245248848	1	1	TSENG, YANG-CHERN MD	6/22/2012	207L00000X	NA	Other	026	PHYSICIANS	41269	05	Anesthesiology	0	In state provider	None	100 S RAYMOND AVENUE	None	ALHAMBRA	CA	91801	3166	19	06037	34.09027878	-118.1450083	Los Angeles County
290062	Fee-for-Service	1336196864	1336196864	1	1	TULPULE, RADHIKA MD INC	6/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	45187	41	Internal Medicine	0	In state provider	None	110 N FOURTH AVE	None	COVINA	CA	91723	1928	19	06037	34.08644652	-117.8944351	Los Angeles County
290104	Fee-for-Service	1427499268	1427499268	1	1	TSAO, DEREK Y C MD	10/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149523	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LN	STE 450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
290150	Fee-for-Service	1841472248	1841472248	1	1	TAYAMA, DARREN Y MD	6/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96852	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
290160	Fee-for-Service	1972549806	1972549806	1	1	TINDALL, LORI M CRNA	5/22/2003	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
290205	Fee-for-Service	1023730926	1023730926	2	1	TUNNEY, SARAH E PHD	9/4/2024	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	435 S CEDROS AVE	SUITE 304	SOLANA BEACH	CA	92075	0000	37	06073	32.98699521	-117.2694503	San Diego County
290232	Fee-for-Service	1205272747	1205272747	1	1	THOMAS, WILSON G MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135759	40	Pediatrics	0	In state provider	None	25845 BARTON ROAD	SUITE F	LOMA LINDA	CA	92354	3899	36	06071	34.04824949	-117.2401425	San Bernardino County
290233	Fee-for-Service	1629124417	1629124417	1	1	TSIMIKAS, SOTIRIOS MD	9/30/1995	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	73170	01	General Practice	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
290237	Fee-for-Service	1427007780	1427007780	1	1	THOMAS W HEJKAL, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	988095 NEBRASKA MEDICAL	None	OMAHA	NE	68198	0000	00	None	0	0	None
290258	Fee-for-Service	1962497826	1962497826	1	1	TOYOS, ROLANDO MD	8/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	63430	18	Ophthalmology	0	In state provider	None	450 N ROXBURY DR	3RD FL	BEVERLY HILLS	CA	90210	4231	19	06037	34.06820793	-118.4070317	Los Angeles County
290374	Fee-for-Service	1083903124	1083903124	1	3	TORRANCE HEALTH ASSOCIATION	10/20/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3330 LOMITA BLVD	CARDIOLOGY DEPARTMENT	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
290381	Fee-for-Service	1659908259	1659908259	1	1	TUPPER, HALEY MD	4/4/2023	390200000X	NA	Other	026	PHYSICIANS	180427	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
290390	Fee-for-Service	1942522453	1942522453	1	1	THORSEN, HALIMA A	1/11/2013	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
290416	Fee-for-Service	1184063034	1184063034	1	1	THOMAS, RANDI L CCC-SLP	9/2/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
290420	Fee-for-Service	1083903124	1083903124	1	3	TORRANCE HEALTH ASSOCIATION	10/20/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3330 LOMITA BLVD	CARDIOLOGY DEPARTMENT	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
290455	Fee-for-Service	1154521730	1154521730	1	1	TABIBIAN, PARICHEHR A MD	7/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94719	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
290463	Fee-for-Service	1083903124	1083903124	1	3	TORRANCE HEALTH ASSOCIATION	10/20/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3330 LOMITA BLVD	CARDIOLOGY DEPARTMENT	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
290489	Fee-for-Service	1043494065	1043494065	1	1	TSENG, MARISA M MD	6/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109310	None	None	0	In state provider	None	101 THE CITY DRIVE	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
290498	Fee-for-Service	1700902798	1700902798	1	2	TARZANA TREATMENT CENTERS, I	3/25/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	44447 N 10TH STREET W	BUILDING C	TARZANA	CA	91356	3324	19	06037	0	0	None
290514	Fee-for-Service	1407236862	1407236862	1	1	TELLEZ, JUAN F DO	8/28/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	15130	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
290585	Fee-for-Service	1023194495	1023194495	1	1	TOMOOKA, LANCE T MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82125	40	Pediatrics	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
290589	Fee-for-Service	1457439242	1457439242	1	1	TURZAN, CHARLES W MD	12/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	47312	34	Urology and Urological Surgery	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
290617	Fee-for-Service	1699766212	1699766212	1	1	TOTAL HOME HEALTH	8/20/2015	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	440 W. COLORADO ST	208A	GLENDALE	CA	91204	1541	19	06037	34.14249549	-118.2628035	Los Angeles County
290635	Fee-for-Service	1225340276	1225340276	1	1	TERCERO, ROSALBA LMFT	8/28/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15336 DEVONSHIRE ST	UNIT 6	MISSION HILLS	CA	91345	2755	19	06037	34.25726849	-118.4664285	Los Angeles County
290693	Fee-for-Service	1588069553	1588069553	1	1	TORRES, JANELLE A LCSW	10/16/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1240 POWELL ST	STE 2D	EMERYVILLE	CA	94608	2600	01	06001	37.84016613	-122.2860284	Alameda County
290694	Fee-for-Service	1083749204	1083749204	1	1	TAGORE, TARLOCHAN S MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31400	None	None	0	In state provider	None	1822 JENSEN AVE	None	SANGER	CA	93657	2811	10	06019	36.70728951	-119.5635105	Fresno County
290695	Fee-for-Service	1912606690	1912606690	1	4	TAHMINA HAQ MD	1/14/2025	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	801 N TUSTIN AVE	STE 700	SANTA ANA	CA	92705	3611	30	06059	33.752286	-117.8341735	Orange County
290701	Fee-for-Service	1497731822	1497731822	1	1	TEW, JOSHUA B MD	2/14/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	None	None	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
290727	Fee-for-Service	1912606690	1912606690	1	4	TAHMINA HAQ MD	1/14/2025	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	801 N TUSTIN AVE	STE 700	SANTA ANA	CA	92705	3611	30	06059	33.752286	-117.8341735	Orange County
290759	Fee-for-Service	1174103451	1174103451	1	1	TAITANO, DANIEL C MD	6/28/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	None	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
290762	Fee-for-Service	1508278359	1508278359	1	4	THE ROADS FOUNDATION	1/20/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	4800 EAST LOS COYOTES DI	None	LONG BEACH	CA	90815	2897	19	06037	33.79304077	-118.1378147	Los Angeles County
290770	Fee-for-Service	1235107566	1235107566	1	1	THE REGENTS OF THE UNIVERSIT	9/24/2019	207Q00000X	NA	Adult Primary Care	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	UCLA DEPT OF MEDICINE	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
290772	Fee-for-Service	1235150467	1235150467	1	1	TRANSFIGURACION, C J DPM	10/5/2005	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1701 CESAR CHAVEZ AVE	STE 100	LOS ANGELES	CA	90033	0000	19	06037	34.05112725	-118.2173921	Los Angeles County
290791	Fee-for-Service	1508278359	1508278359	1	4	THE ROADS FOUNDATION	1/20/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	4800 EAST LOS COYOTES DI	None	LONG BEACH	CA	90815	2897	19	06037	33.79304077	-118.1378147	Los Angeles County
290792	Fee-for-Service	1336349158	1336349158	1	1	TANDON, TEENA MD	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2227	00	None	36.1590063	-115.1674415	Clark County
290794	Fee-for-Service	1235107566	1235107566	1	1	THE REGENTS OF THE UNIVERSIT	1/18/2017	207Q00000X	NA	Adult Primary Care	031	PSYCHOLOGISTS	-	None	None	0	In state provider	UCLA DEPT OF MEDICINE	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
290825	Fee-for-Service	1235107566	1235107566	1	1	THE REGENTS OF THE UNIVERSIT	8/1/1991	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	UCLA DEPT OF MEDICINE	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
290835	Fee-for-Service	1063874840	1063874840	1	1	TSUI, ILENE K MD	8/17/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154639	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1700 N ROSE AVE	STE 280	OXNARD	CA	93030	7645	56	06111	34.21746	-119.155545	Ventura County
290940	Fee-for-Service	1689255697	1689255697	1	1	TRAN, PATRICK MD	3/13/2025	207N00000X	NA	Dermatology	026	PHYSICIANS	180144	07	Dermatology	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
290969	Fee-for-Service	1518015346	1518015346	1	1	TABET, JOSEPH A MD	3/31/1985	204D00000X	NA	Other	026	PHYSICIANS	41959	20	Orthopedic Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
290976	Fee-for-Service	1013646439	1013646439	1	1	TPIRC MEDICAL FOUNDATION INC	7/25/2022	2080P0201X	NA	Neurology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2790 ATLANTIC AVE	None	LONG BEACH	CA	90806	2755	19	06037	33.807708	-118.185004	Los Angeles County
291055	Fee-for-Service	1700029105	1700029105	1	1	THAI, QUAN B NP	10/24/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
291058	Fee-for-Service	1972650380	1972650380	1	1	TULARE CITY SCHOOL DIST	3/29/1994	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	600 N CHERRY ST	None	TULARE	CA	93274	2978	54	06107	36.21679761	-119.3375929	Tulare County
291073	Fee-for-Service	1831365345	1831365345	1	1	TROCCIOLA, SUSAN M MD	11/8/2021	208G00000X	NA	General Surgery	026	PHYSICIANS	174144	None	None	0	In state provider	None	1541 FLORIDA AVE	SUITE 305	MODESTO	CA	95350	4439	50	06099	37.666863	-120.9962775	Stanislaus County
291137	Fee-for-Service	1104273655	1104273655	1	1	TRELOAR, MACKENZIE S MD	9/11/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168892	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
291157	Fee-for-Service	1982933909	1982933909	1	1	TIKOTEKAR, ASHISH A MD	2/1/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	183513	None	None	0	In state provider	None	6555 COYLE AVENUE	STE 215	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
291177	Fee-for-Service	1154468924	1154468924	1	2	THU, AUNG MD INC	11/17/2010	173000000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	27851 BRADLEY RD	STE 180	SUN CITY	CA	92586	2245	33	06065	33.71630969	-117.1904696	Riverside County
291204	Fee-for-Service	1497124689	1497124689	1	1	TT PHARMACY INC	10/27/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1863 ALUM ROCK AVE	SUITE A	SAN JOSE	CA	95116	1397	43	06085	37.35412711	-121.8528521	Santa Clara County
291237	Fee-for-Service	1740673516	1740673516	1	1	THE LAKES TREATMENT CENTER	12/12/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	7260 O'BYRNES FERRY RD	None	COPPEROPOLIS	CA	95228	9761	05	06009	37.89619081	-120.5739836	Calaveras County
291246	Fee-for-Service	1629113675	1629113675	1	1	TAN, TINA O MD	3/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91875	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
291248	Fee-for-Service	1740673516	1740673516	1	1	THE LAKES TREATMENT CENTER	12/12/2016	324500000X	NA	Other	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	7260 O'BYRNES FERRY RD	None	COPPEROPOLIS	CA	95228	9761	05	06009	37.89619081	-120.5739836	Calaveras County
291310	Fee-for-Service	1922069319	1922069319	1	1	TOTAL RENAL CARE, INC	3/1/1999	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	7500 WEST LN	None	STOCKTON	CA	95210	3312	39	06077	38.01793904	-121.294539	San Joaquin County
291338	Fee-for-Service	1710343785	1710343785	1	1	TREADAWAY, JOLENE M LCSW	1/21/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	97579	-	NOT APPLICABLE	0	In state provider	None	675 FIRST STREET	None	UPPER LAKE	CA	95485	9586	17	06033	39.16426454	-122.903172	Lake County
291353	Fee-for-Service	1013171230	1013171230	1	1	TAGANAS, ANDRELEE G MD	9/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115620	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
291355	Fee-for-Service	1225697964	1225697964	1	1	TRISTAN, ROBERT LMFT	12/10/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
291385	Fee-for-Service	1518228188	1518228188	1	1	TSANG, RUEY-SHIUAN T MD	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127164	40	Pediatrics	0	In state provider	None	3030 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798889	-117.150826	San Diego County
291395	Fee-for-Service	1700831534	1700831534	1	1	TRACY JOHN PIERRET, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	901 4TH ST NW	None	WATERTOWN	SD	57201	1558	00	None	44.91086485	-97.12034581	Codington County
291409	Fee-for-Service	1437120532	1437120532	2	1	TRUSCELLO, ANN M MD	7/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68634	40	Pediatrics	0	In state provider	None	1400 FLORIDA AVE	STE 202	MODESTO	CA	95350	4445	50	06099	37.66410995	-120.996159	Stanislaus County
291484	Fee-for-Service	1104976091	1104976091	1	1	TSAI, JERRY MD	3/18/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	91081	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
291490	Fee-for-Service	1578533253	1578533253	1	1	TUPAS, WILFREDO M MD	10/31/1990	207R00000X	NA	Other	026	PHYSICIANS	49615	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
291521	Non-Physician Medical Practitioner	None	1942970769	0	0	TRAN, AMANDA R PA-C	9/19/2023	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	2393	00	06000	32.72663119	-117.1611714	San Diego County
291543	Non-Physician Medical Practitioner	None	1245779669	0	0	TSUKAHARA, LOUISE M NP	3/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2560 S CENTINELA AVE	APT 14	LOS ANGELES	CA	90064	2775	00	06000	34.02423849	-118.449649	Los Angeles County
291555	Non-Physician Medical Practitioner	None	1235307802	0	0	TAUBMAN, DEBORAH ANNE	3/3/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4911 VAN NUYS BLVD	SUITE 100	SHERMAN OAKS	CA	91403	1716	00	06000	34.1596563	-118.4487403	Los Angeles County
291560	Non-Physician Medical Practitioner	None	1508110065	0	0	TRAN, NGAN K	12/28/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	157 COVINGTON CT	None	SAN JOSE	CA	95136	2312	00	06000	37.27237586	-121.8375751	Santa Clara County
291566	Non-Physician Medical Practitioner	None	1285452102	0	0	THIPPA, PRATIBHA P PA-C	11/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1205 E NORTH STREET	None	MANTECA	CA	95336	4932	00	06000	37.80110374	-121.1974853	San Joaquin County
291576	Non-Physician Medical Practitioner	None	1619476942	0	0	TOUCEY, BEN J PA	1/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	00	06000	33.82736911	-116.5109632	Riverside County
291643	Non-Physician Medical Practitioner	None	1689900995	0	0	TRUONG, MICHAEL D	11/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5317 W 137TH PLACE	None	HAWTHORNE	CA	90250	6425	00	06000	33.90721448	-118.372923	Los Angeles County
291662	Non-Physician Medical Practitioner	None	1396218236	0	0	TAUER, MELISSA K NP	10/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	00	06000	34.06704253	-118.3835029	Los Angeles County
291669	Non-Physician Medical Practitioner	None	1780054379	0	0	TRI-CITY HEALTH CENTER	11/15/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	40910 FREMONT BLVD	None	FREMONT	CA	94538	4375	00	06000	37.53384106	-121.9607241	Alameda County
291741	Non-Physician Medical Practitioner	None	1235884941	0	0	TRAN, LINH	4/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6529 RIVERSIDE AVE	SUITE 133	RIVERSIDE	CA	92506	3122	00	06000	33.94754553	-117.3881459	Riverside County
291750	Non-Physician Medical Practitioner	None	1164771747	0	0	THE ACHIEVABLE FOUNDATION	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	5901 GREEN VALLEY CIR	SUITE 405	CULVER CITY	CA	90230	6938	00	06000	33.98409358	-118.3923715	Los Angeles County
291765	Non-Physician Medical Practitioner	None	1225676745	0	0	THOMAS, LEONA NP	8/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3838 SAN DIMAS ST	STE B100	BAKERSFIELD	CA	93301	2285	00	06000	35.3946385	-119.008203	Kern County
291784	Non-Physician Medical Practitioner	None	1710475462	0	0	TAN, MATTHEW PA-C	8/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	309 WEST BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	00	06000	34.01597577	-118.1003516	Los Angeles County
291791	Non-Physician Medical Practitioner	None	1770178758	0	0	TAPP, AMANDA C NP	3/17/2021	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	# B10	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
291849	Non-Physician Medical Practitioner	None	1114425485	0	0	TOBIN, MELISSA A NP	3/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7835 CRYSTAL SHORES CT	None	RENO	NV	89506	2182	00	06000	39.63394831	-119.9085134	Washoe County
291875	Non-Physician Medical Practitioner	None	1457719304	0	0	TANTAU, SHELLEY A NP	3/28/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1703 SHASTA AVENUE	None	NAPA	CA	94558	2354	00	06000	38.32945082	-122.3100232	Napa County
291915	Non-Physician Medical Practitioner	None	1962579425	0	0	TOTAH, JOANN L	4/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11984 WINDOM PEAK WAY	None	SAN DIEGO	CA	92131	3835	00	06000	32.93586966	-117.080424	San Diego County
291937	Non-Physician Medical Practitioner	None	1487351748	0	0	THOMAS, JUSTINA NP	5/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	73700 DINAH SHORE DR	STE 106	PALM DESERT	CA	92211	0813	00	06000	33.79748917	-116.3786855	Riverside County
291946	Non-Physician Medical Practitioner	None	1073807897	0	0	THAO, SAY	2/4/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35751 GATEWAY DRIVE	UNIT B228	PALM DESERT	CA	92211	6034	00	06000	33.78897104	-116.3832297	Riverside County
291966	Non-Physician Medical Practitioner	None	1285961052	0	0	TOMELDEN, JENNIFER D PA-C	3/31/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
291997	Non-Physician Medical Practitioner	None	1255353645	0	0	TUTTLE, KELLY	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	7373 WEST LN	2ND FLOOR, CARDIOLOGY	STOCKTON	CA	95210	3377	00	06000	38.017701	-121.297869	San Joaquin County
292016	Non-Physician Medical Practitioner	None	1376282475	0	0	TAVARES, MARIELLE	9/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	43839 15TH ST W	None	LANCASTER	CA	93534	4756	00	06000	34.678791	-118.156867	Los Angeles County
292027	Non-Physician Medical Practitioner	None	1215389606	0	0	TAT, VELEN PA	10/27/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8733 STEELE ST	None	ROSEMEAD	CA	91770	1738	00	06000	34.07964255	-118.079363	Los Angeles County
292107	Non-Physician Medical Practitioner	None	1649802349	0	0	TRAN, CHRISTINE PA	11/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9080 COLIMA RD	None	WHITTIER	CA	90605	1600	00	06000	33.95062799	-118.0051627	Los Angeles County
292130	Non-Physician Medical Practitioner	None	1235637356	0	0	TAKEMOTO, ERIN NP	3/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	660 SEA ANCHOR DRIVE	UNIT 2708	REDWOOD CITY	CA	94063	2989	00	06000	37.49782461	-122.2207596	San Mateo County
292133	Non-Physician Medical Practitioner	None	1497021109	0	0	TRI CITY HEALTH CENTER	7/20/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3907 MAIN STREET	SUITE B	FREMONT	CA	94538	2211	00	06000	37.53363638	-121.9577348	Alameda County
292152	Non-Physician Medical Practitioner	None	1134425804	0	0	THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR F	12/16/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2360 PACIFIC AVE	None	LONG BEACH	CA	90806	3051	00	06000	33.800049	-118.1936435	Los Angeles County
292156	Non-Physician Medical Practitioner	None	1871007120	0	0	TREWHITT, CHRISTINE M NP	12/18/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	199 WEST PORTAL AVE	None	SAN FRANCISCO	CA	94127	1305	00	06000	37.73890204	-122.467945	San Francisco County
292158	Non-Physician Medical Practitioner	None	1417088469	0	0	TRINIDAD, KENNY D PA-C	6/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	00	06000	34.05362775	-118.2661889	Los Angeles County
292187	Non-Physician Medical Practitioner	None	1336785096	0	0	TEESDALE, JEANNETTE M PA	7/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	251 COHASSET RD	SUITE 370	CHICO	CA	95926	2241	00	06000	39.75090044	-121.8522609	Butte County
292194	Non-Physician Medical Practitioner	None	1427116862	0	0	TAYLOR, BETTY KAY	7/25/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	940 ROYAL AVE	STE 350	MEDFORD	OR	97504	6193	00	06000	42.339654	-122.8626765	Jackson County
292210	Non-Physician Medical Practitioner	None	1053945253	0	0	TIPPETTS, JOSEPH H PA	5/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	00	06000	40.57278686	-122.3958519	Shasta County
292236	Non-Physician Medical Practitioner	None	1871842336	0	0	TORSNEY, DESIREE D J NP	9/6/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	944 11TH ST	APT 9	SANTA MONICA	CA	90403	2970	00	06000	34.02761214	-118.4954285	Los Angeles County
292237	Non-Physician Medical Practitioner	None	1184396731	0	0	TERRAZAS, ANDRIA B NP	12/15/2021	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	STE 10	CAMARILLO	CA	93010	1502	00	06000	34.2415821	-119.0183756	Ventura County
292256	Non-Physician Medical Practitioner	None	1376873224	0	0	TUALLA, HANNAH T	6/22/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD. AC# 1	None	LOS ANGELES	CA	90048	0000	00	06000	34.07671715	-118.3799413	Los Angeles County
292305	Non-Physician Medical Practitioner	None	1720793235	0	0	TERAMAE, SARAH J PA	11/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4151 FOOTHILL ROAD	None	SANTA BARBARA	CA	93110	1110	00	06000	34.45144647	-119.7604485	Santa Barbara County
292307	Non-Physician Medical Practitioner	None	1285272328	0	0	TAGAYUNA, NIKKA T PA-C	1/23/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	869 N CHERRY ST	None	TULARE	CA	93274	2207	00	06000	36.220932	-119.337698	Tulare County
292326	Non-Physician Medical Practitioner	None	1578999124	0	0	TORRES, ALEJANDRO 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	1515 E OCEAN AVE	None	LOMPOC	CA	93436	7092	00	06000	34.63941491	-120.4393023	Santa Barbara County
292331	Non-Physician Medical Practitioner	None	1427427822	0	0	TAYLOR, KYLIE A NP	1/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	609 21ST ST	None	HERMOSA BEACH	CA	90254	3017	00	06000	33.86988121	-118.3966844	Los Angeles County
292345	Non-Physician Medical Practitioner	None	1639877475	0	0	TECKLENBURG, DOMINIQUE PA	10/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
292350	Non-Physician Medical Practitioner	None	1942587498	0	0	THUY, STAATS	3/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1908 COFFEE RD STE 3	None	MODESTO	CA	95355	2719	00	06000	37.67156447	-120.975697	Stanislaus County
292380	Non-Physician Medical Practitioner	None	1699379107	0	0	TURETSKY, YELIZAVETA NP	12/29/2021	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
292403	Non-Physician Medical Practitioner	None	1336425644	0	0	TO, WILLIAM H	6/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3318 BIRCH ST	None	SANTA ANA	CA	92707	4311	00	06000	33.70191062	-117.8713433	Orange County
292416	Non-Physician Medical Practitioner	None	1609524651	0	0	TANAKA, BENJAMIN W PA	5/4/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 BUTTE STREET	None	REDDING	CA	96001	0852	00	06000	40.5853603	-122.3869865	Shasta County
292449	Non-Physician Medical Practitioner	None	1245879683	0	0	TEJEDA, ILSE J PA-C	10/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 COFFEE RD	None	MODESTO	CA	95355	2803	00	06000	37.668645	-120.9756715	Stanislaus County
292512	Non-Physician Medical Practitioner	None	1235682675	0	0	THAKER, SEJAL PA	9/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	00	06000	32.79692047	-117.1567137	San Diego County
292542	Non-Physician Medical Practitioner	None	1285341743	0	0	TIGLAO, RIZA NP	8/2/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
292547	Non-Physician Medical Practitioner	None	1386983583	0	0	TOBIAS, TADD T NP	3/17/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 GOUGH ST	None	SAN FRANCISCO	CA	94109	0000	00	06000	37.78400431	-122.4243885	San Francisco County
292554	Non-Physician Medical Practitioner	None	1568920601	0	0	TAYCHER, GREGORY PA-C	7/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
292558	Non-Physician Medical Practitioner	None	1346285962	0	0	TAKATA, JAY H	7/2/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	00	06000	33.969141	-118.0489095	Los Angeles County
292564	Non-Physician Medical Practitioner	None	1962803635	0	0	TRAN, TRISTAN T NP	6/6/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	10670 SALMON LEAP ST	None	LAS VEGAS	NV	89183	4918	00	06000	35.99600333	-115.1441074	Clark County
292615	Non-Physician Medical Practitioner	None	1437268208	0	0	TRUONG, LINDA	3/15/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	00	06000	37.33578	-121.999329	Santa Clara County
292620	Non-Physician Medical Practitioner	None	1457899296	0	0	TAUFAASAU, NOHEA N NP	5/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	451 COLLINS DR	#8	MERCED	CA	95348	3118	00	06000	37.324386	-120.4758	Merced County
292644	Non-Physician Medical Practitioner	None	1689214074	0	0	TRIEU, AIZZEL R NP	10/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	00	06000	34.10675048	-117.6646365	San Bernardino County
292654	Non-Physician Medical Practitioner	None	1023044427	0	0	TJERANDSEN, CARL E	4/20/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	00	06000	40.57278686	-122.3958519	Shasta County
292711	Non-Physician Medical Practitioner	None	1801271598	0	0	TEJADA, VICENTE REY A NP	3/24/2022	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
292748	Non-Physician Medical Practitioner	None	1053440826	0	0	THEETGE, KRISTIN MARIE	6/11/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1010 W LA VETA AVE STE 6	None	ORANGE	CA	92868	4306	00	06000	33.78028244	-117.8635552	Orange County
292761	Non-Physician Medical Practitioner	None	1770314809	0	0	TINGSTAD, TAYLA CNM	12/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	33 CREEK RD	STE 270	IRVINE	CA	92604	7707	00	06000	33.67506955	-117.796973	Orange County
292774	Non-Physician Medical Practitioner	None	1740970995	0	0	TEWOLDE, SENAIT M PA-C	6/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1535 N CHINA LAKE BLVD	STE A	RIDGECREST	CA	93555	2667	00	06000	35.6489946	-117.6698641	Kern County
292795	Non-Physician Medical Practitioner	None	1881069664	0	0	TAKIGAWA, MIMI T NP	5/9/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2404 PALISADES DRIVE	STE 305	CORONA	CA	92882	3697	00	06000	33.87668581	-117.6173531	Riverside County
292808	Non-Physician Medical Practitioner	None	1457532681	0	0	TONI, FERNANDEZ	2/4/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15888 MAIN ST STE 112B	None	HESPERIA	CA	92345	3467	00	06000	34.42375898	-117.3163823	San Bernardino County
292859	Non-Physician Medical Practitioner	None	1700298072	0	0	TEMPLE, ELIZABETH A	6/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	284 SUN RIDGE LN	None	SAN JOSE	CA	95123	6506	00	06000	37.24772823	-121.8561907	Santa Clara County
292860	Non-Physician Medical Practitioner	None	1346955820	0	0	TORRES-RAMOS, SONIA PA-C	3/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	33077 ALVARADO NILES RD	None	UNION CITY	CA	94587	3109	00	06000	37.59324793	-122.0436351	Alameda County
292870	Non-Physician Medical Practitioner	None	1538535570	0	0	TABAREZ, NORMA A 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	355 REBECCA STREET	None	EL CENTRO	CA	92243	8417	00	06000	32.7619305	-115.5513983	Imperial County
292893	Non-Physician Medical Practitioner	None	1225350135	0	0	TRAN, HOAI	3/22/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
292902	Non-Physician Medical Practitioner	None	1710047220	0	0	TILMON-KELLUM, ROSEMARY	5/19/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1250 BELLFLOWER BLVD	SHS	LONG BEACH	CA	90840	0201	00	06000	33.783174	-118.119528	Los Angeles County
292907	Non-Physician Medical Practitioner	None	1205204179	0	0	TRAN, JOANNA L	5/16/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8718 SCOTT ST	None	ROSEMEAD	CA	91770	1364	00	06000	34.08286275	-118.0791953	Los Angeles County
292923	Non-Physician Medical Practitioner	None	1881388353	0	0	TAYLOR, JAKOB PA	12/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1233 PLUMAS ST	None	YUBA CITY	CA	95991	3410	00	06000	39.14818027	-121.6175196	Sutter County
292927	Non-Physician Medical Practitioner	None	1104572007	0	0	TOLMIE, SIMONE E CNM	12/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 DOYLE PARK DR	STE 200	SANTA ROSA	CA	95405	4559	00	06000	38.44332	-122.6985255	Sonoma County
292931	Non-Physician Medical Practitioner	None	1629288725	0	0	TEOTICO, ANNA L NP	4/2/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	860 N STREAMVIEW ST	None	WALNUT	CA	91789	4440	00	06000	34.02899931	-117.8611895	Los Angeles County
292938	Non-Physician Medical Practitioner	None	1356684435	0	0	TENORIO, DANIA	11/25/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9414 LA ALBA DR	None	WHITTIER	CA	90603	1228	00	06000	33.95234302	-117.9961391	Los Angeles County
292946	Non-Physician Medical Practitioner	None	1285890616	0	0	TELL, STASIA L NP	11/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	00	06000	36.98191238	-121.9975767	Santa Cruz County
293006	Non-Physician Medical Practitioner	None	1124138169	0	0	TARUTIS, JODI LAINE	3/12/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
293029	Non-Physician Medical Practitioner	None	1609325430	0	0	TOM, CASSANDRA NP	3/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18785 BROOKHURST STREET	STE 101	FOUNTAIN VALLEY	CA	92708	7300	00	06000	33.68987636	-117.9542321	Orange County
293056	Non-Physician Medical Practitioner	None	1356842843	0	0	TAN, JERICK N NP	3/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
293057	Non-Physician Medical Practitioner	None	1306433347	0	0	TRUONG, MARIA NP	2/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1850 N RIVERSIDE AVE	STE 230	RIALTO	CA	92376	8071	00	06000	34.132905	-117.3704675	San Bernardino County
293070	Non-Physician Medical Practitioner	None	1326320094	0	0	TUTTLE, DEBBIE J NP	5/13/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1833 S ROEBEN STREET	None	VISALIA	CA	93277	9370	00	06000	36.314037	-119.359017	Tulare County
293073	Non-Physician Medical Practitioner	None	1558630442	0	0	TAOSUVANNA, CATHERINE N PA-C	3/25/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12724 GRANADA COURT	None	GARDEN GROVE	CA	92840	5165	00	06000	33.7783024	-117.9423176	Orange County
293103	Non-Physician Medical Practitioner	None	1770936577	0	0	TRAN, ANDREW D PA-C	12/14/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3130 DEL MONTE BLVD	None	MARINA	CA	93933	3047	00	06000	36.68590557	-121.8010492	Monterey County
293129	Non-Physician Medical Practitioner	None	1679938765	0	0	TAUBE, ANNETTE L NP	2/16/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	37 COOS BAY CT	None	PITTSBURG	CA	94565	7932	00	06000	38.01552233	-121.9552528	Contra Costa County
293142	Non-Physician Medical Practitioner	None	1831799071	0	0	TRUONG, VU N NP	9/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15975 HARBOR BOULEVARD	None	FOUNTAIN VALLEY	CA	92708	1303	00	06000	33.73140379	-117.9200162	Orange County
293148	Non-Physician Medical Practitioner	None	1487358743	0	0	TRAN, DIANA PA-C	5/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	00	06000	37.744011	-121.4349725	San Joaquin County
293167	Non-Physician Medical Practitioner	None	1659542389	0	0	TATE, MATTHEW PAUL	6/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	421 S DIVISION ST	None	SPOKANE	WA	99202	1331	00	06000	47.651715	-117.410751	Spokane County
293195	Non-Physician Medical Practitioner	None	1922085224	0	0	TRAN, TRAM S	3/17/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9874 PAWLET CIR	None	FOUNTAIN VALLEY	CA	92708	1045	00	06000	33.73232832	-117.9568934	Orange County
293217	Non-Physician Medical Practitioner	None	1902131980	0	0	TANNER, TIFFANY J	6/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	44715 SANDHURST LN	None	LANCASTER	CA	93536	6493	00	06000	34.69523772	-118.181101	Los Angeles County
293224	Non-Physician Medical Practitioner	None	1689020729	0	0	TORRES, DAISY L	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	16995 ORANGECREST CT	None	RIVERSIDE	CA	92504	6227	00	06000	33.87343165	-117.3825556	Riverside County
293228	Non-Physician Medical Practitioner	None	1316544034	0	0	TAYLOR, KYNDALL R PA-C	1/22/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 E HIGHLAND AVE	STE 351	SAN BERNARDINO	CA	92404	3830	00	06000	34.1358627	-117.2757778	San Bernardino County
293256	Non-Physician Medical Practitioner	None	1942586433	0	0	TROCHE PEREZ, MARIA D NP	10/15/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3301 C ST	None	SACRAMENTO	CA	95816	3300	00	06000	38.579877	-121.456143	Sacramento County
293277	Non-Physician Medical Practitioner	None	1790071389	0	0	TAKAHASHI, JEREMY H	4/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2257 SUN GLORY LANE	APT A	SAN JOSE	CA	95124	1454	00	06000	37.26865766	-121.9371192	Santa Clara County
293285	Non-Physician Medical Practitioner	None	1720405491	0	0	TIBURCIO VASQUEZ HEALTH CENTER, INC.	9/30/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16110 E 14TH ST	None	SAN LEANDRO	CA	94578	3002	00	06000	37.6977026	-122.1176484	Alameda County
293315	Non-Physician Medical Practitioner	None	1437551462	0	0	TREADWELL, THERESA NP	2/17/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	918 N CORNEJO WAY	None	AZUSA	CA	91702	6285	00	06000	34.138431	-117.897604	Los Angeles County
293372	Non-Physician Medical Practitioner	None	1598264103	0	0	TREMBLAY, COREY A PA-C	5/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	00	06000	34.13189479	-116.2767026	San Bernardino County
293390	Non-Physician Medical Practitioner	None	1790513661	0	0	THOMAS, JILL	8/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
293393	Non-Physician Medical Practitioner	None	1730362229	0	0	TANJUAKIO, J D	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	257 FREEDOM AVE	None	UPLAND	CA	91786	8155	00	06000	34.09137833	-117.636403	San Bernardino County
293413	Non-Physician Medical Practitioner	None	1386249407	0	0	TRUJILLO, JOHANNA L NP	9/6/2022	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
293478	Non-Physician Medical Practitioner	None	1780985457	0	0	TAGASHIRA, PAUL A	12/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	358 CHAIN LOOP	None	CLOVIS	NM	88101	8866	00	06000	34.41597076	-103.1818674	Curry County
293503	Non-Physician Medical Practitioner	None	1518355684	0	0	THAO, CHOUR NP	5/22/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6544 E PONTIAC WAY	None	FRESNO	CA	93727	0809	00	06000	36.78992653	-119.672118	Fresno County
293536	Non-Physician Medical Practitioner	None	1952442535	0	0	TAVERA, LYNNE T NP	11/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1828 SAN JUAN AVE	None	BERKELEY	CA	94707	1622	00	06000	37.89813879	-122.280033	Alameda County
293538	Non-Physician Medical Practitioner	None	1689667636	0	0	TAT, SHELLY MILLER	5/11/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	15021 W BELL RD	SUITE 125	SURPRISE	AZ	85374	3916	00	06000	33.637248	-112.383594	Maricopa County
293559	Non-Physician Medical Practitioner	None	1932629128	0	0	TAYLOR, ALEXANDER J PA	7/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11702 WEMBLEY RD	None	LOS ALAMITOS	CA	90720	4236	00	06000	33.79232695	-118.0851855	Orange County
293566	Non-Physician Medical Practitioner	None	1245771906	0	0	TRINIDAD, RENEE R	4/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	468 E PEMBROOK AVE	None	POMONA	CA	91766	5753	00	06000	34.03423908	-117.745408	Los Angeles County
293579	Non-Physician Medical Practitioner	None	1851673404	0	0	TEIXEIRA, DEBORA M PA-C	5/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26781 PORTOLA PKWY	4E	FOOTHILL RANCH	CA	92610	1758	00	06000	33.6785505	-117.6626791	Orange County
293591	Non-Physician Medical Practitioner	None	1548667454	0	0	THORPE, JENNIFER L PA-C	12/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	116 1/2 AMETHYST AVE	None	NEWPORT BEACH	CA	92662	6408	00	06000	33.605163	-117.891253	Orange County
293627	Non-Physician Medical Practitioner	None	1811990583	0	0	TROOP, PAMELA ANN	9/4/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5087 N INDIANOLA AVE	None	CLOVIS	CA	93619	9427	00	06000	36.80962426	-119.585227	Fresno County
293648	Non-Physician Medical Practitioner	None	1699144618	0	0	TAN, DIANE S F	1/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11625 CANTLAY ST	None	NORTH HOLLYWOOD	CA	91605	3941	00	06000	34.20259229	-118.3855544	Los Angeles County
293650	Non-Physician Medical Practitioner	None	1548740541	0	0	TOWNE, GENEVIEVE C PA	11/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7500 HOSPITAL DRIVE	None	SACRAMENTO	CA	95823	5403	00	06000	38.463381	-121.416183	Sacramento County
293670	Non-Physician Medical Practitioner	None	1811971112	0	0	TE WINKEL, MIHAELA DUMITRU	12/19/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	MEDICAL CENTER BOULEVARD	None	WINSTON SALEM	NC	27157	0001	00	06000	36.08955228	-80.27134643	Forsyth County
293678	Non-Physician Medical Practitioner	None	1205690773	0	0	TANNOUS, PETER NP	1/22/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	00	06000	33.62609529	-117.7293191	Orange County
293693	Non-Physician Medical Practitioner	None	1083701650	0	0	TRAMMELL, JACQUELINE E	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	710 LAWRENCE EXPY	DEPARTMENT 342	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
293731	Non-Physician Medical Practitioner	None	1538749742	0	0	THIND, JASMINE	5/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39159 PASEO PADRE PKWY	STE 121	FREMONT	CA	94538	1600	00	06000	37.5531875	-121.9805141	Alameda County
293732	Non-Physician Medical Practitioner	None	1235761040	0	0	TRAN, JANET PA-C	2/4/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1197 E ARQUES AVE	None	SUNNYVALE	CA	94085	3904	00	06000	37.38051652	-121.9964175	Santa Clara County
293789	Non-Physician Medical Practitioner	None	1386095339	0	0	TAI, LINDA PA-C	6/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	00	06000	33.90290859	-117.4941562	Riverside County
293790	Non-Physician Medical Practitioner	None	1508225608	0	0	TASCHNER, NANCY NP	12/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3835 E. 7TH STREET	None	LONG BEACH	CA	90804	5303	00	06000	33.77537951	-118.147194	Los Angeles County
293793	Non-Physician Medical Practitioner	None	1407354384	0	0	TAKVORIAN, LINDA J NP	10/11/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	714 N AVALON BLVD	None	WILMINGTON	CA	90744	5809	00	06000	33.77897659	-118.2623373	Los Angeles County
293795	Non-Physician Medical Practitioner	None	1851622740	0	0	TADLOCK, KATHRYN B PA-C	8/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
293802	Non-Physician Medical Practitioner	None	1578023289	0	0	TILGHMAN, ANA L PA	6/7/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	00	06000	36.83745149	-119.6604315	Fresno County
293883	Non-Physician Medical Practitioner	None	1235412503	0	0	TRAUTMAN, AMY PA	3/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
293913	Non-Physician Medical Practitioner	None	1225442080	0	0	TINDER, KAREN A NP	7/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1779 SUNNYVALE AVE	None	WALNUT CREEK	CA	94597	1859	00	06000	37.92867453	-122.0698312	Contra Costa County
293916	Non-Physician Medical Practitioner	None	1376748962	0	0	THOMAS, CYRIL F	3/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4238 PILON POINT	None	SAN DIEGO	CA	92130	2206	00	06000	32.94255755	-117.2240687	San Diego County
294001	Non-Physician Medical Practitioner	None	1255963146	0	0	THOMAS, GEORGE PA	4/8/2022	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
294009	Non-Physician Medical Practitioner	None	1063468148	0	0	TOUW, MICHELLE PA-C	6/15/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	825 FAIRFAX AVE	SUITE 572	NORFOLK	VA	23507	1914	00	06000	36.86070865	-76.30339723	Norfolk city
294106	Non-Physician Medical Practitioner	None	1811492242	0	0	THOMAS, MEGAN A NP	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	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	00	06000	32.79692047	-117.1567137	San Diego County
294196	Non-Physician Medical Practitioner	None	1164723649	0	0	TAM, PERLIE MAY	3/4/2013	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	#4300	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
294245	Non-Physician Medical Practitioner	None	1477106326	0	0	THANJU, ASHIKA R NP	7/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3838 SAN DIMAS ST	STE B 201	BAKERSFIELD	CA	93301	2284	00	06000	35.3946385	-119.008203	Kern County
294247	Non-Physician Medical Practitioner	None	1821058140	0	0	TUCKER, PATTY L	8/29/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 DIZZY GILLESPIE WAY	None	WINDSOR	CA	95492	7546	00	06000	38.55447347	-122.8087575	Sonoma County
294323	Non-Physician Medical Practitioner	None	1770139461	0	0	TRAN, HOA T NP	1/21/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11180 WARNER AVE	STE 269	FOUNTAIN VALLEY	CA	92708	7516	00	06000	33.71632048	-117.9334575	Orange County
294372	Non-Physician Medical Practitioner	None	1942776240	0	0	TRAN, LYNDA T NP	8/9/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	351 HOSPITAL ROAD	610	NEWPORT BEACH	CA	92663	3508	00	06000	33.62579141	-117.9299554	Orange County
294410	Non-Physician Medical Practitioner	None	1265457923	0	0	TRAN, CHRISTINE H PA-C	10/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1193 GREYSTONE AVE	None	REDLANDS	CA	92374	4740	00	06000	34.07543091	-117.164491	San Bernardino County
294425	Non-Physician Medical Practitioner	None	1447723879	0	0	TRAN, HONG T NP	1/16/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 THE CITY DR S	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
294427	Non-Physician Medical Practitioner	None	1700172467	0	0	TARRASCH, ALLISON	11/13/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 W SUNSET BLVD	MAILSTOP #69	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
294455	Non-Physician Medical Practitioner	None	1720174048	0	0	TORRES-TORIJA, JOSE	8/6/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3838 CALIFORNIA ST	SUITE 715	SAN FRANCISCO	CA	94118	1522	00	06000	37.78591809	-122.4575439	San Francisco County
294526	Non-Physician Medical Practitioner	None	1326718321	0	0	TENORIO CHAVARRIA, YAZMIN A PA	8/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	00	06000	37.60573981	-122.0835989	Alameda County
294530	Non-Physician Medical Practitioner	None	1114940111	0	0	THOMAS-MOOREHEAD, KRISTEN NP	11/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9037 MCCLOUD RD	None	VENTURA	CA	93004	3005	00	06000	34.2645927	-119.169194	Ventura County
294609	Non-Physician Medical Practitioner	None	1790193894	0	0	TAI, STEVEN	8/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2500 S SECOND AVE	None	ARCADIA	CA	91006	5207	00	06000	34.11039256	-118.0246097	Los Angeles County
294618	Non-Physician Medical Practitioner	None	1184108490	0	0	TRAN, MCSHIRLEY M PA-C	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	2734 EL CAMINO REAL	None	SANTA CLARA	CA	95051	3007	00	06000	37.35228637	-121.9754073	Santa Clara County
294682	Non-Physician Medical Practitioner	None	1669005294	0	0	TAING, SUECHU E PA	3/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3801 HOWE ST	None	OAKLAND	CA	94611	5312	00	06000	37.8242732	-122.2568561	Alameda County
294685	Non-Physician Medical Practitioner	None	1033749270	0	0	TAN, BERNICE NP	8/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	87 SCRIPPS DR	None	SACRAMENTO	CA	95825	6379	00	06000	38.572092	-121.410261	Sacramento County
294726	Non-Physician Medical Practitioner	None	1235332370	0	0	TSANG, CHRISTINE S NP	9/28/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	411 PELHAM COURT	None	DANVILLE	CA	94506	5029	00	06000	37.79698003	-121.8817749	Contra Costa County
294750	Non-Physician Medical Practitioner	None	1346773306	0	0	TRINO, EDWARD NP	1/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1255 TRAVIS BLVD	None	FAIRFIELD	CA	94533	4801	00	06000	38.25815459	-122.0487714	Solano County
294768	Non-Physician Medical Practitioner	None	1639738040	0	0	TIETJEN, KEELY R PA	5/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	00	06000	38.00450116	-122.5540001	Marin County
294781	Non-Physician Medical Practitioner	None	1134845563	0	0	TAUFIK, CHRISTINE PA-C	3/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29826 HAUN RD	314	MENIFEE	CA	92586	6546	00	06000	33.68719818	-117.1748757	Riverside County
294849	Non-Physician Medical Practitioner	None	1013658277	0	0	TUKHI, BRISHNA NP	7/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9888 GENESEE	None	LA JOLLA	CA	92037	1205	00	06000	32.8865608	-117.2250386	San Diego County
294852	Non-Physician Medical Practitioner	None	1235753856	0	0	TWARDOWSKI, MICHAL PA-C	12/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	705 W. LA VETA AVE	SUITE 111	ORANGE	CA	92868	4447	00	06000	33.78062272	-117.8600738	Orange County
294921	Non-Physician Medical Practitioner	None	1366812786	0	0	THUE, TIMOTHY	7/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11510 ABERDARE ST	None	LOMA LINDA	CA	92354	4126	00	06000	34.04456368	-117.2313665	San Bernardino County
294951	Non-Physician Medical Practitioner	None	1902299100	0	0	TAM, AMANDA Y NP	5/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2317 KRISTIE LANE	None	S SAN FRANCISCO	CA	94080	5259	00	06000	37.64571241	-122.4568396	San Mateo County
294962	Non-Physician Medical Practitioner	None	1205172491	0	0	THOMPSON, CHRISTOPHER LESLIE	12/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	811 HOLLYRIDGE DRIVE	None	ENCINITAS	CA	92024	6511	00	06000	33.03378221	-117.2518191	San Diego County
294975	Non-Physician Medical Practitioner	None	1992980270	0	0	TABAREZ, JOE ANTHONY	5/18/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	88775 AVENUE 76, STE. 1	None	THERMAL	CA	92274	9407	00	06000	33.49887952	-116.115372	Riverside County
294987	Non-Physician Medical Practitioner	None	1417164930	0	0	TOMLIN, WALUANA T D NP	1/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2139 HORSE TRAIL DR	None	REDLANDS	CA	92373	6978	00	06000	34.01319484	-117.166197	San Bernardino County
295006	Non-Physician Medical Practitioner	None	1205860988	0	0	TON, KRIS	11/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 E COTTAM PL	None	PLACENTIA	CA	92870	5143	00	06000	33.87428038	-117.861314	Orange County
295050	Non-Physician Medical Practitioner	None	1144272246	0	0	TOWLE, EARL F	11/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 UNIVERSITY AVE	None	SACRAMENTO	CA	95825	6523	00	06000	38.568402	-121.418019	Sacramento County
295077	Non-Physician Medical Practitioner	None	1639463144	0	0	THERESA, OPPEZZO B	11/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15633 RANCHLAND DR.	None	REDDING	CA	96001	9503	00	06000	40.52789527	-122.4824841	Shasta County
295093	Non-Physician Medical Practitioner	None	1669401824	0	0	TAPIA, JEANNE ABAYA	1/12/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1050 LINDEN AVE	EMPLOYEE HEALTH CLINIC	LONG BEACH	CA	90813	3321	00	06000	33.78003775	-118.1866604	Los Angeles County
295117	Non-Physician Medical Practitioner	None	1447817309	0	0	TONGOL, LIANE CHRISTINE H PA	10/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
295119	Non-Physician Medical Practitioner	None	1639548233	0	0	TAMAE, CINDY M NP	1/31/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	928 ASHIYA ROAD	None	MONTEBELLO	CA	90640	2566	00	06000	34.03154705	-118.1032853	Los Angeles County
295162	Non-Physician Medical Practitioner	None	1689203838	0	0	TWIGG, NAOMI NP	6/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
295206	Non-Physician Medical Practitioner	None	1003863341	0	0	TUMAKAY, SUE ANN E	9/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5975 VISTA DEL MAR	None	YORBA LINDA	CA	92887	3223	00	06000	33.87304293	-117.778065	Orange County
295219	Non-Physician Medical Practitioner	None	1396506820	0	0	TOVAR, KARINA NP	2/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3349 G STREET	SUITE F	MERCED	CA	95340	0978	00	06000	37.32432497	-120.4693064	Merced County
295263	Non-Physician Medical Practitioner	None	1174613087	0	0	THORSON, S JANINE NP	10/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	43926 LARINO CT	None	TEMECULA	CA	92592	9356	00	06000	33.48927615	-117.0934376	Riverside County
295329	Non-Physician Medical Practitioner	None	1952577033	0	0	TREMBLE, ANGELIQUE C	8/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	396 BELLEVUE AVE	209	OAKLAND	CA	94610	3411	00	06000	37.81088941	-122.2525882	Alameda County
295342	Non-Physician Medical Practitioner	None	1245952035	0	0	TONG, NICOLE S NP	11/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
295350	Non-Physician Medical Practitioner	None	1225790074	0	0	TOMA, LAUREN R PA-C	1/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	00	06000	34.062852	-117.9446658	Los Angeles County
295394	Non-Physician Medical Practitioner	None	1679111660	0	0	THOMPSON, KERRI R PA	3/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 WEST HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
295413	Non-Physician Medical Practitioner	None	1710904693	0	0	TRAN, KAY P	12/2/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 E VALENCIA MESA DR	SUITE 211	FULLERTON	CA	92835	3813	00	06000	33.89343304	-117.9279349	Orange County
295424	Non-Physician Medical Practitioner	None	1659880623	0	0	TRINH, KIMBERLY NP	12/8/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1225 20TH AVE	SUITE 1	SAN FRANCISCO	CA	94122	1723	00	06000	37.76489105	-122.4783243	San Francisco County
295456	Non-Physician Medical Practitioner	None	1154610863	0	0	TEFERA, HENOK PA-C	1/24/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 COFFEE RD	None	MODESTO	CA	95355	2803	00	06000	37.668645	-120.9756715	Stanislaus County
295458	Non-Physician Medical Practitioner	None	1659558328	0	0	TRUONG, MICHELLE V Y NP	11/3/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	289 BAY RIDGE DR	None	DALY CITY	CA	94014	1570	00	06000	37.70049428	-122.4194648	San Mateo County
295467	Non-Physician Medical Practitioner	None	1700207388	0	0	TEXON, LUIS S NP	3/30/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3420 COUNCIL ST	102	LOS ANGELES	CA	90004	3629	00	06000	34.07514933	-118.2845968	Los Angeles County
295523	Non-Physician Medical Practitioner	None	1346949765	0	0	TATEO, YUME S PA-C	10/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	408 S BEACH BLVD	STE 211	ANAHEIM	CA	92804	1853	00	06000	33.82709101	-117.9932293	Orange County
295548	Non-Physician Medical Practitioner	None	1407517451	0	0	TRAN, DANIELLE V PA	6/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2251 N HARBOR BLVD	None	FULLERTON	CA	92835	2601	00	06000	33.89691672	-117.9291749	Orange County
295584	Non-Physician Medical Practitioner	None	1396282711	0	0	THUVAMONTOLRAT, KASALYN NP	12/8/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	625 S FAIR OAKS AVE	#325	PASADENA	CA	91105	2675	00	06000	34.134894	-118.1504155	Los Angeles County
295639	Non-Physician Medical Practitioner	None	1548021512	0	0	TRESSLAR, PERI NP	7/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1045 E. PENNSYLVANIA AVE	None	ESCONDIDO	CA	92025	4616	00	06000	33.12864423	-117.0681274	San Diego County
295698	Non-Physician Medical Practitioner	None	1588266142	0	0	TEORA, ERIKA D NP	3/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	940 N WESTERN AVE	A	SAN PEDRO	CA	90732	2403	00	06000	33.75111361	-118.3090432	Los Angeles County
295703	Non-Physician Medical Practitioner	None	1427117845	0	0	TYLER-EVANS, MARCIA E NP	12/8/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2646 OAK SHORES DR	None	BRADLEY	CA	93426	9608	00	06000	35.75308082	-120.9901025	San Luis Obispo County
295717	Non-Physician Medical Practitioner	None	1700529484	0	0	TRAN, JOSEPH V NP	3/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9201 W SUNSET BLVD	SUITE 812	WEST HOLLYWOOD	CA	90069	3709	00	06000	34.09054375	-118.392295	Los Angeles County
295761	Non-Physician Medical Practitioner	None	1619600723	0	0	TORRES, DENISE	2/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	00	06000	34.68938848	-118.158354	Los Angeles County
295801	Non-Physician Medical Practitioner	None	1992001002	0	0	TOPO, JEFFREY PAUL	4/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 GRASS VALLEY HWY	None	AUBURN	CA	95603	4533	00	06000	38.9017595	-121.0759505	Placer County
295804	Non-Physician Medical Practitioner	None	1609128693	0	0	TANG, PHUONG N PA	8/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	50 ALESSANDRO PLACE	SUITE 440	PASADENA	CA	91105	0000	00	06000	34.13101049	-118.151532	Los Angeles County
295822	Non-Physician Medical Practitioner	None	1265858146	0	0	TROCHANOVA, NADIA NP	7/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5825 KANAN RD	B	AGOURA HILLS	CA	91301	1651	00	06000	34.15592291	-118.7563824	Los Angeles County
295828	Non-Physician Medical Practitioner	None	1073855714	0	0	THIARA, JAGMOHAN S NP	12/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1130 4TH AVE	None	RIO OSO	CA	95674	9656	00	06000	38.949948	-121.5386215	Sutter County
295850	Non-Physician Medical Practitioner	None	1487061164	0	0	TURNER, MIA PA	9/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 CORPORATE POINTE	STE 465	CULVER CITY	CA	90230	8706	00	06000	33.98867148	-118.3837334	Los Angeles County
295863	Non-Physician Medical Practitioner	None	1659870186	0	0	TODD, SHANNON C NP	4/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3883 AIRWAY DR	120	SANTA ROSA	CA	95403	1671	00	06000	38.483226	-122.739705	Sonoma County
295893	Non-Physician Medical Practitioner	None	1477513596	0	0	TALTY, MICHAEL M	1/17/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1022 NORTH FILBERT AVE	None	CLOVIS	CA	93611	8143	00	06000	36.84836431	-119.6740545	Fresno County
295897	Non-Physician Medical Practitioner	None	1891745097	0	0	TREPANIER, RUSSELL J	12/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5630 AMAYA DR	APT 86	LA MESA	CA	91942	3661	00	06000	32.78626019	-117.0010291	San Diego County
295914	Non-Physician Medical Practitioner	None	1023390606	0	0	TALMICH, EMILY E PA	5/5/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
295931	Non-Physician Medical Practitioner	None	1962548669	0	0	TOLBERT, REGINA MICHELE	5/11/2004	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
295936	Non-Physician Medical Practitioner	None	1861750671	0	0	TELETEN, ALEKSANDR	12/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6560 GREENBACK LN	SUITE 200	CITRUS HEIGHTS	CA	95621	6237	00	06000	38.677716	-121.310793	Sacramento County
295948	Non-Physician Medical Practitioner	None	1871005884	0	0	THOMPSON, KATIE M NP	6/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18251 FETTERBUSH LANE	None	SAN BERNARDINO	CA	92407	0405	00	06000	34.1845869	-117.4090124	San Bernardino County
296003	Non-Physician Medical Practitioner	None	1033898127	0	0	THACH, DARLENA	7/26/2023	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
296009	Non-Physician Medical Practitioner	None	1790035046	0	0	TA, JENNIFER NP	6/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4770 W HERNDON AVE	SUITE 108	FRESNO	CA	93722	8401	00	06000	36.83717984	-119.8778388	Fresno County
296023	Non-Physician Medical Practitioner	None	1104983444	0	0	TRUONG, LAN THI	12/15/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3300 STOCKTON BLVD	CAARE CENTER	SACRAMENTO	CA	95820	1451	00	06000	38.544282	-121.4530155	Sacramento County
296027	Non-Physician Medical Practitioner	None	1790751303	0	0	TURNER, SUSAN K.	10/7/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	821 SAINT HELENA HWY S	None	SAINT HELENA	CA	94574	2266	00	06000	38.48731402	-122.448269	Napa County
296074	Non-Physician Medical Practitioner	None	1417536657	0	0	TANG, MILTON PA	9/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	340 DARDANELLI	STE 10	LOS GATOS	CA	95032	1418	00	06000	37.262079	-121.9673345	Santa Clara County
296081	Non-Physician Medical Practitioner	None	1013360106	0	0	TODD, LARISSA A NP	4/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26800 CROWN VALLEY PKWY	STE 305, 315, 325, 330	MISSION VIEJO	CA	92691	8033	00	06000	33.56286021	-117.6673449	Orange County
296090	Non-Physician Medical Practitioner	None	1861826042	0	0	TORRES, ARLYN M NP	5/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1260 15TH STREET	1501, 1502	SANTA MONICA	CA	90404	1150	00	06000	34.02648965	-118.4867439	Los Angeles County
296097	Non-Physician Medical Practitioner	None	1275092629	0	0	TAUBE, ALDA E NP	7/12/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11100 WARNER AVE	STE 368	FOUNTAIN VALLEY	CA	92708	7514	00	06000	33.716291	-117.9355051	Orange County
296182	Non-Physician Medical Practitioner	None	1588284251	0	0	TAKANG, KEMERICK NP	10/4/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2131 ELKS	104	SAN BERNARDINO	CA	92404	5544	00	06000	34.13470788	-117.262434	San Bernardino County
296192	Non-Physician Medical Practitioner	None	1629120480	0	0	TAMURA, JULIANA SILVA	5/10/2011	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
296195	Non-Physician Medical Practitioner	None	1609537745	0	0	TANALEON, MICHELLE V	2/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8112 MILLIKEN AVE	SUITE 201	RANCHO CUCAMONGA	CA	91730	7473	00	06000	34.10480366	-117.5570863	San Bernardino County
296268	Non-Physician Medical Practitioner	None	1497748594	0	0	TOMPKINS, JAIME NP	12/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18181 BUTTERFIELD BLVD	185	MORGAN HILL	CA	95037	8108	00	06000	37.13904584	-121.6547035	Santa Clara County
296289	Non-Physician Medical Practitioner	None	1770257511	0	0	TALBOTT, SARAH E NP	12/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	00	06000	32.781483	-117.007182	San Diego County
296297	Non-Physician Medical Practitioner	None	1760706170	0	0	THOMAS, TRACI	1/12/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1725 MONTGOMERY ST STE 2	None	SAN FRANCISCO	CA	94111	1019	00	06000	37.80507835	-122.4052508	San Francisco County
296299	Non-Physician Medical Practitioner	None	1598327967	0	0	TAN, JESSICA PA-C	3/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11180 WARNER AVE	SUITE 167	FOUNTAIN VALLEY	CA	92708	7515	00	06000	33.71632048	-117.9334575	Orange County
296338	Non-Physician Medical Practitioner	None	1649768086	0	0	TERASHIMA, SARA T	11/14/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	38258 FREMONT BLVD	None	FREMONT	CA	94536	6021	00	06000	37.55324345	-121.9971639	Alameda County
296361	Non-Physician Medical Practitioner	None	1073043006	0	0	TONG, YANNIE	2/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1826 41ST AVE	None	SAN FRANCISCO	CA	94122	4004	00	06000	37.7526427	-122.4999639	San Francisco County
296362	Non-Physician Medical Practitioner	None	1609124965	0	0	TOBIAS, ALFRED F	10/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	540 GRANITE SPRINGS WAY	None	AMERICAN CANYON	CA	94503	3129	00	06000	38.1719448	-122.2439973	Napa County
296388	Non-Physician Medical Practitioner	None	1992934988	0	0	TURNER, SHEREENA PA	11/16/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
296434	Non-Physician Medical Practitioner	None	1831533553	0	0	TREADWELL, JENNIFER Y CNP	12/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1451 SECRET RAVINE PKWY	STE 150	ROSEVILLE	CA	95661	6052	00	06000	38.7647101	-121.2431538	Placer County
296438	Non-Physician Medical Practitioner	None	1285098053	0	0	THOMPSON, AILEEN L NP	12/30/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7712 CRENSHAW WAY	None	LAS VEGAS	NV	89129	5496	00	06000	36.23378977	-115.2640135	Clark County
296473	Non-Physician Medical Practitioner	None	1396741609	0	0	TRACY, CAROL L CNM	3/12/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1685 HOLLAND DR	None	WALNUT CREEK	CA	94597	2244	00	06000	37.92092529	-122.0905124	Contra Costa County
296491	Non-Physician Medical Practitioner	None	1457880932	0	0	TRAYLOR, MICHAEL A PA-C	9/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2519 E WHITMORE AVE	None	CERES	CA	95307	2634	00	06000	37.59479844	-120.9491078	Stanislaus County
296507	Non-Physician Medical Practitioner	None	1184709875	0	0	TAGATZ, JENNIFER	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	5TH FLOOR, OB/GYN	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
296530	Non-Physician Medical Practitioner	None	1477365997	0	0	TEA, JACKSON NP	2/12/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1720 W BALL RD	STE 4C	ANAHEIM	CA	92804	5500	00	06000	33.8178465	-117.9425115	Orange County
296560	Non-Physician Medical Practitioner	None	1881805851	0	0	TAPIA, BORIS D	2/21/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19753 BYRNE PL	None	SANTA CLARITA	CA	91350	3874	00	06000	34.44812841	-118.482378	Los Angeles County
296561	Non-Physician Medical Practitioner	None	1003221102	0	0	TANG, SHUK FONG NP	7/15/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	601 ALMARIDA DR	APT A16	CAMPBELL	CA	95008	0248	00	06000	37.29641657	-121.9411265	Santa Clara County
296571	Non-Physician Medical Practitioner	None	1952927907	0	0	TABANGCURA, DEMY PA-C	5/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	00	06000	33.912117	-117.195849	Riverside County
296577	Non-Physician Medical Practitioner	None	1497159776	0	0	TRAN, DAPHNE D NP	7/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
296578	Non-Physician Medical Practitioner	None	1982212148	0	0	TRAN, ELLEN PA-C	3/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	801 S BROOKHURST ST.	None	ANAHEIM	CA	92804	4302	00	06000	33.821568	-117.9589665	Orange County
296580	Non-Physician Medical Practitioner	None	1740296318	0	0	TORRES, JOSE A NP	3/30/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1814 W DUSTY WREN DRIVE	None	PHOENIX	AZ	85085	8061	00	06000	33.779835	-112.0981275	Maricopa County
296583	Non-Physician Medical Practitioner	None	1043241094	0	0	TIMBERLAKE, JOANN M PA-C	8/29/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18111 BROOKHURST ST	LL0300	FOUNTAIN VALLEY	CA	92708	6728	00	06000	33.70027259	-117.9544055	Orange County
296629	Non-Physician Medical Practitioner	None	1083009286	0	0	TSOU, SHIHHUI S NP	2/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1818 N ORANGE GROVE AVE	200	POMONA	CA	91767	3028	00	06000	34.07694934	-117.7489598	Los Angeles County
296631	Non-Physician Medical Practitioner	None	1588946677	0	0	TROTTER, DAVID J PA-C	6/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	360 S LOLA LN	None	PAHRUMP	NV	89048	0884	00	06000	36.214524	-116.025615	Nye County
296643	Non-Physician Medical Practitioner	None	1952902058	0	0	TAYLOR, RYAN P PA-C	8/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9333 GENESSE AVE	STE 350	SAN DIEGO	CA	92121	2103	00	06000	32.875668	-117.2139225	San Diego County
296661	Non-Physician Medical Practitioner	None	1205369758	0	0	TRAN, RACHEL H PA-C	8/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
296677	Non-Physician Medical Practitioner	None	1346649928	0	0	TANGCHAIBURANA, SAMANTHA	10/28/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	845 S MANHATTAN PL	305	LOS ANGELES	CA	90005	3375	00	06000	34.05679393	-118.3101873	Los Angeles County
296682	Non-Physician Medical Practitioner	None	1528358926	0	0	TWITCHELL, DENICE K NP	3/30/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	4044 W HACKAMORE DR	None	PHOENIX	AZ	85083	2469	00	06000	33.714612	-112.1480595	Maricopa County
296691	Non-Physician Medical Practitioner	None	1720002975	0	0	TRUONG, HANG	12/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	00	06000	37.63347961	-122.0897735	Alameda County
296712	Non-Physician Medical Practitioner	None	1689600470	0	0	TRUMPLER, MICHELLE A	4/6/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2301 CAMINO RAMON, SUITE	None	SAN RAMON	CA	94583	0000	00	06000	37.77574883	-121.9663326	Contra Costa County
296743	Non-Physician Medical Practitioner	None	1497893051	0	0	TEIPE, STEPHEN E	7/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4820 LARWIN AVE	None	CYPRESS	CA	90630	3515	00	06000	33.81641143	-118.0484284	Orange County
296767	Non-Physician Medical Practitioner	None	1407398266	0	0	TUT, OPKARDEEP K PA	9/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
296819	Non-Physician Medical Practitioner	None	1144685504	0	0	TRIEU, ERICSSON PA-C	10/15/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12456 WASHINGTON BLVD	None	WHITTIER	CA	90602	1005	00	06000	33.96757592	-118.046351	Los Angeles County
296840	Non-Physician Medical Practitioner	None	1528282852	0	0	TARLOW, LESLIE J NP	7/8/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25932 BELLIS DRIVE	None	VALENCIA	CA	90033	5310	00	06000	34.40218058	-118.5543293	Los Angeles County
296869	Non-Physician Medical Practitioner	None	1609803972	0	0	TIZON, JANICE K NP	11/16/2021	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
296886	Non-Physician Medical Practitioner	None	1629521307	0	0	THOMPSON, DIANE M NP	12/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3280 WASHINGTON ST	None	PLACERVILLE	CA	95667	5838	00	06000	38.72270909	-120.7893981	El Dorado County
296923	Non-Physician Medical Practitioner	None	1124457544	0	0	TIMOTHEE, MARIE-CLAIRE PA-C	1/6/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	00	06000	39.33573744	-120.180872	Nevada County
296962	Non-Physician Medical Practitioner	None	1437689346	0	0	TYLER-RICHARD, RENITA L	8/21/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	720 W MONTGOMERY AVE	None	ROCKVILLE	MD	20850	3818	00	06000	39.08566888	-77.16914132	Montgomery County
297037	Non-Physician Medical Practitioner	None	1174033807	0	0	TRAN, KHOA PA	3/16/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2888 COCHRAN STREET	None	SIMI VALLEY	CA	93065	2782	00	06000	34.27898255	-118.7378325	Ventura County
297046	Non-Physician Medical Practitioner	None	1073899878	0	0	TRAN, NHU	11/13/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1 MADRONE ST	None	WILLITS	CA	95490	4225	00	06000	39.40088064	-123.3510718	Mendocino County
297064	Non-Physician Medical Practitioner	None	1538198114	0	0	TREMBLAY, ROBERT J	10/25/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	911 SUNSET DR	None	HOLLISTER	CA	95023	5602	00	06000	36.83504962	-121.3858245	San Benito County
297067	Non-Physician Medical Practitioner	None	1073849196	0	0	TROXELL, SONIA M	12/28/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	440 PLUMAS BLVD	None	YUBA CITY	CA	95991	5071	00	06000	39.13140416	-121.6141951	Sutter County
297069	Non-Physician Medical Practitioner	None	1386362705	0	0	TRINH, DAROLD PA	10/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18040 SHERMAN WAY	SUITE 304	RESEDA	CA	91335	4656	00	06000	34.20103048	-118.526787	Los Angeles County
297073	Non-Physician Medical Practitioner	None	1235647728	0	0	TRIVETTE, CAROLYN D NP	8/21/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2610 E NEES AVE	APT 170	FRSENO	CA	93720	6018	00	06000	36.85217642	-119.7373427	Fresno
297077	Non-Physician Medical Practitioner	None	1316147580	0	0	TSOU, GEE Y PA	1/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20055 LAKE CHABOT RD	STE 230	CASTRO VALLEY	CA	94546	5333	00	06000	37.69836512	-122.0873587	Alameda County
297084	Non-Physician Medical Practitioner	None	1023665916	0	0	TOWNSEND, LINSY A PA	12/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	06000	33.38982	-111.8760885	Maricopa County
297086	Non-Physician Medical Practitioner	None	1861068496	0	0	TSAO, COCO L NP	10/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2637 SHADELANDS DR	None	WALNUT CREEK	CA	94598	2512	00	06000	37.925712	-122.021856	Contra Costa County
297156	Non-Physician Medical Practitioner	None	1427502004	0	0	TAYLOR, KATASHA NP	9/11/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	302 SILVER AVE	None	SAN FRANCISCO	CA	94112	1510	00	06000	37.72851602	-122.4296638	San Francisco County
297158	Non-Physician Medical Practitioner	None	1518915032	0	0	TERRY, MICHAEL P	1/1/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	00	06000	37.819368	-122.263902	Alameda County
297171	Non-Physician Medical Practitioner	None	1992323356	0	0	THRIFT, JESSICA 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	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	00	06000	34.444782	-119.7794675	Santa Barbara County
297252	Non-Physician Medical Practitioner	None	1649868191	0	0	TOVAR, JHOANA B NP	4/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1590 SOUTH IMPERIAL AVE	None	EL CENTRO	CA	92243	4241	00	06000	32.77950118	-115.5697279	Imperial County
297295	Non-Physician Medical Practitioner	None	1841521366	0	0	TRAN, CHRISTOPHER M	10/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14525 SADDLEPEAK CT	None	FONTANA	CA	92336	0166	00	06000	34.15100473	-117.4878644	San Bernardino County
297298	Non-Physician Medical Practitioner	None	1538423447	0	0	TATE, JOSEPH PA-C	1/11/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4199 FLAT ROCK DR	147	RIVERSIDE	CA	92505	7115	00	06000	33.90364208	-117.4931242	Riverside County
297314	Non-Physician Medical Practitioner	None	1548499460	0	0	THOMPSON, LUCIA	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	450 GREENFIELD AVE	None	HANFORD	CA	93230	3513	00	06000	36.328968	-119.6582195	Kings County
297319	Non-Physician Medical Practitioner	None	1164621074	0	0	TETZLAFF, JOEL	12/5/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2720 N HARBOR BLVD	SUITE 130	FULLERTON	CA	92835	2609	00	06000	33.90126238	-117.9292154	Orange County
297357	Non-Physician Medical Practitioner	None	1518107556	0	0	TAKATANI, RYAN	4/30/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	00	06000	32.89687721	-117.2418677	San Diego County
297396	Non-Physician Medical Practitioner	None	1609285220	0	0	TELESCO, CHARLES G	11/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 BARTON RD	APT 208	REDLANDS	CA	92373	5440	00	06000	34.049079	-117.205767	San Bernardino County
297430	Non-Physician Medical Practitioner	None	1447603139	0	0	TROST, JENNIFER PA	4/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2021 HERNDON AVE	SUITE 101	CLOVIS	CA	93611	6101	00	06000	36.83757551	-119.6792955	Fresno County
297435	Non-Physician Medical Practitioner	None	1306573480	0	0	TERLEP, ZANDRI PA-C	9/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13193 CENTRAL AVE	SUITE 220	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
297462	Non-Physician Medical Practitioner	None	1821636234	0	0	TARIN WOFFORD, LESLIE E 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	3551 Q ST	None	BAKERSFIELD	CA	93301	1657	00	06000	35.392059	-119.010556	Kern County
297465	Non-Physician Medical Practitioner	None	1750143392	0	0	THOMAS, SOPHIA	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	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
297468	Non-Physician Medical Practitioner	None	1447851324	0	0	TORRES, ANNA P NP	11/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
297472	Non-Physician Medical Practitioner	None	1518939636	0	0	TALOB, ROGER A	2/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3656 W SHAW AVE	None	FRESNO	CA	93711	3231	00	06000	36.80840238	-119.8594473	Fresno County
297485	Non-Physician Medical Practitioner	None	1356856132	0	0	TEDLA, TILKSEW A NP	4/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3751 E SHIELDS AVE	None	FRESNO	CA	93726	0000	00	06000	36.7796958	-119.7618088	Fresno County
297487	Non-Physician Medical Practitioner	None	1386320380	0	0	TAGHILOU, CRISTINA	9/20/2023	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
297498	Non-Physician Medical Practitioner	None	1962714964	0	0	THOMPSON, SCOTT JACOB	9/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31 ROYAL VICTORIA	None	IRVINE	CA	92606	1919	00	06000	33.70583649	-117.7994959	Orange County
297519	Non-Physician Medical Practitioner	None	1871900423	0	0	TRYBUS, ANNA M NP	11/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7930 HALF MOON POINT DR	None	LAS VEGAS	NV	89113	3078	00	06000	36.04442568	-115.244759	Clark County
297526	Non-Physician Medical Practitioner	None	1962436568	0	0	TSUCHIYAMA, ANNE EMIKO	5/10/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 MEDICAL PLAZA	#530	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
297528	Non-Physician Medical Practitioner	None	1700591484	0	0	TRAN, ADAM T PA-C	6/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	999 N. TUSTIN AVE	UNIT # 216	SANTA ANA	CA	92705	3528	00	06000	33.754167	-117.834191	Orange County
297544	Non-Physician Medical Practitioner	None	1659706455	0	0	TORRES, NHORDIA NP	3/9/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9159 PARISE DR	None	WHITTIER	CA	90603	1950	00	06000	33.9485441	-118.0116838	Los Angeles County
297609	Non-Physician Medical Practitioner	None	1821332016	0	0	TOLEDO, CHRISTINA M NP	4/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3721 CARTER DRIVE	APT 1209	S SAN FRANCISCO	CA	94080	3890	00	06000	37.64519052	-122.4680959	San Mateo County
297635	Non-Physician Medical Practitioner	None	1457008807	0	0	THONG, SARAH PA	1/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	00	06000	34.2064445	-118.8824085	Ventura County
297643	Non-Physician Medical Practitioner	None	1477168342	0	0	TSAY, CYNTHIA PA	9/9/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1450 SAN PABLO STREET	SUITE 6200	LOS ANGELES	CA	90033	4500	00	06000	34.06189518	-118.203256	Los Angeles County
297721	Non-Physician Medical Practitioner	None	1013502343	0	0	TAYLOR, RANDAL T NP	10/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 OLD RIVER ROAD	None	BAKERSFIELD	CA	93311	9781	00	06000	35.351487	-119.1143025	Kern County
297735	Non-Physician Medical Practitioner	None	1598170862	0	0	TANEDO, DEBBIE R P	2/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9527 PIPILO ST	None	SAN DIEGO	CA	92129	3566	00	06000	32.95405637	-117.1232441	San Diego County
297752	Non-Physician Medical Practitioner	None	1619628179	0	0	TERJANYAN, SONA NP	6/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6098	00	06000	34.0956033	-118.2916918	Los Angeles County
297773	Non-Physician Medical Practitioner	None	1154918456	0	0	TELLEZ, LAURA A NP	2/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4770 W HERNDON AVE	STE 111	FRESNO	CA	93722	8401	00	06000	36.83717984	-119.8778388	Fresno County
297816	Non-Physician Medical Practitioner	None	1194230805	0	0	TIBON, JAMIE D NP	12/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
297818	Non-Physician Medical Practitioner	None	1871761445	0	0	TERWEY, HEIDI A	6/4/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
297870	Non-Physician Medical Practitioner	None	1154053528	0	0	TOWNLEY, ANDREW C	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	1292 W MILL ST	105	SAN BERNARDINO	CA	92410	2500	00	06000	34.09216953	-117.313173	San Bernardino County
297905	Non-Physician Medical Practitioner	None	1528411618	0	0	TAYLOR, KRISTIE E	12/28/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	260 WAVERLEY ST	APT 5	MENLO PARK	CA	94025	3631	00	06000	37.45323357	-122.1681729	San Mateo County
297928	Non-Physician Medical Practitioner	None	1891252318	0	0	THOMPSON, STACY L NP	2/19/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	115 MALL DRIVE	None	HANFORD	CA	93230	5786	00	06000	36.32396253	-119.6688834	Kings County
298021	Non-Physician Medical Practitioner	None	1366606238	0	0	TURNER, LEE ANN	11/9/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	680 W TENNYSON RD	None	HAYWARD	CA	94544	5236	00	06000	37.63204354	-122.0681454	Alameda County
298028	Non-Physician Medical Practitioner	None	1669768867	0	0	TOY, ALISON L NP	12/23/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19639 MONTEANO LN	None	YORBA LINDA	CA	92886	3527	00	06000	33.89282149	-117.7925996	Orange County
298052	Non-Physician Medical Practitioner	None	1629684683	0	0	TANNER, SHARON L PA	12/28/2021	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
298056	Non-Physician Medical Practitioner	None	1982029161	0	0	TREJO, JEANETTE	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	100 S ALAMEDA STREET	441	LOS ANGELES	CA	90012	3919	00	06000	34.048008	-118.2380905	Los Angeles County
298061	Non-Physician Medical Practitioner	None	1295734150	0	0	TURNER, WILLIAM M	9/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2722 BUNGALOW DR	None	MARINA	CA	93933	6058	00	06000	36.66379023	-121.8045352	Monterey County
298089	Non-Physician Medical Practitioner	None	1346026051	0	0	TRAN, TRAN PA-C	4/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8101 NEWMAN AVE	A	HUNTINGTON BEACH	CA	92647	7042	00	06000	33.70483151	-117.987264	Orange County
298117	Non-Physician Medical Practitioner	None	1750023164	0	0	TACKETT, AMBER NP	5/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	00	06000	34.1010559	-117.6369445	San Bernardino County
298125	Non-Physician Medical Practitioner	None	1699017236	0	0	THOMAS, LINDSAY RENNER	9/1/2013	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	ROOM H2103	STANFORD	CA	94305	5218	00	06000	37.43304542	-122.1759654	Santa Clara County
298150	Non-Physician Medical Practitioner	None	1184362675	0	0	TAUTUA, KRISTEN L NP	8/9/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41880 KALMIA ST	SUITE 100	MURRIETA	CA	92562	8835	00	06000	33.55740114	-117.2157733	Riverside County
298153	Non-Physician Medical Practitioner	None	1003683590	0	0	TREIBER, VICTORIA PA	4/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
298175	Non-Physician Medical Practitioner	None	1083743769	0	0	TANNER, CATHERINE D	1/2/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3100 SUMMIT ST	THIRD FLOOR, SUITE 3206	OAKLAND	CA	94609	3412	00	06000	37.82018974	-122.2643221	Alameda County
298196	Non-Physician Medical Practitioner	None	1811172794	0	0	TEBON, RENEE M	1/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3905 WARING RD	None	OCEANSIDE	CA	92056	4405	00	06000	33.18781249	-117.2923383	San Diego County
298270	Non-Physician Medical Practitioner	None	1184168387	0	0	THOMPSON, MELISSA PA	11/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1835 SUNNYCREST DR	None	FULLERTON	CA	92835	3616	00	06000	33.89224326	-117.9312781	Orange County
298280	Non-Physician Medical Practitioner	None	1639640782	0	0	THOMPSON, CORT	3/17/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	276 S MILL ST	STE C	TEHACHAPI	CA	93561	1678	00	06000	35.13089495	-118.4526363	Kern County
298282	Non-Physician Medical Practitioner	None	1194195719	0	0	THAM, JANICE Y NP	11/16/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	147 W ROUTE 66	PMB 719	GLENDORA	CA	91740	6208	00	06000	34.1288583	-117.8658287	Los Angeles County
298316	Non-Physician Medical Practitioner	None	1336625318	0	0	THIESEN, TIMOTHY J NP	9/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	00	06000	36.327888	-119.294919	Tulare County
298333	Non-Physician Medical Practitioner	None	1912299124	0	0	THOMAS, LEVON J	9/22/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	928 LALANIA	None	REDLANDS	CA	92374	2504	00	06000	34.07445281	-117.1696449	San Bernardino County
298348	Non-Physician Medical Practitioner	None	1164773594	0	0	TAYLOR, BONNIE L	8/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 MAIN STREET	30A	SAN FRANCISCO	CA	94105	5049	00	06000	37.7892281	-122.3915877	San Francisco County
298361	Non-Physician Medical Practitioner	None	1609402221	0	0	TUN, SWE L NP	7/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	00	06000	38.55204	-121.455387	Sacramento County
298371	Non-Physician Medical Practitioner	None	1316935026	0	0	TOWERY, BOBBY N	4/30/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7811 DENROCK AVENUE	None	LOS ANGELES	CA	90045	1111	00	06000	33.97002909	-118.4076857	Los Angeles County
298387	Non-Physician Medical Practitioner	None	1689186132	0	0	THRASHER, TAMMY R NP	7/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17820 DOTY AVE	None	TORRANCE	CA	90504	3819	00	06000	33.86863399	-118.3399518	Los Angeles County
298402	Non-Physician Medical Practitioner	None	1033593520	0	0	TRUONG, JUDY D PA-C	2/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4201 TORRANCE BLVD	SUITE 520	TORRANCE	CA	90503	4009	00	06000	33.8375955	-118.358748	Los Angeles County
298411	Non-Physician Medical Practitioner	None	1235559246	0	0	TUYA-PAREDES, MARIA JOSEPHINE NP	3/16/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	36243 INLAND VALLEY DR	STE 80	WILDOMAR	CA	92595	9547	00	06000	33.591528	-117.2393325	Riverside County
298491	Non-Physician Medical Practitioner	None	1679127518	0	0	TALAMAYAN, LIEZL G NP	4/29/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 W STEWART DR	None	ORANGE	CA	92868	3849	00	06000	33.78236558	-117.8648414	Orange County
298513	Non-Physician Medical Practitioner	None	1750164745	0	0	TRAN, UYEN PHUONG PA-C	12/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3700 SOUTH ST	None	LAKEWOOD	CA	90712	1419	00	06000	33.86019848	-118.148166	Los Angeles County
298544	Non-Physician Medical Practitioner	None	1588108732	0	0	TOMPKINS, BROOKE A	3/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3990 CENTRE ST	UNIT 103	SAN DIEGO	CA	92103	3493	00	06000	32.75030699	-117.1474626	San Diego County
298547	Non-Physician Medical Practitioner	None	1477230225	0	0	TAVAKKOLI, NADIA PA	3/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31581 CANYON ESTATES DR	None	LAKE ELSINORE	CA	92532	0424	00	06000	33.66552989	-117.300491	Riverside County
298548	Non-Physician Medical Practitioner	None	1902374572	0	0	TUANQUI, MICHAEL G NP	11/18/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
298553	Non-Physician Medical Practitioner	None	1326560699	0	0	TRUONG, WILSON	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	3453 VAN WIG AVE	None	BALDWIN PARK	CA	91706	5455	00	06000	34.07597175	-117.9575001	Los Angeles County
298595	Non-Physician Medical Practitioner	None	1467975219	0	0	THAMMAROSSOPON, SUWIMON PA-C	10/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2525 ERRINGER RD.	None	SIMI VALLEY	CA	93065	2352	00	06000	34.280838	-118.7614975	Ventura County
298691	Non-Physician Medical Practitioner	None	1124018726	0	0	TOLBERT, MARGARET M NP	7/24/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	630 VETERANS BLVD	UNIT 383	REDWOOD CITY	CA	94063	1474	00	06000	37.49225358	-122.2320116	San Mateo County
298734	Non-Physician Medical Practitioner	None	1306411137	0	0	TORSAK, COLLIN B PA	2/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	102 E LAKE MEAD PKWY	None	HENDERSON	NV	89015	5575	00	06000	36.03815706	-114.9842287	Clark County
298756	Non-Physician Medical Practitioner	None	1487267233	0	0	THEPMONTRY-NHEP, CHANCE C NP	1/22/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	245 TERRACINA BLVD	SUITE 102	REDLANDS	CA	92373	4865	00	06000	34.03858912	-117.2066515	San Bernardino County
298761	Non-Physician Medical Practitioner	None	1942788047	0	0	THOMSON, ANNIE L NP	2/9/2022	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
298771	Non-Physician Medical Practitioner	None	1649613407	0	0	TOMLINSON, STARR NP	5/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1571 ROSITA ROAD	None	PACIFICA	CA	94044	4430	00	06000	37.58025003	-122.479943	San Mateo County
298807	Non-Physician Medical Practitioner	None	1881124220	0	0	TERRY, GENEVIEVE M PA-C	10/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13855 E 14TH ST	None	SAN LEANDRO	CA	94578	2611	00	06000	37.712385	-122.143428	Alameda County
298834	Non-Physician Medical Practitioner	None	1235368788	0	0	TANG, KAI-HOO	6/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15765 CAMINO CORDONIZ	None	SAN DIEGO	CA	92127	5823	00	06000	33.00130251	-117.0953701	San Diego County
298841	Non-Physician Medical Practitioner	None	1164681482	0	0	TIPPETT, VICKI M	5/4/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	711 PARADISE WAY	None	EMERALD HILLS	CA	94062	4019	00	06000	37.45910004	-122.2696265	San Mateo County
298863	Non-Physician Medical Practitioner	None	1699263814	0	0	TOPPENBERG, SHERILYN R NP	12/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	00	06000	34.04805253	-117.249534	San Bernardino County
298869	Non-Physician Medical Practitioner	None	1407398852	0	0	TAM, CHRISTINE NP	9/21/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1014 PALM AVENUE	None	SOUTH PASADENA	CA	91030	3031	00	06000	34.11348141	-118.1635534	Los Angeles County
298921	Non-Physician Medical Practitioner	None	1598716151	0	0	TRISTAN, VINCENT M	5/1/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13536 LA SIERRA DR	None	CHINO HILLS	CA	91790	1325	00	06000	34.00843964	-117.7587328	San Bernardino County
298931	Non-Physician Medical Practitioner	None	1699375717	0	0	TONG, SEEMA NP	2/7/2022	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
298947	Non-Physician Medical Practitioner	None	1801670559	0	0	THOMAS, JASMINE PA	1/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2704 E WILLOW ST	None	SIGNAL HILL	CA	90755	2217	00	06000	33.80432955	-118.1594295	Los Angeles County
298981	Non-Physician Medical Practitioner	None	1447893052	0	0	TOPIOL, LISA M PA-C	9/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	333 HEGENBERGER RD	STE 100	OAKLAND	CA	94621	1452	00	06000	37.7350428	-122.1976624	Alameda County
298991	Non-Physician Medical Practitioner	None	1326670530	0	0	THOMPSON, ERIN L PA	1/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1280 VICTORIA	250	VENTURA	CA	93003	6555	00	06000	34.26344767	-119.2119344	Ventura County
299033	Non-Physician Medical Practitioner	None	1124506407	0	0	TSUN, ZHI-FANG PA-C	1/22/2023	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
299034	Non-Physician Medical Practitioner	None	1780878132	0	0	TAFT, BONNIE	7/20/2009	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
299041	Non-Physician Medical Practitioner	None	1235896911	0	0	TRAN, RAYMOND NP	2/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	00	06000	34.06238259	-118.2030986	Los Angeles County
299066	Non-Physician Medical Practitioner	None	1225738826	0	0	TRANG, TAMMY PA-C	3/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	801 S BROOKHURST ST.	None	ANAHEIM	CA	92804	4302	00	06000	33.821568	-117.9589665	Orange County
299069	Non-Physician Medical Practitioner	None	1154759231	0	0	TAUSSIG, BRIAN K PA-C	1/8/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4598 MISSION STREET	None	SAN FRANCISCO	CA	94112	2622	00	06000	37.72470903	-122.4348557	San Francisco County
299129	Non-Physician Medical Practitioner	None	1285656165	0	0	TAPIA, MIRIAM L NP	10/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2436 REDWOOD ROAD	None	NAPA	CA	94588	3104	00	06000	38.31933885	-122.3199744	Napa County
299131	Non-Physician Medical Practitioner	None	1871624155	0	0	TAMURA, ANDREW T	7/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12 KING EIDER LN	None	ALISO VIEJO	CA	92656	1816	00	06000	33.59997483	-117.7421692	Orange County
299133	Non-Physician Medical Practitioner	None	1609417161	0	0	TIENDA, MARISOL NP	10/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	115 MALL DRIVE	None	HANFORD	CA	93230	5786	00	06000	36.32396253	-119.6688834	Kings County
299139	Non-Physician Medical Practitioner	None	1568913382	0	0	THIELEN, TANYA	12/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5225 BLAKESLEE AVE	APT 413	N HOLLYWOOD	CA	91601	3247	00	06000	34.16546273	-118.372504	Los Angeles County
299147	Non-Physician Medical Practitioner	None	1396462917	0	0	TRUJILLO, ERIKA NP	3/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1740 ROSECRANS ST	None	SAN DIEGO	CA	92106	1928	00	06000	32.72903913	-117.2254885	San Diego County
299148	Non-Physician Medical Practitioner	None	1831443878	0	0	TAKES, VALERIE H NP	9/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	PO BOX 314	None	DILLON BEACH	CA	94929	0314	00	06000	0	0	None
299164	Non-Physician Medical Practitioner	None	1730713488	0	0	TIO, ANDREW-JUSTIN C NP	4/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
299178	Non-Physician Medical Practitioner	None	1447687884	0	0	TAYLOR, LAUREN D PA	6/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
299179	Non-Physician Medical Practitioner	None	1093727992	0	0	TESSIER, BRIAN E	11/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1689 SUNNYBROOK AVE	None	UPLAND	CA	91784	2070	00	06000	34.12473442	-117.6439341	San Bernardino County
299206	Non-Physician Medical Practitioner	None	1841798410	0	0	TRAN, LIEN PA-C	6/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11420 WARNER AVE.	None	FOUNTAIN VALLEY	CA	92708	2529	00	06000	33.71633952	-117.929061	Orange County
299255	Non-Physician Medical Practitioner	None	1184101354	0	0	TIRPACK, AMANDA K PA-C	4/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3000 Q STREET	4TH FLOOR	SACRAMENTO	CA	95816	7058	00	06000	38.564991	-121.4696565	Sacramento County
299260	Non-Physician Medical Practitioner	None	1972131761	0	0	TOLENTINO, JAMES PA-C	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	17822 BEACH BLVD	SUITE 200	HUNTINGTON BEACH	CA	92647	7101	00	06000	33.70331388	-117.9890471	Orange County
299299	Non-Physician Medical Practitioner	None	1669072690	0	0	TRAN, ERICA NP	10/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	00	06000	34.13998921	-118.7070142	Los Angeles County
299306	Non-Physician Medical Practitioner	None	1588610042	0	0	TENAZAS, ALEX M PA	4/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	00	06000	33.808185	-118.1850575	Los Angeles County
299341	Non-Physician Medical Practitioner	None	1326527417	0	0	TASIOS, EVAN T PA	1/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	00	06000	37.65894608	-122.440161	San Mateo County
299346	Non-Physician Medical Practitioner	None	1114079050	0	0	TRAYLOR, RONALD L	6/28/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2840 WHITEGATE DRIVE	None	MERCED	CA	95340	2714	00	06000	37.31071211	-120.4368278	Merced County
299472	Non-Physician Medical Practitioner	None	1720177884	0	0	TILLEY, MARK A	5/6/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1408 COTTONWOOD ST	None	WOODLAND	CA	95695	5134	00	06000	38.66161679	-121.7934623	Yolo County
299501	Non-Physician Medical Practitioner	None	1841466406	0	0	TJANDRA, CORNELIA A NP	3/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
299529	Non-Physician Medical Practitioner	None	1750757043	0	0	TSCHABOLD, LYNETTE NP	2/8/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1502 BEDFORD AVE.	None	SUNNYVALE	CA	94807	3921	00	06000	37.34461619	-122.0623382	Santa Clara County
299531	Non-Physician Medical Practitioner	None	1932671435	0	0	TRAN, JENNIFER L NP	11/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	00	06000	34.27684353	-118.4684024	Los Angeles County
299557	Non-Physician Medical Practitioner	None	1720531148	0	0	THOMAS, EMILY R PA	2/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	316 MONROE ST	None	NEVADA CITY	CA	95959	2110	00	06000	39.26263597	-121.0233519	Nevada County
299579	Non-Physician Medical Practitioner	None	1538944764	0	0	TOKER, JONATHAN PA	11/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	225 N JACKSON AVE	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	00	06000	37.36217918	-121.8472051	Santa Clara County
299602	Non-Physician Medical Practitioner	None	1285277400	0	0	TOOMBS, ANNALEE PA-C	11/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2550 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	00	06000	40.14847323	-122.2180997	Tehama County
299638	Non-Physician Medical Practitioner	None	1174951016	0	0	TILLANO, DORIANNE NP	3/29/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	00	06000	33.89356031	-117.9271656	Orange County
299643	Non-Physician Medical Practitioner	None	1811462310	0	0	TYNAN, PATRICIA K NP	2/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3813	00	06000	33.89343304	-117.9279349	Orange County
299662	Non-Physician Medical Practitioner	None	1073949863	0	0	TABONE, BRENDA A NP	11/27/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16152 BEACH BLVD	#200	HUNTINGTON BEACH	CA	92647	3806	00	06000	33.72889962	-117.9891397	Orange County
299665	Non-Physician Medical Practitioner	None	1780939066	0	0	THISSEN, GISELE M NP	10/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1832 E BELLA SENTERIO AV	None	FRESNO	CA	93730	7038	00	06000	36.90629537	-119.7494139	Fresno County
299669	Non-Physician Medical Practitioner	None	1073160081	0	0	THIELING, RACQUELLE R NP	11/25/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1450 SAN PABLO STREET	SUITE 6200	LOS ANGELES	CA	90033	4500	00	06000	34.06189518	-118.203256	Los Angeles County
299709	Non-Physician Medical Practitioner	None	1285157818	0	0	THOMPSON, JASON A	10/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2200 H STREET	None	SACRAMENTO	CA	95816	4024	00	06000	38.577879	-121.476195	Sacramento County
299720	Non-Physician Medical Practitioner	None	1285303339	0	0	TRAN, PETER PA-C	3/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	801 S BROOKHURST ST.	None	ANAHEIM	CA	92804	4302	00	06000	33.821568	-117.9589665	Orange County
299759	Non-Physician Medical Practitioner	None	1487344677	0	0	TORRES, SABRINA PA	11/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	575 LENNON LN	None	WALNUT CREEK	CA	94598	2443	00	06000	37.92946711	-122.0316061	Contra Costa County
299762	Non-Physician Medical Practitioner	None	1619406287	0	0	TOBLER, CLARK J NP	4/17/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2510 AIRPARK DR	STE 301	REDDING	CA	96001	2462	00	06000	40.57119566	-122.4016582	Shasta County
299793	Non-Physician Medical Practitioner	None	1538615778	0	0	TRAN, KATIE D NP	11/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3661 JULIAN AVENUE	None	LONG BEACH	CA	90808	3113	00	06000	33.82307552	-118.0772024	Los Angeles County
299814	Non-Physician Medical Practitioner	None	1689387490	0	0	TAN, MICHELLE PA-C	12/6/2023	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
299831	Non-Physician Medical Practitioner	None	1487357224	0	0	TIEU, ELIZABETH NP	6/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2650 S BRISTOL ST	STE 101-103	SANTA ANA	CA	92704	5751	00	06000	33.71118647	-117.885452	Orange County
299870	Non-Physician Medical Practitioner	None	1295139244	0	0	TIEDGE, NORMA NP	7/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
299875	Non-Physician Medical Practitioner	None	1972329779	0	0	TAMAYO, CARMENCITA R NP	3/4/2025	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
299883	Non-Physician Medical Practitioner	None	1316689185	0	0	TASSEW, NAHOM NP	8/4/2023	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
299887	Non-Physician Medical Practitioner	None	1750632253	0	0	TRAN, EVANS PHUNG	11/7/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3801 KATELLA AVE	SUITE 110	LOS ALAMITOS	CA	90720	3338	00	06000	33.80318951	-118.066068	Orange County
299912	Non-Physician Medical Practitioner	None	1083040117	0	0	TAYLOR, JONATHAN L	1/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	370 FILLMORE STREET	UNIT 3	SAN FRANCISCO	CA	94117	3443	00	06000	37.77284405	-122.430543	San Francisco County
299957	Non-Physician Medical Practitioner	None	1457981748	0	0	THAPA, SUBITA NP	1/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5122 KATELLA AVE	STE 308	LOS ALAMITOS	CA	90720	2826	00	06000	33.80290311	-118.0433422	Orange County
299961	Non-Physician Medical Practitioner	None	1740818012	0	0	TIZCARENO, YOLANDA	10/15/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2210 E ILLINOIS	STE 406	FRESNO	CA	93701	2167	00	06000	36.74500687	-119.7846885	Fresno County
299971	Non-Physician Medical Practitioner	None	1144642109	0	0	TAHERAN, CHRISTINE NP	6/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 W STEWART DR	None	ORANGE	CA	92868	3849	00	06000	33.78236558	-117.8648414	Orange County
299988	Non-Physician Medical Practitioner	None	1184607376	0	0	TALAMANTES, ENRIQUE JR	7/28/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6084 JOSIE STREET	None	ATWATER	CA	95301	9105	00	06000	37.310388	-120.5981184	Merced County
300034	Non-Physician Medical Practitioner	None	1548880750	0	0	TERRELL, SHARKEIYA T NP	6/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2752 HARRISON AVE	STE A	EUREKA	CA	95501	4738	00	06000	40.7831071	-124.139684	Humboldt County
300043	Non-Physician Medical Practitioner	None	1124761309	0	0	TOMAGAN, RENALEEN NP	4/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11370 ANDERSON ST	STE 2050	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
300064	Non-Physician Medical Practitioner	None	1437877834	0	0	TAPULOA, SERYNA	10/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	615 OCEAN ST	None	SANTA CRUZ	CA	95060	4005	00	06000	36.97734512	-122.0204895	Santa Cruz County
300070	Non-Physician Medical Practitioner	None	1407165350	0	0	TEITLER, LEAH	12/26/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1150 VETERANS BLVD	GASTROENTEROLOGY	REDWOOD CITY	CA	94063	2037	00	06000	37.48948529	-122.2232468	San Mateo County
300079	Non-Physician Medical Practitioner	None	1558472845	0	0	TINIO, SUSANNA	7/22/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	423 7TH STREET	UNIT 602	OAKLAND	CA	94607	6550	00	06000	37.79930565	-122.2737748	Alameda County
300084	Non-Physician Medical Practitioner	None	1851775795	0	0	THE CHILDREN'S CLINIC, 'SERVING CHILDREN & THEIR F	11/25/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1574 LINDEN AVE	None	LONG BEACH	CA	90813	2032	00	06000	33.786486	-118.1866335	Los Angeles County
300139	Non-Physician Medical Practitioner	None	1942345939	0	0	THE CHILDREN'S CLINIC, SERVING CHILDREN AND THEIR	9/18/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1301 W 12TH ST	None	LONG BEACH	CA	90813	2720	00	06000	33.78201945	-118.2088381	Los Angeles County
300247	Non-Physician Medical Practitioner	None	1144500760	0	0	THORPE, SHELLY N NP	7/25/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1150 FRONT ST	None	KLAMATH FALLS	OR	97601	1106	00	06000	42.24102759	-121.811513	Klamath County
300286	Non-Physician Medical Practitioner	None	1760799324	0	0	TUOZO, FROILAN C NP	2/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	314 W SUMMERFIELD CIRCLE	None	ANAHEIM	CA	92802	4771	00	06000	33.79219125	-117.9112376	Orange County
300298	Non-Physician Medical Practitioner	None	1811074677	0	0	TRIPP, ELTON R	3/10/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	282 HEMINGWAY COURT	None	TULARE	CA	93274	6046	00	06000	36.23611295	-119.3515003	Tulare County
300308	Non-Physician Medical Practitioner	None	1205402377	0	0	TRAN, ALEXANDER PA-C	10/17/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	00	06000	37.25111017	-121.9465891	Santa Clara County
300328	Non-Physician Medical Practitioner	None	1326769837	0	0	TRAN, MATTHEW B PA-C	2/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	00	06000	37.43920432	-122.162109	Santa Clara County
300393	Non-Physician Medical Practitioner	None	1447556170	0	0	THE CHILDREN'S CLINIC 'SERVING CHILDREN AND THEIR	12/16/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17660 LAKEWOOD BLVD	None	BELLFLOWER	CA	90706	6410	00	06000	33.87138705	-118.142548	Los Angeles County
300455	Non-Physician Medical Practitioner	None	1699800383	0	0	TIDWELL, BRENDA L NP	11/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17026 IDAHO AVENUE	None	LEMOORE	CA	93245	9112	00	06000	36.26920327	-119.7634588	Kings County
300493	Non-Physician Medical Practitioner	None	1689178659	0	0	TAWIL, CHRISTINE PA-C	12/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8112 MILLIKEN AVE	SUITE 201	RANCHO CUCAMONGA	CA	91730	7473	00	06000	34.10480366	-117.5570863	San Bernardino County
300501	Non-Physician Medical Practitioner	None	1609439553	0	0	TURNAGE, ANDREA M NP	9/16/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 N MEDICAL CENTER DR	STE. 125	CLOVIS	CA	93611	6881	00	06000	36.84186593	-119.6624867	Fresno County
300520	Non-Physician Medical Practitioner	None	1114033867	0	0	TODD, WILLIAM D	3/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	104 N CENTER ST	None	REDLANDS	CA	92373	8128	00	06000	34.05550955	-117.1925662	San Bernardino County
300535	Non-Physician Medical Practitioner	None	1801154463	0	0	TOTAL CARE MEDICAL CLINIC INC	3/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1110 W ANAHEIM ST	SUITE 6	WILMINGTON	CA	90744	4131	00	06000	33.77921216	-118.2759309	Los Angeles County
300545	Non-Physician Medical Practitioner	None	1932502440	0	0	TURNER, DARRYL J NP	12/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1020 29TH ST	STE 120	SACRAMENTO	CA	95816	5173	00	06000	38.572803	-121.4685	Sacramento County
300562	Non-Physician Medical Practitioner	None	1740966449	0	0	THAYER, KELSEY N PA-C	2/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	490 POST ST	STE 1701	SAN FRANCISCO	CA	94102	1308	00	06000	37.78812774	-122.4096884	San Francisco County
300575	Non-Physician Medical Practitioner	None	1609587328	0	0	TESFAYE, BEYENE PA	12/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5311 HOPYARD RD	None	PLEASANTON	CA	94588	3307	00	06000	37.69896849	-121.9046448	Alameda County
300598	Non-Physician Medical Practitioner	None	1144855107	0	0	TAWFILIS, AMY C NP	3/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9850 GENESEE AVE	SUITE 440	SAN DIEGO	CA	92037	1212	00	06000	32.882913	-117.226341	San Diego County
300630	Non-Physician Medical Practitioner	None	1154083939	0	0	TOUBAT, KASEM H PA	6/23/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
300635	Non-Physician Medical Practitioner	None	1619272218	0	0	TEKLEHAIMANOTE, CHRISTINE H	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	1028 SPENCER AVE	None	SAN JOSE	CA	95125	1673	00	06000	37.31388146	-121.8920975	Santa Clara County
300648	Non-Physician Medical Practitioner	None	1629146881	0	0	TOLENTINO, LORELIE	10/4/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1873 COMMERCENTER WEST	None	SAN BERNARDINO	CA	92408	0000	00	06000	34.067781	-117.286122	San Bernardino County
300660	Non-Physician Medical Practitioner	None	1205205788	0	0	TURNER, SHANNON P NP	1/29/2018	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
300666	Non-Physician Medical Practitioner	None	1609235613	0	0	TRUONG, DANNY N NP	5/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	938 STEELE DR	None	BREA	CA	92821	2229	00	06000	33.93536869	-117.9114987	Orange County
300669	Non-Physician Medical Practitioner	None	1871790444	0	0	THOMAS, SELEAINA A	4/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39974 SAVANNA WAY	None	MURRIETA	CA	92563	4395	00	06000	33.55263619	-117.1654416	Riverside County
300671	Non-Physician Medical Practitioner	None	1962482877	0	0	TIPTON, SHANE A PA-C	10/3/2024	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
300744	Non-Physician Medical Practitioner	None	1275917692	0	0	THE CHILDREN'S CLINIC, 'SERVING CHILDREN & THEIR F	8/5/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2000 SAN GABRIEL AVENUE	None	LONG BEACH	CA	90810	0000	00	06000	33.79184648	-118.2238052	Los Angeles County
300758	Non-Physician Medical Practitioner	None	1487291431	0	0	TRUONG, DANIEL PA	12/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2116 E ORANGEBURG AVE	SUITE A	MODESTO	CA	95355	3370	00	06000	37.66354152	-120.958056	Stanislaus County
300800	Non-Physician Medical Practitioner	None	1447759725	0	0	THAO, YING NP	3/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4933 E FLORADORA AVE	None	FRESNO	CA	93727	1923	00	06000	36.75955076	-119.7302928	Fresno County
300849	Non-Physician Medical Practitioner	None	1508865031	0	0	TAYLOR, KATHY W	8/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	225 ROCHELLE COURT	None	ROSEVILLE	CA	95661	3921	00	06000	38.74695981	-121.2325504	Placer County
300854	Non-Physician Medical Practitioner	None	1114156171	0	0	THOMPSON, DIANE L	1/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	46102 GOLDEN ROAD	None	BIG BEAR CITY	CA	92314	2281	00	06000	34.28410786	-116.797343	San Bernardino County
300874	Non-Physician Medical Practitioner	None	1174111967	0	0	TRAN, AMY NP	10/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	00	06000	33.78785649	-117.8276715	Orange County
300905	Non-Physician Medical Practitioner	None	1841751815	0	0	TRAN, MA KOREENA JAYNE Y PA	1/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1514 VALLEY VISTA DR	None	DIAMOND BAR	CA	91765	3929	00	06000	33.99491668	-117.8399137	Los Angeles County
300933	Non-Physician Medical Practitioner	None	1164670592	0	0	TURNER, VIVIAN SAKURA	9/15/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8007 E GOLDENROD LN	None	ANAHEIM	CA	92808	1937	00	06000	33.86167095	-117.7413803	Orange County
300945	Non-Physician Medical Practitioner	None	1447038518	0	0	TER-BARSEGHYAN, ARMINE PA	1/11/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1737 W GLENOAKS BLVD	None	GLENDALE	CA	91201	1542	00	06000	34.17214599	-118.2908947	Los Angeles County
300966	Non-Physician Medical Practitioner	None	1457023681	0	0	TANNACI, GRACE L NP	12/6/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1575 SOQUEL DRIVE	SUITE C	SANTA CRUZ	CA	95065	1700	00	06000	36.98861921	-121.9831127	Santa Cruz County
300971	Non-Physician Medical Practitioner	None	1174589923	0	0	TRAMPOSH, LISA MARIE	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	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	00	06000	38.576079	-121.2938325	Sacramento County
300995	Non-Physician Medical Practitioner	None	1326604216	0	0	TALLMAN, KELSEY E PA-C	8/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
301060	Non-Physician Medical Practitioner	None	1245995323	0	0	TROUPE, KYLE B NP	10/5/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8670 WILSHIRE BLVD	STE 200	BEVERLY HILLS	CA	90211	2930	00	06000	34.06629779	-118.3807407	Los Angeles County
301093	Non-Physician Medical Practitioner	None	1417963398	0	0	TORRES, MARIA C	8/22/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1349 GROVE AVE	None	UPLAND	CA	91786	2858	00	06000	34.112466	-117.629308	San Bernardino County
301154	Non-Physician Medical Practitioner	None	1548896079	0	0	TO, EMILY PA	4/13/2020	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
301172	Non-Physician Medical Practitioner	None	1073687893	0	0	THUMAN, CAROL L.	8/9/2004	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
301182	Non-Physician Medical Practitioner	None	1750866422	0	0	TERZYAN, ELIZABETH NP	6/12/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1509 WILSON TER	None	GLENDALE	CA	91206	4007	00	06000	34.14950866	-118.2311155	Los Angeles County
301229	Non-Physician Medical Practitioner	None	1508254095	0	0	TITTLE, TITIAN O NP	7/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	255 TERRACINA BLVD	STE 101	REDLANDS	CA	92373	4870	00	06000	34.03788441	-117.2055761	San Bernardino County
301263	Non-Physician Medical Practitioner	None	1689659203	0	0	THWEATT, ELAINE W NP	3/24/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	617 BEDFORD AVE	None	CLOVIS	CA	93611	7021	00	06000	36.84646051	-119.7050985	Fresno County
301266	Non-Physician Medical Practitioner	None	1598351033	0	0	TRAN, TRISH H PA-C	9/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17782 COWAN STE A	None	IRVINE	CA	92614	6041	00	06000	33.69590054	-117.862371	Orange County
301271	Non-Physician Medical Practitioner	None	1124227343	0	0	TOSCANO, MICHELLE M PA	8/13/2020	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
301273	Non-Physician Medical Practitioner	None	1619256625	0	0	TSAI, JAMIE H T NP	7/21/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4335 BELVEDERE DRIVE	None	SAN JOSE	CA	95129	2306	00	06000	37.31247524	-121.9789505	Santa Clara County
301281	Non-Physician Medical Practitioner	None	1841891710	0	0	THWE, HLAHLA M NP	3/29/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	FL 6	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
301302	Non-Physician Medical Practitioner	None	1912256439	0	0	TSU, WILLIAM V PA	9/26/2022	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
301335	Non-Physician Medical Practitioner	None	1588674527	0	0	TURPEN, TERRENCE C	4/26/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	601 COURT ST STE 210	None	JACKSON	CA	95642	2163	00	06000	38.35197656	-120.7705907	Amador County
301357	Non-Physician Medical Practitioner	None	1790327872	0	0	TOMS, KRISTIN PA	5/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4860 Y ST	None	SACRAMENTO	CA	95817	2307	00	06000	38.552211	-121.449429	Sacramento County
301382	Non-Physician Medical Practitioner	None	1346748365	0	0	TRASK, CHELSEA PA-C	1/28/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	00	06000	35.640783	-117.6698475	Kern County
301397	Non-Physician Medical Practitioner	None	1700327046	0	0	TRAN, NAM PA	7/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23931375	-121.8014189	Santa Clara County
301411	Non-Physician Medical Practitioner	None	1467089821	0	0	TRUONG, HIEN M PA	8/2/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3600 BROADWAY	None	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
301434	Non-Physician Medical Practitioner	None	1306344825	0	0	TSEGAY, DANIEL W NP	1/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1255 TRAVIS BLVD	None	FAIRFIELD	CA	94533	4801	00	06000	38.25815459	-122.0487714	Solano County
301436	Non-Physician Medical Practitioner	None	1720489024	0	0	TERZIAN, KEELEY D	7/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	130 N GARDEN ST	UNIT 1411	VENTURA	CA	93001	2557	00	06000	34.28284538	-119.3017938	Ventura County
301458	Non-Physician Medical Practitioner	None	1851955488	0	0	TAPIA, VANESSA	12/11/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	06000	36.180999	-115.3174815	Clark County
301494	Non-Physician Medical Practitioner	None	1972542447	0	0	TRUONG, JEFFREY C	10/5/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5501 HALISON ST	None	TORRANCE	CA	90503	1214	00	06000	33.85129453	-118.3707945	Los Angeles County
301577	Non-Physician Medical Practitioner	None	1568775641	0	0	TOVAR, JOSE NP	8/14/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 N PALM CANYON DR	STE 211	PALM SPRINGS	CA	92262	4426	00	06000	33.838182	-116.546744	Riverside County
301581	Non-Physician Medical Practitioner	None	1154458370	0	0	TAHA, ASMA A NP	10/9/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19502 DENAIR CT	None	RIVERSIDE	CA	92508	6132	00	06000	33.9068515	-117.3218085	Riverside County
301643	Non-Physician Medical Practitioner	None	1386901700	0	0	TOROK, ELIZABETH M NP	3/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	212 6TH STREET	None	SEAL BEACH	CA	90740	6133	00	06000	33.74314968	-118.1071165	Orange County
301659	Non-Physician Medical Practitioner	None	1215488697	0	0	TOAL, JACQUELINE J NP	7/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	00	06000	33.67831005	-117.852138	Orange County
301667	Non-Physician Medical Practitioner	None	1891391074	0	0	TEMPELIS, ERINN PA-C	9/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1050 LINDEN AVENUE	None	LONG BEACH	CA	90813	3321	00	06000	33.78003775	-118.1866604	Los Angeles County
301684	Non-Physician Medical Practitioner	None	1013730787	0	0	TOSTADO, LOUISA PA-C	3/24/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26357 MCBEAN PKWY	None	VALENCIA	CA	91355	4488	00	06000	34.41257644	-118.5597683	Los Angeles County
301725	Non-Physician Medical Practitioner	None	1710435250	0	0	TAGGAR, SHARNDIP CNP	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	4100 E COMMERCE WAY	BLDG J STE 100	SACRAMENTO	CA	95834	9679	00	06000	38.644866	-121.519188	Sacramento County
301741	Non-Physician Medical Practitioner	None	1518261858	0	0	TYLER, HOLLIE MAE	7/19/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2075 E FLAMINGO RD	None	LAS VEGAS	NV	89119	5188	00	06000	36.112671	-115.1248725	Clark County
301748	Non-Physician Medical Practitioner	None	1538223912	0	0	TROTTER, THOMAS C	2/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26485 MISSION FIELDS RD	None	CARMEL	CA	93923	9010	00	06000	36.53928998	-121.9147179	Monterey County
301754	Non-Physician Medical Practitioner	None	1346722741	0	0	TERREROS UGARTE, CHRISTOPHER PA-C	3/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 SOUTH MAIN STREET	SUITE 200	ORANGE	CA	92868	3852	00	06000	33.784695	-117.867327	Orange County
301803	Non-Physician Medical Practitioner	None	1154623890	0	0	TANG, MARIA ROSALIE S NP	5/21/2019	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
301808	Non-Physician Medical Practitioner	None	1568013142	0	0	THAI, DAVID NP	12/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	00	06000	34.68938848	-118.158354	Los Angeles County
301810	Non-Physician Medical Practitioner	None	1588360127	0	0	TAN, MARILETH NP	6/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	00	06000	35.38333823	-119.0188872	Kern County
301813	Non-Physician Medical Practitioner	None	1386045045	0	0	THAKKAR, MEGHA S PA-C	6/27/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
301834	Non-Physician Medical Practitioner	None	1629603972	0	0	THONG, SAU 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	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
301842	Non-Physician Medical Practitioner	None	1992229801	0	0	THOMETZ, AMANDA M PA-C	9/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8805 HAVEN AVE	SUITE 100	RANCHO CUCAMONGA	CA	91730	5149	00	06000	34.09424614	-117.5756838	San Bernardino County
301861	Non-Physician Medical Practitioner	None	1215411574	0	0	THOMPSON, NICOLE L NP	1/15/2019	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	None	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
301922	Non-Physician Medical Practitioner	None	1649929381	0	0	THOMPSON, CARALEA A NP	11/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6926 BROCKTON AVE	SUITE 6	RIVERSIDE	CA	92506	3804	00	06000	33.947919	-117.3967225	Riverside County
301927	Non-Physician Medical Practitioner	None	1427435247	0	0	TRAN, SYLVIA M	12/10/2019	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
301953	Non-Physician Medical Practitioner	None	1518203652	0	0	TRAN, HOAI-HUONG	1/30/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1704 PLEASANT VALLEY	APT 2	OAKLAND	CA	94611	4235	00	06000	37.82853097	-122.2448456	Alameda County
302072	Non-Physician Medical Practitioner	None	1811365877	0	0	TSE, BECKY BK NP	8/29/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1275 PINE CREEK WAY	B	CONCORD	CA	94520	5900	00	06000	37.96286112	-122.0382908	Contra Costa County
302083	Non-Physician Medical Practitioner	None	1760046924	0	0	TABUNGAR, VANESSA NP	8/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2270 E PALMDALE BLVD	STE F	PALMDALE	CA	93550	1334	00	06000	34.58009827	-118.0881861	Los Angeles County
302122	Non-Physician Medical Practitioner	None	1598357899	0	0	TORRIGIANI, MARISSA D PA-C	10/29/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41540 WINCHESTER	None	TEMECULA	CA	92590	4877	00	06000	33.52069117	-117.1653103	Riverside County
302158	Non-Physician Medical Practitioner	None	1033514567	0	0	THOMPSON, RACHEL R R	11/15/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3661 W SHIELD AVE	None	FRESNO	CA	93722	6586	00	06000	36.77902051	-119.8596735	Fresno County
302178	Non-Physician Medical Practitioner	None	1235279811	0	0	TOMLIN, NICOLE M	5/26/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9051 ANNIK DRIVE	None	HUNTINGTON BEACH	CA	92646	2759	00	06000	33.68000057	-117.9702662	Orange County
302217	Non-Physician Medical Practitioner	None	1558845792	0	0	TABIBIAN, MOJDEH	9/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5725 S SOTO ST	None	HUNTINGTON PARK	CA	90255	9993	00	06000	33.990444	-118.2193965	Los Angeles County
302230	Non-Physician Medical Practitioner	None	1720091929	0	0	TRAN, DEBBIE N	9/30/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11575 MISSOURI AVENUE	APT 9	LOS ANGELES	CA	90025	5479	00	06000	34.03988477	-118.449416	Los Angeles County
302246	Non-Physician Medical Practitioner	None	1326584095	0	0	THOMAS, STEPHEN P NP	11/6/2019	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
302271	Non-Physician Medical Practitioner	None	1902448475	0	0	TRAN, LONG D PA	1/24/2024	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	# B10	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
302316	Non-Physician Medical Practitioner	None	1760762983	0	0	TRUEBLOOD, NATHAN A	10/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3430 SEABRIGHT AVE	None	DAVIS	CA	95616	5641	00	06000	38.55952869	-121.7933426	Yolo County
302320	Non-Physician Medical Practitioner	None	1437860020	0	0	TAN, ANGELICA NP	1/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	461 TENNESSEE ST	SUITE C	REDLANDS	CA	92373	8161	00	06000	34.058745	-117.2000975	San Bernardino County
302324	Non-Physician Medical Practitioner	None	1598913410	0	0	TOUART, JACIE CHRISTINE	10/31/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4420 DUCKHORN DR STE 200	None	SACRAMENTO	CA	95834	2590	00	06000	38.651652	-121.532337	Sacramento County
302335	Non-Physician Medical Practitioner	None	1336316504	0	0	TEODORO, AMI C PA-C	9/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4531 ROLANDO BLVD	None	SAN DIEGO	CA	92115	5925	00	06000	32.7599778	-117.0565989	San Diego County
302339	Non-Physician Medical Practitioner	None	1588161442	0	0	THOMPSON-TUCKER, ALYSSA NP	12/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	38690 STIVERS ST	None	FREMONT	CA	94536	5279	00	06000	37.55724607	-121.9830866	Alameda County
302388	Non-Physician Medical Practitioner	None	1770989410	0	0	TOUSSAINT, TRACY NP	1/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	00	06000	33.6526055	-117.910746	Orange County
302389	Non-Physician Medical Practitioner	None	1003383480	0	0	TYLER, ANDREW PA-C	11/25/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	00	06000	34.12632952	-117.1956652	San Bernardino County
302444	Non-Physician Medical Practitioner	None	1427626456	0	0	TSANG, HUIYING PA-C	8/10/2022	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
302463	Non-Physician Medical Practitioner	None	1467823831	0	0	TRISTAN, JANA	1/9/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	06000	32.683167	-114.633459	Yuma County
302476	Non-Physician Medical Practitioner	None	1235959560	0	0	TOVMASYAN, JULIETA NP	2/17/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	606 34TH ST	None	BAKERSFIELD	CA	93301	2208	00	06000	35.39051746	-119.008611	Kern County
302505	Non-Physician Medical Practitioner	None	1386416006	0	0	TRAN, LAN PA-C	3/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	631 S BROOKHURST ST	SUITE # 101	ANAHEIM	CA	92804	3510	00	06000	33.823647	-117.9589675	Orange County
302552	Non-Physician Medical Practitioner	None	1881360543	0	0	TACHIQUIN, DENISE NP	8/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8150 HAGEMAN RD	None	BAKERSFIELD	CA	93312	1959	00	06000	35.40166449	-119.0933415	Kern County
302562	Non-Physician Medical Practitioner	None	1922443373	0	0	TOSTADO, TERESA AVENDANO	9/6/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	956 HUNTINGTON DR	None	SAN MARINO	CA	91108	1825	00	06000	34.11231693	-118.1258249	Los Angeles County
302611	Non-Physician Medical Practitioner	None	1831658145	0	0	TOPICO, JOSE JEFFREY C NP	3/9/2022	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
302621	Non-Physician Medical Practitioner	None	1497407399	0	0	TRAN, THU T PA-C	10/5/2022	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
302623	Non-Physician Medical Practitioner	None	1467527481	0	0	TANIMUNE, LISA	3/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	192 WATERSIDE CIRCLE	None	SAN RAFAEL	CA	94903	2792	00	06000	38.00763315	-122.5262093	Marin County
302639	Non-Physician Medical Practitioner	None	1669094587	0	0	TURNEY, CARLYNN PA	9/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	00	06000	38.571084	-121.471074	Sacramento County
302668	Non-Physician Medical Practitioner	None	1770984064	0	0	TRACY, KRISTIN PA	3/16/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	06000	36.21499805	-115.2504953	Clark County
302679	Non-Physician Medical Practitioner	None	1487353082	0	0	TRAN, RICHARD NP	9/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9850 GENESEE AVE	SUITE 570	LA JOLLA	CA	92037	1224	00	06000	32.882913	-117.226341	San Diego County
302701	Non-Physician Medical Practitioner	None	1306524731	0	0	THAPA MAGAR, RITU NP	2/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	82013 DOCTOR CARREON BLV	STE G	INDIO	CA	92201	4832	00	06000	33.70738152	-116.233002	Riverside County
302718	Non-Physician Medical Practitioner	None	1417324344	0	0	TANABE, KYLIE L	3/9/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	640 N BEACHWOOD DR	STE 103	LOS ANGELES	CA	90004	1424	00	06000	34.08287509	-118.3216757	Los Angeles County
302737	Non-Physician Medical Practitioner	None	1629628649	0	0	TATLONGHARI, WILLIAMRAY N PA-C	8/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	00	06000	36.98191238	-121.9975767	Santa Cruz County
302769	Non-Physician Medical Practitioner	None	1881877876	0	0	TURNER, LISA S	3/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1537 S RICE RD	None	OJAI	CA	93023	3863	00	06000	34.43013368	-119.2932342	Ventura County
302775	Non-Physician Medical Practitioner	None	1336441153	0	0	TURNBULL, SANDRA L NP	11/21/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
302802	Non-Physician Medical Practitioner	None	1982843173	0	0	TALIERCIO, HOWARD W A	11/30/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1636 GULF AVE	None	WILMINGTON	CA	90744	1309	00	06000	33.79589869	-118.2742131	Los Angeles County
302818	Non-Physician Medical Practitioner	None	1144403676	0	0	TRAN, LONG THANH	12/28/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7750 LA MONICA ST	None	HIGHLAND	CA	92346	6354	00	06000	34.11242175	-117.1355138	San Bernardino County
302857	Non-Physician Medical Practitioner	None	1366102154	0	0	TRUJILLO, VICTORIA NP	8/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25405 HANCOCK AVENUE	STE. 105	MURRIETA	CA	92562	5978	00	06000	33.5580833	-117.1850127	Riverside County
302859	Non-Physician Medical Practitioner	None	1598956815	0	0	TAGUINOD, GENEVIEVE	5/10/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11480 BROOKSHIRE AVE	SUITE 309	DOWNEY	CA	90241	5018	00	06000	33.93622932	-118.1311752	Los Angeles County
302898	Non-Physician Medical Practitioner	None	1962586339	0	0	TROLINGER, JOANNA	4/12/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	770 MASON ST	None	VACAVILLE	CA	95688	4646	00	06000	38.35504697	-121.983852	Solano County
302914	Non-Physician Medical Practitioner	None	1871845917	0	0	TROEGER, DAWN NP	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	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
302915	Non-Physician Medical Practitioner	None	1821693490	0	0	TURPIN, IVAN J PA-C	11/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 COFFEE RD	None	MODESTO	CA	95355	2803	00	06000	37.668645	-120.9756715	Stanislaus County
302938	Non-Physician Medical Practitioner	None	1952014201	0	0	TABAFUNDA, SHARLET NP	4/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1680 EAST 120TH STREET	None	LOS ANGELES	CA	90059	3026	00	06000	33.92456051	-118.2417525	Los Angeles County
302945	Non-Physician Medical Practitioner	None	1184943367	0	0	TILAK, SNEHA	6/21/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3000 Q ST	None	SACRAMENTO	CA	95816	7058	00	06000	38.564991	-121.4696565	Sacramento County
302968	Non-Physician Medical Practitioner	None	1013461698	0	0	TANG, SONYA PA	2/20/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1502 WEST COVINA PKWY	None	WEST COVINA	CA	91790	2703	00	06000	34.06975232	-117.9394512	Los Angeles County
302978	Non-Physician Medical Practitioner	None	1396484945	0	0	TALAMANTEZ, JUAN NP	2/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	00	06000	35.38333823	-119.0188872	Kern County
302994	Non-Physician Medical Practitioner	None	1396052007	0	0	THOMAS, KIMBERLY E PA	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	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	00	06000	32.55831005	-117.0475102	San Diego County
303000	Non-Physician Medical Practitioner	None	1225327257	0	0	TURINGAN, GENALYN G PA-C	9/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15944 LOS SERRANOS COUNT	STE 110	CHINO HILLS	CA	91709	6377	00	06000	33.9635227	-117.695881	San Bernardino County
303040	Non-Physician Medical Practitioner	None	1730251794	0	0	TANAKA, LINDA KUMIKO	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	2350 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3305	00	06000	37.78305866	-122.4421313	San Francisco County
303218	Non-Physician Medical Practitioner	None	1346393196	0	0	TRAN, LYNN KIM	5/1/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	407 W COLLEGE ST	None	LOS ANGELES	CA	90012	2313	00	06000	34.06413934	-118.237719	Los Angeles County
303228	Non-Physician Medical Practitioner	None	1912200072	0	0	TURCIOS, YESENIA ESMERALDA	7/17/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	00	06000	34.0981755	-118.295055	Los Angeles County
303274	Non-Physician Medical Practitioner	None	1679304844	0	0	TRENDT, MEGAN M PA-C	10/16/2024	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
303279	Non-Physician Medical Practitioner	None	1487427621	0	0	TSO, IRIS PA-C	11/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
303287	Non-Physician Medical Practitioner	None	1144389990	0	0	TING, JANET	5/10/2011	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 DEPT 1	None	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
303306	Non-Physician Medical Practitioner	None	1093306367	0	0	TAKANO, MAYA PA	11/3/2023	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
303308	Non-Physician Medical Practitioner	None	1902379233	0	0	TRUONG, LINA PA-C	11/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	06000	36.132948	-115.136874	Clark County
303322	Non-Physician Medical Practitioner	None	1871884585	0	0	TULARE LOCAL HEALTH CARE DISTRICT	2/27/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16796 AVENUE 168	None	WOODVILLE	CA	93257	0000	00	06000	36.09525474	-119.1967539	Tulare County
303347	Non-Physician Medical Practitioner	None	1891046330	0	0	TRAN, VY-VAN	11/2/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1212 S BRISTOL ST STE 16	None	SANTA ANA	CA	92704	3439	00	06000	33.731874	-117.8852195	Orange County
303377	Non-Physician Medical Practitioner	None	1487960910	0	0	TRINIDAD, REYGIL S	6/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6901 VANGUARD AVE	None	GARDEN GROVE	CA	92845	1408	00	06000	33.78738613	-118.0124441	Orange County
303416	Non-Physician Medical Practitioner	None	1639935968	0	0	TEJADA, VINCENT-RAY NP	2/11/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	00	06000	34.0956033	-118.2916918	Los Angeles County
303419	Non-Physician Medical Practitioner	None	1184228256	0	0	TSAI, MICHELLE NP	4/16/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11160 WARNER AVE	STE 417	FOUNTAIN VALLEY	CA	92708	8703	00	06000	33.71630854	-117.934317	Orange County
303480	Non-Physician Medical Practitioner	None	1023858925	0	0	THOMAS, MEDJINN NP	8/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1010 W CHAPMAN AVE	None	ORANGE	CA	92868	2847	00	06000	33.78785047	-117.8631495	Orange County
303482	Non-Physician Medical Practitioner	None	1629322110	0	0	TIU, MARIA M	12/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1624 ORCHARD DR	APT P	PLACENTIA	CA	92870	7422	00	06000	33.8711187	-117.8298057	Orange County
303488	Non-Physician Medical Practitioner	None	1275108037	0	0	TRAN, THUHANG C PA	8/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	00	06000	34.04805253	-117.249534	San Bernardino County
303571	Non-Physician Medical Practitioner	None	1982367306	0	0	TRAN, KEVIN PA-C	7/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1887 MONTEREY RD	STE 200	SAN JOSE	CA	95112	6136	00	06000	37.308636	-121.8664102	Santa Clara County
303598	Non-Physician Medical Practitioner	None	1295016368	0	0	TAGAN, DOROTHY A NP	4/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3122 CALLE GRANDE VISTA	None	SAN CLEMENTE	CA	92672	4338	00	06000	33.45209728	-117.6480544	Orange County
303611	Non-Physician Medical Practitioner	None	1992938559	0	0	TOY, LILY WONG	1/10/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1501 TROUSDALE DR FL 5	None	BURLINGAME	CA	94010	4506	00	06000	37.592811	-122.382351	San Mateo County
303630	Non-Physician Medical Practitioner	None	1073815353	0	0	TOKUNAGA, ALICIA	3/17/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2621 S BRISTOL ST #203	None	SANTA ANA	CA	92707	0000	00	06000	33.711876	-117.885371	Orange County
303649	Non-Physician Medical Practitioner	None	1376731257	0	0	TRIPP, ARTURO	7/28/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15852 MOHICAN WAY	None	VICTORVILLE	CA	92394	6736	00	06000	34.53664802	-117.3503908	San Bernardino County
303694	Non-Physician Medical Practitioner	None	1982087680	0	0	TUBBS, RUTH S NP	8/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	521 LEONA DRIVE	None	LIVERMORE	CA	94550	5237	00	06000	37.67019086	-121.797965	Alameda County
303696	Non-Physician Medical Practitioner	None	1831668508	0	0	TRINH, PETER T PA-C	8/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	00	06000	33.68568661	-117.9714001	Orange County
303704	Non-Physician Medical Practitioner	None	1053733709	0	0	TORRES, NADIA J NP	2/28/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10534 HEATHER ST	None	ALTA LOMA	CA	91737	4407	00	06000	34.13375098	-117.575132	San Bernardino County
303744	Non-Physician Medical Practitioner	None	1912466848	0	0	TRAN, MICHAEL NP	4/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9201 W SUNSET BLVD	SUITE 812	WEST HOLLYWOOD	CA	90069	3709	00	06000	34.09054375	-118.392295	Los Angeles County
303820	Non-Physician Medical Practitioner	None	1285101956	0	0	TINSLEY, EBONY Y PA-C	4/28/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	00	06000	34.28200485	-118.4030797	Los Angeles County
303839	Non-Physician Medical Practitioner	None	1124503057	0	0	TKACS, JESSICA NP	8/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
303851	Non-Physician Medical Practitioner	None	1710320031	0	0	TAN, NORALDA Q NP	2/16/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27341 ROSE MALLOW LANE	None	CANYON COUNTRY	CA	91387	6954	00	06000	34.41022161	-118.4325928	Los Angeles County
303868	Non-Physician Medical Practitioner	None	1124421532	0	0	TANAKA, KARIN N	10/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	130 BLAKE AVENUE	None	SANTA CLARA	CA	95051	6804	00	06000	37.32557651	-121.9800956	Santa Clara County
303880	Non-Physician Medical Practitioner	None	1548621006	0	0	TRASCA, FELICIA	4/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8680 N GLENN AVE	STE 218	FRESNO	CA	93711	6944	00	06000	36.8630894	-119.7939706	Fresno County
303934	Non-Physician Medical Practitioner	None	1073723284	0	0	TEFERA, EDEN A	5/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29 SUNSET RIDGE CIRCLE	None	POMONA	CA	91766	4941	00	06000	34.03899412	-117.7698136	Los Angeles County
303950	Non-Physician Medical Practitioner	None	1285930396	0	0	TARZANA TREATMENT CENTERS, INC.	9/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	422 W AVENUE P STE C280	None	PALMDALE	CA	93551	3793	00	06000	34.6016397	-118.1369679	Los Angeles County
304016	Non-Physician Medical Practitioner	None	1831220102	0	0	TRAN, JACQUELINE D	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	3202 LINDA WAY	None	SANTA ANA	CA	92704	6140	00	06000	33.70486416	-117.8950036	Orange County
304108	Non-Physician Medical Practitioner	None	1316333792	0	0	TOMICICH, STEPHANIE S NP	9/7/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3839 VIA ESCUDA	None	LA MESA	CA	91941	7315	00	06000	32.74927606	-116.9517195	San Diego County
304125	Non-Physician Medical Practitioner	None	1871291328	0	0	TADROS, MATTHEW M PA	6/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2623 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	00	06000	33.98921547	-118.2242565	Los Angeles County
304145	Non-Physician Medical Practitioner	None	1952838120	0	0	TANGCORA, JHO M S NP	8/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20 PARK ST	APT B	ALHAMBRA	CA	91801	5826	00	06000	34.08909403	-118.1222631	Los Angeles County
304166	Non-Physician Medical Practitioner	None	1043688161	0	0	TITUS, JENINE K NP	11/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31845 TEMECULA PKWY	STE 102	TEMECULA	CA	92592	0001	00	06000	33.48002471	-117.1022044	Riverside County
304167	Non-Physician Medical Practitioner	None	1780346072	0	0	TRAVIS, LIISA M NP	3/10/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
304208	Non-Physician Medical Practitioner	None	1033543533	0	0	TIEMPO, STEPHANIE B NP	3/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10849 RESEDA BOULEVARD	None	NORTHRIDGE	CA	91326	3134	00	06000	34.26777	-118.5361395	Los Angeles County
304210	Non-Physician Medical Practitioner	None	1043455140	0	0	TSHIAMALA, PRESCILLIA M	12/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
304217	Non-Physician Medical Practitioner	None	1528519519	0	0	THORNE, NICHOLE NP	4/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	00	06000	33.67831005	-117.852138	Orange County
304234	Non-Physician Medical Practitioner	None	1003228115	0	0	THAN, GINNY K NP	4/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
304238	Non-Physician Medical Practitioner	None	1821474230	0	0	TIWANA, SUPINDER K NP	10/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4128 CASTELLINA WAY	None	MANTECA	CA	95337	8456	00	06000	37.77927246	-121.2913023	San Joaquin County
304243	Non-Physician Medical Practitioner	None	1679701049	0	0	TU, GRACE M	9/22/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13042 MOZART WAY	None	CERRITOS	CA	90703	1379	00	06000	33.87919248	-118.053711	Los Angeles County
304245	Non-Physician Medical Practitioner	None	1629510433	0	0	TENG, DIANA NP	2/8/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	00	06000	37.592811	-122.382351	San Mateo County
304261	Non-Physician Medical Practitioner	None	1457431348	0	0	TSE, FRANKLIN MUNG	2/20/2013	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 ST	None	MORENO VALLEY	CA	92553	6102	00	06000	33.91718453	-117.228627	Riverside County
304271	Non-Physician Medical Practitioner	None	1538269592	0	0	TRAN, CINDY C	12/9/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	782 CAMINO MAGNIFICO	None	SAN MARCOS	CA	92069	7356	00	06000	33.16561902	-117.183056	San Diego County
304283	Non-Physician Medical Practitioner	None	1568760577	0	0	TATEL, EMILY NP	5/26/2017	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
304328	Non-Physician Medical Practitioner	None	1851435457	0	0	TADESSE, AKLIL	3/3/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2618 S WESTERN AVE	None	LOS ANGELES	CA	90018	2627	00	06000	34.03197	-118.3089435	Los Angeles County
304341	Non-Physician Medical Practitioner	None	1669984282	0	0	TRUDEAU, MEGHAN PA-C	6/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	190 LEAVESLEY	STE 102	GILROY	CA	95020	3635	00	06000	37.01991719	-121.5728065	Santa Clara County
304370	Non-Physician Medical Practitioner	None	1306245519	0	0	TOMCZYK, THAO D PA-C	12/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9041 MAGNOLIA AVE	STE 305	RIVERSIDE	CA	92503	3957	00	06000	33.92541585	-117.4378266	Riverside County
304382	Non-Physician Medical Practitioner	None	1851712426	0	0	THOMAS, JACQUE A NP	3/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 30TH ST	100	OAKLAND	CA	94609	3422	00	06000	37.81892183	-122.2640154	Alameda County
304388	Non-Physician Medical Practitioner	None	1215358924	0	0	THE DAVIS STREET COMMUNITY CENTER INCORPORATED	5/12/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3081 TEGARDEN	None	SAN LEANDRO	CA	94577	5720	00	06000	37.70519163	-122.1536391	Alameda County
304409	Non-Physician Medical Practitioner	None	1982710174	0	0	TRAN, VINH-NINH P NP	7/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	520 N MAIN ST	SUITE 120	SANTA ANA	CA	92701	4623	00	06000	33.749316	-117.868123	Orange County
304462	Non-Physician Medical Practitioner	None	1598004574	0	0	TOUSSAINT, RUTH B NP	5/2/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	905 S HALE AVE	APT 12	ESCONDIDO	CA	92029	2161	00	06000	33.11200831	-117.10741	San Diego County
304464	Non-Physician Medical Practitioner	None	1528624558	0	0	TAKLA, FRANCOIS NP	5/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4500 BROCKTON AVE	STE 319	RIVERSIDE	CA	92501	4090	00	06000	33.97785263	-117.3836152	Riverside County
304466	Non-Physician Medical Practitioner	None	1245754258	0	0	TADI, MARISSA J NP	10/11/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3512 RICHMOND AVE	None	CLOVIS	CA	93619	8035	00	06000	36.85799055	-119.64564	Fresno County
304474	Non-Physician Medical Practitioner	None	1356365563	0	0	TURPIN, TIFFANY C PA-C	6/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
304551	Non-Physician Medical Practitioner	None	1669107512	0	0	TADEVICH, MIRANDA	5/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	447 W EATON AVE	None	TRACY	CA	95376	3420	00	06000	37.74338833	-121.432305	San Joaquin County
304591	Non-Physician Medical Practitioner	None	1528150539	0	0	TREGO, NANCY C	11/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	00	06000	38.32103673	-122.3025002	Napa County
304594	Non-Physician Medical Practitioner	None	1215639315	0	0	TRUONG, DAN PA	11/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3655 RAMON RD	None	PALM SPRINGS	CA	92264	1150	00	06000	33.81585702	-116.5066057	Riverside County
304671	Non-Physician Medical Practitioner	None	1962420539	0	0	THONEY, JIHANN M	2/18/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7955 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4001	00	06000	33.75932839	-117.9902744	Orange County
304679	Non-Physician Medical Practitioner	None	1679979553	0	0	TIBURCIO VASQUEZ HEALTH CENTER, INC.	5/13/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1633 EAST AVE	None	HAYWARD	CA	94541	5314	00	06000	37.67250121	-122.0686664	Alameda County
304693	Non-Physician Medical Practitioner	None	1871648196	0	0	TIBBETTS, NANCY M CNM	1/29/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 SIERRA COLLEGE DR	STE 115	GRASS VALLEY	CA	95945	5763	00	06000	39.23410746	-121.0515391	Nevada County
304723	Non-Physician Medical Practitioner	None	1811551096	0	0	TEETER, KELLY L PA-C	7/12/2022	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
304733	Non-Physician Medical Practitioner	None	1073228797	0	0	TRAN, TINA PHUONG PA-C	9/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
304750	Non-Physician Medical Practitioner	None	1588790836	0	0	TANG, NANCY	11/15/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
304815	Non-Physician Medical Practitioner	None	1760032692	0	0	TOLENTINO, DENACEL NP	12/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	555 E HARDY ST	IRA KAUFMAN PAVILION	INGLEWOOD	CA	90301	4106	00	06000	33.94909549	-118.3481595	Los Angeles County
304850	Non-Physician Medical Practitioner	None	1184173288	0	0	TESHOME, REDET CNP	3/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1155 MILL ST	None	RENO	NV	89502	1576	00	06000	39.52483792	-119.7968314	Washoe County
304868	Non-Physician Medical Practitioner	None	1316644545	0	0	TINTLY, ANN PA-C	6/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12601 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	1908	00	06000	33.77450951	-117.913014	Orange County
304953	Non-Physician Medical Practitioner	None	1164749206	0	0	TOMATSU, ELIZABETH LEE	8/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4751 ARAGON DR	None	SAN DIEGO	CA	92115	4219	00	06000	32.76441565	-117.057157	San Diego County
304985	Non-Physician Medical Practitioner	None	1184609208	0	0	TARAZON, JENNIFER G NP	8/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5567 WEST BEECHWOOD AVE	None	FRESNO	CA	93722	2806	00	06000	36.83817652	-119.891803	Fresno County
305043	Non-Physician Medical Practitioner	None	1033926472	0	0	THOMAS, KATHRINE NP	2/3/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1423 MAGNOLIA	None	CHICO	CA	95926	3226	00	06000	39.74063551	-121.8499048	Butte County
305053	Non-Physician Medical Practitioner	None	1710793146	0	0	TEAGUE, COURTNEY J PA	2/12/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2309 ANTONIO AVE	None	CAMARILLO	CA	93010	1414	00	06000	34.24435917	-119.0191975	Ventura County
305058	Non-Physician Medical Practitioner	None	1639547631	0	0	TIPEI, CRISTINA -	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	135 CARMEN LN	None	SANTA MARIA	CA	93458	7729	00	06000	34.92484952	-120.4374645	Santa Barbara County
305094	Non-Physician Medical Practitioner	None	1134947955	0	0	TU, JUDY NP	10/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	650 W ALLUVIAL AVE	#101	FRESNO	CA	93711	5507	00	06000	36.84470615	-119.8046407	Fresno County
305113	Non-Physician Medical Practitioner	None	1154580348	0	0	TRI-CITY PETCT LLC	10/13/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	902 SYCAMORE AVE	None	VISTA	CA	92081	7879	00	06000	33.16083881	-117.2197986	San Diego County
305128	Non-Physician Medical Practitioner	None	1063464022	0	0	TOLEDO, SILVA P PA-C	5/31/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
305144	Non-Physician Medical Practitioner	None	1336653195	0	0	TOUGH, DARCIE R RN	9/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	00	06000	34.47092468	-117.2977236	San Bernardino County
305148	Non-Physician Medical Practitioner	None	1003182130	0	0	THOMPSON, KATHRYN L PA-C	10/21/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1010 W LA VETA AVE	STE 200	ORANGE	CA	92868	4301	00	06000	33.78028244	-117.8635552	Orange County
305167	Non-Physician Medical Practitioner	None	1275511354	0	0	THOMAS, SUE A NP	2/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10786 N EAGLE CREST LN	None	FRESNO	CA	93730	3594	00	06000	36.89365751	-119.7535182	Fresno County
305177	Non-Physician Medical Practitioner	None	1083008254	0	0	TYCE, MARETHA S 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	5711 29TH STREET	None	RIVERSIDE	CA	92509	2006	00	06000	34.00830834	-117.4006745	Riverside County
305281	Non-Physician Medical Practitioner	None	1841347226	0	0	TUITE, CLARE K	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	223 PASEO DE GRANADA	None	REDONDO BEACH	CA	90277	6720	00	06000	33.80690842	-118.3764311	Los Angeles County
305315	Non-Physician Medical Practitioner	None	1770241879	0	0	TRAN, ELAINE NP	2/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2409 S VERMONT AVE	None	LOS ANGELES	CA	90007	1661	00	06000	34.0343121	-118.2915755	Los Angeles County
305363	Non-Physician Medical Practitioner	None	1043442361	0	0	TREVOR, KRISTIN M NP	2/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1255 LIBERTY STREET	None	REDDING	CA	96001	0814	00	06000	40.58769807	-122.3879041	Shasta County
305365	Non-Physician Medical Practitioner	None	1871800714	0	0	TRUNECEK, JILL A NP	12/30/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	129 ALTA AVE	UNIT 6	SANTA MONICA	CA	90402	2739	00	06000	34.02447026	-118.5091286	Los Angeles County
305381	Non-Physician Medical Practitioner	None	1831941277	0	0	TRUONG, TIEN T PA-C	12/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 S. ANAHEIM BLVD	SUITE 250	ANAHEIM	CA	92805	9280	00	06000	33.83528856	-117.913627	Orange County
305398	Non-Physician Medical Practitioner	None	1427514454	0	0	THOMAS, AUSTIN J PA	4/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
305413	Non-Physician Medical Practitioner	None	1285010322	0	0	TAN, JONATHAN J PA-C	3/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 VALENCIA MESA	None	FULLERTON	CA	92835	3809	00	06000	33.89356031	-117.9271656	Orange County
305469	Non-Physician Medical Practitioner	None	1013785039	0	0	THAI, DANIEL PA-C	4/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2070 CLINTON AVE	None	ALAMEDA	CA	94501	4399	00	06000	37.76333626	-122.253868	Alameda County
305474	Non-Physician Medical Practitioner	None	1407987472	0	0	TUAZON, BEVERLY	6/11/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1801 W ROMNEYA DR	203	ANAHEIM	CA	92801	1830	00	06000	33.8506615	-117.946413	Orange County
305479	Non-Physician Medical Practitioner	None	1437534005	0	0	TABATA, BRIAN E	1/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10924 EVANS ST	None	LOMA LINDA	CA	92354	2762	00	06000	34.05516529	-117.2669334	San Bernardino County
305511	Non-Physician Medical Practitioner	None	1275861668	0	0	THOTTI, SATHYAPRIYA PA-C	8/11/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	390 N PACIFIC COAST HWY	STE 1000	EL SEGUNDO	CA	90245	4475	00	06000	33.92077214	-118.3960953	Los Angeles County
305542	Non-Physician Medical Practitioner	None	1316246770	0	0	TAYLOR, ANGELIQUE B.	8/21/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	819 FOOTHILL BLVD	None	OAKLAND	CA	94606	3011	00	06000	37.7944387	-122.2491132	Alameda County
305559	Non-Physician Medical Practitioner	None	1023031655	0	0	TAM, MADELINE NP	9/4/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2300 DUBOIS ST	None	MILPITAS	CA	95035	7812	00	06000	37.42159941	-121.8632085	Santa Clara County
305613	Non-Physician Medical Practitioner	None	1861545444	0	0	TAYLOR, DAWN ADELE	10/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3700 VACA VALLEY PKWY	MINOR INJURY CLINIC KAIS	VACAVILLE	CA	95688	9430	00	06000	38.39008977	-121.9378499	Solano County
305631	Non-Physician Medical Practitioner	None	1033153572	0	0	TANG, QUINN VI	7/8/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	00	06000	34.12811155	-118.2577764	Los Angeles County
305641	Non-Physician Medical Practitioner	None	1184350712	0	0	TIMPERLAKE-OLIVARES, KIMBERLY A NP	8/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	333 ABBOTT ST	SUITE C	SALINAS	CA	93901	4486	00	06000	36.66658598	-121.6447027	Monterey County
305644	Non-Physician Medical Practitioner	None	1720810005	0	0	TORRES, FRANCISCO PA-C	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	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	00	06000	37.63347961	-122.0897735	Alameda County
305668	Non-Physician Medical Practitioner	None	1174900989	0	0	TEOLI, MELISSA A PA-C	7/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	00	06000	33.89552551	-117.186021	Riverside County
305674	Non-Physician Medical Practitioner	None	1740420918	0	0	TOTTEN, SEAN D	2/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	162 THE MASTERS CIRCLE	None	COSTA MESA	CA	92627	4640	00	06000	33.66900373	-117.8870808	Orange County
305680	Non-Physician Medical Practitioner	None	1245791672	0	0	THANT, WAI PA	10/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	825 DELBON AVE	None	TURLOCK	CA	95382	2016	00	06000	37.51052943	-120.8386573	Stanislaus County
305716	Non-Physician Medical Practitioner	None	1427432293	0	0	TOUGAS, JENNIFER A NP	8/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3409 CALLOWAY DR	SUITE 602	BAKERSFIELD	CA	93312	2534	00	06000	35.39132551	-119.11007	Kern County
305754	Non-Physician Medical Practitioner	None	1770204075	0	0	TANNA, SAI H NP	12/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2280 HARRISON AVE	STE K	EUREKA	CA	95501	3200	00	06000	40.78745765	-124.1396643	Humboldt County
305775	Non-Physician Medical Practitioner	None	1871026526	0	0	TINGLIN, PATRICIA R NP	8/30/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3567 SARDINIA ISLAND WAY	None	SACRAMENTO	CA	95834	7760	00	06000	38.646036	-121.5411885	Sacramento County
305853	Non-Physician Medical Practitioner	None	1336893288	0	0	TURKSON, MARGARET E NP	11/21/2022	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
305893	Non-Physician Medical Practitioner	None	1073502449	0	0	THAXTER, CATHERINE C	11/10/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
305958	Non-Physician Medical Practitioner	None	1043981558	0	0	TAGGART, CANDICE PA-C	3/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	801 S BROOKHURST ST.	None	ANAHEIM	CA	92804	4302	00	06000	33.821568	-117.9589665	Orange County
305968	Non-Physician Medical Practitioner	None	1295112316	0	0	TRAN, BRIAN	9/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	506 W ASH AVE	None	FULLERTON	CA	92832	2702	00	06000	33.86476251	-117.9334478	Orange County
305983	Non-Physician Medical Practitioner	None	1154040376	0	0	TRIPLETT, MAYA M PA-C	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	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	00	06000	34.68938848	-118.158354	Los Angeles County
306033	Non-Physician Medical Practitioner	None	1467982348	0	0	TIGER, REBECCA PA-C	3/5/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5671 BALBOA AVE	None	SAN DIEGO	CA	92111	2705	00	06000	32.82010691	-117.1788026	San Diego County
306055	Non-Physician Medical Practitioner	None	1609006527	0	0	TERRY, YUSEF U	1/5/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 SOUTH BUENA VISTA ST	PACIFIC GYNECOLOGIC SPEC	BURBANK	CA	91505	4809	00	06000	34.15729818	-118.3277073	Los Angeles County
306069	Non-Physician Medical Practitioner	None	1831841253	0	0	TAMBUNAN, CATHERINE D NP	7/12/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	251 COHASSET	None	CHICO	CA	95926	2241	00	06000	39.75090044	-121.8522609	Butte County
306087	Non-Physician Medical Practitioner	None	1184735391	0	0	TAYLOR, JENNIFER MILLSPAUGH	2/11/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2051 JOHN JONES RD	None	DAVIS	CA	95616	9701	00	06000	38.56371578	-121.7691963	Yolo County
306094	Non-Physician Medical Practitioner	None	1174725956	0	0	TOWNSEND, NICOLE	7/16/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6121 N THESTA ST	STE 303	FRESNO	CA	93710	8603	00	06000	36.82493955	-119.783139	Fresno County
306096	Non-Physician Medical Practitioner	None	1700096468	0	0	TURNER, MISCHELLE B	1/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	45710 BARHAM AVE	None	LANCASTER	CA	93534	5474	00	06000	34.7134829	-118.1577624	Los Angeles County
306100	Non-Physician Medical Practitioner	None	1063058519	0	0	THAKUR, RENUKA NP	11/12/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14860 ROSCOE BLVD	SUITE 300	VAN NUYS	CA	91402	7902	00	06000	34.2214515	-118.4573205	Los Angeles County
306102	Non-Physician Medical Practitioner	None	1760745418	0	0	THURN-TAMAYO, BARBARA L NP	5/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3191 E DEL MAR BLVD	None	PASADENA	CA	91107	4650	00	06000	34.14222645	-118.084446	Los Angeles County
306118	Non-Physician Medical Practitioner	None	1174863971	0	0	TAN, VERNA O PA	3/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1074 MURRIETA BLVD	None	LIVERMORE	CA	94550	4111	00	06000	37.67593509	-121.7822303	Alameda County
306120	Non-Physician Medical Practitioner	None	1508419458	0	0	TRAN, LANA PA	4/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	00	06000	34.20289797	-118.6294006	Los Angeles County
306122	Non-Physician Medical Practitioner	None	1487240982	0	0	THERIEN, JULIE PA	12/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2351 CLAY STREET	SUITE 501	SAN FRANCISCO	CA	94115	1931	00	06000	37.79101512	-122.4316059	San Francisco County
306128	Non-Physician Medical Practitioner	None	1124487335	0	0	THOMAS, KATHLEEN	7/28/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	06000	36.180999	-115.3174815	Clark County
306160	Non-Physician Medical Practitioner	None	1750716007	0	0	THENO, JESSICA L NP	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	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
306182	Non-Physician Medical Practitioner	None	1033744123	0	0	TANG, RICHARD PA-C	10/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 N. WESTERN AVE	SUITE 204	SAN BERNARDINO	CA	92411	1353	00	06000	34.1315778	-117.3182453	San Bernardino County
306186	Non-Physician Medical Practitioner	None	1982710190	0	0	TENAZAS, ALAN M	10/31/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7952 EAST CHESHIRE RD	None	ORANGE	CA	92867	1502	00	06000	33.82953598	-117.7687285	Orange County
306188	Non-Physician Medical Practitioner	None	1013215060	0	0	TOGNOZZI, EMILY S	11/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1203 LINDA MAR BLVD	None	PACIFICA	CA	94044	4246	00	06000	37.58523129	-122.4880481	San Mateo County
306192	Non-Physician Medical Practitioner	None	1760855118	0	0	TEMPERA MADDOCKS, VERONICA 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	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	00	06000	34.06704253	-118.3835029	Los Angeles County
306204	Non-Physician Medical Practitioner	None	1043988231	0	0	TATARKHANOVA, DIANA NP	4/30/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	00	06000	37.51438187	-122.2607682	San Mateo County
306218	Non-Physician Medical Practitioner	None	1124615661	0	0	TRATTNER, HEATHER A PA-C	1/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	00	06000	33.60848903	-117.7079742	Orange County
306225	Non-Physician Medical Practitioner	None	1275275307	0	0	THACKER, JERRICK NP	10/11/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13024 HESPERIA ROAD	STE 103	VICTORVILLE	CA	92395	8303	00	06000	34.48893153	-117.29123	San Bernardino County
306237	Non-Physician Medical Practitioner	None	1306443288	0	0	TOROSSIAN, KARINE NP	7/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9375 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1418	00	06000	34.2395322	-118.3939944	Los Angeles County
306252	Non-Physician Medical Practitioner	None	1669994547	0	0	TAM, CARLA K PA	6/24/2021	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
306255	Non-Physician Medical Practitioner	None	1295427508	0	0	TATE, HANNAH	6/23/2023	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
306276	Non-Physician Medical Practitioner	None	1386157642	0	0	TRUONG, ANNIE V NP	5/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5132 ANDREW DRIVE	None	LA PALMA	CA	90623	1504	00	06000	33.85211952	-118.04382	Orange County
306282	Non-Physician Medical Practitioner	None	1194387373	0	0	TAYLOR, TIMOTHY M NP	8/28/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2 W FERN AVE	None	REDLANDS	CA	92373	5916	00	06000	34.05016907	-117.1793443	San Bernardino County
306324	Non-Physician Medical Practitioner	None	1124333828	0	0	TRINH, LINDA H V NP	2/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10492 STERN AVE	None	WESTMINSTER	CA	92683	5819	00	06000	33.74612191	-117.9465558	Orange County
306330	Non-Physician Medical Practitioner	None	1831614353	0	0	TON NU, KHANH NGOC C PA-C	1/10/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11160 WARNER AVE	SUITE 201	FOUNTAIN VALLEY	CA	92708	4008	00	06000	33.71630854	-117.934317	Orange County
306334	Non-Physician Medical Practitioner	None	1477569010	0	0	TAN, JONAH O	8/12/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3200 E LOS ANGELES AVE	SUITE 20	SIMI VALLEY	CA	93065	3971	00	06000	34.27165547	-118.73403	Ventura County
306348	Non-Physician Medical Practitioner	None	1841430741	0	0	TABUCHI, RUBY	3/26/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1560 E CHEVY CHASE DR	SUITE 255	GLENDALE	CA	91206	4197	00	06000	34.15290734	-118.2302295	Los Angeles County
306368	Non-Physician Medical Practitioner	None	1134716517	0	0	TORREZ-BIRKLAND, RAQUEL PA-C	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	26357 MCBEAN PARKWAY	STE 255	VALENCIA	CA	91355	5504	00	06000	34.41257644	-118.5597683	Los Angeles County
306372	Non-Physician Medical Practitioner	None	1750928552	0	0	TADAS, ANN C NP	2/16/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
306427	Non-Physician Medical Practitioner	None	1215460001	0	0	THRANE, HYEKYUNG	4/25/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26702 BRANDON	None	MISSION VIEJO	CA	92692	4137	00	06000	33.57488136	-117.6492957	Orange County
306448	Non-Physician Medical Practitioner	None	1669054953	0	0	THOMAS, FIFY F 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	500 OLD RIVER RD	250	BAKERSFIELD	CA	93311	9515	00	06000	35.35127492	-119.1142991	Kern County
306457	Non-Physician Medical Practitioner	None	1932325131	0	0	TRACY, CHIN RN CPNP	4/8/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	00	06000	36.88437894	-119.8003484	Madera County
306460	Non-Physician Medical Practitioner	None	1982327631	0	0	TURNER, IRENE W	1/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
306486	Non-Physician Medical Practitioner	None	1760910376	0	0	TANIGUCHI, KIMBERLY K NP	12/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2330 W COVELL BLVD	None	DAVIS	CA	95616	5658	00	06000	38.56097929	-121.7800614	Yolo County
306489	Non-Physician Medical Practitioner	None	1174848295	0	0	TENG, MARIA K NP	4/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	316 TREASURE ISLAND	None	BELMONT	CA	94002	4115	00	06000	37.53371565	-122.2686743	San Mateo County
306509	Non-Physician Medical Practitioner	None	1588448518	0	0	TRUONG, CHRISTINA L 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	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
306525	Non-Physician Medical Practitioner	None	1386110070	0	0	TONG, JACKLIN H NP	9/16/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
306593	Non-Physician Medical Practitioner	None	1770991986	0	0	TRAN, KIMOANH T	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	10181 FINCHLEY AVE	None	WESTMINISTER	CA	92683	1701	00	06000	33.75110062	-117.9518019	Orange County
306619	Non-Physician Medical Practitioner	None	1962512079	0	0	TOMISTA, JOCELYN M	9/29/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	790 E BONITA AVE	2ND FLOOR	POMONA	CA	91767	1906	00	06000	34.09621447	-117.737406	Los Angeles County
306626	Non-Physician Medical Practitioner	None	1245701895	0	0	TELIMI, ANI NP	8/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 N VERMONT AVE	SUITE 307	LOS ANGELES	CA	90027	6005	00	06000	34.0956033	-118.2916918	Los Angeles County
306648	Non-Physician Medical Practitioner	None	1285086686	0	0	TRAN, TARRYN T	10/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9261 JUDY LN	None	GARDEN GROVE	CA	92841	3417	00	06000	33.78707373	-117.970404	Orange County
306671	Non-Physician Medical Practitioner	None	1386242543	0	0	TRAN, RICKY PA-C	5/18/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
306709	Non-Physician Medical Practitioner	None	1376840231	0	0	TRUMAN, LAURA L	5/20/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24015 DEL AMO ROAD	None	RAMONA	CA	92065	4122	00	06000	33.01197295	-116.8095452	San Diego County
306771	Non-Physician Medical Practitioner	None	1568041424	0	0	TIEN, MADELINE PA	4/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1019 S CENTRAL AVENUE	None	GLENDALE	CA	91204	2542	00	06000	34.13405999	-118.2578839	Los Angeles County
306785	Non-Physician Medical Practitioner	None	1518269067	0	0	TUCHAN, ALVARO H PA-C	5/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	00	06000	34.2214515	-118.4573205	Los Angeles County
306788	Non-Physician Medical Practitioner	None	1922371004	0	0	TYLER, MEGAN M NP	1/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1184 ESSEX STREET	None	LIVERMORE	CA	94550	5539	00	06000	37.6680728	-121.7761629	Alameda County
306805	Non-Physician Medical Practitioner	None	1972764173	0	0	TAPIA, CARLA F O	3/16/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2219 VANDERBILT LANE	APT 2	REDONDO BEACH	CA	90278	3157	00	06000	33.87190902	-118.3711936	Los Angeles County
306857	Non-Physician Medical Practitioner	None	1679768774	0	0	TATMAN, KYRA DEE	2/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 PERSHING DR UNIT 23	None	PLAYA DEL REY	CA	90293	8040	00	06000	33.95478332	-118.4413188	Los Angeles County
306874	Non-Physician Medical Practitioner	None	1669462552	0	0	TILTON, CHRISTOPHER E	8/15/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	82 VELLA CIRCLE	None	OAKLEY	CA	94561	1794	00	06000	37.99496801	-121.6952366	Contra Costa County
306883	Non-Physician Medical Practitioner	None	1942358221	0	0	THIRLBENNY, KENDEL	12/23/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	540 E ARTESIA BLVD	None	LONG BEACH	CA	90805	1476	00	06000	33.87435148	-118.186947	Los Angeles County
306917	Non-Physician Medical Practitioner	None	1467567370	0	0	TAFOYA, RITA KAREN	10/20/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9401 LONG BEACH BLVD	None	SOUTH GATE	CA	90280	4144	00	06000	33.95036421	-118.2177464	Los Angeles County
307013	Non-Physician Medical Practitioner	None	1083149306	0	0	TURNER, CHRISTINA M	8/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	785 S CAMINO GRANDE	UNIT 5	ANAHEIM	CA	92807	4951	00	06000	33.83876772	-117.7599474	Orange County
307016	Non-Physician Medical Practitioner	None	1629752431	0	0	TEMPLEMAN, BRYCE PA-C	8/7/2023	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
307019	Non-Physician Medical Practitioner	None	1992148092	0	0	TANIG-SANJONGCO, EDITHA NP	5/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22 NEW HAMPSHIRE	None	IRVINE	CA	92606	1786	00	06000	33.71536807	-117.790106	Orange County
307022	Non-Physician Medical Practitioner	None	1134632490	0	0	TANGLAO, MARY ANN M NP	11/4/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26730 TOWNE CENTRE DR ST	SUITE 102	FOOTHILL RANCH	CA	92610	2857	00	06000	33.67419218	-117.6628315	Orange County
307026	Non-Physician Medical Practitioner	None	1205841970	0	0	TARANGO, NIMALJEET KAUR	2/18/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 POTRERO AVE	SFGH FAMILY HEALTH CLINI	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
307038	Non-Physician Medical Practitioner	None	1235789298	0	0	TRUONG, DORIAN PA-C	8/15/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	00	06000	35.3687456	-119.1106561	Kern County
307073	Non-Physician Medical Practitioner	None	1407488638	0	0	TRINH, HALEY B PA-C	8/14/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9330 STOCKDALE HWY	600	BAKERSFIELD	CA	93311	3614	00	06000	35.35452946	-119.106351	Kern County
307094	Non-Physician Medical Practitioner	None	1164772448	0	0	TANG, SAI YING M NP	6/1/2017	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
307122	Non-Physician Medical Practitioner	None	1710434659	0	0	TRINH, TUYEN PA-C	4/17/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	33494 OAK GLEN RD	None	YUCAIPA	CA	92399	2057	00	06000	34.03255442	-117.0737219	San Bernardino County
307128	Non-Physician Medical Practitioner	None	1659600245	0	0	TRINBISHEH, SHAHRZAD	4/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2275 SAN YSIDRO DR	None	BEVERLY HILLS	CA	90210	1548	00	06000	34.11311375	-118.4249276	Los Angeles County
307162	Non-Physician Medical Practitioner	None	1225530686	0	0	TETELMAN, ELISE M PA	2/28/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
307235	Non-Physician Medical Practitioner	None	1841616968	0	0	THURSTON, STEPHEN H	4/14/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1042 SAPPHIRE ST	None	SAN DIEGO	CA	92109	1865	00	06000	32.80878439	-117.2544662	San Diego County
307244	Non-Physician Medical Practitioner	None	1326894270	0	0	THON, SALINA NP	7/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	212 COFFEE RD	SUITE 100	BAKERSFIELD	CA	93309	1273	00	06000	35.356392	-119.092153	Kern County
307306	Non-Physician Medical Practitioner	None	1235862780	0	0	TORIOLA, ABIODUN A NP	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	12442 LIMONITE AVE	UNIT 104	EASTVALE	CA	91752	2467	00	06000	33.97511454	-117.5531895	Riverside County
307316	Non-Physician Medical Practitioner	None	1780889477	0	0	TOWNSEND, SPENCER W	1/14/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	888 WUKLET COURT	None	ARRYO GRANDE	CA	93420	5539	00	06000	35.06143288	-120.5779809	San Luis Obispo County
307318	Non-Physician Medical Practitioner	None	1265981617	0	0	TEDROW, VICTORIA PA-C	4/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5215 TORRANCE BLVD	STE 300	TORRANCE	CA	90503	4009	00	06000	33.83760237	-118.3692467	Los Angeles County
307324	Non-Physician Medical Practitioner	None	1366884520	0	0	TURNER, JACQUELINE PA	1/14/2020	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
307347	Non-Physician Medical Practitioner	None	1215713078	0	0	TUCKER, ANNE R PA	12/14/2023	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
307401	Non-Physician Medical Practitioner	None	1770127334	0	0	THOMPSON, ANDREW L NP	1/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
307445	Non-Physician Medical Practitioner	None	1770964082	0	0	THOMPSON, CAMELOT 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	3032 EAST HILLS DRIVE	None	SAN JOSE	CA	95127	3103	00	06000	37.36132468	-121.8262941	Santa Clara County
307467	Non-Physician Medical Practitioner	None	1548460926	0	0	THOMPSON, NANORA MARIE	2/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 W SUNSET BLVD	MAILSTOP 2	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
307504	Non-Physician Medical Practitioner	None	1174153027	0	0	TEXLEY, HALEY N NP	10/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1321 COTTONWOOD ST	3RD FL	WOODLAND	CA	95695	5131	00	06000	38.66479566	-121.7933418	Yolo County
307523	Non-Physician Medical Practitioner	None	1801978374	0	0	TRUJILLO, JORGE 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	73700 DINAH SHORE DR	STE 106	PALM DESERT	CA	92211	0813	00	06000	33.79748917	-116.3786855	Riverside County
307540	Non-Physician Medical Practitioner	None	1568173367	0	0	THAI, MARIA NP	3/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1010 W CHAPMAN AVE	None	ORANGE	CA	92868	2847	00	06000	33.78785047	-117.8631495	Orange County
307566	Non-Physician Medical Practitioner	None	1215366851	0	0	THOMAS, NYSSA C NP	4/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9524 RIVER ROSE WAY	None	SACRAMENTO	CA	95827	3269	00	06000	38.557908	-121.342068	Sacramento County
307575	Non-Physician Medical Practitioner	None	1811272974	0	0	THOMPSON, DAVID M PA-C	2/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	00	06000	36.98191238	-121.9975767	Santa Cruz County
307578	Non-Physician Medical Practitioner	None	1477032621	0	0	TAN, KINGSLEY PA-C	9/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1701 SANTA ANITA AVE	None	EL MONTE	CA	91733	3411	00	06000	34.04810648	-118.0424794	Los Angeles County
307593	Non-Physician Medical Practitioner	None	1568005155	0	0	TRUONG, DON T PA-C	3/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	00	06000	37.37715796	-122.0651926	Santa Clara County
307611	Non-Physician Medical Practitioner	None	1578298121	0	0	TEJERO BINGHAM, TESSA I PA-C	12/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	137 E THOUSAND OAKS BLVD	None	THOUSAND OAKS	CA	91360	1985	00	06000	34.17919939	-118.8745721	Ventura County
307624	Non-Physician Medical Practitioner	None	1952340705	0	0	TISKA, MICHAEL A	12/15/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7996 LA RIVIERA DR	APT 12	SACRAMENTO	CA	95826	1680	00	06000	38.55744	-121.406382	Sacramento County
307627	Non-Physician Medical Practitioner	None	1285008938	0	0	TARZANA TREATMENT CENTERS, I	3/29/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14660 OXNARD ST	None	VAN NUYS	CA	91411	3119	00	06000	34.17932474	-118.452237	Los Angeles County
307657	Non-Physician Medical Practitioner	None	1295264760	0	0	THOMAS, LISA M PA	8/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2200 H ST	None	SACRAMENTO	CA	95816	4024	00	06000	38.577879	-121.476195	Sacramento County
307658	Non-Physician Medical Practitioner	None	1306342860	0	0	TIRPAK, ELIZABETH T NP	12/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	00	06000	33.795261	-118.125222	Los Angeles County
307667	Non-Physician Medical Practitioner	None	1740047919	0	0	TRANG, LILLIAN PA	7/31/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	225 N JACKSON AVE	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	00	06000	37.36217918	-121.8472051	Santa Clara County
307671	Non-Physician Medical Practitioner	None	1679864243	0	0	TRAPP, ANN M NP	8/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2825 CAPITOL AVENUE	None	SACRAMENTO	CA	95816	6039	00	06000	38.570805	-121.4696385	Sacramento County
307672	Non-Physician Medical Practitioner	None	1801324892	0	0	TORRES, AIMEE J PA-C	7/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	408 S BEACH BLVD	STE 211	ANAHEIM	CA	92804	1853	00	06000	33.82709101	-117.9932293	Orange County
307673	Non-Physician Medical Practitioner	None	1992929335	0	0	TAWADROS, HEIDI	3/18/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5920 ATLANTIC BLVD	None	MAYWOOD	CA	90270	3101	00	06000	33.98637627	-118.185642	Los Angeles County
307674	Non-Physician Medical Practitioner	None	1679809263	0	0	TRAN, THAI GIA D PA	9/6/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23181 VERDUGO DR STE 103	None	LAGUNA HILLS	CA	92653	1313	00	06000	33.62609529	-117.7293191	Orange County
307675	Non-Physician Medical Practitioner	None	1598438996	0	0	TRAN, DIANE T NP	1/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	181 ANDRIEUX ST	STE 208	SONOMA	CA	95476	6920	00	06000	38.28809911	-122.4613026	Sonoma County
307683	Non-Physician Medical Practitioner	None	1649673989	0	0	TUTTLE-KAMON, STEPHANIE L NP	8/29/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28793 HARWICK DR	None	HIGHLAND	CA	92346	5065	00	06000	34.12783648	-117.1754685	San Bernardino County
307692	Non-Physician Medical Practitioner	None	1669188843	0	0	TERAMOTO, ERIN 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	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23931375	-121.8014189	Santa Clara County
307693	Non-Physician Medical Practitioner	None	1962913723	0	0	TAYLOR, SARAH M PA-C	5/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
307739	Non-Physician Medical Practitioner	None	1134699218	0	0	THEY, MICHAEL NP	2/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3751 E SHIELDS AVE	None	FRESNO	CA	93726	0000	00	06000	36.7796958	-119.7618088	Fresno County
307832	Non-Physician Medical Practitioner	None	1750012498	0	0	TELANDER, KELSEY J PA	8/15/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 4TH ST	None	MARYSVILLE	CA	95901	5656	00	06000	39.13872267	-121.5944372	Yuba County
307971	Non-Physician Medical Practitioner	None	1164699344	0	0	TROFIMENKO, MICHAEL A	7/6/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	00	06000	38.66314048	-121.794696	Yolo County
307990	Non-Physician Medical Practitioner	None	1811069271	0	0	TAN, CARMELA PA	4/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
308006	Non-Physician Medical Practitioner	None	1346463239	0	0	TOUTANT, LOUISE E NP	3/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	180 ELM DR	None	CAMARILLO	CA	93010	4573	00	06000	34.21424674	-119.0400109	Ventura County
308055	Non-Physician Medical Practitioner	None	1689748584	0	0	TONGSON, VICTORIA C	12/12/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	00	06000	37.706364	-122.165163	Alameda County
308057	Non-Physician Medical Practitioner	None	1902939515	0	0	TATOYAN, TANIA	5/11/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	544 N. GLENDALE AVE	None	GLENDALE	CA	91206	0000	00	06000	34.15454904	-118.2429872	Los Angeles County
308069	Non-Physician Medical Practitioner	None	1982833281	0	0	TAN, IVY YING	8/16/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	888 PARIS ST STE 202	None	SAN FRANCISCO	CA	94112	3858	00	06000	37.71592892	-122.4392834	San Francisco County
308113	Non-Physician Medical Practitioner	None	1275313959	0	0	TYLER, KYLIE PA-C	2/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1050 LINDEN AVENUE	None	LONG BEACH	CA	90813	3321	00	06000	33.78003775	-118.1866604	Los Angeles County
308122	Non-Physician Medical Practitioner	None	1851018469	0	0	TRAN, BRIAN NP	8/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1704 WEST MANCHESTER AVE	SUITE 106	LOS ANGELES	CA	90047	3056	00	06000	33.9599425	-118.307079	Los Angeles County
308154	Non-Physician Medical Practitioner	None	1235324062	0	0	TAYLOR, CAROL P	8/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13421 IOWA ST	None	WESTMINSTER	CA	92683	7846	00	06000	33.76725979	-117.9999797	Orange County
308164	Non-Physician Medical Practitioner	None	1609348671	0	0	TAVAKOLI PARSA, ASSAL PA-C	3/12/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 N HARBOR BLVD	SUITE 540	FULLERTON	CA	92835	4126	00	06000	33.88408114	-117.9253959	Orange County
308207	Non-Physician Medical Practitioner	None	1942731187	0	0	TRINH, THU A NP	4/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	34490 BOB HOPE	None	RANCHO MIRAGE	CA	92270	1713	00	06000	33.79844194	-116.40586	Riverside County
308226	Non-Physician Medical Practitioner	None	1083199194	0	0	TORRES, FEDERICO A NP	11/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2623 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	00	06000	33.98921547	-118.2242565	Los Angeles County
308238	Non-Physician Medical Practitioner	None	1760717193	0	0	THORNTON, COLLEEN M	9/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5600 WILSHIRE BOULEVARD	APT 428	LOS ANGELES	CA	90036	3779	00	06000	34.06233427	-118.3512599	Los Angeles County
308258	Non-Physician Medical Practitioner	None	1609993708	0	0	TANWANGCO, LOUMIZELLE D	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	491 LASALLE ST	None	REDLANDS	CA	92376	6472	00	06000	34.04675398	-117.1431426	San Bernardino County
308268	Non-Physician Medical Practitioner	None	1255892683	0	0	TRAN, STEPHANIE PA	9/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
308280	Non-Physician Medical Practitioner	None	1306053038	0	0	TAYLOR SERAFINI, AMY MICHELLE	3/10/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2001 SANTA MONICA BLVD	SUITE 360W	SANTA MONICA	CA	90404	0000	00	06000	34.02891163	-118.4797466	Los Angeles County
308312	Non-Physician Medical Practitioner	None	1730817313	0	0	TARIN, AISHA NP	10/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2100 FOREST AVENUE	SUITE 108	SAN JOSE	CA	95128	5168	00	06000	37.3270195	-121.9368645	Santa Clara County
308386	Non-Physician Medical Practitioner	None	1386945806	0	0	THORVALDSDOTTIR, ASGERDUR U NP	7/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	690 KEARNEY ST	None	BENICIA	CA	94510	3939	00	06000	38.0866653	-122.1541171	Solano County
308429	Non-Physician Medical Practitioner	None	1174156194	0	0	TYAU, CHLOE A PA	6/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1010 W. LA VETA AVENUE	SUITE 320	ORANGE	CA	92868	4218	00	06000	33.78028244	-117.8635552	Orange County
308438	Non-Physician Medical Practitioner	None	1013656354	0	0	TONG, JENNA J CNM	12/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4560 ADMIRALTY WAY	SUITE 105	MARINA DEL REY	CA	90292	5423	00	06000	33.98364904	-118.4449069	Los Angeles County
308447	Non-Physician Medical Practitioner	None	1669106779	0	0	TORRES, STEPHANIE PA	10/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2623 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	00	06000	33.98921547	-118.2242565	Los Angeles County
308452	Non-Physician Medical Practitioner	None	1184788101	0	0	TAYLOR, BARTON B	5/9/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5880 BRIDLE TRAIL LANE	None	PILOT HILL	CA	95664	9662	00	06000	38.80479825	-121.0560979	El Dorado County
308456	Non-Physician Medical Practitioner	None	1346474467	0	0	TRUAX, THUHA T NP	9/25/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9968 GLADIOLA CIR	None	FOUNTAIN VALLEY	CA	92708	2036	00	06000	33.72676022	-117.9552689	Orange County
308464	Non-Physician Medical Practitioner	None	1831861129	0	0	TRUONG, DINH N NP	11/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5827 PINE AVE	SUITE A	CHINO HILLS	CA	91709	6534	00	06000	33.94745656	-117.6777147	San Bernardino County
308468	Non-Physician Medical Practitioner	None	1629275722	0	0	THOMAS, NAIMA B	11/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 MUIR RD	None	MARTINEZ	CA	94553	4614	00	06000	37.99430233	-122.1107194	Contra Costa County
308479	Non-Physician Medical Practitioner	None	1861624082	0	0	TELLO, ALEXIS	10/28/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
308506	Non-Physician Medical Practitioner	None	1831513290	0	0	TEEHANKEE, CARLA MICHELLE LIM	5/30/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1200 EL CAMINO REAL	None	SOUTH SAN FRANCIS	CA	94080	3208	00	06000	37.65894608	-122.440161	San Mateo County
308660	Non-Physician Medical Practitioner	None	1528692761	0	0	THOMAS, MEGAN M NP	5/21/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	902 CIRBY WAY	None	ROSEVILLE	CA	95661	4420	00	06000	38.7294585	-121.2763095	Placer County
308674	Non-Physician Medical Practitioner	None	1821142647	0	0	THOMAS, ALAN V PA	4/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6501 TRUXTUN AVE	None	BAKERSFIELD	CA	93309	0633	00	06000	35.36196445	-119.0749413	Kern County
308688	Non-Physician Medical Practitioner	None	1841038494	0	0	TANGCO, ALEXANDRA MARIE C PA-C	9/24/2024	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
308697	Non-Physician Medical Practitioner	None	1477325181	0	0	TUCKER, LANIKA A	11/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
308734	Non-Physician Medical Practitioner	None	1467282996	0	0	TRAN, CHRISTINE L NP	9/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
308824	Non-Physician Medical Practitioner	None	1902865785	0	0	THRALL, CAROL M	8/3/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5930 E NORTH LANE	None	SCOTTSDALE	AZ	85253	1109	00	06000	33.582006	-111.953322	Maricopa County
308865	Non-Physician Medical Practitioner	None	1982122776	0	0	TILLER, COREY R PA-C	12/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	00	06000	34.13502	-117.2758635	San Bernardino County
308881	Non-Physician Medical Practitioner	None	1821488735	0	0	TRAN, HANNAH H NP	2/26/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	417 S BELLA VISTA ST	None	ANAHEIM	CA	92804	2705	00	06000	33.82624942	-118.0070042	Orange County
308900	Non-Physician Medical Practitioner	None	1578837779	0	0	TORTOSA, GINA R	7/17/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1479 LA GRANDE AVE	None	YUBA CITY	CA	95991	6718	00	06000	39.10569442	-121.6245231	Sutter County
308913	Non-Physician Medical Practitioner	None	1093065765	0	0	TATUM, RONIC SHENAY	12/17/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12898 TOWNE CENTER DR	None	CERRITOS	CA	90703	8546	00	06000	33.86701513	-118.0576798	Los Angeles County
308974	Non-Physician Medical Practitioner	None	1104583590	0	0	TOMSEJOVA, NIKOL NP	2/10/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
308983	Non-Physician Medical Practitioner	None	1780732693	0	0	TORRE, JOANNA C	9/8/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3025 W CHRISTOFFERSEN PK	APT K206	TURLOCK	CA	95382	8078	00	06000	37.5292063	-120.8826253	Stanislaus County
309000	Non-Physician Medical Practitioner	None	1295943801	0	0	TOMOKIYO, REBECCA Y NP	5/17/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1957 SUNNY HEIGHTS	None	LOS ANGELES	CA	90065	3324	00	06000	34.10566951	-118.2248285	Los Angeles County
309019	Non-Physician Medical Practitioner	None	1528252418	0	0	TANSY, CHRISTINA M PA-C	11/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
309036	Non-Physician Medical Practitioner	None	1083914626	0	0	TRIPLETT, JENNY L	3/7/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3726 FRUITVALE AVE	None	OAKLAND	CA	94602	2420	00	06000	37.80332014	-122.2148809	Alameda County
309069	Non-Physician Medical Practitioner	None	1699948596	0	0	TATUM, CHRISTOPHER	1/17/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	637 S LUCAS AVE	FL 1	LOS ANGELES	CA	90017	0000	00	06000	34.05351827	-118.2646017	Los Angeles County
309078	Non-Physician Medical Practitioner	None	1497757413	0	0	TOPPING, DAWN M	2/14/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4341 SURITA STREET	None	SACRAMENTO	CA	95864	3170	00	06000	38.593134	-121.3615215	Sacramento County
309086	Non-Physician Medical Practitioner	None	1952485534	0	0	TINOCO, MONA	4/28/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13719 PUTNAM ST	None	WHITTIER	CA	90605	2251	00	06000	33.95722508	-118.0299788	Los Angeles County
309094	Non-Physician Medical Practitioner	None	1245603059	0	0	TENG, CRYSTAL T	2/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22018 E SNOW CREEK DR	None	WALNUT	CA	91789	1495	00	06000	34.03566894	-117.8307383	Los Angeles County
309113	Non-Physician Medical Practitioner	None	1609034222	0	0	TUPPER, LAURIE ANNE	10/2/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	875 BLAKE WILBUR DR	STANFORD CANCER CENTER	STANFORD	CA	94305	5847	00	06000	37.43562782	-122.1766097	Santa Clara County
309140	Non-Physician Medical Practitioner	None	1518600360	0	0	TYSON, FABIOLA	9/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2026 N IMPERIAL AVE	STE C	EL CENTRO	CA	92243	1607	00	06000	32.81256347	-115.5700202	Imperial County
309145	Non-Physician Medical Practitioner	None	1104441021	0	0	TELLACHE, KIRA A PA-C	9/22/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3095 OLD CONEJO RD	None	THOUSAND OAKS	CA	91320	2130	00	06000	34.18969088	-118.9412876	Ventura County
309192	Non-Physician Medical Practitioner	None	1205551751	0	0	TUBBS, SHERMEKA NP	9/12/2023	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
309202	Non-Physician Medical Practitioner	None	1588161129	0	0	THOMPSON, LOUISE NP	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	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	00	06000	33.12181055	-117.2840499	San Diego County
309208	Non-Physician Medical Practitioner	None	1528116423	0	0	THAI, DONNY T	3/20/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	38 TWIN GABLES	None	IRVINE	CA	92620	3507	00	06000	33.69361035	-117.7501599	Orange County
309256	Non-Physician Medical Practitioner	None	1104699941	0	0	TITUS, AMY NP	5/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 W BONITA AVE	STE 100	POMONA	CA	91767	1865	00	06000	34.09639602	-117.750267	Los Angeles County
309285	Non-Physician Medical Practitioner	None	1518326107	0	0	TRAN, PHUONG NP	9/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 E BEVERLY	SUITE 200	MONTEBELLO	CA	90640	4315	00	06000	34.01556395	-118.0983878	Los Angeles County
309298	Non-Physician Medical Practitioner	None	1710376090	0	0	TERPENING, TINA L 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	9202 CORNELL WAY	None	BUENA PARK	CA	90620	4625	00	06000	33.82908729	-118.015665	Orange County
309299	Non-Physician Medical Practitioner	None	1790474518	0	0	TRAN, VINH QUANG B NP	6/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8251 WESTMINSTER BLVD	STE 110	WESTMINSTER	CA	92683	3370	00	06000	33.75934151	-117.985113	Orange County
309306	Non-Physician Medical Practitioner	None	1699420331	0	0	TYRELL, MONIQUE T NP	12/9/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
309332	Non-Physician Medical Practitioner	None	1699843169	0	0	THEISEN, DEBORAH GAYLE	10/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
309337	Non-Physician Medical Practitioner	None	1699839126	0	0	TRAMBLEY, MARY ANN ELIZABETH	4/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	230 PAULA CT	None	MARTINEZ	CA	94553	6219	00	06000	37.95910703	-122.0980812	Contra Costa County
309358	Non-Physician Medical Practitioner	None	1134672108	0	0	TREIBER, JESSICA M PA	8/15/2022	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
309374	Non-Physician Medical Practitioner	None	1962512103	0	0	TRABER, SUSANA	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	555 CASTRO ST	None	MOUNTAIN VIEW	CA	94041	2009	00	06000	37.38946454	-122.0815711	Santa Clara County
309383	Non-Physician Medical Practitioner	None	1639843923	0	0	THIARA, HERJOT K PA-C	12/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	825 DELBON AVE	None	TURLOCK	CA	95382	2016	00	06000	37.51052943	-120.8386573	Stanislaus County
309387	Non-Physician Medical Practitioner	None	1285989491	0	0	TORRES, JENNIFER T PA-C	5/4/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5395 RUFFIN ROAD	STE. 204	SAN DIEGO	CA	92123	1338	00	06000	32.832387	-117.1266225	San Diego County
309440	Non-Physician Medical Practitioner	None	1922519222	0	0	THRASHER, SARAH L NP	2/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	00	06000	38.66314048	-121.794696	Yolo County
309476	Non-Physician Medical Practitioner	None	1205391356	0	0	TAYLOR, ANTOINE V NP	8/25/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3113	00	06000	33.80318353	-118.0666665	Orange County
309491	Non-Physician Medical Practitioner	None	1861069874	0	0	TONG, KIM NP	7/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	450 4TH AVENUE	SUITE 311	CHULA VISTA	CA	91910	4429	00	06000	32.63513513	-117.0820663	San Diego County
309497	Non-Physician Medical Practitioner	None	1982329579	0	0	TULOD, EDUARDO NP	8/2/2023	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
309609	Non-Physician Medical Practitioner	None	1780331256	0	0	TRANG, CHERYL PA-C	12/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	STE 1000A	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
309696	Non-Physician Medical Practitioner	None	1063821809	0	0	TRAN, BINHGIANG	10/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
309711	Non-Physician Medical Practitioner	None	1114935269	0	0	THOMASEN, DIANE A	10/27/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	480 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	00	06000	39.13286634	-121.6142652	Sutter County
309730	Non-Physician Medical Practitioner	None	1942512454	0	0	TEICH, CHRISTOPHER S	4/28/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1208 MATEO DRIVE	None	ROHNERT PARK	CA	94928	5451	00	06000	38.32765099	-122.6874413	Sonoma County
309795	Non-Physician Medical Practitioner	None	1750581203	0	0	TSIPERFAL, ANGELA	11/9/2007	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 # H2149	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
309811	Non-Physician Medical Practitioner	None	1477267821	0	0	THANG, MELISSA PA-C	6/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	730 WOODSIDE ROAD	None	REDWOOD CITY	CA	94061	3749	00	06000	37.46743742	-122.2240658	San Mateo County
309812	Non-Physician Medical Practitioner	None	1497302525	0	0	TSE, SANDY H NP	12/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 S VINCENT AVE	SUITE 205	WEST COVINA	CA	91790	6712	00	06000	34.0662144	-117.9274205	Los Angeles County
309815	Non-Physician Medical Practitioner	None	1922417625	0	0	TOPOR DIAZ, CATHERINE H	11/16/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7923 W 87TH PL	None	HICKORY HILLS	IL	60457	1572	00	06000	41.73185824	-87.81705815	Cook County
309822	Non-Physician Medical Practitioner	None	1942853627	0	0	TUCKER, CHRISTOPHER PA	3/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1922 HILLHURST	STE 200	LOS ANGELES	CA	90027	2712	00	06000	34.106166	-118.2873815	Los Angeles County
309851	Non-Physician Medical Practitioner	None	1053487611	0	0	THOMAS, MARICE M	1/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1966 ROTH COURT	None	EUREKA	CA	95503	0100	00	06000	40.77144603	-124.1484136	Humboldt County
309853	Non-Physician Medical Practitioner	None	1295508646	0	0	TAYLOR, GRAHAM PA-C	7/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
309860	Non-Physician Medical Practitioner	None	1265452007	0	0	TIBBS, DARYL E PA-C	9/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	360 SAN MIGUEL DR	STE 309	NEWPORT BEACH	CA	92660	7836	00	06000	33.61321911	-117.8722084	Orange County
309866	Non-Physician Medical Practitioner	None	1275271389	0	0	TWOMEY, KARA L NP	1/24/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	STE 1300	LOS ANGELES	CA	90033	5312	00	06000	34.06269295	-118.2030006	Los Angeles County
309898	Non-Physician Medical Practitioner	None	1174236830	0	0	TAGUACTA-BRAVO, VALENE K NP	2/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
309945	Non-Physician Medical Practitioner	None	1154343622	0	0	THOMPSON, TOLYA L PA-C	11/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	00	06000	38.76553806	-121.2497067	Placer County
309965	Non-Physician Medical Practitioner	None	1285203422	0	0	TAUSHECK, BENJAMIN R PA	12/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	00	06000	37.37715796	-122.0651926	Santa Clara County
309976	Non-Physician Medical Practitioner	None	1073939781	0	0	TIZON, ELADIO M L NP	5/26/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19016 SHAKESPEARE DRIVE	None	WALNUT	CA	97189	4239	00	06000	34.01771508	-117.887423	Los Angeles County
309981	Non-Physician Medical Practitioner	None	1679359681	0	0	TESTERMAN, CHARLES W PA-C	10/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12 UPPER RAGSDALE	None	MONTEREY	CA	93940	5730	00	06000	36.57482436	-121.8101797	Monterey County
309985	Non-Physician Medical Practitioner	None	1174891550	0	0	TANG, SOPHIE H NP	6/2/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3656 W SHAW AVE	None	FRESNO	CA	93711	3231	00	06000	36.80840238	-119.8594473	Fresno County
309988	Non-Physician Medical Practitioner	None	1104638378	0	0	TORRES, SABRINA A PA-C	2/26/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3151 AIRWAY AVE	SUITE G1	COSTA MESA	CA	92626	4624	00	06000	33.67783408	-117.8720921	Orange County
309999	Non-Physician Medical Practitioner	None	1992150775	0	0	TUCKER, TAMARA D NP	5/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	805 BUTTERFIELD LN	None	SAN MARCOS	CA	92069	2215	00	06000	33.14944554	-117.1251235	San Diego County
310004	Non-Physician Medical Practitioner	None	1811561566	0	0	TERRIZZANO, CRISTINA M PA-C	7/26/2024	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
310070	Non-Physician Medical Practitioner	None	1073845327	0	0	TANNER, NATASHA A NP	6/18/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
310083	Non-Physician Medical Practitioner	None	1922114693	0	0	THOMAS, LINDA	10/30/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2175 ROSALINE AVE	MERCY MEDICAL CENTER- ED	REDDING	CA	96001	2509	00	06000	40.57278686	-122.3958519	Shasta County
310125	Non-Physician Medical Practitioner	None	1992807101	0	0	TOM, LILI	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	00	06000	37.55102172	-121.9759026	Alameda County
310150	Non-Physician Medical Practitioner	None	1790524833	0	0	TAPANES, ILIANNA NP	10/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1580 W EL CAMINO REAL	5	MOUNTAIN VIEW	CA	94040	2461	00	06000	37.39001812	-122.0922931	Santa Clara County
310158	Non-Physician Medical Practitioner	None	1336187699	0	0	THOMPSON, BRIAN M	11/6/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2605 FREEPORT BLVD	None	SACRAMENTO	CA	95818	2442	00	06000	38.558925	-121.488552	Sacramento County
310186	Non-Physician Medical Practitioner	None	1144597477	0	0	TIBURCIO VASQUEZ HEALTH CENTER, INC.	1/9/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	680 W TENNYSON RD RM 12	None	HAYWARD	CA	94544	5236	00	06000	37.63204354	-122.0681454	Alameda County
310193	Non-Physician Medical Practitioner	None	1437289832	0	0	THOMAS, JEFFREY MICHAEL	6/28/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	00	06000	37.819368	-122.263902	Alameda County
310199	Non-Physician Medical Practitioner	None	1790733764	0	0	TETREAULT, JOYCE J NP	1/2/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3438 E OREGON AVE	None	PHOENIX	AZ	85018	1528	00	06000	33.514236	-112.0069935	Maricopa County
310205	Non-Physician Medical Practitioner	None	1841473097	0	0	THEROITH, LESLIE VANESSA	11/16/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8251 N. RIVERSIDE AVE	None	RIALTO	CA	92376	0000	00	06000	34.12141165	-117.370422	San Bernardino County
310207	Non-Physician Medical Practitioner	None	1487076402	0	0	TANNER, BENJAMIN W	3/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3338 WINTERHAVEN ST	UNIT 104	LAS VEGAS	NV	89108	5065	00	06000	36.22153246	-115.2454918	Clark County
310248	Non-Physician Medical Practitioner	None	1609200898	0	0	TOPACIO, ALVIN MEDALLA	12/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 E. ILLINOIS AVE.	None	FRESNO	CA	93701	0000	00	06000	36.74505638	-119.783366	Fresno County
310269	Non-Physician Medical Practitioner	None	1316355605	0	0	TEBSHERANI, SARAH	10/23/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
310279	Non-Physician Medical Practitioner	None	1154627362	0	0	THOMPSON, AMAIYA M PA-C	4/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
310332	Non-Physician Medical Practitioner	None	1659686459	0	0	TEETER, CHRISTINA L PA	9/3/2024	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
310356	Non-Physician Medical Practitioner	None	1437818523	0	0	THAYER, CRYSTAL PA-C	11/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31720 S TEMECULA PARKWAY	203	TEMECULA	CA	92592	2034	00	06000	33.4799323	-117.1033702	Riverside County
310359	Non-Physician Medical Practitioner	None	1225684566	0	0	TIZON-DAMIANO, MARITONI NP	4/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	00	06000	34.2064445	-118.8824085	Ventura County
310389	Non-Physician Medical Practitioner	None	1114634185	0	0	TUNG, JESSE	3/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
310390	Non-Physician Medical Practitioner	None	1346310109	0	0	TOUBIANA, DANIEL M	7/18/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	00	06000	38.26109552	-122.0470245	Solano County
310391	Non-Physician Medical Practitioner	None	1578656997	0	0	TONEVA-MERDJANOVA, EUGENIA S	7/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5 PASEO AZUCENO	None	RANCHO SANTA MARG	CA	92688	3947	00	06000	33.64177195	-117.58944	Orange County
310394	Non-Physician Medical Practitioner	None	1578082939	0	0	TABORGA, KARLA A NP	6/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17051 SIERRA LAKES PKWY	STE 101	FONTANA	CA	92336	1274	00	06000	34.13797332	-117.4324372	San Bernardino County
310442	Non-Physician Medical Practitioner	None	1548936602	0	0	TAN, RICHARD NP	2/20/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	678 INDIAN HILL BLVD	STE 200	CLAREMONT	CA	91711	6002	00	06000	34.083495	-117.719192	Los Angeles County
310518	Non-Physician Medical Practitioner	None	1831826106	0	0	TAVANGARY, FOYA	8/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1231 N AVALON BLVD	None	WILMINGTON	CA	90744	2601	00	06000	33.78765728	-118.2630655	Los Angeles County
310542	Non-Physician Medical Practitioner	None	1285266593	0	0	TERHEYDEN, MARIELLE R NP	5/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2720 LOW CT	None	FAIRFIELD	CA	94534	9771	00	06000	38.23580279	-122.0858445	Solano County
310616	Non-Physician Medical Practitioner	None	1326881582	0	0	TANG, DAYNA K NP	11/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 THE CITY DR S	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
310623	Non-Physician Medical Practitioner	None	1659301208	0	0	THIBERT, MICHAEL D	4/1/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	475 BRUCE ST	None	YREKA	CA	96097	3474	00	06000	41.71860037	-122.6467317	Siskiyou County
310627	Non-Physician Medical Practitioner	None	1902449598	0	0	TRANG, VICTORIA PA	1/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	00	06000	37.706364	-122.165163	Alameda County
310648	Non-Physician Medical Practitioner	None	1700227030	0	0	TYMN, AMANDA A NP	9/20/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 N MEDICAL CENTER DR	STE. 125	CLOVIS	CA	93611	6881	00	06000	36.84186593	-119.6624867	Fresno County
310649	Non-Physician Medical Practitioner	None	1467987487	0	0	TAN, JUDITH L CNP	8/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2435 FIRE MESA ST	SUITE 120	LAS VEGAS	NV	89128	9009	00	06000	36.20469539	-115.2575248	Clark County
310653	Non-Physician Medical Practitioner	None	1043753643	0	0	THORNEY, BRITNEY S M	7/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25814 LAWTON AVE	None	LOMA LINDA	CA	92354	3841	00	06000	34.04484321	-117.2414369	San Bernardino County
310699	Non-Physician Medical Practitioner	None	1619488905	0	0	THIELEMAN, CHLOE L	1/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4865 OLD REDWOOD HIGHWAY	None	SANTA ROSA	CA	95403	1415	00	06000	38.50146053	-122.7525201	Sonoma County
310707	Non-Physician Medical Practitioner	None	1578922068	0	0	TRAN, TAMMY NP	11/21/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9711 VERDE MAR DRIVE	None	HUNTINGTON	CA	92646	7523	00	06000	33.65109052	-117.9579195	Orange County
310747	Non-Physician Medical Practitioner	None	1104351469	0	0	TAYLOR, LINDSAY S PA	11/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2377 COLLEGE DR	None	COSTA MESA	CA	92626	6307	00	06000	33.66065625	-117.9158961	Orange County
310760	Non-Physician Medical Practitioner	None	1508101791	0	0	TINSETH, ASHLEE A CNP	4/5/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1155 MILL ST	None	RENO	NV	89502	1576	00	06000	39.52483792	-119.7968314	Washoe County
310763	Non-Physician Medical Practitioner	None	1669472916	0	0	TAN, CHARITY L 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	7357 AMHERST STREET	None	SACRAMENTO	CA	95822	4753	00	06000	38.489868	-121.5050805	Sacramento County
310787	Non-Physician Medical Practitioner	None	1932601473	0	0	TAI, DIANA B NP	11/6/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26800 CROWN VALLEY PKWY	STE 305, 315, 325, 330	MISSION VIEJO	CA	92691	8033	00	06000	33.56286021	-117.6673449	Orange County
310902	Non-Physician Medical Practitioner	None	1548018088	0	0	TAYLOR, KIERSAULA	7/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	06000	36.132948	-115.136874	Clark County
310908	Non-Physician Medical Practitioner	None	1740518208	0	0	TARR, LEANNE D PA	12/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
310915	Non-Physician Medical Practitioner	None	1639540131	0	0	TAGGART, TRAVIS L	11/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	808 RACHEL CT	None	REDLANDS	CA	92373	4563	00	06000	34.05340117	-117.1937016	San Bernardino County
310932	Non-Physician Medical Practitioner	None	1750772000	0	0	TORTORELLI, MIKI K NP	9/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16055 BROOKHURST ST	SUITE C	FOUNTAIN VALLEY	CA	92708	1544	00	06000	33.72960657	-117.9548029	Orange County
310937	Non-Physician Medical Practitioner	None	1366865636	0	0	TREE OF LIFE FOR HEALTHY BIRTHING AND PARENTING	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	617 SAXONY PL	SUITE 103	ENCINITAS	CA	92024	2797	00	06000	33.05482353	-117.285912	San Diego County
310959	Non-Physician Medical Practitioner	None	1508966474	0	0	TRULSON, KENNETH M PA	11/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6060 HELLYER AVE	150	SAN JOSE	CA	95138	1046	00	06000	37.25670154	-121.7796404	Santa Clara County
311027	Non-Physician Medical Practitioner	None	1003584087	0	0	THANGARAJ, CHERRY P NP	9/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1574 W BASE LINE ST	STE 107	SAN BERNARDINO	CA	92411	1736	00	06000	34.12134348	-117.321282	San Bernardino County
311090	Non-Physician Medical Practitioner	None	1245796366	0	0	THOMPSON, CHRISTIAN	9/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5600 CALIFORNIA AVE	STE 101	BAKERSFIELD	CA	93309	1614	00	06000	35.356203	-119.0612695	Kern County
311111	Non-Physician Medical Practitioner	None	1922477306	0	0	TIAO, LILY J NP	9/10/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	211 W RINCON STREET	SUITE 208	CORONA	CA	92880	2061	00	06000	33.88741595	-117.5666117	Riverside County
311140	Non-Physician Medical Practitioner	None	1659906238	0	0	TAYLOR, KIM NP	10/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 N PRAIRIE AVE	SUITE 230	INGLEWOOD	CA	90301	4507	00	06000	33.965712	-118.3439965	Los Angeles County
311152	Non-Physician Medical Practitioner	None	1497855688	0	0	TURPENFOLKS, HEIDI R	10/11/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	36284 POPLAR DRIVE	None	YUCAIPA	CA	92399	5726	00	06000	34.01827718	-117.0127616	San Bernardino County
311248	Non-Physician Medical Practitioner	None	1467073379	0	0	TOMME, MICHELLE M NP	9/8/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	00	06000	33.838623	-116.542737	Riverside County
311256	Non-Physician Medical Practitioner	None	1558706879	0	0	TANKERSLEY, JULIE ANNE	5/15/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	00	06000	40.57278686	-122.3958519	Shasta County
311278	Non-Physician Medical Practitioner	None	1063728996	0	0	THOMPSON, SCOTT E	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	3380 SOUTH 2130 EAST	None	SALT LAKE CITY	UT	84109	2668	00	06000	40.69779893	-111.8298648	Salt Lake County
311310	Non-Physician Medical Practitioner	None	1427474600	0	0	THOMAS, ANGELA M CNP	9/4/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1825 SONOMA ST	None	REDDING	CA	96001	2519	00	06000	40.5756004	-122.3928987	Shasta County
311334	Non-Physician Medical Practitioner	None	1861290520	0	0	TAYLOR, ERIN M NP	4/3/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
311347	Non-Physician Medical Practitioner	None	1881991487	0	0	TURAY, SHAVANA PA-C	12/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2720 LOW CT	None	FAIRFIELD	CA	94534	9771	00	06000	38.23580279	-122.0858445	Solano County
311355	Non-Physician Medical Practitioner	None	1124661186	0	0	TSUJIMOTO, BRYAN J PA	11/20/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	108 LA CASA VIA	SUITE 100	WALNUT CREEK	CA	94598	3013	00	06000	37.9124899	-122.0426939	Contra Costa County
311379	Non-Physician Medical Practitioner	None	1992227193	0	0	TOTEN, MONICA L NP	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	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	00	06000	33.12181055	-117.2840499	San Diego County
311381	Non-Physician Medical Practitioner	None	1770583056	0	0	TIEN, STACEY CAM	7/6/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1140 W LA VETA AVE	STE. 850	ORANGE	CA	92868	4225	00	06000	33.7802984	-117.8651669	Orange County
311383	Non-Physician Medical Practitioner	None	1003219775	0	0	TARZANA TREATMENT CENTERS, INC	1/23/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10605 BALBOA BLVD	None	GRANADA HILLS	CA	91344	6342	00	06000	34.263378	-118.5022965	Los Angeles County
311391	Non-Physician Medical Practitioner	None	1144614066	0	0	TIMBERMAN, SARAH A NP	2/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1019 DORNAJO WAY	218	SACRAMENTO	CA	95825	7392	00	06000	38.584323	-121.406814	Sacramento County
311447	Non-Physician Medical Practitioner	None	1164700084	0	0	TORRES, MELISSA V NP	5/4/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3152 N MILLBROOK AVE	STE. B	FRESNO	CA	93703	1400	00	06000	36.779166	-119.7634925	Fresno County
311452	Non-Physician Medical Practitioner	None	1699393884	0	0	TANG, NANCY PA-C	12/21/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	615 OCEAN ST	None	SANTA CRUZ	CA	95060	4005	00	06000	36.97734512	-122.0204895	Santa Cruz County
311501	Non-Physician Medical Practitioner	None	1760009989	0	0	TRAN, LILI PA-C	12/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	00	06000	33.746805	-117.834147	Orange County
311502	Non-Physician Medical Practitioner	None	1497125371	0	0	TAUR, HAO Y NP	8/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	00	06000	37.51438187	-122.2607682	San Mateo County
311506	Non-Physician Medical Practitioner	None	1508278359	0	0	THE ROADS FOUNDATION, INC.	3/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
311511	Non-Physician Medical Practitioner	None	1619405537	0	0	TRAN, LILY V PA	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	14443 CULVER DR	14443-A	IRVINE	CA	92604	0343	00	06000	33.70541708	-117.7871432	Orange County
311523	Non-Physician Medical Practitioner	None	1750992152	0	0	TRAN, JOLENE T PA	11/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	00	06000	37.32710433	-121.9386474	Santa Clara County
311589	Non-Physician Medical Practitioner	None	1992347629	0	0	TIH, STELLA A NP	3/2/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	00	06000	33.6526055	-117.910746	Orange County
311616	Non-Physician Medical Practitioner	None	1356050967	0	0	TRAM, DAVID W NP	5/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	525 NORTH GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	00	06000	34.06794352	-118.1229278	Los Angeles County
311628	Non-Physician Medical Practitioner	None	1255056834	0	0	TINUNGKI, PRAISE NP	1/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	461 TENNESSEE ST	SUITE C	REDLANDS	CA	92373	8161	00	06000	34.058745	-117.2000975	San Bernardino County
311654	Non-Physician Medical Practitioner	None	1508592759	0	0	TANG, SYDNEY J PA-C	8/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3095 OLD CONEJO RD	None	THOUSAND OAKS	CA	91320	2130	00	06000	34.18969088	-118.9412876	Ventura County
311681	Non-Physician Medical Practitioner	None	1558845859	0	0	THROMBLEY, EDWARD G PA-C	3/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 PARK PL	SUITE 200	SAN RAMON	CA	94583	1761	00	06000	37.7730841	-121.9883297	Contra Costa County
311689	Non-Physician Medical Practitioner	None	1750955894	0	0	TRAN, JESSICA PA	5/28/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	00	06000	33.969141	-118.0489095	Los Angeles County
311693	Non-Physician Medical Practitioner	None	1932584737	0	0	THAKKAR, NOEL S NP	10/26/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6385 TERRACINA AVE	None	ALTA LOMA	CA	91737	6986	00	06000	34.13824369	-117.5667572	San Bernardino County
311744	Non-Physician Medical Practitioner	None	1316049380	0	0	TAMMARA, EDWARD THOMAS	5/1/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	43839 15TH ST W	None	LANCASTER	CA	93534	4756	00	06000	34.678791	-118.156867	Los Angeles County
311757	Non-Physician Medical Practitioner	None	1447297379	0	0	THE CENTER FOR AIDS RESEARCH EDUCATION AND SERVICE	7/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 21ST ST	None	SACRAMENTO	CA	95814	5216	00	06000	38.570553	-121.481325	Sacramento County
311770	Non-Physician Medical Practitioner	None	1306566120	0	0	TAN-GREY, JEANNETTE PA	1/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
311771	Non-Physician Medical Practitioner	None	1790235323	0	0	THELEN, KENDALL L NP	10/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	616 RUSSELL DRIVE	None	FOLSOM	CA	95630	6358	00	06000	38.658258	-121.100733	Sacramento County
311835	Non-Physician Medical Practitioner	None	1407009624	0	0	TRAN, DANIEL HAU	4/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5475 WALNUT AVE.	MY FAMILY MEDICAL GROUP	CHINO	CA	91710	2699	00	06000	34.02627053	-117.684846	San Bernardino County
311850	Non-Physician Medical Practitioner	None	1174697551	0	0	TANKERSLEY, JAMES D	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	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
311899	Non-Physician Medical Practitioner	None	1760004485	0	0	TAYLOR, MELVINA M PA	11/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	00	06000	34.072245	-117.4319685	San Bernardino County
311901	Non-Physician Medical Practitioner	None	1568766442	0	0	TAYKELLEY, SIOKHIAN NP	3/27/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4135 SHELTER CREEK LANE	None	SAN BRUNO	CA	94066	6002	00	06000	37.61937559	-122.4258547	San Mateo County
311905	Non-Physician Medical Practitioner	None	1811380009	0	0	TEWS, HEATHER A	1/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5231 GENOA ST	None	OAKLAND	CA	94608	3213	00	06000	37.83743133	-122.2712804	Alameda County
311907	Non-Physician Medical Practitioner	None	1861860306	0	0	TIBURCIO VASQUEZ HEALTH CENTER, INC. FIREHOUSE CLI	3/30/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28300 HUNTWOOD AVE	None	HAYWARD	CA	94544	5425	00	06000	37.63265296	-122.0643095	Alameda County
311918	Non-Physician Medical Practitioner	None	1477527398	0	0	TEMECULA CA ENDOSCOPY ASC LP	1/26/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25150 HANCOCK AVE	SUITE 208	MURRIETA	CA	92562	5987	00	06000	33.56635084	-117.1823956	Riverside County
311921	Non-Physician Medical Practitioner	None	1194143578	0	0	TRELA, ANTHONY V NP	12/26/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4950 CHERRY AVE	APT 169	SAN JOSE	CA	95118	2728	00	06000	37.25905119	-121.8823892	Santa Clara County
311980	Non-Physician Medical Practitioner	None	1497952626	0	0	TANABE, RYOKO	12/31/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	BECKER 113	LOS ANGELES	CA	90048	0000	00	06000	34.07671715	-118.3799413	Los Angeles County
312028	Non-Physician Medical Practitioner	None	1689422214	0	0	TEODOSIO, GENNA NP	9/26/2024	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
312063	Non-Physician Medical Practitioner	None	1114379120	0	0	TAPSCOTT, LEAH J NP	3/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1784 WEST SHELBY LN	None	REDWOOD CITY	CA	94061	3430	00	06000	37.45053241	-122.2248782	San Mateo County
312095	Non-Physician Medical Practitioner	None	1003120676	0	0	TAYLOR, ISHA S PA	5/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27480 AROMATIC COURT	None	MORENO VALLEY	CA	92555	3038	00	06000	33.9096218	-117.1833575	Riverside County
312140	Non-Physician Medical Practitioner	None	1083809552	0	0	TIMMERMAN, RICHARD A PA-C	9/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27700 MEDICAL CENTER	None	MISSION VIEJO	CA	92691	6426	00	06000	33.56008604	-117.6657795	Orange County
312215	Non-Physician Medical Practitioner	None	1740683648	0	0	TRAN, KAY K	3/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7026 WELLS SPRINGS ST	None	MIRA LOMA	CA	91752	1477	00	06000	33.960366	-117.552784	Riverside County
312223	Non-Physician Medical Practitioner	None	1467662304	0	0	TOBIN, DEBRA L NP	6/16/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1220 HEMLOCK WAY	200	SANTA ANA	CA	92707	3655	00	06000	33.70975375	-117.8842792	Orange County
312266	Non-Physician Medical Practitioner	None	1477263986	0	0	TRAN, HIEU D	6/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 W STEWART DR	None	ORANGE	CA	92868	3849	00	06000	33.78236558	-117.8648414	Orange County
312267	Non-Physician Medical Practitioner	None	1134734205	0	0	TRAN, JEFFREY V PA	10/28/2020	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
312275	Non-Physician Medical Practitioner	None	1619527371	0	0	TIMOTHY, PARKER D PA-C	12/27/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	208 CONCOURSE BLVD	STE 1	SANTA ROSA	CA	95403	8120	00	06000	38.51255309	-122.7884839	Sonoma County
312282	Non-Physician Medical Practitioner	None	1740862887	0	0	TYAN, KEVIN PA-C	11/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 NORTH PEPPER AVENUE	None	COLTON	CA	92324	1819	00	06000	34.073505	-117.3505995	San Bernardino County
312288	Non-Physician Medical Practitioner	None	1922062041	0	0	TOMLINSON, ANN ELIZABETH	9/6/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	00	06000	32.68637926	-117.0828839	San Diego County
312297	Non-Physician Medical Practitioner	None	1568447324	0	0	TOWLE, JULIE A	2/28/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
312302	Non-Physician Medical Practitioner	None	1194291351	0	0	TABORA, REGINA NP	7/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2067 W VISTA WAY	250	VISTA	CA	92083	6034	00	06000	33.18505594	-117.285958	San Diego County
312303	Non-Physician Medical Practitioner	None	1881710887	0	0	TARZANA TREATMENT CENTERS, INC.	10/11/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7101 BAIRD AVE	None	RESEDA	CA	91335	4150	00	06000	34.1995012	-118.5373824	Los Angeles County
312398	Non-Physician Medical Practitioner	None	1578691754	0	0	TUNG, VICTORIA H W	9/11/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	44926 NARAGANSETT COURT	None	FREMONT	CA	94539	6655	00	06000	37.51008474	-121.9225176	Alameda County
312427	Non-Physician Medical Practitioner	None	1730304635	0	0	THERESA, HELM A	5/27/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4123 CULVER STREET	None	OAKLAND	CA	94619	1802	00	06000	37.78602409	-122.2004845	Alameda County
312441	Non-Physician Medical Practitioner	None	1386168037	0	0	TIMMS, NICOLE L	11/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	902 POSSUM HILL STREET	None	HENDERSON	NV	89014	0344	00	06000	36.07172783	-115.0538133	Clark County
312472	Non-Physician Medical Practitioner	None	1518232602	0	0	TONG, ERICA	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	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	00	06000	38.669562	-121.31379	Sacramento County
312473	Non-Physician Medical Practitioner	None	1306356878	0	0	TCHEUMANI, GERARD NP	7/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17075 DEVONSHIRE STREET	SUITE 204	NORTHRIDGE	CA	91325	5408	00	06000	34.25755945	-118.50471	Los Angeles County
312475	Non-Physician Medical Practitioner	None	1467686972	0	0	TU, AMY NP	7/28/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	850 S MANSFIELD AVE	3	LOS ANGELES	CA	90036	4920	00	06000	34.05917605	-118.3417661	Los Angeles County
312640	Non-Physician Medical Practitioner	None	1851953335	0	0	TRAN, LEYNA 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	5801 S FIGUEROA STREET	None	LOS ANGELES	CA	90003	1016	00	06000	33.98958	-118.2827085	Los Angeles County
312655	Non-Physician Medical Practitioner	None	1619024882	0	0	THOMAS, PEGGY BOYAR	1/4/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15630 18TH AVE	None	CLEARLAKE	CA	95422	0000	00	06000	38.93612361	-122.6201499	Lake County
312674	Non-Physician Medical Practitioner	None	1790422111	0	0	TORRES, ARVIN NP	8/31/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9057 CENTRAL AVE	None	MONTCLAIR	CA	91763	1622	00	06000	34.0896003	-117.6894613	San Bernardino County
312709	Non-Physician Medical Practitioner	None	1902149495	0	0	TROWER, KRISTEN A	12/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5230 MARYLAND AVE	None	LA MESA	CA	91942	1512	00	06000	32.77343868	-117.0412935	San Diego County
312738	Non-Physician Medical Practitioner	None	1184344103	0	0	TRAN, JUSTINA PA-C	8/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11160 WARNER AVE	STE 417	FOUNTAIN VALLEY	CA	92708	8703	00	06000	33.71630854	-117.934317	Orange County
312763	Non-Physician Medical Practitioner	None	1760153902	0	0	THOMAS, CHLOE PA	7/24/2023	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
312781	Non-Physician Medical Practitioner	None	1174265151	0	0	TEMMEN, CAITRIN NP	3/19/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	00	06000	37.43920432	-122.162109	Santa Clara County
312861	Non-Physician Medical Practitioner	None	1144833989	0	0	TAYLOR, TRISHA A PA-C	12/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	00	06000	34.03717616	-117.2046115	San Bernardino County
312879	Non-Physician Medical Practitioner	None	1215629209	0	0	TRAN, KIMBERLY PA	2/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6060 HELLYER AVE	150	SAN JOSE	CA	95138	1046	00	06000	37.25670154	-121.7796404	Santa Clara County
312962	Non-Physician Medical Practitioner	None	1700437241	0	0	TRAN, MICHELLE R NP	10/5/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
313042	Non-Physician Medical Practitioner	None	1174991954	0	0	TRAN, DAN C	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	13447 JASMINE WAY	None	GARDEN GROVE	CA	92843	1006	00	06000	33.76749734	-117.9318054	Orange County
313048	Non-Physician Medical Practitioner	None	1285196998	0	0	TAKANIKOS, ALEXANDRA NP	7/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7677 CENTER AVE	STE 214	HUNTINGTON BEACH	CA	92647	9102	00	06000	33.736257	-117.995535	Orange County
313072	Non-Physician Medical Practitioner	None	1508023599	0	0	TOLAND, PAMELA D	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	19831 NOATAK CANYON WAY	None	GRASS VALLEY	CA	95945	7619	00	06000	39.15588539	-121.0203906	Nevada County
313164	Non-Physician Medical Practitioner	None	1427416841	0	0	THACH, VIVIEN T NP	5/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9402 RUSSELL AVE	None	GARDEN GROVE	CA	92844	2327	00	06000	33.76925368	-117.9649501	Orange County
313179	Non-Physician Medical Practitioner	None	1629749056	0	0	TAIT, KRISTEN M NP	10/20/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
313191	Non-Physician Medical Practitioner	None	1437822962	0	0	THAO, CELENA NP	4/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7035 N MAPLE AVE	102A	FRESNO	CA	93720	8027	00	06000	36.83856379	-119.7452911	Fresno County
313225	Non-Physician Medical Practitioner	None	1760039119	0	0	TAKINAN, AGI NAYA G NP	9/4/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	FIVE MEDICAL PLAZA	STE 190	ROSEVILLE	CA	95661	2865	00	06000	38.76523677	-121.2493453	Placer County
313241	Non-Physician Medical Practitioner	None	1568991701	0	0	THOMAS, RAHITHA M NP	2/12/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	125 HOSPITAL DR	None	VALLEJO	CA	94589	2562	00	06000	38.13104151	-122.2391565	Solano County
313314	Non-Physician Medical Practitioner	None	1982808234	0	0	TOMAFSKY, PATRICK J	4/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	120 PROVINCETOWN COURT	None	APTOS	CA	95003	5821	00	06000	36.9522499	-121.873665	Santa Cruz County
313334	Non-Physician Medical Practitioner	None	1578235842	0	0	TOGNERI, ELIZABETH PA	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	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	0000	00	06000	34.158213	-118.328112	Los Angeles County
313344	Non-Physician Medical Practitioner	None	1285297192	0	0	TRAN, CECILIA V NP	9/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 N MEDICAL CTR DR E	STE 209	CLOVIS	CA	93611	6886	00	06000	36.84186593	-119.6624867	Fresno County
313370	Non-Physician Medical Practitioner	None	1427592476	0	0	TUMASYAN, YELENA PA-C	10/17/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
313383	Non-Physician Medical Practitioner	None	1275120313	0	0	TAYLOR, TERRY E PA-C	11/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3853 W STETSON AVE	STE 100	HEMET	CA	92545	9674	00	06000	33.7293005	-117.011457	Riverside County
313410	Non-Physician Medical Practitioner	None	1821332255	0	0	THOMS, TRISHA A	10/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3916 NE GRAND AVE	None	PORTLAND	OR	97212	1106	00	06000	45.55112618	-122.6605248	Multnomah County
313414	Non-Physician Medical Practitioner	None	1942293394	0	0	TIMPLE, FELURYNE L NP	5/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2174 FALCON CREST DRIVE	None	RIVERSIDE	CA	92506	3473	00	06000	33.94607305	-117.3562324	Riverside County
313439	Non-Physician Medical Practitioner	None	1972767739	0	0	TANTARELLI, JENIFER J	11/19/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1154 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4816	00	06000	38.44309513	-122.7002777	Sonoma County
313443	Non-Physician Medical Practitioner	None	1508319088	0	0	TARANTINO, ASHLEY M	12/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	85 EL PLAZUELA ST	None	SAN FRANCISCO	CA	94127	2742	00	06000	37.72756844	-122.4711065	San Francisco County
313506	Non-Physician Medical Practitioner	None	1407188006	0	0	TARAVELLA, SONYA N	9/17/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3130 RUBINO DR	APT 317	SAN JOSE	CA	95125	6393	00	06000	37.2793138	-121.87391	Santa Clara County
313558	Non-Physician Medical Practitioner	None	1881630572	0	0	TILLER, RONALD D	12/13/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	640 E 700 S	SUITE 203	ST GEORGE	UT	84770	4023	00	06000	37.09623954	-113.569641	Washington County
313579	Non-Physician Medical Practitioner	None	1619328291	0	0	TSAI, MARGARET W	7/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	63 CRESTWICK	None	IRVINE	CA	92620	1006	00	06000	33.71125138	-117.7444156	Orange County
313598	Non-Physician Medical Practitioner	None	1619223955	0	0	TREXLER, JAMIE E NP	4/7/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3011 DEVONSHIRE ROAD	None	ALLENTOWN	PA	18103	6305	00	06000	40.56308717	-75.49590976	Lehigh County
313609	Non-Physician Medical Practitioner	None	1427439652	0	0	TORNG, SHERRY S PA	5/31/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
313657	Non-Physician Medical Practitioner	None	1417506445	0	0	TARNOWSKI, JOHN R PA-C	8/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	00	06000	34.5406159	-117.2658221	San Bernardino County
313676	Non-Physician Medical Practitioner	None	1730697301	0	0	TOGASHI, ALLYSON J	8/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1545 WIGWAM PKWY	APT 1012	HENDERSON	NV	89074	8725	00	06000	36.031014	-115.049925	Clark County
313692	Non-Physician Medical Practitioner	None	1043979859	0	0	TRUONG, LOC V PA-C	1/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16630 BROADWAY	None	GARDENA	CA	90248	2716	00	06000	33.87988966	-118.278108	Los Angeles County
313698	Non-Physician Medical Practitioner	None	1780816025	0	0	TITTELFITZ, TAMI D NP	2/21/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
313711	Non-Physician Medical Practitioner	None	1053681114	0	0	TANG TILT, ANNA PA-C	7/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1850 W. FLORIDA AVE.	None	HEMET	CA	92545	6738	00	06000	33.74751552	-116.991432	Riverside County
313742	Non-Physician Medical Practitioner	None	1326438946	0	0	TOLLES, WESLEY W PA-C	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
313766	Non-Physician Medical Practitioner	None	1982928859	0	0	TROUTMAN, KATHERINE C NP	4/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
313797	Non-Physician Medical Practitioner	None	1497018584	0	0	TOVAR, MANUEL PA-C	3/26/2020	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	STE M	INDIO	CA	92201	4832	00	06000	33.70738152	-116.233002	Riverside County
313827	Non-Physician Medical Practitioner	None	1588274526	0	0	TON, AIMI PA-C	11/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	00	06000	34.13998921	-118.7070142	Los Angeles County
313828	Non-Physician Medical Practitioner	None	1962703504	0	0	TIRADO, OLIVIA	3/2/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1668 DOMINICAN WAY	None	SANTA CRUZ	CA	95065	1522	00	06000	36.99025828	-121.9810944	Santa Cruz County
313834	Non-Physician Medical Practitioner	None	1932339785	0	0	TURNEY, JENNIFER C	3/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	111 BEAN CREEK RD	None	SCOTTS VALLEY	CA	95066	4133	00	06000	37.04785114	-122.0242763	Santa Cruz County
313873	Non-Physician Medical Practitioner	None	1316552987	0	0	TRAN, KATHERINE PA-C	1/20/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	611 ABBOTT ST	100	SALINAS	CA	93901	4389	00	06000	36.66192801	-121.6413283	Monterey County
313891	Non-Physician Medical Practitioner	None	1285224097	0	0	TAPIA, JENNIFER L	4/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	00	06000	34.51312455	-117.325854	San Bernardino County
313897	Non-Physician Medical Practitioner	None	1689459430	0	0	TAN, TIFFANY NP	1/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1309 S MARY AVE	STE 200	SUNNYVALE	CA	94087	2315	00	06000	37.34939241	-122.0505414	Santa Clara County
313905	Non-Physician Medical Practitioner	None	1881736452	0	0	TIMBO, MAHMOOD BULKO	3/3/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	00	06000	33.94274917	-118.2461916	Los Angeles County
313908	Non-Physician Medical Practitioner	None	1205250263	0	0	THE CHILDREN'S CLINIC, 'SERVING CHILDREN & THEIR F	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	2125 SANTA FE AVE	None	LONG BEACH	CA	90810	3547	00	06000	33.795585	-118.215548	Los Angeles County
313944	Non-Physician Medical Practitioner	None	1609141415	0	0	TRAN, DUC M	3/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9631 BLANCHE AVE	None	GARDEN GROVE	CA	92841	3718	00	06000	33.78630052	-117.9650229	Orange County
313953	Non-Physician Medical Practitioner	None	1033404330	0	0	TATE, PATRICIA L 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	19212 REDBLUFF DRIVE	None	TRABUCO CANYON	CA	92679	1113	00	06000	33.68286948	-117.634464	Orange County
313958	Non-Physician Medical Practitioner	None	1992450829	0	0	TAGLE, HANNA D NP	7/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1223 16TH STREET 3RD FLO	SUITE 3400 POD D	SANTA MONICA	CA	90404	1279	00	06000	34.02773198	-118.4862675	Los Angeles County
313967	Non-Physician Medical Practitioner	None	1114349651	0	0	TOKISHI, TARRAH Y	11/20/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11228 SAN JUAN ST	None	LOMA LINDA	CA	92354	3216	00	06000	34.04983274	-117.2685226	San Bernardino County
313978	Non-Physician Medical Practitioner	None	1871106294	0	0	TAYLOR, KAITLYN NP	1/17/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7677 CENTER AVE	SUITE 214	HUNTINGTON BEACH	CA	92647	3074	00	06000	33.736257	-117.995535	Orange County
313980	Non-Physician Medical Practitioner	None	1497130769	0	0	TRAN, KIMBERLY N NP	1/19/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5833 OAK AVE	None	TEMPLE CITY	CA	91780	2132	00	06000	34.10528099	-118.065025	Los Angeles County
313999	Non-Physician Medical Practitioner	None	1013078674	0	0	THIBAULT, KEITH M	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 W MACARTHUR	None	OAKLAND	CA	94611	5641	00	06000	37.82397231	-122.2578822	Alameda County
314014	Non-Physician Medical Practitioner	None	1205659299	0	0	TAYLOR, PARKER PA	4/18/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	33494 OAK GLEN RD	None	YUCAIPA	CA	92399	2057	00	06000	34.03255442	-117.0737219	San Bernardino County
314034	Non-Physician Medical Practitioner	None	1295519239	0	0	TATRO, ANNA	6/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	00	06000	33.746805	-117.834147	Orange County
314043	Non-Physician Medical Practitioner	None	1295966489	0	0	TRAN, THU M NP	12/8/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16067 FRANCISQUITO AVE	None	LA PUENTE	CA	91744	1233	00	06000	34.05043258	-117.9321062	Los Angeles County
314070	Non-Physician Medical Practitioner	None	1609501253	0	0	TOOLSON, EMMA L	12/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
314088	Non-Physician Medical Practitioner	None	1073695946	0	0	TALLMON, KIRSTEN PINA	7/25/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	0000	00	06000	34.129683	-117.970857	Los Angeles County
314097	Non-Physician Medical Practitioner	None	1619505922	0	0	TYNAN, JUSTIN J PA	7/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	00	06000	34.44257521	-119.7584538	Santa Barbara County
314118	Non-Physician Medical Practitioner	None	1073240925	0	0	TAKKE, AMANDA V PA-C	2/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 COFFEE RD	None	MODESTO	CA	95355	2803	00	06000	37.668645	-120.9756715	Stanislaus County
314119	Non-Physician Medical Practitioner	None	1841207669	0	0	THOMPSON, LESLIE	8/16/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3325 RESEARCH WAY	None	CARSON CITY	NV	89706	7913	00	06000	39.189159	-119.749842	Consolidated Municipality of Carson City
314129	Non-Physician Medical Practitioner	None	1447378757	0	0	TODD, CAROL E	2/8/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	705 E VIRGINIA WAY	SUITE F	BARSTOW	CA	92311	3978	00	06000	34.88815781	-117.018543	San Bernardino County
314135	Non-Physician Medical Practitioner	None	1376507426	0	0	TORRES, FRANK D	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	420 W ROWLAND ST	None	COVINA	CA	91723	2943	00	06000	34.078949	-117.8963031	Los Angeles County
314141	Non-Physician Medical Practitioner	None	1245362375	0	0	TAPANG ALBAYALDE, SHALANI NP	10/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5052 CITATION AVE	None	CYPRESS	CA	90630	4402	00	06000	33.81204682	-118.0444527	Orange County
314194	Non-Physician Medical Practitioner	None	1225287725	0	0	TANAKA, DOUGLAS S	1/27/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16088 N FRONT RD	None	FRIANT	CA	93626	0223	00	06000	0	0	None
314284	Non-Physician Medical Practitioner	None	1962822254	0	0	TAM, KATHLEEN K	8/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2318 MONTE VISTA DR	None	PINOLE	CA	94564	1123	00	06000	37.98292867	-122.2698887	Contra Costa County
314286	Non-Physician Medical Practitioner	None	1194358010	0	0	TAHMASSEBI, VICTORIA S PA	5/25/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23931375	-121.8014189	Santa Clara County
314287	Non-Physician Medical Practitioner	None	1174972897	0	0	TERZIAN, GARY J	6/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	818 E OLIVE AVE	None	BURBANK	CA	91501	1426	00	06000	34.18834823	-118.3007854	Los Angeles County
314322	Non-Physician Medical Practitioner	None	1336563279	0	0	TONKINSON, SANDRA NP	4/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	06000	34.480224	-114.3390555	Mohave County
314365	Non-Physician Medical Practitioner	None	1346803152	0	0	TRAN, UYEN H NP	10/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	631 COOPER RD	None	OXNARD	CA	93030	5427	00	06000	34.20454837	-119.1719737	Ventura County
314386	Non-Physician Medical Practitioner	None	1205209285	0	0	TRUONG, DUNG Q NP	2/22/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10838 REXBON CT	None	FOUNTAIN VALLEY	CA	92708	1156	00	06000	33.73212792	-117.9399682	Orange County
314398	Non-Physician Medical Practitioner	None	1659466001	0	0	THAKKAR, PINKY R	3/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2117 PLANT AVE	4	REDONDO BEACH	CA	90278	2011	00	06000	33.88094771	-118.3733804	Los Angeles County
314420	Non-Physician Medical Practitioner	None	1851321434	0	0	THOMAS, ROGER W PA	3/16/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 S IMPERIAL AVE	STE 1	EL CENTRO	CA	92243	4241	00	06000	32.77989821	-115.5697418	Imperial County
314436	Non-Physician Medical Practitioner	None	1346435625	0	0	TINIO, BIBIANE KIM	4/21/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	550 WASHINGTON ST	SUITE 601	SAN DIEGO	CA	92103	2213	00	06000	32.75003652	-117.1603431	San Diego County
314497	Non-Physician Medical Practitioner	None	1134301070	0	0	TRAN, DONNA H NP	3/11/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13442 FLOWER ST	#11	GARDEN GROVE	CA	92843	6129	00	06000	33.767667	-117.9535245	Orange County
314525	Non-Physician Medical Practitioner	None	1154516789	0	0	THOMAS, WALTER	5/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5724 W 74TH ST	None	WESTCHESTER	CA	90045	1712	00	06000	33.97200405	-118.380822	Los Angeles County
314539	Non-Physician Medical Practitioner	None	1043460306	0	0	TAKASHIMA, EMAKA NP	10/21/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	00	06000	33.6526055	-117.910746	Orange County
314563	Non-Physician Medical Practitioner	None	1184791998	0	0	TRI-CITY HEALTH CENTER	4/27/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1999 MOWRY AVENUE	None	FREMONT	CA	94538	1436	00	06000	37.55783419	-121.9808484	Alameda County
314585	Non-Physician Medical Practitioner	None	1013310135	0	0	THE OASIS MEDICAL CLINIC INC	6/24/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2635 WALNUT ST	None	HUNTINGTON PARK	CA	90255	5709	00	06000	33.97320947	-118.2240158	Los Angeles County
314628	Non-Physician Medical Practitioner	None	1467055855	0	0	THUKHOTSONG, DICKEY W NP	2/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 CASA BUENA DR	None	CORTE MADERA	CA	94925	1762	00	06000	37.92483214	-122.51669	Marin County
314650	Non-Physician Medical Practitioner	None	1518316405	0	0	TERHUNE, ANDREW P PA-C	6/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	FIVE MEDICAL PLAZA	STE 190	ROSEVILLE	CA	95661	2865	00	06000	38.76523677	-121.2493453	Placer County
314652	Non-Physician Medical Practitioner	None	1679118293	0	0	TERRY, CARLOTA NP	12/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	00	06000	33.6526055	-117.910746	Orange County
314653	Non-Physician Medical Practitioner	None	1992341606	0	0	TAN, BRIANA X PA-C	3/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	00	06000	36.327888	-119.294919	Tulare County
314656	Non-Physician Medical Practitioner	None	1497766208	0	0	THOMAS, CHERYCE	4/28/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1035 PLACER ST	None	REDDING	CA	96001	1125	00	06000	40.58349378	-122.3853903	Shasta County
314672	Non-Physician Medical Practitioner	None	1982836854	0	0	THOMAS, JINA	10/20/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
314690	Non-Physician Medical Practitioner	None	1780157032	0	0	TCHICAYA, ANA V NP	2/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28359 ROBIN AVE	None	SANTA CLARITA	CA	91350	1432	00	06000	34.456851	-118.4967095	Los Angeles County
314693	Non-Physician Medical Practitioner	None	1407225147	0	0	TOOL, FRANKLIN D NP	7/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	325 GELLERT BLVD	None	DALY CITY	CA	94015	2613	00	06000	37.66753085	-122.4686194	San Mateo County
314706	Non-Physician Medical Practitioner	None	1992380828	0	0	THOMAS, MARIAN A PA-C	7/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
314720	Non-Physician Medical Practitioner	None	1326411414	0	0	TUEL, AMANDA L NP	8/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14255 SAN ANTONIO ROAD	None	ATASCADERO	CA	93422	6327	00	06000	35.4304799	-120.6247453	San Luis Obispo County
314743	Non-Physician Medical Practitioner	None	1184886178	0	0	TAHERI, MERRY NP	10/20/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 ATLANTIC AVE	UNIT 1108	LONG BEACH	CA	90802	5151	00	06000	33.7684102	-118.1850289	Los Angeles County
314760	Non-Physician Medical Practitioner	None	1346715661	0	0	TRAN, THAO D NP	10/12/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9191 WESTMINSTER AVE	SUITE 207	GARDEN GROVE	CA	92844	2751	00	06000	33.75946879	-117.9688437	Orange County
314764	Non-Physician Medical Practitioner	None	1316032501	0	0	THARES-CALLAWAY, SHEILA MICHELLE	5/26/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19000 HOMESTEAD	None	CUPERTINO	CA	95014	0000	00	06000	37.33773494	-122.0043395	Santa Clara County
314770	Non-Physician Medical Practitioner	None	1689396111	0	0	TRAN, LINH PA	9/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	594 EL CAMINO REAL	None	SANTA CLARA	CA	95050	4345	00	06000	37.35293214	-121.9385135	Santa Clara County
314780	Non-Physician Medical Practitioner	None	1578009718	0	0	TAYLOR, KELLI A	7/14/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5175 JERRY TARKANIAN WAY	APT 17302	LAS VEGAS	NV	89148	0011	00	06000	36.09492885	-115.2903782	Clark County
314785	Non-Physician Medical Practitioner	None	1922356369	0	0	TRI-STATE COMMUNITY HEALTHCARE CENTER	2/21/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1402 BAILEY AVE	None	NEEDLES	CA	92363	3104	00	06000	34.832781	-114.618349	San Bernardino County
314798	Non-Physician Medical Practitioner	None	1659921641	0	0	TABARES, JESSICA NP	9/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
314816	Non-Physician Medical Practitioner	None	1699952929	0	0	TRAN, TAI T	3/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24982 SINGINGWOODS	None	LAKE FOREST	CA	92630	3233	00	06000	33.63628797	-117.6946684	Orange County
314823	Non-Physician Medical Practitioner	None	1669526174	0	0	TASHJIAN, ANNIE NP	12/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	403 W ADAMS BLVD	None	LOS ANGELES	CA	90007	2664	00	06000	34.02741539	-118.2743622	Los Angeles County
314844	Non-Physician Medical Practitioner	None	1275569113	0	0	TODD, GERALD ANDREW	1/9/1997	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6333 WILSHIRE BLVD	STE 411	LOS ANGELES	CA	90048	5702	00	06000	34.06355697	-118.366413	Los Angeles County
314852	Non-Physician Medical Practitioner	None	1033299920	0	0	TAMAGNI, DAWN P NP	8/16/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3082 MCMURRAY	None	ANDERSON	CA	96007	3544	00	06000	40.45499506	-122.2929002	Shasta County
314869	Non-Physician Medical Practitioner	None	1548634520	0	0	TRAN, JENNIFER NP	3/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18785 BROOKHURST STREET	STE 101	FOUNTAIN VALLEY	CA	92708	7300	00	06000	33.68987636	-117.9542321	Orange County
314887	Non-Physician Medical Practitioner	None	1720601396	0	0	THOMPSON, CYNTHIA PA-C	12/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3680 INDUSTRIAL BLVD	STE 550-H	WEST SACRAMENTO	CA	95691	6500	00	06000	38.57331162	-121.566125	Yolo County
314899	Non-Physician Medical Practitioner	None	1427460856	0	0	TUANO, ARISTOTLE I NP	2/17/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3406 ROCKHAMPTON DR	None	CAMARILLO	CA	93010	4573	00	06000	34.21167307	-119.0234123	Ventura County
314903	Non-Physician Medical Practitioner	None	1215125570	0	0	TORRES, HECTOR	10/25/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2551 SANTA ANA AVE	None	COSTA MESA	CA	92627	1143	00	06000	33.65704018	-117.8924252	Orange County
314905	Non-Physician Medical Practitioner	None	1922190867	0	0	TROMPETA, LUIS A	9/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12134 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	3205	00	06000	34.18664618	-118.3978356	Los Angeles County
314990	Non-Physician Medical Practitioner	None	1548921398	0	0	TOBIN, SANDI I PA	8/9/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2545 W HAMMER LN	None	STOCKTON	CA	95209	2839	00	06000	38.0214303	-121.3461515	San Joaquin County
315048	Non-Physician Medical Practitioner	None	1811645997	0	0	TRAN, STEPHANIE NP	11/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26501 RANCHO PKWY	SUITE #103 FOOTHILL RANC	LAKE FOREST	CA	92630	8359	00	06000	33.67429702	-117.6716867	Orange County
315050	Non-Physician Medical Practitioner	None	1609272384	0	0	TORRES, JASON NP	2/17/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	625 TIMBERLINE DRIVE	None	AZUSA	CA	91702	1426	00	06000	34.14854397	-117.914791	Los Angeles County
315085	Non-Physician Medical Practitioner	None	1942724042	0	0	TESFAI, HELEN S PA	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	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
315091	Non-Physician Medical Practitioner	None	1588804827	0	0	THANAWALA, KATHERINE M CNM	6/22/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1142 GARFIELD AVE	None	SAN JOSE	CA	92125	3113	00	06000	37.3095244	-121.9039773	Santa Clara County
315094	Non-Physician Medical Practitioner	None	1700029105	0	0	THAI, QUAN	6/3/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2001 DWIGHT WAY	ALTA BATES COMPREHENSIVE	BERKELEY	CA	94704	2608	00	06000	37.86379498	-122.2689084	Alameda County
315119	Non-Physician Medical Practitioner	None	1306597307	0	0	TANSUWAN, SUJITRA NP	5/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3466 EL CAMINO REAL	None	SANTA CLARA	CA	95051	2809	00	06000	37.35225555	-121.9921875	Santa Clara County
315224	Non-Physician Medical Practitioner	None	1912073404	0	0	TURNIPSEED, STEVEN D	5/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3203 SISLEY GARDEN AVE	None	HENDERSON	NV	89044	0399	00	06000	35.95069153	-115.1283605	Clark County
315249	Non-Physician Medical Practitioner	None	1598547713	0	0	TOMLINSON, LISA	3/5/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 MISSION BLVD	STE 2800	JACKSON	CA	95642	2536	00	06000	38.35163001	-120.7670107	Amador County
315287	Non-Physician Medical Practitioner	None	1194400929	0	0	TRINH, KHAI NP	6/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1002 N FAIRVIEW ST	None	SANTA ANA	CA	92703	1811	00	06000	33.75346151	-117.9023004	Orange County
315331	Non-Physician Medical Practitioner	None	1336693324	0	0	TUBBS, LAURA N NP	8/20/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2777 LONG BEACH BLVD	STE 200	LONG BEACH	CA	90806	1513	00	06000	33.80734327	-118.189472	Los Angeles County
315332	Non-Physician Medical Practitioner	None	1083108310	0	0	TIU, TONY W PA	7/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22110 ROSCOE BLVD	STE 201	CANOGA PARK	CA	91304	3861	00	06000	34.21957849	-118.6082685	Los Angeles County
315343	Non-Physician Medical Practitioner	None	1740756279	0	0	TOLOPILO, REBEKAH M PA-C	5/22/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28780 SINGLE OAK DRIVE	SUITE 160	TEMECULA	CA	92590	5528	00	06000	33.49890392	-117.1612965	Riverside County
315373	Non-Physician Medical Practitioner	None	1407297781	0	0	TAYAG, ARMINE T NP	10/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2101 N DONOVAN WAY	None	SAN RAMON	CA	94582	3275	00	06000	37.76457873	-121.8970008	Contra Costa County
315380	Non-Physician Medical Practitioner	None	1053660464	0	0	TRIAS, MICHAEL PEDRANO	5/2/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15733 WHITTIER BLVD	None	WHITTIER	CA	90603	2312	00	06000	33.94402086	-117.9922473	Los Angeles County
315393	Non-Physician Medical Practitioner	None	1285806794	0	0	TRUJILLO, MIGUEL	9/25/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	685 CARNEGIE DR STE 230	None	SAN BERNARDINO	CA	92408	3583	00	06000	34.06854657	-117.2701375	San Bernardino County
315394	Non-Physician Medical Practitioner	None	1437795333	0	0	THANTERAPHONG, MIKEY NP	4/7/2023	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
315406	Non-Physician Medical Practitioner	None	1952603896	0	0	THATCHER, AMY E NP	10/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
315506	Non-Physician Medical Practitioner	None	1538677877	0	0	THIK, MELISSA T NP	10/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2210 E ILLINOIS AVE	SUITE 408	FRESNO	CA	93701	2168	00	06000	36.74500687	-119.7846885	Fresno County
315514	Non-Physician Medical Practitioner	None	1316247661	0	0	TSAI, LAWRENCE	2/6/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7872 WALKER ST	None	LA PALMA	CA	90623	1796	00	06000	33.84787056	-118.0372511	Orange County
315528	Non-Physician Medical Practitioner	None	1487939989	0	0	TERAN, RAFAEL R	9/25/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2576 S DUKE	None	FRESNO	CA	93737	5298	00	06000	36.708489	-119.6916985	Fresno County
315569	Non-Physician Medical Practitioner	None	1639214638	0	0	TAYAG, JEFFREY	3/16/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3801 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1625	00	06000	37.78707021	-122.4555217	San Francisco County
315606	Non-Physician Medical Practitioner	None	1437696226	0	0	TERMECHI, MICHELA S NP	4/4/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1017 S FAIR OAKS AVE	None	PASADENA	CA	91105	2621	00	06000	34.12830178	-118.1503497	Los Angeles County
315610	Non-Physician Medical Practitioner	None	1649528357	0	0	TAING, JENNIFER S	3/9/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8746 COVINA CIRCLE	None	SAN DIEGO	CA	92126	3627	00	06000	32.90510284	-117.1357509	San Diego County
315625	Non-Physician Medical Practitioner	None	1609489145	0	0	TOVEY, KAILYN R	5/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
315657	Non-Physician Medical Practitioner	None	1891805289	0	0	THORNBURG, DENISE R	9/7/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3196 S MARYLAND PKWY	SUITE 217	LAS VEGAS	NV	89109	2305	00	06000	36.13194	-115.136873	Clark County
315662	Non-Physician Medical Practitioner	None	1437599834	0	0	TOWNSEND, AMI N NP	9/9/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
315686	Non-Physician Medical Practitioner	None	1063740272	0	0	TORRES-YAYA, ISABELL I NP	5/20/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	257 SAN JOSE AVE	None	SAN FRANCISCO	CA	94110	3746	00	06000	37.75118842	-122.4214802	San Francisco County
315689	Non-Physician Medical Practitioner	None	1063972214	0	0	TOM, CHRISTOPHER PA	6/29/2020	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
315765	Non-Physician Medical Practitioner	None	1265147201	0	0	THOMSON, BENJAMIN	5/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	160 E ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	00	06000	34.07556833	-117.7507835	Los Angeles County
315787	Non-Physician Medical Practitioner	None	1548485386	0	0	TORRES, GUY	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2520 ELISHA AVE	None	ZION	IL	60099	2676	00	06000	42.449373	-87.827967	Lake County
315797	Non-Physician Medical Practitioner	None	1447848247	0	0	TRAN, PHA PA-C	12/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	00	06000	33.62609529	-117.7293191	Orange County
315810	Non-Physician Medical Practitioner	None	1831258557	0	0	TAPERT, KELLY H	3/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1104 N SIERRA BONITA AVE	None	PASADENA	CA	91104	3144	00	06000	34.16503215	-118.1177631	Los Angeles County
315832	Non-Physician Medical Practitioner	None	1023488814	0	0	TAN, WANTING NP	7/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	00	06000	33.6526055	-117.910746	Orange County
315846	Non-Physician Medical Practitioner	None	1841966249	0	0	TAN, BENJO YSMAEL C NP	4/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	520 N MAIN ST	SUITE 120	SANTA ANA	CA	92701	4623	00	06000	33.749316	-117.868123	Orange County
315887	Non-Physician Medical Practitioner	None	1841772944	0	0	TRAINA, NICOLE R PA	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	1628 PALM AVE	None	SAN DIEGO	CA	92154	1027	00	06000	32.58396546	-117.098649	San Diego County
315913	Non-Physician Medical Practitioner	None	1548217474	0	0	TRIPP, WILLIAM CHASE	3/8/2012	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
315939	Non-Physician Medical Practitioner	None	1073202750	0	0	TANTIONGCO, RHEALYN NP	7/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	00	06000	33.83760674	-118.3572569	Los Angeles County
315953	Non-Physician Medical Practitioner	None	1053530147	0	0	TRAN, HUGHES H	12/7/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7261 ERICA CT	None	RIVERSIDE	CA	92506	6104	00	06000	33.91882456	-117.3256262	Riverside County
315964	Non-Physician Medical Practitioner	None	1568244200	0	0	TAN, SALLY NP	12/29/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
315971	Non-Physician Medical Practitioner	None	1194188854	0	0	TAHOE FOREST HOSPITAL DISTRI	11/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10051 LAKE AVE	SUITE 3	TRUCKEE	CA	96161	4870	00	06000	39.32550268	-120.2025066	Nevada County
316000	Non-Physician Medical Practitioner	None	1124573209	0	0	TAM, DIANA	6/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	718 OLD SAN FRANCISCO RD	APT 342	SUNNYVALE	CA	94086	8022	00	06000	37.36668096	-122.0184179	Santa Clara County
316014	Non-Physician Medical Practitioner	None	1700902947	0	0	THOMSON, KALANI K	3/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1975 VIA SEGOVIA	None	LA JOLLA	CA	92037	6441	00	06000	32.83365681	-117.2545049	San Diego County
316018	Non-Physician Medical Practitioner	None	1972382067	0	0	TRAN, KELLEY	1/21/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 E CARRILLO ST	None	SANTA BARBARA	CA	93101	1460	00	06000	34.42588572	-119.6972176	Santa Barbara County
316058	Ordering, Referring, Prescribing	N/A	1003015835	0	0	THOMAS, KAREN L LCSW	6/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW23037	N/A	N/A	N/A	N/A	N/A	5275 CLAREMONT AVE	None	OAKLAND	CA	94618	1032	00	06000	37.8391822	-122.260841	Alameda County
316069	Ordering, Referring, Prescribing	N/A	1003046848	0	0	THOMAS, LOWELL G	1/17/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D34234	N/A	N/A	N/A	N/A	N/A	175 MAIN ST	#1100	GUALALA	CA	95445	1100	00	06000	0	0	None
316083	Ordering, Referring, Prescribing	N/A	1003088063	0	0	TOVAR, NICOLE M PT	6/13/2023	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	33914	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
316142	Ordering, Referring, Prescribing	N/A	1003169715	0	0	TAI, MAGGIE	8/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68125	N/A	N/A	N/A	N/A	N/A	1306 S MARY AVE	None	SUNNYVALE	CA	94087	3130	00	06000	37.35157944	-122.0505128	Santa Clara County
316161	Ordering, Referring, Prescribing	N/A	1003200841	0	0	TORRES, DENISE LMFT	8/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	120688	N/A	N/A	N/A	N/A	N/A	6400 LAUREL CANYON BLVD	500	NORTH HOLLYWOOD	CA	91606	1571	00	06000	34.18698871	-118.3964897	Los Angeles County
316181	Ordering, Referring, Prescribing	N/A	1003214446	0	0	THOMPSON, VICTOR	8/17/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140958	N/A	N/A	N/A	N/A	N/A	96 S 14TH ST	None	SAN JOSE	CA	95112	2015	00	06000	37.34094484	-121.8759294	Santa Clara County
316228	Ordering, Referring, Prescribing	N/A	1003288655	0	0	THOMPSON, SACHEEN LMFT	4/28/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132533	N/A	N/A	N/A	N/A	N/A	3727 SUNSET LANE	100	ANTIOCH	CA	94509	9998	00	06000	37.98376866	-121.8041894	Contra Costa County
316263	Ordering, Referring, Prescribing	N/A	1003343161	0	0	TAYLOR, ANTOINETTE	11/6/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	105302	N/A	N/A	N/A	N/A	N/A	2000 EMBARCADERO	400	OAKLAND	CA	94606	5334	00	06000	37.78179304	-122.2428136	Alameda County
316292	Ordering, Referring, Prescribing	N/A	1003379223	0	0	TOUMA, ELIE DPM	1/31/2022	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	5831	N/A	N/A	N/A	N/A	N/A	425 N DATE ST	None	ESCONDIDO	CA	92025	3413	00	06000	33.1292461	-117.0716509	San Diego County
316342	Ordering, Referring, Prescribing	N/A	1003445057	0	0	TIAN, LU DDS	8/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	106058	N/A	N/A	N/A	N/A	N/A	1141 PEAR TREE LN	120	NAPA	CA	94558	6484	00	06000	38.32125908	-122.2921523	Napa County
316346	Ordering, Referring, Prescribing	N/A	1003452517	0	0	TIGLAO, KRISKA NP	8/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013667	N/A	N/A	N/A	N/A	N/A	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	00	06000	34.06477215	-117.9845382	Los Angeles County
316358	Ordering, Referring, Prescribing	N/A	1003468034	0	0	TOBAR, MAYRA LMFT	12/30/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130326	N/A	N/A	N/A	N/A	N/A	6301 BEACH BLVD	STE 245	BUENA PARK	CA	90621	2840	00	06000	33.86880928	-117.9983013	Orange County
316360	Ordering, Referring, Prescribing	N/A	1003464777	0	0	TEJEDA, ROMINA LMFT	8/30/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT141252	N/A	N/A	N/A	N/A	N/A	5100 S EASTERN AVE	None	LOS ANGELES	CA	90040	2938	00	06000	33.98882955	-118.1615175	Los Angeles County
316371	Ordering, Referring, Prescribing	N/A	1003489816	0	0	TOWNS, TAMMY NP	8/26/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95031869	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
316399	Ordering, Referring, Prescribing	N/A	1003556044	0	0	TAYLOR, EMILY J LCSW	4/12/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	28176	N/A	N/A	N/A	N/A	N/A	1255 E HIGHLAND AVE	107	SAN BERNARDINO	CA	92404	6804	00	06000	34.13584648	-117.259875	San Bernardino County
316478	Ordering, Referring, Prescribing	N/A	1003975566	0	0	TURNER, KARLA M	10/2/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D50135	N/A	N/A	N/A	N/A	N/A	4816 E 3RD ST	None	LOS ANGELES	CA	90022	1602	00	06000	34.03327647	-118.16037	Los Angeles County
316483	Ordering, Referring, Prescribing	N/A	1003990920	0	0	TAKAHASHI, SCOTT H PHARMD	7/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	42737	N/A	N/A	N/A	N/A	N/A	4700 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	00	06000	34.09812055	-118.2921165	Los Angeles County
316485	Ordering, Referring, Prescribing	N/A	1003994526	0	0	TAM, TSUI PHARMD	3/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	CA47209	N/A	N/A	N/A	N/A	N/A	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	00	06000	37.706364	-122.165163	Alameda County
316554	Ordering, Referring, Prescribing	N/A	1013129659	0	0	TETZLAFF, CINDY E PA-C	3/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	11644	N/A	N/A	N/A	N/A	N/A	15462 MAIN ST	None	HESPERIA	CA	92345	3318	00	06000	34.42553716	-117.3261813	San Bernardino County
316620	Ordering, Referring, Prescribing	N/A	1013244235	0	0	THARANI, TANINDER K MD	4/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A109480	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
316634	Ordering, Referring, Prescribing	N/A	1013275148	0	0	TANG, VIVIAN K MD	11/1/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150329	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	D-5	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
316638	Ordering, Referring, Prescribing	N/A	1013290402	0	0	TAN, FRANCES PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH52017	N/A	N/A	N/A	N/A	N/A	2105 MORRILL AVE	None	SAN JOSE	CA	95132	1130	00	06000	37.4139393	-121.8742316	Santa Clara County
316700	Ordering, Referring, Prescribing	N/A	1013371756	0	0	TAILOR, NEELAM MD	1/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A192727	N/A	N/A	N/A	N/A	N/A	2611 N DINUBA BLVD	None	VISALIA	CA	93291	9003	00	06000	36.352935	-119.297565	Tulare County
316709	Ordering, Referring, Prescribing	N/A	1013385277	0	0	TURNBULL, CHRISTINE A OT	3/23/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT16995	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	#53	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
316769	Ordering, Referring, Prescribing	N/A	1013443803	0	0	TAYLOR, KIERSTEN P PHARMD	8/25/2020	Taxonomy not applicable	NA	n/a	000	Unknown	10767	N/A	N/A	N/A	N/A	N/A	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
316776	Ordering, Referring, Prescribing	N/A	1013493279	0	0	TANG, KAREN NP	5/20/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021030	N/A	N/A	N/A	N/A	N/A	3810 ROSIN CT	STE 100	SACRAMENTO	CA	95834	1657	00	06000	38.637702	-121.474773	Sacramento County
316779	Ordering, Referring, Prescribing	N/A	1013490606	0	0	TRAN, JESSICA Q CNP	4/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95009841	N/A	N/A	N/A	N/A	N/A	2740 S ELM AVE	None	FRESNO	CA	93706	5435	00	06000	36.70101129	-119.7908643	Fresno County
316782	Ordering, Referring, Prescribing	N/A	1013502343	0	0	TAYLOR, RANDAL T NP	3/8/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016893	N/A	N/A	N/A	N/A	N/A	7400 DISTRICT BLVD	C	BAKERSFIELD	CA	93313	4817	00	06000	35.31317675	-119.0831837	Kern County
316792	Ordering, Referring, Prescribing	N/A	1013525260	0	0	TAN, DENISE PHARMD	4/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82546	N/A	N/A	N/A	N/A	N/A	1755 BAGPIPE WAY	None	SAN JOSE	CA	95121	1510	00	06000	37.30691173	-121.809889	Santa Clara County
316808	Ordering, Referring, Prescribing	N/A	1013564806	0	0	TRAVERS, AMANDA L LCSW	10/31/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	111645	N/A	N/A	N/A	N/A	N/A	1400 EMELINE AVE	None	SANTA CRUZ	CA	95060	1976	00	06000	36.99276804	-122.0178271	Santa Cruz County
316818	Ordering, Referring, Prescribing	N/A	1013573302	0	0	TALLEY, MONIKA J NP	4/25/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011693	N/A	N/A	N/A	N/A	N/A	14544 7TH ST	None	VICTORVILLE	CA	92395	4214	00	06000	34.5148385	-117.314799	San Bernardino County
316844	Ordering, Referring, Prescribing	N/A	1013769116	0	0	TAYLOR, ALEXIS M OT	3/14/2024	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT26198	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
316847	Ordering, Referring, Prescribing	N/A	1013788199	0	0	TRAJANO, LAUREN NP	7/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025799	N/A	N/A	N/A	N/A	N/A	276 W COLLEGE ST	None	COVINA	CA	91723	1902	00	06000	34.08747441	-117.8941951	Los Angeles County
316868	Ordering, Referring, Prescribing	N/A	1023002136	0	0	TOBIAS, MANUEL D PHD	6/6/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY7320	N/A	N/A	N/A	N/A	N/A	10529 VISTA LAGO PLACE	SUITE 227	SAN DIEGO	CA	92131	1223	00	06000	32.90756542	-117.1039067	San Diego County
316871	Ordering, Referring, Prescribing	N/A	1023021763	0	0	TRISTAN, BIANCA L CNP	4/5/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP11252	N/A	N/A	N/A	N/A	N/A	302 FRESNO ST	STE 101	FRESNO	CA	93706	3611	00	06000	36.72393092	-119.8091084	Fresno County
316888	Ordering, Referring, Prescribing	N/A	1023090305	0	0	TAYLOR, INGE HELENE CNM	1/22/2018	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	458848	N/A	N/A	N/A	N/A	N/A	6973 LINDA VISTA RD	None	SAN DIEGO	CA	92111	6342	00	06000	32.78725456	-117.1698028	San Diego County
316921	Ordering, Referring, Prescribing	N/A	1023161486	0	0	TORRES, BLANCA C LCSW	1/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26203	N/A	N/A	N/A	N/A	N/A	1360 E.LASSEN AVE	None	CHICO	CA	95973	7823	00	06000	39.77359746	-121.8420053	Butte County
316965	Ordering, Referring, Prescribing	N/A	1023259793	0	0	TENG, HUI-HUA S LMFT	3/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	87220	N/A	N/A	N/A	N/A	N/A	2621 OSWELL ST	119	BAKERSFIELD	CA	93306	3172	00	06000	35.393283	-118.9496505	Kern County
316990	Ordering, Referring, Prescribing	N/A	1023318532	0	0	TILKIAN, NINA PHARMD	3/22/2018	Taxonomy not applicable	NA	n/a	000	Unknown	48832	N/A	N/A	N/A	N/A	N/A	24160 LYONS AVE	None	NEWHALL	CA	91321	2442	00	06000	34.37872109	-118.5572162	Los Angeles County
317019	Ordering, Referring, Prescribing	N/A	1023383072	0	0	TAO, DANIEL	2/20/2023	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	14284	N/A	N/A	N/A	N/A	N/A	5168 HONPIE RD	None	PLACERVILLE	CA	95667	8635	00	06000	38.6943603	-120.9018271	El Dorado County
317022	Ordering, Referring, Prescribing	N/A	1023391075	0	0	TABLIZO, JOY L PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62343	N/A	N/A	N/A	N/A	N/A	7299 LAGUNA BLVD	None	ELK GROVE	CA	95758	5059	00	06000	38.424105	-121.418532	Sacramento County
317062	Ordering, Referring, Prescribing	N/A	1023440781	0	0	TEJEDA, DARIO LCSW	8/3/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88606	N/A	N/A	N/A	N/A	N/A	510 S VERMONT AVE.	None	LOS ANGELES	CA	90020	9998	00	06000	34.065	-118.291631	Los Angeles County
317067	Ordering, Referring, Prescribing	N/A	1023453206	0	0	TORRES, TYSON S MD	5/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133932	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
317097	Ordering, Referring, Prescribing	N/A	1023498821	0	0	TODD, SERENA W LMFT	9/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53719	N/A	N/A	N/A	N/A	N/A	633 MIRAMONTE DR	None	SANTA BARBARA	CA	93109	1428	00	06000	34.40817829	-119.707	Santa Barbara County
317143	Ordering, Referring, Prescribing	N/A	1023568276	0	0	TORRES, DANNA G LMFT	12/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123525	N/A	N/A	N/A	N/A	N/A	650 CLARK WAY	None	PALO ALTO	CA	94304	2300	00	06000	37.43949537	-122.1784133	Santa Clara County
317171	Ordering, Referring, Prescribing	N/A	1023634524	0	0	TRAN, ANNIE LMFT	1/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT136980	N/A	N/A	N/A	N/A	N/A	1555 PARKMOOR AVE	None	SAN JOSE	CA	95128	2407	00	06000	37.31712017	-121.9185451	Santa Clara County
317182	Ordering, Referring, Prescribing	N/A	1023655115	0	0	TRAN, KIM NGAN T PHARMD	12/5/2019	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81416	N/A	N/A	N/A	N/A	N/A	12740 SEAL BEACH BLVD	None	SEAL BEACH	CA	90740	0000	00	06000	33.77717348	-118.0723775	Orange County
317212	Ordering, Referring, Prescribing	N/A	1023738408	0	0	TENLEY, PAGE PA	1/23/2024	Taxonomy not applicable	NA	n/a	000	Unknown	63962	N/A	N/A	N/A	N/A	N/A	2 H ST	None	SAN RAFAEL	CA	94901	1700	00	06000	37.97437033	-122.5385699	Marin County
317259	Ordering, Referring, Prescribing	N/A	1033152616	0	0	TUCHMAN, LESLIE J MD	2/3/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C148437	N/A	N/A	N/A	N/A	N/A	16745 W. BERNARDO DRIVE	SUITE 240	SAN DIEGO	CA	92127	1907	00	06000	33.01539521	-117.0824934	San Diego County
317260	Ordering, Referring, Prescribing	N/A	1033153572	0	0	TANG, QUINN PA-C	10/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	15202	N/A	N/A	N/A	N/A	N/A	5205 MELROSE AVE	None	LOS ANGELES	CA	90038	3144	00	06000	34.08354051	-118.314009	Los Angeles County
317277	Ordering, Referring, Prescribing	N/A	1033230537	0	0	TRUTA, MIRCEA MD	2/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A75064	N/A	N/A	N/A	N/A	N/A	1393 BAILEY ST	None	HANFORD	CA	93230	5922	00	06000	36.32728474	-119.665912	Kings County
317315	Ordering, Referring, Prescribing	N/A	1033289178	0	0	TAVAKOLI, GHAZALEH PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	45714	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY	625	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
317340	Ordering, Referring, Prescribing	N/A	1033318191	0	0	TOLENTINO, RHODORA P MD	12/11/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A101194	N/A	N/A	N/A	N/A	N/A	20151 NORDHOFF ST	None	CHATSWORTH	CA	91311	6215	00	06000	34.23182352	-118.572948	Los Angeles County
317368	Ordering, Referring, Prescribing	N/A	1033385364	0	0	TINOCO, ANGELA MSW LCSW	6/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW74975	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR.	210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
317381	Ordering, Referring, Prescribing	N/A	1033412424	0	0	TORRES, CHRISTOPHER O	6/15/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	102346	N/A	N/A	N/A	N/A	N/A	925 BEVINS CT	None	LAKEPORT	CA	95453	8778	00	06000	39.03772106	-122.9223338	Lake County
317385	Ordering, Referring, Prescribing	N/A	1033415518	0	0	TRAN, VIET PHARMD	4/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH59155	N/A	N/A	N/A	N/A	N/A	6750 STANFORD RANCH RD	None	ROSEVILLE	CA	95678	1907	00	06000	38.780055	-121.2657575	Placer County
317393	Ordering, Referring, Prescribing	N/A	1033428792	0	0	TSUJII, ERI LCSW	11/6/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW65821	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	157	SAN MATEO	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
317408	Ordering, Referring, Prescribing	N/A	1033452768	0	0	TRAN, MINH-CHI MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133546	N/A	N/A	N/A	N/A	N/A	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	00	06000	38.602089	-121.3925895	Sacramento County
317435	Ordering, Referring, Prescribing	N/A	1033485016	0	0	TRUDEAU, JACQUELINE D MD	10/31/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A131135	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPRESSWAY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
317461	Ordering, Referring, Prescribing	N/A	1033509799	0	0	TWILLING, KIMBERLY	12/4/2022	Taxonomy not applicable	NA	n/a	000	Unknown	28337	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
317514	Ordering, Referring, Prescribing	N/A	1033586094	0	0	TAM, ALEXANDER PHARMD	1/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	72989	N/A	N/A	N/A	N/A	N/A	4071 18TH ST	None	SAN FRANCISCO	CA	94114	2535	00	06000	37.76089183	-122.4343778	San Francisco County
317524	Ordering, Referring, Prescribing	N/A	1033598081	0	0	TU, KHANH PHARMD	10/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58524	N/A	N/A	N/A	N/A	N/A	13270 NEWPORT AVE	None	TUSTIN	CA	92780	0000	00	06000	33.74605628	-117.8139923	Orange County
317553	Ordering, Referring, Prescribing	N/A	1033654074	0	0	TRAN, HOANG-ANH DDS	9/21/2022	Taxonomy not applicable	NA	n/a	000	Unknown	101087	N/A	N/A	N/A	N/A	N/A	7601 IMPERIAL HWY	None	DOWNEY	CA	90242	3456	00	06000	33.929829	-118.157607	Los Angeles County
317591	Ordering, Referring, Prescribing	N/A	1033703038	0	0	THORNTON, RACHEL	8/2/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017965	N/A	N/A	N/A	N/A	N/A	201 29TH STREET	B	SACRAMENTO	CA	95816	3288	00	06000	38.581875	-121.463802	Sacramento County
317612	Ordering, Referring, Prescribing	N/A	1033751227	0	0	TON, NINA PA-C	11/30/2020	Taxonomy not applicable	NA	n/a	000	Unknown	58900	N/A	N/A	N/A	N/A	N/A	1009 N. AVALON AVE	None	WILMINGTON	CA	90744	4505	00	06000	33.78320457	-118.2627263	Los Angeles County
317633	Ordering, Referring, Prescribing	N/A	1033832019	0	0	TAGATAC, PHILIP DMD	9/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	108138	N/A	N/A	N/A	N/A	N/A	2015 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4810	00	06000	34.13318786	-117.2787325	San Bernardino County
317684	Ordering, Referring, Prescribing	N/A	1043304017	0	0	TARSHIS, THOMAS P MD MPH	4/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A81257	N/A	N/A	N/A	N/A	N/A	1175 SARATOGA AVE	14	SAN JOSE	CA	95129	3427	00	06000	37.30311805	-121.9800175	Santa Clara County
317692	Ordering, Referring, Prescribing	N/A	1043318173	0	0	TRAN, LOANNE B MD MPH	8/26/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A63084	N/A	N/A	N/A	N/A	N/A	624 W DUARTE RD	# 205	ARCADIA	CA	91007	7603	00	06000	34.12637452	-118.0527313	Los Angeles County
317728	Ordering, Referring, Prescribing	N/A	1043387954	0	0	TREJO, EMMA B MD	1/24/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A56299	N/A	N/A	N/A	N/A	N/A	1403 W. LOMITA BLVD	101	HARBOR CITY	CA	90710	2067	00	06000	33.79785936	-118.3016552	Los Angeles County
317739	Ordering, Referring, Prescribing	N/A	1043405285	0	0	TIRAYAN, ANAID A LCSW	9/1/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24678	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
317792	Ordering, Referring, Prescribing	N/A	1043525306	0	0	TRUONG, FELIX LCSW	3/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82321	N/A	N/A	N/A	N/A	N/A	11110 W PICO BLVD	None	LOS ANGELES	CA	90064	1709	00	06000	34.03673559	-118.4355655	Los Angeles County
317797	Ordering, Referring, Prescribing	N/A	1043538150	0	0	TORRES, EDGAR L MD	6/17/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C173179	N/A	N/A	N/A	N/A	N/A	47647 CALEO BAY DR.	230	LA QUINTA	CA	92253	8854	00	06000	33.70305235	-116.2936509	Riverside County
317803	Ordering, Referring, Prescribing	N/A	1043529167	0	0	TUCKER, KIM M NP	10/1/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006257	N/A	N/A	N/A	N/A	N/A	2041 BELSHAW ST	None	MOJAVE	CA	93501	1601	00	06000	35.0563195	-118.1681479	Kern County
317819	Ordering, Referring, Prescribing	N/A	1043588577	0	0	TESORO, JOSEPH M LMFT	6/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT83968	N/A	N/A	N/A	N/A	N/A	940 AVENUE 64	None	PASADENA	CA	91105	2711	00	06000	34.124895	-118.174671	Los Angeles County
317861	Ordering, Referring, Prescribing	N/A	1043626831	0	0	TSEHERIDIS, ANASTASIOS LMFT	10/4/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT150361	N/A	N/A	N/A	N/A	N/A	120 S STATE COLLEGE BLVD	150	BREA	CA	92821	5807	00	06000	33.92111797	-117.8828786	Orange County
317920	Ordering, Referring, Prescribing	N/A	1043729353	0	0	TOLEDO, BLANCA V	9/20/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	101394	N/A	N/A	N/A	N/A	N/A	66675 PIERSON BLVD	None	DSRT HOT SPGS	CA	92240	3737	00	06000	33.96138951	-116.498223	Riverside County
317940	Ordering, Referring, Prescribing	N/A	1043745904	0	0	TODD, MYRON P PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75696	N/A	N/A	N/A	N/A	N/A	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
317973	Ordering, Referring, Prescribing	N/A	1043798622	0	0	TANG, ASHLEY OD	12/19/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT33981	N/A	N/A	N/A	N/A	N/A	2067 W VISTA WAY	120	VISTA	CA	92083	6032	00	06000	33.18505594	-117.285958	San Diego County
318004	Ordering, Referring, Prescribing	N/A	1043867062	0	0	TRAN, VAN NP	8/29/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012043	N/A	N/A	N/A	N/A	N/A	801 S CHEVY CHASE DR	250	GLENDALE	CA	91205	4431	00	06000	34.136757	-118.2396195	Los Angeles County
318013	Ordering, Referring, Prescribing	N/A	1043877681	0	0	TRAN, CECILIA MINH THU H OT	11/12/2018	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT18006	N/A	N/A	N/A	N/A	N/A	9862 CHAPMAN AVE.	None	GARDEN GROVE	CA	92841	2726	00	06000	33.78849558	-117.9607338	Orange County
318025	Ordering, Referring, Prescribing	N/A	1043907587	0	0	TAVES, DAVID A DDS	7/8/2023	Taxonomy not applicable	NA	n/a	000	Unknown	108941	N/A	N/A	N/A	N/A	N/A	3590 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2655	00	06000	33.93042906	-118.2056035	Los Angeles County
318045	Ordering, Referring, Prescribing	N/A	1043994528	0	0	TOLEDO, SANDRA CNP	6/9/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95025549	N/A	N/A	N/A	N/A	N/A	1900 ATLANTIC AVE	None	LONG BEACH	CA	90806	5502	00	06000	33.791976	-118.1850125	Los Angeles County
318053	Ordering, Referring, Prescribing	N/A	1053039826	0	0	TRAN, ALEXIS PHARMD	8/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86449	N/A	N/A	N/A	N/A	N/A	8440 E CHAPMAN AVE	None	ORANGE	CA	92869	2459	00	06000	33.7927103	-117.7632194	Orange County
318089	Ordering, Referring, Prescribing	N/A	1053308239	0	0	TAFT, JAMES D DO	7/8/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A6512	N/A	N/A	N/A	N/A	N/A	1700 N. ROSE AVE	SUITE 450	OXNARD	CA	93030	7626	00	06000	34.21746	-119.155545	Ventura County
318160	Ordering, Referring, Prescribing	N/A	1053491886	0	0	THOMPSON, CHRISTOPHER R MD	10/31/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A72925	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	10TH FLOOR	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
318186	Ordering, Referring, Prescribing	N/A	1053538108	0	0	THOMPSON, TRACY A LMFT	4/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125306	N/A	N/A	N/A	N/A	N/A	123 W GUTIERREZ ST	None	SANTA BARBARA	CA	93101	3424	00	06000	34.41387023	-119.6962788	Santa Barbara County
318216	Ordering, Referring, Prescribing	N/A	1053595991	0	0	TSENG, KIMBERLY J MD	4/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A100814	N/A	N/A	N/A	N/A	N/A	720 SACRAMENTO ST	None	SAN FRANCISCO	CA	94108	2535	00	06000	37.79355846	-122.4050846	San Francisco County
318221	Ordering, Referring, Prescribing	N/A	1053601823	0	0	TRAN, DIEP T PHARMD	1/4/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60452	N/A	N/A	N/A	N/A	N/A	1100 EL CAMINO REAL	None	BELMONT	CA	94002	3904	00	06000	37.51941385	-122.2748458	San Mateo County
318258	Ordering, Referring, Prescribing	N/A	1053674770	0	0	TRANDEM, KATHRYN MD	2/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A155864	N/A	N/A	N/A	N/A	N/A	290 N WAYTE LN	None	FRESNO	CA	93701	2124	00	06000	36.74643429	-119.7837416	Fresno County
318265	Ordering, Referring, Prescribing	N/A	1053681114	0	0	TANG TILT, ANNA PA	1/29/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA22040	N/A	N/A	N/A	N/A	N/A	1780 E FLORIDA AVE	None	HEMET	CA	92544	4679	00	06000	33.74770382	-116.9532553	Riverside County
318281	Ordering, Referring, Prescribing	N/A	1053705905	0	0	TO, JUSTIN LMFT	12/7/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	151875	N/A	N/A	N/A	N/A	N/A	4000 METROPOLITAN DR	#401	ORANGE	CA	92868	3506	00	06000	33.78016046	-117.8956101	Orange County
318287	Ordering, Referring, Prescribing	N/A	1053703520	0	0	THOMAS, JULIE A MD	2/27/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G61513	N/A	N/A	N/A	N/A	N/A	650 N STATE ST	None	HEMET	CA	92543	2960	00	06000	33.757695	-116.9717535	Riverside County
318311	Ordering, Referring, Prescribing	N/A	1053740225	0	0	TAM, PEONY C OD	11/9/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	15089	N/A	N/A	N/A	N/A	N/A	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	00	06000	36.332757	-119.288682	Tulare County
318314	Ordering, Referring, Prescribing	N/A	1053742858	0	0	TIMMONS, AMY S LMFT	3/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52552	N/A	N/A	N/A	N/A	N/A	1925 E DAKOTA AVE	None	FRESNO	CA	93726	4821	00	06000	36.78683208	-119.7876584	Fresno County
318320	Ordering, Referring, Prescribing	N/A	1053750265	0	0	TRAN, TONY T DO	2/4/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15767	N/A	N/A	N/A	N/A	N/A	9862 CHAPMAN AVE	SUITE B	GARDEN GROVE	CA	92841	2726	00	06000	33.78849558	-117.9607338	Orange County
318334	Ordering, Referring, Prescribing	N/A	1053766113	0	0	TOPEL, RACHAEL LMFT	12/4/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116657	N/A	N/A	N/A	N/A	N/A	5350 MACHADO RD	None	CULVER CITY	CA	90230	8800	00	06000	33.99781622	-118.3966503	Los Angeles County
318387	Ordering, Referring, Prescribing	N/A	1053824870	0	0	THOMAS, JEFFERY D LMFT	6/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108772	N/A	N/A	N/A	N/A	N/A	4441 E. KINGS CANYON ROA	None	FRESNO	CA	93702	3604	00	06000	36.738144	-119.753361	Fresno County
318394	Ordering, Referring, Prescribing	N/A	1053841478	0	0	THACH, QUEEN L OD	7/29/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	33685	N/A	N/A	N/A	N/A	N/A	555 BROADWAY	1021	CHULA VISTA	CA	91910	5397	00	06000	32.630292	-117.085293	San Diego County
318403	Ordering, Referring, Prescribing	N/A	1053860221	0	0	TONG, TIMOTHY S PHARMD	1/31/2017	Taxonomy not applicable	NA	n/a	000	Unknown	CA75006	N/A	N/A	N/A	N/A	N/A	1240 S LOOP ROAD	None	ALAMEDA	CA	94502	7084	00	06000	37.72440803	-122.2341866	Alameda County
318424	Ordering, Referring, Prescribing	N/A	1053900290	0	0	TRAN, KARINA PA	8/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA59167	N/A	N/A	N/A	N/A	N/A	2680 SATURN AVE	None	HUNTINGTON PARK	CA	90255	4377	00	06000	33.9768845	-118.222884	Los Angeles County
318432	Ordering, Referring, Prescribing	N/A	1053902130	0	0	THIND, SIMRANJOT K NP	5/20/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017366	N/A	N/A	N/A	N/A	N/A	31292 ALPINE MEADOWS ROA	None	SHINGLETOWN	CA	96088	9462	00	06000	40.49127155	-121.8856374	Shasta County
318451	Ordering, Referring, Prescribing	N/A	1053974147	0	0	TRINH, CHRISTINE T DO	7/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19918	N/A	N/A	N/A	N/A	N/A	227 N JACKSON AVE	235	SAN JOSE	CA	95116	1632	00	06000	37.36478223	-121.8497978	Santa Clara County
318471	Ordering, Referring, Prescribing	N/A	1063028892	0	0	THOMPSON, JORDAN I PHARMD	1/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81408	N/A	N/A	N/A	N/A	N/A	4905 HOLLYWOOD BLVD	None	LOS ANGELES	CA	90027	6101	00	06000	34.10180109	-118.2963991	Los Angeles County
318473	Ordering, Referring, Prescribing	N/A	1063031649	0	0	TOWLE, SYDNEY LMFT	1/16/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT137641	N/A	N/A	N/A	N/A	N/A	232 E GISH RD	None	SAN JOSE	CA	95112	4706	00	06000	37.36411044	-121.9052075	Santa Clara County
318505	Ordering, Referring, Prescribing	N/A	1063130979	0	0	TRAN, THERESA OD	8/15/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35170	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
318527	Ordering, Referring, Prescribing	N/A	1063271377	0	0	TERAN, LESLIE RN MA	6/7/2023	Taxonomy not applicable	NA	n/a	000	Unknown	95071287	N/A	N/A	N/A	N/A	N/A	150 DISTRICT CENTER DR	None	PALM SPRINGS	CA	92264	3626	00	06000	33.82485354	-116.4955129	Riverside County
318552	Ordering, Referring, Prescribing	N/A	1063502508	0	0	TRUONG, JENNY Y PHARMD	2/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55745	N/A	N/A	N/A	N/A	N/A	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	00	06000	37.48892015	-122.218747	San Mateo County
318581	Ordering, Referring, Prescribing	N/A	1063541894	0	0	TOPRAKCI, KRISTI I LMFT	7/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50108	N/A	N/A	N/A	N/A	N/A	2300 NORTHPOINT PKWY	None	SANTA ROSA	CA	95407	5004	00	06000	38.415258	-122.7536325	Sonoma County
318615	Ordering, Referring, Prescribing	N/A	1063585966	0	0	THOMAS, JOSEPH L NP	4/16/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	128445	N/A	N/A	N/A	N/A	N/A	525 BRANSON LANDING BLVD	None	BRANSON	MO	65616	2052	00	06000	36.65109796	-93.2204608	Taney County
318620	Ordering, Referring, Prescribing	N/A	1063602282	0	0	THOMAS, VIJU V LCSW	6/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS18844	N/A	N/A	N/A	N/A	N/A	39155 LIBERTY ST	None	FREMONT	CA	94538	1513	00	06000	37.55123907	-121.9828956	Alameda County
318655	Ordering, Referring, Prescribing	N/A	1063675999	0	0	TRANG, THIEN H	12/12/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D57181	N/A	N/A	N/A	N/A	N/A	510 KAINS AVE	None	ALBANY	CA	94706	1217	00	06000	37.89648088	-122.2999875	Alameda County
318659	Ordering, Referring, Prescribing	N/A	1063688802	0	0	TALAMANTES, EFRAIN MD	11/3/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A109825	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	SUITE 2100	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
318675	Ordering, Referring, Prescribing	N/A	1063712370	0	0	TREJO, OLYMPIA LCSW	4/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW92764	N/A	N/A	N/A	N/A	N/A	530 SOQUEL AVE	None	SANTA CRUZ	CA	95062	2301	00	06000	36.97593531	-122.017209	Santa Cruz County
318682	Ordering, Referring, Prescribing	N/A	1063726487	0	0	TIEU, CHRISTINE W PHARMD	3/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64092	N/A	N/A	N/A	N/A	N/A	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
318706	Ordering, Referring, Prescribing	N/A	1063761963	0	0	TAM, LOK LCSW	2/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	90519	N/A	N/A	N/A	N/A	N/A	1126 N GRAND AVE	None	COVINA	CA	91724	1552	00	06000	34.100082	-117.8724825	Los Angeles County
318709	Ordering, Referring, Prescribing	N/A	1063767796	0	0	TANNER, MARY ELLEN LCSW	11/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	73551	N/A	N/A	N/A	N/A	N/A	4740 N GRAND AVE	None	COVINA	CA	91724	2005	00	06000	34.098597	-117.8724715	Los Angeles County
318736	Ordering, Referring, Prescribing	N/A	1063795680	0	0	TRAN, ANTHONY PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50760	N/A	N/A	N/A	N/A	N/A	75 N HAM LN	None	LODI	CA	95242	2700	00	06000	38.1357851	-121.2884423	San Joaquin County
318740	Ordering, Referring, Prescribing	N/A	1063795169	0	0	TINT, EAINDRA PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64748	N/A	N/A	N/A	N/A	N/A	128 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	2921	00	06000	33.840252	-117.889103	Orange County
318743	Ordering, Referring, Prescribing	N/A	1063804755	0	0	TRUONG, KEVIN MD	5/12/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158018	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
318752	Ordering, Referring, Prescribing	N/A	1063814960	0	0	THAO, LEE LCSW	11/17/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW105616	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DRIVE	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
318758	Ordering, Referring, Prescribing	N/A	1063819159	0	0	TUAHIVAATETONOHITI, MATTHIEU B	5/17/2017	Taxonomy not applicable	NA	n/a	000	Unknown	52213	N/A	N/A	N/A	N/A	N/A	1530 E MANNING AVE	None	REEDLEY	CA	93654	2346	00	06000	36.60413846	-119.4316515	Fresno County
318761	Ordering, Referring, Prescribing	N/A	1063821247	0	0	TITUS, TANYA LCSW	8/23/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW103422	N/A	N/A	N/A	N/A	N/A	7003 N FIGUEROA ST	None	LOS ANGELES	CA	90042	1247	00	06000	34.12951669	-118.1880773	Los Angeles County
318770	Ordering, Referring, Prescribing	N/A	1063825917	0	0	THOMPSON, SHERRY B	12/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	67522	N/A	N/A	N/A	N/A	N/A	7815 N LAKE BLVD	None	KINGS BEACH	CA	96143	4516	00	06000	39.23820667	-120.0335811	Placer County
318779	Ordering, Referring, Prescribing	N/A	1063844983	0	0	TOY, GERALD PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69075	N/A	N/A	N/A	N/A	N/A	498 CASTRO ST	None	SAN FRANCISCO	CA	94114	2763	00	06000	37.76111969	-122.4350504	San Francisco County
318803	Ordering, Referring, Prescribing	N/A	1063878056	0	0	THOMAS, ANNA M LCSW	3/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	89323	N/A	N/A	N/A	N/A	N/A	560 COHASSET RD	175	CHICO	CA	95926	2281	00	06000	39.7519137	-121.8477606	Butte County
318843	Ordering, Referring, Prescribing	N/A	1063937084	0	0	TABAGON, THIA LCSW	12/8/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW127631	N/A	N/A	N/A	N/A	N/A	2351 OLIVERA RD	None	CONCORD	CA	94520	1626	00	06000	37.99636083	-122.0356799	Contra Costa County
318884	Ordering, Referring, Prescribing	N/A	1073016804	0	0	TRAN, CINDY MD	7/23/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164048	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	DEPT. 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
319016	Ordering, Referring, Prescribing	N/A	1073398145	0	0	THOMAS, TREESJE M	1/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	4114	N/A	N/A	N/A	N/A	N/A	519 E BADILLO ST	None	COVINA	CA	91723	2803	00	06000	34.0863153	-117.8807372	Los Angeles County
319032	Ordering, Referring, Prescribing	N/A	1073581385	0	0	TENNANT, GREGORY DO	4/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A9121	N/A	N/A	N/A	N/A	N/A	42135 10TH ST W.	SUITE 101	LANCASTER	CA	93534	7099	00	06000	34.648533	-118.1477975	Los Angeles County
319053	Ordering, Referring, Prescribing	N/A	1073658142	0	0	TANG, MINH OD	6/18/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT11754	N/A	N/A	N/A	N/A	N/A	10440 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	1812	00	06000	33.91038747	-117.4638633	Riverside County
319073	Ordering, Referring, Prescribing	N/A	1073692521	0	0	TANDON, BHAVNA S PA	2/18/2020	Taxonomy not applicable	NA	n/a	000	Unknown	PA18189	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
319086	Ordering, Referring, Prescribing	N/A	1073729646	0	0	TEAGUE, CATHERINE M LMFT	4/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT44225	N/A	N/A	N/A	N/A	N/A	1212 N CALIFORNIA ST	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
319088	Ordering, Referring, Prescribing	N/A	1073730826	0	0	TAMEZ, JOSE M LMFT	4/13/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125505	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
319126	Ordering, Referring, Prescribing	N/A	1073837662	0	0	TIGLAO, LAWRENCE M MD	3/25/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A118082	N/A	N/A	N/A	N/A	N/A	4555 PRECISSI LANE	None	STOCKTON	CA	92507	6239	00	06000	37.98919284	-121.3152121	San Joaquin County
319132	Ordering, Referring, Prescribing	N/A	1073844460	0	0	TRIANA, JENNIFER LCSW	9/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88589	N/A	N/A	N/A	N/A	N/A	2130 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	2209	00	06000	32.69800063	-117.1411927	San Diego County
319162	Ordering, Referring, Prescribing	N/A	1073880555	0	0	TSAI, YUEN PHARMD	6/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH68130	N/A	N/A	N/A	N/A	N/A	653 S STATE ST	None	UKIAH	CA	95482	4912	00	06000	39.14431887	-123.2066078	Mendocino County
319200	Ordering, Referring, Prescribing	N/A	1073968244	0	0	TAYLOR, TRACEY L DO	3/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17010	N/A	N/A	N/A	N/A	N/A	10561 MERRITT ST	None	CASTROVILLE	CA	95012	3310	00	06000	36.76699229	-121.7597014	Monterey County
319201	Ordering, Referring, Prescribing	N/A	1073971479	0	0	TYLER, ELIZA K LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116762	N/A	N/A	N/A	N/A	N/A	401 ROLAND WAY	SUITE 150	OAKLAND	CA	94621	2034	00	06000	37.74106765	-122.2051051	Alameda County
319222	Ordering, Referring, Prescribing	N/A	1073973210	0	0	TEJADA, TIFFANI PSYD	10/6/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY34592	N/A	N/A	N/A	N/A	N/A	1000 VETERAN AVE	None	LOS ANGELES	CA	90095	7142	00	06000	34.0605595	-118.4499527	Los Angeles County
319226	Ordering, Referring, Prescribing	N/A	1073995288	0	0	TAN, JEANNIE PHARMD	1/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54770	N/A	N/A	N/A	N/A	N/A	133 W ROUTE 66	None	GLENDORA	CA	91740	6208	00	06000	34.12882549	-117.8650035	Los Angeles County
319232	Ordering, Referring, Prescribing	N/A	1083009286	0	0	TSOU, SHIHHUI S NP	2/13/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	678626	N/A	N/A	N/A	N/A	N/A	1818 N. ORANGE GROVE AVE	200	POMONA	CA	91767	3028	00	06000	34.07694934	-117.7489598	Los Angeles County
319249	Ordering, Referring, Prescribing	N/A	1083025639	0	0	THODE, LAURA C PHD	8/4/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	34436	N/A	N/A	N/A	N/A	N/A	41840 ENTERPRISE CIR N	None	TEMECULA	CA	92590	5654	00	06000	33.51730799	-117.1697125	Riverside County
319254	Ordering, Referring, Prescribing	N/A	1083025795	0	0	TORRES, LINDSAY LMFT	4/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111092	N/A	N/A	N/A	N/A	N/A	1612 1ST ST	None	COACHELLA	CA	92236	1612	00	06000	33.68337881	-116.1784614	Riverside County
319287	Ordering, Referring, Prescribing	N/A	1083076129	0	0	THOUVENOT, CHELSEA M MD	5/16/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173869	N/A	N/A	N/A	N/A	N/A	1250 6TH AVE	None	SAN DIEGO	CA	92101	4300	00	06000	32.71854144	-117.1593008	San Diego County
319291	Ordering, Referring, Prescribing	N/A	1083084909	0	0	TUKEY, LAUREN E	7/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW86840	N/A	N/A	N/A	N/A	N/A	1617 CRAVENS AVENUE	None	TORRANCE	CA	90501	3203	00	06000	33.83269486	-118.3158222	Los Angeles County
319299	Ordering, Referring, Prescribing	N/A	1083092753	0	0	TUWATANANURAK, IDA P DO	5/11/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16453	N/A	N/A	N/A	N/A	N/A	3727 W 6TH ST.	SUITE 200	LOS ANGELES	CA	90020	5108	00	06000	34.06358655	-118.3037656	Los Angeles County
319386	Ordering, Referring, Prescribing	N/A	1083236558	0	0	THOMPSON, ROBERT L LMFT	2/21/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	145202	N/A	N/A	N/A	N/A	N/A	2001 THE ALAMEDA	None	SAN JOSE	CA	95127	1439	00	06000	37.34293689	-121.9270392	Santa Clara County
319390	Ordering, Referring, Prescribing	N/A	1083245138	0	0	TRAN, ANH N LAC	5/25/2020	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	18467	N/A	N/A	N/A	N/A	N/A	4241 FLORIN RD	STE 240	SACRAMENTO	CA	95824	2335	00	06000	38.496816	-121.4582625	Sacramento County
319408	Ordering, Referring, Prescribing	N/A	1083286850	0	0	TRIVEDI, HIMJA LMFT	9/10/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	149640	N/A	N/A	N/A	N/A	N/A	401 ROLAND WAY	SUITE 150	OAKLAND	CA	94621	2027	00	06000	37.74106765	-122.2051051	Alameda County
319475	Ordering, Referring, Prescribing	N/A	1083705461	0	0	TEKOLA, ABRHAM MD	7/23/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A50974	N/A	N/A	N/A	N/A	N/A	5740 WINDMILL WAY	5	CARMICHAEL	CA	95608	1379	00	06000	38.647494	-121.330044	Sacramento County
319499	Ordering, Referring, Prescribing	N/A	1083749204	0	0	TAGORE, TARLOCHAN	1/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A31400	N/A	N/A	N/A	N/A	N/A	210 E MERCED ST	None	FOWLER	CA	93625	2313	00	06000	36.63067035	-119.6786702	Fresno County
319509	Ordering, Referring, Prescribing	N/A	1083787105	0	0	TRAUB, DIANA LCSW	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW90467	N/A	N/A	N/A	N/A	N/A	251 LLEWELYN AVENUE	None	CAMPBELL	CA	95008	1940	00	06000	37.29173129	-121.9584335	Santa Clara County
319540	Ordering, Referring, Prescribing	N/A	1083849897	0	0	TREVINO, SERVANDO LMFT	8/10/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105118	N/A	N/A	N/A	N/A	N/A	135 EAST THIRD AVE.	None	ESCONDIDO	CA	92025	4252	00	06000	33.12022391	-117.0793824	San Diego County
319565	Ordering, Referring, Prescribing	N/A	1083914139	0	0	TOGONON, MICHELLE G PHARMD	7/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH60059	N/A	N/A	N/A	N/A	N/A	2010 ALAMO DR	None	VACAVILLE	CA	95687	6289	00	06000	38.33537552	-121.9692825	Solano County
319627	Ordering, Referring, Prescribing	N/A	1093001216	0	0	THAO, LEE PHARMD	3/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	54969	N/A	N/A	N/A	N/A	N/A	2700 CLOVIS AVE	None	CLOVIS	CA	93612	3951	00	06000	36.80242636	-119.7004598	Fresno County
319628	Ordering, Referring, Prescribing	N/A	1083999254	0	0	TRUBSCHENCK, JENNIFER PA-C	8/25/2020	Taxonomy not applicable	NA	n/a	000	Unknown	21834	N/A	N/A	N/A	N/A	N/A	425 HAALAND DRIVE	SUITE 204	THOUSAND OAKS	CA	91361	5231	00	06000	34.17512608	-118.8697623	Ventura County
319646	Ordering, Referring, Prescribing	N/A	1093030637	0	0	THURSTON, SOPHIA L LMFT	6/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53230	N/A	N/A	N/A	N/A	N/A	101 WIKIUP DR	None	SANTA ROSA	CA	95403	1375	00	06000	38.50788547	-122.7587646	Sonoma County
319650	Ordering, Referring, Prescribing	N/A	1093036915	0	0	TALK, DOUGLAS W MD	10/25/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A152333	N/A	N/A	N/A	N/A	N/A	1524 W LACEY BLVD	STE 204	HANFORD	CA	93230	5977	00	06000	36.32816338	-119.6690189	Kings County
319666	Ordering, Referring, Prescribing	N/A	1093059693	0	0	TALENT, NICOLE LCSW	12/10/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28867	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HIG	SUITE 100	LONG BEACH	CA	90804	3394	00	06000	33.7831762	-118.1333125	Los Angeles County
319672	Ordering, Referring, Prescribing	N/A	1093091639	0	0	TO, TINA C PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	56601	N/A	N/A	N/A	N/A	N/A	18568 VENTURA BLVD	None	TARZANA	CA	91356	4146	00	06000	34.16940375	-118.5377537	Los Angeles County
319674	Ordering, Referring, Prescribing	N/A	1093095564	0	0	TSE, YVONNE PHARMD	12/13/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH59037	N/A	N/A	N/A	N/A	N/A	217 ALMA STREET	200	PALO ALTO	CA	94301	1017	00	06000	37.44563438	-122.1673764	Santa Clara County
319726	Ordering, Referring, Prescribing	N/A	1093170193	0	0	TAOW, AUBREY	8/24/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16484	N/A	N/A	N/A	N/A	N/A	3081 TEAGARDEN ST	None	SAN LEANDRO	CA	94577	5720	00	06000	37.70519163	-122.1536391	Alameda County
319740	Ordering, Referring, Prescribing	N/A	1093187676	0	0	TRAN, YEN LMFT	4/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109695	N/A	N/A	N/A	N/A	N/A	11057 BASYE STREET	None	EL MONTE	CA	91731	1655	00	06000	34.08243391	-118.02946	Los Angeles County
319782	Ordering, Referring, Prescribing	N/A	1093250185	0	0	TORRES, KAYLE A LMFT	4/9/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	96009	N/A	N/A	N/A	N/A	N/A	1106 WINDFIELD WAY	STE 1	EL DORADO HILLS	CA	95762	9360	00	06000	38.64127831	-121.0707141	El Dorado County
319874	Ordering, Referring, Prescribing	N/A	1093481350	0	0	TUITE, MARIA	12/2/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016157	N/A	N/A	N/A	N/A	N/A	201 29TH STREET	B	SACRAMENTO	CA	95816	0000	00	06000	38.581875	-121.463802	Sacramento County
319879	Ordering, Referring, Prescribing	N/A	1093495004	0	0	TUCKER, AMI NP	7/17/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026044	N/A	N/A	N/A	N/A	N/A	5959 GREENBACK LN	STE 500	CITRUS HEIGHTS	CA	95621	4700	00	06000	38.681397	-121.322682	Sacramento County
319881	Ordering, Referring, Prescribing	N/A	1093537797	0	0	TULI, JASLEEN K NP	10/21/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95032673	N/A	N/A	N/A	N/A	N/A	1098 MELODY LN	102	ROSEVILLE	CA	95661	9998	00	06000	38.72604506	-121.2909698	Placer County
319894	Ordering, Referring, Prescribing	N/A	1093732851	0	0	TOLOUSHAMS, MARINA PHD	1/16/2018	Taxonomy not applicable	NA	n/a	000	Unknown	28007	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVENUE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
319903	Ordering, Referring, Prescribing	N/A	1093763484	0	0	TRINH, HOI K MD	10/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A51429	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE #A, B	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
319977	Ordering, Referring, Prescribing	N/A	1093917080	0	0	THAO, LENG H DO	9/24/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A9920	N/A	N/A	N/A	N/A	N/A	1041 ROSE AVE	None	SELMA	CA	93662	3240	00	06000	36.56879252	-119.596257	Fresno County
320005	Ordering, Referring, Prescribing	N/A	1093964272	0	0	TAIRA, BREENA R	5/25/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A120473	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DRIVE	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
320021	Ordering, Referring, Prescribing	N/A	1104014356	0	0	TENNANT, JOY E LMFT	8/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50367	N/A	N/A	N/A	N/A	N/A	590 ANTELOPE BLVD	None	RED BLUFF	CA	96080	2474	00	06000	40.18602075	-122.2057399	Tehama County
320064	Ordering, Referring, Prescribing	N/A	1104100221	0	0	THORNG, SEIHA DPM	9/20/2020	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5293	N/A	N/A	N/A	N/A	N/A	420 W ACACIA ST	STE 18	STOCKTON	CA	95203	2441	00	06000	37.96135715	-121.2996632	San Joaquin County
320107	Ordering, Referring, Prescribing	N/A	1104191014	0	0	THANG, TRACY K PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	53992	N/A	N/A	N/A	N/A	N/A	12155 TECH CENTER DR	None	POWAY	CA	92064	7156	00	06000	32.937048	-117.032895	San Diego County
320111	Ordering, Referring, Prescribing	N/A	1104194364	0	0	TAJVAR, FARIBA PHARMD	7/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH47221	N/A	N/A	N/A	N/A	N/A	20011 BOLLINGER RD	None	CUPERTINO	CA	95014	4532	00	06000	37.3100911	-122.0238802	Santa Clara County
320131	Ordering, Referring, Prescribing	N/A	1104221167	0	0	TRAN, BACH D NP	2/6/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001434	N/A	N/A	N/A	N/A	N/A	1311 N SAN FERNANDO BLVD	None	BURBANK	CA	91504	2436	00	06000	34.18947282	-118.3206362	Los Angeles County
320144	Ordering, Referring, Prescribing	N/A	1104240928	0	0	TRAN, PHUONG Q MD	10/26/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A152612	N/A	N/A	N/A	N/A	N/A	1550 SUPERIOR AVENUE	None	COSTAMESA	CA	92627	3653	00	06000	33.63305341	-117.9266303	Orange County
320177	Ordering, Referring, Prescribing	N/A	1104299015	0	0	TAYNTON, JEFFREY R LMFT	6/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	109665	N/A	N/A	N/A	N/A	N/A	625 FAIR OAKS AVE	300	SOUTH PASADENA	CA	91030	5805	00	06000	34.117947	-118.1503575	Los Angeles County
320218	Ordering, Referring, Prescribing	N/A	1104352848	0	0	TAM, JACQUELINE LMFT	7/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112369	N/A	N/A	N/A	N/A	N/A	1617 CRAVENS AVE	None	TORRANCE	CA	90501	3203	00	06000	33.83269486	-118.3158222	Los Angeles County
320245	Ordering, Referring, Prescribing	N/A	1104387406	0	0	TU, MANUEL S MD	11/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL555	N/A	N/A	N/A	N/A	N/A	7800 NILES ST	None	BAKERSFIELD	CA	93306	4922	00	06000	35.37628052	-118.9179	Kern County
320303	Ordering, Referring, Prescribing	N/A	1104574235	0	0	TAN, ARA D NP	3/16/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020348	N/A	N/A	N/A	N/A	N/A	1704 W MANCHESTER AVE	109	LOS ANGELES	CA	90047	3063	00	06000	33.9599425	-118.307079	Los Angeles County
320397	Ordering, Referring, Prescribing	N/A	1114016938	0	0	TRADUP, NICOLE A OD	2/19/2020	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	595	N/A	N/A	N/A	N/A	N/A	1559 WATASHEAMU	None	GARDNERVILLE	NV	89460	7455	00	06000	38.90016089	-119.7157447	Douglas County
320404	Ordering, Referring, Prescribing	N/A	1114036050	0	0	TSUANG, JOHN W MD	11/10/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A45602	N/A	N/A	N/A	N/A	N/A	1000 WEST CARSON STREET,	None	TORRANCE	CA	90509	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
320426	Ordering, Referring, Prescribing	N/A	1114051505	0	0	TSAO, EUGENIA H PHD	10/27/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY19867	N/A	N/A	N/A	N/A	N/A	1000 VETERAN AVENUE	None	LOS ANGELES	CA	90095	7142	00	06000	34.0605595	-118.4499527	Los Angeles County
320443	Ordering, Referring, Prescribing	N/A	1114108651	0	0	TEWKSBURY, TRACIE A LMFT	10/3/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	95118	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	00	06000	34.41078438	-118.510775	Los Angeles County
320500	Ordering, Referring, Prescribing	N/A	1114215050	0	0	TYLER, JULIA M LMFT	3/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT86822	N/A	N/A	N/A	N/A	N/A	71175 AURORA RD	None	DESERT HOT SPRING	CA	92241	7631	00	06000	33.92130141	-116.4203976	Riverside County
320502	Ordering, Referring, Prescribing	N/A	1114222916	0	0	TAMBURRO, ESTRELLA M LCSW	1/13/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99586	N/A	N/A	N/A	N/A	N/A	1940 E DEERE AVE	None	SANTA ANA	CA	92705	5718	00	06000	33.70430421	-117.8482556	Orange County
320515	Ordering, Referring, Prescribing	N/A	1114251956	0	0	TRINH, MY-LINH H MD	2/6/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A127452	N/A	N/A	N/A	N/A	N/A	9143 VALLEY BLVD	SUITE 201A	ROSEMEAD	CA	91770	1992	00	06000	34.08096534	-118.0700742	Los Angeles County
320537	Ordering, Referring, Prescribing	N/A	1114295920	0	0	TRAN, PHU H PHARMD	7/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	48605	N/A	N/A	N/A	N/A	N/A	8052 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	3303	00	06000	33.75925468	-117.988843	Orange County
320545	Ordering, Referring, Prescribing	N/A	1114310372	0	0	TRAN, MICHELLE T CNP	9/13/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002067	N/A	N/A	N/A	N/A	N/A	3260 KERNER BLVD	None	SAN RAFAEL	CA	94901	4840	00	06000	37.96081282	-122.501833	Marin County
320547	Ordering, Referring, Prescribing	N/A	1114314259	0	0	TORRES, ALEJANDRA LMFT	11/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110510	N/A	N/A	N/A	N/A	N/A	12510 VAN NUYS BLVD	SUITE 201	PACOIMA	CA	91331	1338	00	06000	34.27814981	-118.4055414	Los Angeles County
320555	Ordering, Referring, Prescribing	N/A	1114323607	0	0	TURNER, HAYLEE DO	11/22/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	14149	N/A	N/A	N/A	N/A	N/A	2010 ZONAL AVE	OPD 3061	LOS ANGELES	CA	90033	1026	00	06000	34.05986523	-118.2057472	Los Angeles County
320567	Ordering, Referring, Prescribing	N/A	1114336658	0	0	THOMAS, ANN G CNP	5/12/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95138442	N/A	N/A	N/A	N/A	N/A	7800 NILES ST	None	BAKERSFIELD	CA	93306	4922	00	06000	35.37628052	-118.9179	Kern County
320579	Ordering, Referring, Prescribing	N/A	1114358116	0	0	TORRES, YARELY E LPCC	2/11/2019	Taxonomy not applicable	NA	n/a	000	Unknown	4679	N/A	N/A	N/A	N/A	N/A	29995 TECHNOLOGY DR	None	MURRIETA	CA	92563	0300	00	06000	33.56041691	-117.1370428	Riverside County
320581	Ordering, Referring, Prescribing	N/A	1114354628	0	0	THOMAS, EBONY D PHARMD	3/15/2018	Taxonomy not applicable	NA	n/a	000	Unknown	69754	N/A	N/A	N/A	N/A	N/A	20261 HIGHWAY 18	None	APPLE VALLEY	CA	92307	0000	00	06000	34.52556433	-117.2198711	San Bernardino County
320593	Ordering, Referring, Prescribing	N/A	1114380326	0	0	TOURTELLOTTE, JOEL MD	3/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150517	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1460	00	06000	38.555181	-121.4566785	Sacramento County
320599	Ordering, Referring, Prescribing	N/A	1114387669	0	0	TO, THI T NP	7/25/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	714765	N/A	N/A	N/A	N/A	N/A	1691 THE ALAMEDA	None	SAN JOSE	CA	95126	2203	00	06000	37.3373761	-121.9192532	Santa Clara County
320617	Ordering, Referring, Prescribing	N/A	1114421641	0	0	TRAN, ANH LMFT	7/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133615	N/A	N/A	N/A	N/A	N/A	499 LOMA ALTA AVE	None	LOS GATOS	CA	95030	6227	00	06000	37.21747493	-121.9662128	Santa Clara County
320625	Ordering, Referring, Prescribing	N/A	1114424504	0	0	TORCZYNSKI, AMANDA E MD	8/25/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174677	N/A	N/A	N/A	N/A	N/A	1430 FREEDOM BLVD	D	WATSONVILLE	CA	95076	2752	00	06000	36.92713051	-121.7652145	Santa Cruz County
320648	Ordering, Referring, Prescribing	N/A	1114466521	0	0	TANNOUS, SLIMAN C PT	10/5/2021	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	292841	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
320651	Ordering, Referring, Prescribing	N/A	1114470457	0	0	TUCKER, J'QUAYSHA K LMFT	1/17/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110419	N/A	N/A	N/A	N/A	N/A	1187 COAST VILLAGE RD	STE 1-360	SANTA BARBARA	CA	93108	2737	00	06000	34.4210386	-119.6449357	Santa Barbara County
320653	Ordering, Referring, Prescribing	N/A	1114471844	0	0	THOMPSON, SUMMER R NP	2/22/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004657	N/A	N/A	N/A	N/A	N/A	770 MASON STREET	120	VACAVILLE	CA	95688	4648	00	06000	38.35504697	-121.983852	Solano County
320683	Ordering, Referring, Prescribing	N/A	1114543246	0	0	TRINIDAD, ANTHONY JAMES T MD	7/27/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A188170	N/A	N/A	N/A	N/A	N/A	5454 EL CAJON BLVD	None	SAN DIEGO	CA	92115	3621	00	06000	32.75809043	-117.0778038	San Diego County
320695	Ordering, Referring, Prescribing	N/A	1114564069	0	0	TIPPLE, CAITLIN A PHARMD	3/8/2020	Taxonomy not applicable	NA	n/a	000	Unknown	80979	N/A	N/A	N/A	N/A	N/A	2449 W KETTLEMAN LN	None	LODI	CA	95242	4124	00	06000	38.117124	-121.3058115	San Joaquin County
320717	Ordering, Referring, Prescribing	N/A	1114624723	0	0	TRAN, VINCENT PA	12/30/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA62162	N/A	N/A	N/A	N/A	N/A	8581 SANTA MONICA BLVD	137	WEST HOLLYWOOD	CA	90069	4120	00	06000	34.08873966	-118.3779575	Los Angeles County
320727	Ordering, Referring, Prescribing	N/A	1114651841	0	0	TELON, MADISYN C PA-C	6/4/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA64575	N/A	N/A	N/A	N/A	N/A	2801 S SAN PEDRO ST	None	LOS ANGELES	CA	90011	2023	00	06000	34.01966657	-118.2625434	Los Angeles County
320755	Ordering, Referring, Prescribing	N/A	1114786977	0	0	TOLEDO, MARY L NP	7/25/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026286	N/A	N/A	N/A	N/A	N/A	1101 N CHERRY ST	None	TULARE	CA	93274	2231	00	06000	36.22333808	-119.337575	Tulare County
320782	Ordering, Referring, Prescribing	N/A	1124070560	0	0	TANASE, LIANA N MD	3/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A79427	N/A	N/A	N/A	N/A	N/A	855 N. EUCLID AVE	None	ONTARIO	CA	91762	2729	00	06000	34.074063	-117.6514785	San Bernardino County
320804	Ordering, Referring, Prescribing	N/A	1124120977	0	0	TAKEDA, DANIEL B MD	4/20/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G54086	N/A	N/A	N/A	N/A	N/A	2750 SYCAMORE DR	STE 202	SIMI VALLEY	CA	93065	1500	00	06000	34.28529962	-118.7437672	Ventura County
320805	Ordering, Referring, Prescribing	N/A	1124128335	0	0	TRAN, YVONNE T LMFT	4/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49892	N/A	N/A	N/A	N/A	N/A	1627 S HARGRAVE ST	None	BANNING	CA	92220	6169	00	06000	33.910425	-116.867936	Riverside County
320810	Ordering, Referring, Prescribing	N/A	1124138169	0	0	TARUTIS, JODI L	11/8/2013	Taxonomy not applicable	NA	n/a	000	Unknown	PA18111	N/A	N/A	N/A	N/A	N/A	15403 PARK AVE	None	VICTORVILLE	CA	92391	2482	00	06000	34.50640129	-117.3250645	San Bernardino County
320816	Ordering, Referring, Prescribing	N/A	1124147400	0	0	TAO, CHIN	9/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42106	N/A	N/A	N/A	N/A	N/A	2674 E MAIN STREET	E806	VENTURA	CA	93003	2820	00	06000	34.27388698	-119.2602437	Ventura County
320824	Ordering, Referring, Prescribing	N/A	1124152145	0	0	TAKEMOTO, SUNISA LMSW	8/8/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61389	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
320887	Ordering, Referring, Prescribing	N/A	1124263108	0	0	TAWA, MICHELLE MD	10/28/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A127131	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	498	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
320899	Ordering, Referring, Prescribing	N/A	1124300264	0	0	TOLEDO, VEENA R PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH52647	N/A	N/A	N/A	N/A	N/A	3571 N 1ST	SUITE 201	SAN JOSE	CA	95134	1803	00	06000	37.40770226	-121.9439259	Santa Clara County
320907	Ordering, Referring, Prescribing	N/A	1124321971	0	0	TOVAR, DENISSE LMFT	11/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116237	N/A	N/A	N/A	N/A	N/A	2425 BISSO LANE	SUITE 130	CONCORD	CA	94520	4897	00	06000	37.98393807	-122.0466953	Contra Costa County
320926	Ordering, Referring, Prescribing	N/A	1124335864	0	0	TROCHEZ, MELISSA LMFT	12/27/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103854	N/A	N/A	N/A	N/A	N/A	760 MOUNTAIN VIEW ST	None	ALTADENA	CA	91001	4925	00	06000	34.19178664	-118.1657029	Los Angeles County
320970	Ordering, Referring, Prescribing	N/A	1124412754	0	0	THOMAS, CHRISTINE M LMFT	3/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52011	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	STE 207	SANTA ROSA	CA	95407	5486	00	06000	38.425266	-122.749875	Sonoma County
320976	Ordering, Referring, Prescribing	N/A	1124417902	0	0	THURMAN-HATCH, AMANDA J LMFT	12/16/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102970	N/A	N/A	N/A	N/A	N/A	1393 BAILEY DRIVE	None	HANFORD	CA	93230	5922	00	06000	36.32726257	-119.6663418	Kings County
320996	Ordering, Referring, Prescribing	N/A	1124460332	0	0	TORRES, JOHANNA M LCSW	3/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW68105	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
321032	Ordering, Referring, Prescribing	N/A	1124509120	0	0	TONG, JESSICA PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH77295	N/A	N/A	N/A	N/A	N/A	8201 GREENLEAF AVE	None	WHITTIER	CA	90602	2910	00	06000	33.96517117	-118.0376617	Los Angeles County
321043	Ordering, Referring, Prescribing	N/A	1124528336	0	0	TORRES, LINDA T LCSW	10/7/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104599	N/A	N/A	N/A	N/A	N/A	515 COLUMBIA AVENUE	200	LOS ANGELES	CA	90017	0000	00	06000	34.05683109	-118.265995	Los Angeles County
321089	Ordering, Referring, Prescribing	N/A	1124589668	0	0	TORRES, TERESA O	2/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95047500	N/A	N/A	N/A	N/A	N/A	9333 LOCH LOMOND DR	None	PICO RIVERA	CA	90660	2913	00	06000	33.99484196	-118.0815839	Los Angeles County
321109	Ordering, Referring, Prescribing	N/A	1124642384	0	0	THOMPSON, LATOYA PHARMD	1/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80161	N/A	N/A	N/A	N/A	N/A	1380 HOWARD ST	None	SAN FRANCISCO	CA	94103	2638	00	06000	37.77424669	-122.4141502	San Francisco County
321137	Ordering, Referring, Prescribing	N/A	1124699426	0	0	TIDD, JESSICA F PA-C	10/4/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA61757	N/A	N/A	N/A	N/A	N/A	10956 DONNER PASS RD	STE 110	TRUCKEE	CA	96161	4860	00	06000	39.32625521	-120.2012059	Nevada County
321150	Ordering, Referring, Prescribing	N/A	1124762950	0	0	TAN, XIAO F PHARMD	10/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85242	N/A	N/A	N/A	N/A	N/A	2424 MISSION ST	None	SAN FRANCISCO	CA	94110	2415	00	06000	37.75816928	-122.4190376	San Francisco County
321184	Ordering, Referring, Prescribing	N/A	1134203110	0	0	TOTH, THOMAS L MD	5/30/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G68775	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3314	00	06000	38.62729851	-122.8637785	Sonoma County
321209	Ordering, Referring, Prescribing	N/A	1134245640	0	0	TAKEDA, AKIKO LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	78872	N/A	N/A	N/A	N/A	N/A	3333 SKYPARK DR	220	TORRANCE	CA	90505	5023	00	06000	33.81036565	-118.3466218	Los Angeles County
321224	Ordering, Referring, Prescribing	N/A	1134261183	0	0	TAFOLLA MARTINEZ, BRIZIA G LCSW	11/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74789	N/A	N/A	N/A	N/A	N/A	162 E CARSON ST	None	COLUSA	CA	95932	2880	00	06000	39.20587882	-122.0061518	Colusa County
321293	Ordering, Referring, Prescribing	N/A	1134410160	0	0	TRAN, DONOVAN P	7/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH56943	N/A	N/A	N/A	N/A	N/A	3201 W. 6TH ST.	None	LOS ANGELES	CA	90020	5001	00	06000	34.0636545	-118.2922515	Los Angeles County
321298	Ordering, Referring, Prescribing	N/A	1134418106	0	0	TAPIA, LUCIA LMFT	11/19/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT84385	N/A	N/A	N/A	N/A	N/A	15305 RAYEN ST	None	NORTH HILLS	CA	91343	5117	00	06000	34.23191048	-118.4657625	Los Angeles County
321305	Ordering, Referring, Prescribing	N/A	1134427743	0	0	TRINH, ALICE D PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62656	N/A	N/A	N/A	N/A	N/A	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
321309	Ordering, Referring, Prescribing	N/A	1134454978	0	0	TRAN, MANDA C PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	63169	N/A	N/A	N/A	N/A	N/A	3444 KATHLEEN STREET	None	SAN JOSE	CA	95124	2135	00	06000	37.263267	-121.9270425	Santa Clara County
321321	Ordering, Referring, Prescribing	N/A	1134466758	0	0	THOMAS-CHANDLER, SARA M LCSW	5/1/2014	Taxonomy not applicable	NA	n/a	034	MEDICARE CROSSOVER PROVIDER ONLY	19400	N/A	N/A	N/A	N/A	N/A	1014 CALLOWAY	None	BAKERSFIELD	CA	93312	6337	00	06000	35.36769028	-119.1111246	Kern County
321328	Ordering, Referring, Prescribing	N/A	1134490055	0	0	TSAI, THEODORE M PHARMD	7/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54134	N/A	N/A	N/A	N/A	N/A	301 UNIVERSITY AVE	None	SAN DIEGO	CA	92103	3008	00	06000	32.74824655	-117.162423	San Diego County
321340	Ordering, Referring, Prescribing	N/A	1134498439	0	0	THAN, HAI K PHARMD	10/11/2018	Taxonomy not applicable	NA	n/a	000	Unknown	58711	N/A	N/A	N/A	N/A	N/A	751 S BASCOM AVE	None	CAMPBELL	CA	95008	0000	00	06000	37.313433	-121.9318385	Santa Clara County
321383	Ordering, Referring, Prescribing	N/A	1134569387	0	0	TRAN, RUBY LCSW	3/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89116	N/A	N/A	N/A	N/A	N/A	820 E. GILBERT ST	None	SAN BERNARDINO CA	CA	92415	9999	00	06000	34.1268333	-117.2687417	San Bernardino County
321406	Ordering, Referring, Prescribing	N/A	1134600034	0	0	TEJEDA, LORENA	8/16/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84877	N/A	N/A	N/A	N/A	N/A	1007 E COOLEY DR	SUITE 100	COLTON	CA	92324	3901	00	06000	34.05461152	-117.310599	San Bernardino County
321438	Ordering, Referring, Prescribing	N/A	1134656010	0	0	TOH, MUN KEONG JOSHUA LMFT	1/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124148	N/A	N/A	N/A	N/A	N/A	251 LLEWELLYN AVE	None	CAMPBELL	CA	95008	1940	00	06000	37.29173129	-121.9584335	Santa Clara County
321469	Ordering, Referring, Prescribing	N/A	1134699218	0	0	THEY, MICHAEL NP	12/3/2018	Taxonomy not applicable	NA	n/a	000	Unknown	95010524	N/A	N/A	N/A	N/A	N/A	400 W I ST	None	LOS BANOS	CA	93635	3459	00	06000	37.06347448	-120.858102	Merced County
321502	Ordering, Referring, Prescribing	N/A	1134777915	0	0	TAGMIZYAN, ZORIK PHARMD	9/5/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH88438	N/A	N/A	N/A	N/A	N/A	8510 BALBOA BLVD	150	NORTHRIDGE	CA	91325	3583	00	06000	34.224507	-118.5026015	Los Angeles County
321505	Ordering, Referring, Prescribing	N/A	1134791593	0	0	TANG, MENGDI PHARMD	3/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83042	N/A	N/A	N/A	N/A	N/A	2235 MERCURY WAY	None	SANTA ROSA	CA	95407	5473	00	06000	38.422404	-122.751261	Sonoma County
321538	Ordering, Referring, Prescribing	N/A	1144070822	0	0	TEDLA, ALEMANTE MD	8/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	15429	N/A	N/A	N/A	N/A	N/A	2051 MARENGO STREET	None	LOS ANGELES	CA	90033	1352	00	06000	34.05627579	-118.2064774	Los Angeles County
321601	Ordering, Referring, Prescribing	N/A	1144375791	0	0	TEEPLE, KATHERINE A MD	5/27/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A84177	N/A	N/A	N/A	N/A	N/A	23521 PASEO DE VALENCIA	STE 200	LAGUNA HILLS	CA	92653	3101	00	06000	33.61113028	-117.7126684	Orange County
321668	Ordering, Referring, Prescribing	N/A	1144521063	0	0	TAULBEE, REBECCA T	8/22/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95008512	N/A	N/A	N/A	N/A	N/A	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
321716	Ordering, Referring, Prescribing	N/A	1144620147	0	0	TU, STEPHANIE C PHARMD	3/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70966	N/A	N/A	N/A	N/A	N/A	2000 PORTOLA AVENUE	None	LIVERMORE	CA	94551	1762	00	06000	37.69125899	-121.7746983	Alameda County
321744	Ordering, Referring, Prescribing	N/A	1144653148	0	0	THAI, MAI P PHARMD	10/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55403	N/A	N/A	N/A	N/A	N/A	1844 E ROUTE 66	None	GLENDORA	CA	91740	3868	00	06000	34.12856885	-117.8298553	Los Angeles County
321804	Ordering, Referring, Prescribing	N/A	1144730359	0	0	TANG, SI PHARMD	7/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79990	N/A	N/A	N/A	N/A	N/A	3601 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1701	00	06000	37.78635452	-122.4535829	San Francisco County
321809	Ordering, Referring, Prescribing	N/A	1144738667	0	0	THORNHILL, LISA M LMFT	11/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123310	N/A	N/A	N/A	N/A	N/A	8912 VOLUNTEER LN	None	SACRAMENTO	CA	95826	3221	00	06000	38.55438	-121.3756965	Sacramento County
321813	Ordering, Referring, Prescribing	N/A	1144741463	0	0	TURNMIRE, DONALD A LMFT	4/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT118711	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
321819	Ordering, Referring, Prescribing	N/A	1144752486	0	0	TRAN, CONNIE S NP	11/20/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95013311	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
321841	Ordering, Referring, Prescribing	N/A	1144779109	0	0	TUOMAINEN, ALEXANDRIA M LMFT	11/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT122917	N/A	N/A	N/A	N/A	N/A	3845 SPRING DRIVE	SUITE 16	SPRING VALLEY	CA	91977	1030	00	06000	32.74889129	-117.0031816	San Diego County
321875	Ordering, Referring, Prescribing	N/A	1144833989	0	0	TAYLOR, TRISHA PA-C	9/17/2020	Taxonomy not applicable	NA	n/a	000	Unknown	PA58524	N/A	N/A	N/A	N/A	N/A	9041 MAGNOLIA AVE	SUITE 107	RIVERSIDE	CA	92503	3942	00	06000	33.92541585	-117.4378266	Riverside County
321910	Ordering, Referring, Prescribing	N/A	1144883331	0	0	TSAI, NATHANIEL DDS	7/26/2023	Taxonomy not applicable	NA	n/a	000	Unknown	104615	N/A	N/A	N/A	N/A	N/A	164 KINMAN AVE	None	GOLETA	CA	93117	3481	00	06000	34.436277	-119.8222815	Santa Barbara County
321915	Ordering, Referring, Prescribing	N/A	1144874058	0	0	THIRTLE, KATHALEENA A LMFT	6/16/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133281	N/A	N/A	N/A	N/A	N/A	5051 PACIFIC COAST HIGHW	SUITE 100	LONG BEACH	CA	90804	3394	00	06000	33.78433086	-118.1346227	Los Angeles County
321921	Ordering, Referring, Prescribing	N/A	1144950932	0	0	TAYLOR, PAMELA L LCSW	12/7/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW22589	N/A	N/A	N/A	N/A	N/A	3030 BRIDGEWAY	241	SAUSALITO	CA	94965	3801	00	06000	37.87041225	-122.5035792	Marin County
321923	Ordering, Referring, Prescribing	N/A	1144953159	0	0	TOMANENG, CHRISANTA PA	6/5/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA64584	N/A	N/A	N/A	N/A	N/A	4402 E COMPTON BLVD	None	COMPTON	CA	90221	3667	00	06000	33.8960937	-118.1944727	Los Angeles County
321925	Ordering, Referring, Prescribing	N/A	1144953761	0	0	TRAN, ANH N PHARMD	4/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86085	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
321934	Ordering, Referring, Prescribing	N/A	1144979097	0	0	TREPTE, CODY	10/25/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A22211	N/A	N/A	N/A	N/A	N/A	2441 W LA PALMA AVE	100	ANAHEIM	CA	92801	2658	00	06000	33.84691193	-117.9697045	Orange County
321951	Ordering, Referring, Prescribing	N/A	1154057420	0	0	TRAN, DIANA P PA-C	10/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61859	N/A	N/A	N/A	N/A	N/A	1520 NUTMEG PL	UNIT 101	COSTA MESA	CA	92626	2501	00	06000	33.68196448	-117.920322	Orange County
322006	Ordering, Referring, Prescribing	N/A	1154397768	0	0	TIEU, KEVIN KHAI T MD	5/28/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A77268	N/A	N/A	N/A	N/A	N/A	16543 BROOKHURST ST.	None	FOUNTAIN VALLEY	CA	92708	2343	00	06000	33.72276183	-117.9547129	Orange County
322046	Ordering, Referring, Prescribing	N/A	1154477164	0	0	TRAN, WENDY U OD	10/24/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	9823	N/A	N/A	N/A	N/A	N/A	1206 E 17TH STREET, STE	None	SANT A ANA	CA	92701	2641	00	06000	33.75983651	-117.8539425	Orange County
322053	Ordering, Referring, Prescribing	N/A	1154503449	0	0	THOMPSON, ROGELIO F	5/23/1995	Taxonomy not applicable	NA	n/a	099	DENTIST	D40400	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
322054	Ordering, Referring, Prescribing	N/A	1154502342	0	0	TODESCO, MICHELLE	9/26/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0592421	N/A	N/A	N/A	N/A	N/A	303 W LINCOLN AVE	#105	ANAHEIM	CA	92805	2928	00	06000	33.83508976	-117.9177981	Orange County
322074	Ordering, Referring, Prescribing	N/A	1154531481	0	0	TAYLOR, PATRICIA G LMFT	12/13/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	30970	N/A	N/A	N/A	N/A	N/A	3787 S. VERMONT	None	LOS ANGLES	CA	90007	4203	00	06000	34.01739	-118.291567	Los Angeles County
322094	Ordering, Referring, Prescribing	N/A	1154584357	0	0	THIHALOLIPAVAN, SAYONE MD	5/16/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A135653	N/A	N/A	N/A	N/A	N/A	3851 ROSECRANS ST	None	SAN DIEGO	CA	92110	3115	00	06000	32.75343795	-117.2028528	San Diego County
322097	Ordering, Referring, Prescribing	N/A	1154586352	0	0	TSENG, BETH PHARMD	2/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	56116	N/A	N/A	N/A	N/A	N/A	2034 W PICO BLVD	None	LOS ANGELES	CA	90006	5011	00	06000	34.04706445	-118.2822723	Los Angeles County
322105	Ordering, Referring, Prescribing	N/A	1154598365	0	0	TWITE LEHNEN, KRISTINE K CNM	5/10/2018	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	235955	N/A	N/A	N/A	N/A	N/A	821 SAINT HELENA HWY S	None	ST HELENA	CA	94574	2266	00	06000	38.48731402	-122.448269	Napa County
322126	Ordering, Referring, Prescribing	N/A	1154625523	0	0	THOMSON, ANDREW T	9/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55774	N/A	N/A	N/A	N/A	N/A	1509 E VALLEY PARKWAY	None	ESCONDIDO	CA	92027	1000	00	06000	33.131502	-117.059544	San Diego County
322138	Ordering, Referring, Prescribing	N/A	1154670891	0	0	TRAN, ANTHONY-HUNG C LCSW	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87573	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVE	100	GILROY	CA	95020	3673	00	06000	37.03080985	-121.5741639	Santa Clara County
322141	Ordering, Referring, Prescribing	N/A	1154672442	0	0	TOMCZAK, AMBER L LMFT	4/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84010	N/A	N/A	N/A	N/A	N/A	17800 HIGHWAY 18	None	APPLE VALLEY	CA	92307	0000	00	06000	34.54007429	-117.2744761	San Bernardino County
322157	Ordering, Referring, Prescribing	N/A	1154691186	0	0	THAN, PENDLETON T PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH51881	N/A	N/A	N/A	N/A	N/A	11950 VALLEY VIEW	None	GARDEN GROVE	CA	92845	1239	00	06000	33.7890093	-118.0283611	Orange County
322192	Ordering, Referring, Prescribing	N/A	1154750164	0	0	TAYLOR, KIMBERLY S LCSW	6/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76821	N/A	N/A	N/A	N/A	N/A	972 MISSION ST	None	SAN FRANCISCO	CA	94103	2931	00	06000	37.78149089	-122.4080877	San Francisco County
322199	Ordering, Referring, Prescribing	N/A	1154770782	0	0	TORRES, ZUGIEL E LMFT	6/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111044	N/A	N/A	N/A	N/A	N/A	1161 BAY BLVD	STE B	CHULA VISTA	CA	91911	2670	00	06000	32.6050811	-117.0922508	San Diego County
322215	Ordering, Referring, Prescribing	N/A	1154789360	0	0	TIMMER, CAROLINE LCSW	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94055	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
322220	Ordering, Referring, Prescribing	N/A	1154797785	0	0	TEMPLE, WILLIAM K LCSW	3/31/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88336	N/A	N/A	N/A	N/A	N/A	1035 MARKET STREET	None	SF	CA	94103	1600	00	06000	37.78152549	-122.4111668	San Francisco County
322223	Ordering, Referring, Prescribing	N/A	1154778173	0	0	TENPAS, HEIDI E OT	6/9/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT16894	N/A	N/A	N/A	N/A	N/A	4211 SOUTH AVALON	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
322232	Ordering, Referring, Prescribing	N/A	1154824860	0	0	TANG, SANG-PATTY G LCSW	4/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75126	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	SUITE 200	ANAHEIM	CA	92806	5159	00	06000	33.81812448	-117.8880075	Orange County
322256	Ordering, Referring, Prescribing	N/A	1154855856	0	0	THORNBERRY, DAVID MD	4/18/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A195638	N/A	N/A	N/A	N/A	N/A	444 BRUCE STREET	None	YREKA	CA	96097	3450	00	06000	41.71863548	-122.6458755	Siskiyou County
322281	Ordering, Referring, Prescribing	N/A	1154894244	0	0	TAM, HELEN	2/11/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	18822	N/A	N/A	N/A	N/A	N/A	425 DIVISADERO ST	300	SAN FRANCISCO	CA	94117	2242	00	06000	37.77336026	-122.4375022	San Francisco County
322286	Ordering, Referring, Prescribing	N/A	1154899250	0	0	THOMAS, MEGAN K LMFT	9/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121601	N/A	N/A	N/A	N/A	N/A	411 E LAKE AVE	None	WATSONVILLE	CA	95076	4424	00	06000	36.91720138	-121.7507888	Santa Cruz County
322290	Ordering, Referring, Prescribing	N/A	1154929347	0	0	TRICHTER, JUSTIN D LMFT	3/23/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131944	N/A	N/A	N/A	N/A	N/A	118 LIVINGSTON AVE	None	PLACENTIA	CA	92870	2546	00	06000	33.89281649	-117.8648036	Orange County
322292	Ordering, Referring, Prescribing	N/A	1154932721	0	0	TRAN, HIEP PHARMD	7/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80181	N/A	N/A	N/A	N/A	N/A	3301 PANAMA LN	None	BAKERSFIELD	CA	93313	3631	00	06000	35.29582172	-119.039711	Kern County
322316	Ordering, Referring, Prescribing	N/A	1154966588	0	0	TRAN, VY T PHARMD	2/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	63578	N/A	N/A	N/A	N/A	N/A	261 E BRADDOCK DR	None	FRESNO	CA	93720	0826	00	06000	36.86687223	-119.7786242	Fresno County
322322	Ordering, Referring, Prescribing	N/A	1154970069	0	0	TAGLIERI, JENNIFER T LMFT	9/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT122159	N/A	N/A	N/A	N/A	N/A	24028 LAKE DR	None	CRESTLINE	CA	92325	4028	00	06000	34.24350549	-117.2789521	San Bernardino County
322334	Ordering, Referring, Prescribing	N/A	1164008942	0	0	TENG, CHIH YUN MD	11/14/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A191975	N/A	N/A	N/A	N/A	N/A	3569 ROUND BARN CIRCLE	None	SANTA ROSA	CA	95403	5781	00	06000	38.479743	-122.729625	Sonoma County
322368	Ordering, Referring, Prescribing	N/A	1164069340	0	0	THAI, JOHNNY K PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79259	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	None	OAKLAND	CA	94611	4611	00	06000	37.8237837	-122.2590026	Alameda County
322369	Ordering, Referring, Prescribing	N/A	1164058731	0	0	TRINH, SHANNON T PHARMD	4/27/2020	Taxonomy not applicable	NA	n/a	000	Unknown	82239	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD MA	None	BOISE	ID	83702	3940	00	06000	43.59860438	-116.1806635	Ada County
322414	Ordering, Referring, Prescribing	N/A	1164199048	0	0	TRAN, TRANG V PHARMD	6/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84472	N/A	N/A	N/A	N/A	N/A	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
322425	Ordering, Referring, Prescribing	N/A	1164243655	0	0	TOWLE, JULIANA DDS	10/10/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110921	N/A	N/A	N/A	N/A	N/A	3415 MARTIN LUTHER KING	None	SACRAMENTO	CA	95817	3648	00	06000	38.54376	-121.4644095	Sacramento County
322477	Ordering, Referring, Prescribing	N/A	1164569646	0	0	TAN, MARISTELA GR D	10/22/2003	Taxonomy not applicable	NA	n/a	099	DENTIST	D50829	N/A	N/A	N/A	N/A	N/A	2201 COURAGE DR	None	FAIRFIELD	CA	94533	6733	00	06000	38.23727106	-122.0692856	Solano County
322483	Ordering, Referring, Prescribing	N/A	1164577342	0	0	TALBOT, ANGELA M LMFT	2/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53812	N/A	N/A	N/A	N/A	N/A	855 N EUCLID AVE	None	ONTARIO	CA	91762	2729	00	06000	34.074063	-117.6514785	San Bernardino County
322510	Ordering, Referring, Prescribing	N/A	1164626347	0	0	TARABAY, LUCILIA LMFT	3/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53872	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
322529	Ordering, Referring, Prescribing	N/A	1164667895	0	0	TROTTIER, PAMELA NP	1/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003997	N/A	N/A	N/A	N/A	N/A	2800 RIVERSIDE AVE	None	PASO ROBLES	CA	93446	1311	00	06000	35.64351546	-120.6888699	San Luis Obispo County
322532	Ordering, Referring, Prescribing	N/A	1164672069	0	0	TRANG, JANET PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57732	N/A	N/A	N/A	N/A	N/A	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
322548	Ordering, Referring, Prescribing	N/A	1164706354	0	0	TRUJILLO, VERONICA PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	56907	N/A	N/A	N/A	N/A	N/A	305 N BREED ST	None	LOS ANGELES	CA	90033	1801	00	06000	34.04750163	-118.208751	Los Angeles County
322588	Ordering, Referring, Prescribing	N/A	1164775912	0	0	TANNOUS, JOHN K MD	6/4/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G172994	N/A	N/A	N/A	N/A	N/A	9095 TELSTAR AVE	None	EL MONTE	CA	91731	2809	00	06000	34.06884893	-118.0694311	Los Angeles County
322679	Ordering, Referring, Prescribing	N/A	1164931127	0	0	THAI, KAREN T PHARMD	4/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH77304	N/A	N/A	N/A	N/A	N/A	2680 REYNOLDS RANCH PKWY	None	LODI	CA	95240	6848	00	06000	38.1006	-121.263147	San Joaquin County
322685	Ordering, Referring, Prescribing	N/A	1164939898	0	0	TAN, NICOLE R PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77093	N/A	N/A	N/A	N/A	N/A	498 CASTRO ST	None	SAN FRANCISCO	CA	94114	2020	00	06000	37.76111969	-122.4350504	San Francisco County
322686	Ordering, Referring, Prescribing	N/A	1164933206	0	0	TO, JENNIFER V	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75926	N/A	N/A	N/A	N/A	N/A	20940 BURBANK BLVD	None	WOODLAND HILLS	CA	91316	0000	00	06000	34.1719401	-118.5881418	Los Angeles County
322698	Ordering, Referring, Prescribing	N/A	1164960324	0	0	TRAN, VI ANH N NP	9/10/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006059	N/A	N/A	N/A	N/A	N/A	1725 W. 17TH ST	None	SANTA ANA	CA	92706	2316	00	06000	33.75999552	-117.892593	Orange County
322739	Ordering, Referring, Prescribing	N/A	1174023816	0	0	TRAN, MY T PHARMD	7/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78185	N/A	N/A	N/A	N/A	N/A	12001 EUCLID ST	None	GARDEN GROVE	CA	92840	3332	00	06000	33.78758768	-117.941271	Orange County
322742	Ordering, Referring, Prescribing	N/A	1174033807	0	0	TRAN, KHOA PA-C	6/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	58094	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
322751	Ordering, Referring, Prescribing	N/A	1174055636	0	0	TRINH, ELYSE V MD	10/19/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159067	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPRESSWAY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
322771	Ordering, Referring, Prescribing	N/A	1174090666	0	0	TRUONG, PETER PHARMD	9/22/2019	Taxonomy not applicable	NA	n/a	000	Unknown	RPH75813	N/A	N/A	N/A	N/A	N/A	2110 TRUXTUN AVE	SUITE 400	BAKERSFIELD	CA	93301	3703	00	06000	35.37344851	-119.0261655	Kern County
322778	Ordering, Referring, Prescribing	N/A	1174103451	0	0	TAITANO, DANIEL MD	8/13/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	6515	N/A	N/A	N/A	N/A	N/A	505 S MAIN ST	525	ORANGE	CA	92868	4553	00	06000	33.78004808	-117.8672472	Orange County
322797	Ordering, Referring, Prescribing	N/A	1174134258	0	0	TAM, TRISTA PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82925	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
322812	Ordering, Referring, Prescribing	N/A	1174152524	0	0	TOPETE, CASSANDRA V LMFT	1/13/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152651	N/A	N/A	N/A	N/A	N/A	201 N. K ST	None	TULARE	CA	93274	4005	00	06000	36.20957262	-119.3464875	Tulare County
322829	Ordering, Referring, Prescribing	N/A	1174172357	0	0	TELLO, SARAH M	8/28/2019	Taxonomy not applicable	NA	n/a	000	Unknown	LEP3947	N/A	N/A	N/A	N/A	N/A	4161 W 147TH ST	None	LAWNDALE	CA	90260	1709	00	06000	33.8983413	-118.3479126	Los Angeles County
322876	Ordering, Referring, Prescribing	N/A	1174528350	0	0	TRAN, JOHN T MD	2/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A88474	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
322883	Ordering, Referring, Prescribing	N/A	1174601652	0	0	THOMAS, BRIAN E MD	2/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G87390	N/A	N/A	N/A	N/A	N/A	720 WOOD ST	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
322884	Ordering, Referring, Prescribing	N/A	1174607501	0	0	TSUEI, LING PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47472	N/A	N/A	N/A	N/A	N/A	100 BOLLA AVE	None	ALAMO	CA	94507	1629	00	06000	37.85528959	-122.017877	Contra Costa County
322896	Ordering, Referring, Prescribing	N/A	1174642250	0	0	TSUKIMURA, ALLISON	8/29/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	18765	N/A	N/A	N/A	N/A	N/A	333 BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
322912	Ordering, Referring, Prescribing	N/A	1174654065	0	0	THOMAS, NICOLE LMFT	11/16/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	101182	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
322949	Ordering, Referring, Prescribing	N/A	1174724090	0	0	TROTMAN, MISA D LCSW	5/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW20625	N/A	N/A	N/A	N/A	N/A	777 DAVIS ST	# 300	SAN LEANDRO	CA	94577	6923	00	06000	37.72317409	-122.162925	Alameda County
322983	Ordering, Referring, Prescribing	N/A	1174807630	0	0	TRUONG, DALTON PHARMD	8/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH56796	N/A	N/A	N/A	N/A	N/A	7015 N WEST AVE	None	FRESNO	CA	93711	0461	00	06000	36.83777613	-119.8264816	Fresno County
323024	Ordering, Referring, Prescribing	N/A	1174870497	0	0	TORRES-MOLINA, PATRICIA I	4/29/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D61606	N/A	N/A	N/A	N/A	N/A	4129 S MOONEY BLVD	None	VISALIA	CA	93277	9147	00	06000	36.292923	-119.314458	Tulare County
323040	Ordering, Referring, Prescribing	N/A	1174891550	0	0	TANG, SOPHIE H NP	9/2/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95012320	N/A	N/A	N/A	N/A	N/A	3645 W SHAW AVE STE 101	None	CLOVIS	CA	93611	3206	00	06000	36.80836991	-119.6385726	Fresno County
323050	Ordering, Referring, Prescribing	N/A	1174904312	0	0	TSAI, JESSICA S MD	4/24/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A155582	N/A	N/A	N/A	N/A	N/A	1975 VERDUGO BLVD	STE B	LA CANADA	CA	91011	3024	00	06000	34.20501855	-118.219857	Los Angeles County
323081	Ordering, Referring, Prescribing	N/A	1174943229	0	0	TORRES, KRISTEN N LMFT	6/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105822	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	STE. 210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
323191	Ordering, Referring, Prescribing	N/A	1184080756	0	0	TRUSCOTT, LYLE M LMFT	8/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121394	N/A	N/A	N/A	N/A	N/A	2017 MISSION ST	STE. 2	SAN FRANCISCO	CA	94110	6345	00	06000	37.76481663	-122.4196159	San Francisco County
323220	Ordering, Referring, Prescribing	N/A	1184114712	0	0	TOPALIAN, SONA LMFT	5/31/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133028	N/A	N/A	N/A	N/A	N/A	5900 EASTERN AVE	138	COMMERCE	CA	90040	2040	00	06000	33.98421287	-118.162224	Los Angeles County
323234	Ordering, Referring, Prescribing	N/A	1184145708	0	0	TORCEDO, ABIGAIL LMFT	8/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121312	N/A	N/A	N/A	N/A	N/A	2008 NORTH GAREY AVENUE	None	POMONA	CA	91767	3032	00	06000	34.08295003	-117.7528173	Los Angeles County
323253	Ordering, Referring, Prescribing	N/A	1184166852	0	0	THOMAS BOND, JANET NP	6/19/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017890	N/A	N/A	N/A	N/A	N/A	5650 JILLSON ST	None	COMMERCE	CA	90040	1482	00	06000	34.00007121	-118.1563132	Los Angeles County
323276	Ordering, Referring, Prescribing	N/A	1184215659	0	0	TRAN, DUYEN K PA-C	4/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA59249	N/A	N/A	N/A	N/A	N/A	425 DEL SOL PKWY	None	DELANO	CA	93215	3442	00	06000	35.75415446	-119.250612	Kern County
323286	Ordering, Referring, Prescribing	N/A	1184234577	0	0	TRAN, TEENA P NP	8/21/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014956	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
323317	Ordering, Referring, Prescribing	N/A	1184280612	0	0	TURNIER, NICOLE B MD	1/20/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL2095	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
323320	Ordering, Referring, Prescribing	N/A	1184287336	0	0	TRAN, JESSICA H MD	9/29/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A182578	N/A	N/A	N/A	N/A	N/A	1535 W ORANGEWOOD AVE	None	ORANGE	CA	92868	2006	00	06000	33.79496753	-117.868869	Orange County
323347	Ordering, Referring, Prescribing	N/A	1184381576	0	0	THOMAS, RHEA PHARMD	11/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH85573	N/A	N/A	N/A	N/A	N/A	9000 MING AVE	None	BAKERSFIELD	CA	93311	1318	00	06000	35.33989328	-119.1034715	Kern County
323358	Ordering, Referring, Prescribing	N/A	1184432270	0	0	THAO, YUE PHENG	12/20/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95033385	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DR	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
323371	Ordering, Referring, Prescribing	N/A	1184609208	0	0	TARAZON, JENNIFER G NP	9/11/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	13408	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
323372	Ordering, Referring, Prescribing	N/A	1184611543	0	0	TCHING, BRUNO T PHARMD	4/21/2017	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	51073	N/A	N/A	N/A	N/A	N/A	1001 E LATHAM AVE	None	HEMET	CA	92543	4435	00	06000	33.74937254	-116.961804	Riverside County
323375	Ordering, Referring, Prescribing	N/A	1184651721	0	0	TEMEROVA, ANDREA MD	12/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A85963	N/A	N/A	N/A	N/A	N/A	15339 SATICOY STREET	None	VAN NUYS	CA	91406	3345	00	06000	34.2084865	-118.4678505	Los Angeles County
323407	Ordering, Referring, Prescribing	N/A	1184749798	0	0	TAKANO, ROBERT DDS	12/21/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	52501	N/A	N/A	N/A	N/A	N/A	19969 GREENLEY ROAD	SUITE C AND D	SONORA	CA	95370	5908	00	06000	37.98497262	-120.3669198	Tuolumne County
323434	Ordering, Referring, Prescribing	N/A	1184792145	0	0	TRAN, TIEN M	8/15/1993	Taxonomy not applicable	NA	n/a	099	DENTIST	D41685	N/A	N/A	N/A	N/A	N/A	3124 SENTER RD	DENTAL CLINIC	SAN JOSE	CA	95111	1257	00	06000	37.29445073	-121.834085	Santa Clara County
323449	Ordering, Referring, Prescribing	N/A	1184830606	0	0	THOMPSON, WILLIAM K LMFT	6/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	85708	N/A	N/A	N/A	N/A	N/A	2060 CAMPUS DRIVE	None	YREKA	CA	96097	9538	00	06000	41.7050458	-122.6481121	Siskiyou County
323548	Ordering, Referring, Prescribing	N/A	1184991481	0	0	TRUONG, EMILY PHARMD	8/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68806	N/A	N/A	N/A	N/A	N/A	6400 HAVEN AVE	None	RANCHO CUCAMONGA	CA	91737	3823	00	06000	34.138377	-117.575997	San Bernardino County
323562	Ordering, Referring, Prescribing	N/A	1194023143	0	0	TORRES, CHRISTINA B LMFT	3/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113120	N/A	N/A	N/A	N/A	N/A	1200 N MAIN ST	#200	SANTA ANA	CA	92701	3640	00	06000	33.755175	-117.8676195	Orange County
323585	Ordering, Referring, Prescribing	N/A	1194068064	0	0	TOPIC, ADRIENNE S MD	7/18/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A135781	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
323593	Ordering, Referring, Prescribing	N/A	1194087874	0	0	TAN, CANDACE PHARMD	3/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62670	N/A	N/A	N/A	N/A	N/A	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
323597	Ordering, Referring, Prescribing	N/A	1194093799	0	0	TOLENTINO, JENNIFER M PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH50957	N/A	N/A	N/A	N/A	N/A	1334 SARATOGA AVE	None	SAN JOSE	CA	95129	4336	00	06000	37.30015404	-121.982283	Santa Clara County
323598	Ordering, Referring, Prescribing	N/A	1194093682	0	0	THOMAS, JOSHUA P LCSW	1/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65309	N/A	N/A	N/A	N/A	N/A	1965 LIVE OAK BLVD	None	YUBA CITY	CA	95991	8850	00	06000	39.15563037	-121.620091	Sutter County
323626	Ordering, Referring, Prescribing	N/A	1194139766	0	0	TILFORD, SARAH MD	12/3/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A154086	N/A	N/A	N/A	N/A	N/A	700 S TUSTIN ST	None	ORANGE	CA	92866	3425	00	06000	33.77685748	-117.8357804	Orange County
323681	Ordering, Referring, Prescribing	N/A	1194230805	0	0	TIBON, JAMIE D NP	4/12/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007795	N/A	N/A	N/A	N/A	N/A	1014 N BROADWAY	None	SANTA ANA	CA	92701	3408	00	06000	33.75354748	-117.8697553	Orange County
323736	Ordering, Referring, Prescribing	N/A	1194341644	0	0	TYLER, TRACIE LMFT	6/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119440	N/A	N/A	N/A	N/A	N/A	5601 W SLAUSON AVE	SUITE 192	CULVER CITY	CA	90230	0011	00	06000	33.98900447	-118.37979	Los Angeles County
323812	Ordering, Referring, Prescribing	N/A	1194804781	0	0	TEE, PETER A	11/3/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D43254	N/A	N/A	N/A	N/A	N/A	1400 N MAIN ST	None	SANTA ANA	CA	92701	2304	00	06000	33.75688822	-117.8676134	Orange County
323839	Ordering, Referring, Prescribing	N/A	1194841809	0	0	TAVASSOLI, SHAGHAYEGH MD	6/11/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A9861	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
323877	Ordering, Referring, Prescribing	N/A	1194913327	0	0	THOMAS, COURTNEY J PHD	1/28/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	28843	N/A	N/A	N/A	N/A	N/A	1212 BROADWAY	1200	OAKLAND	CA	94612	1814	00	06000	37.80315112	-122.2718722	Alameda County
323878	Ordering, Referring, Prescribing	N/A	1194919910	0	0	TEHRANI, FEDRA LMFT	10/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117155	N/A	N/A	N/A	N/A	N/A	1900 THE ALAMEDA	SUITE 200	SAN JOSE	CA	95126	1459	00	06000	37.34098783	-121.923253	Santa Clara County
323879	Ordering, Referring, Prescribing	N/A	1194921072	0	0	TAN, SAM T	11/28/2011	Taxonomy not applicable	NA	n/a	099	DENTIST	D47570	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
323934	Ordering, Referring, Prescribing	N/A	1205046315	0	0	THOMASSON, TOMMY P LMFT	2/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT106365	N/A	N/A	N/A	N/A	N/A	169 MASON ST.	SUITE 300	UKIAH	CA	95482	4483	00	06000	39.15102821	-123.2051831	Mendocino County
323950	Ordering, Referring, Prescribing	N/A	1205085669	0	0	TESSIER, SUZAN PSYD	7/11/2017	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY25574	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	00	06000	34.41078438	-118.510775	Los Angeles County
323964	Ordering, Referring, Prescribing	N/A	1205108602	0	0	TAK, EUGENE L	10/5/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55398	N/A	N/A	N/A	N/A	N/A	30530 RANCHO CALIFORNIA	None	TEMECULA	CA	92591	3277	00	06000	33.50860426	-117.1275323	Riverside County
324024	Ordering, Referring, Prescribing	N/A	1205223161	0	0	TRAN, NHI T MD MPH	2/15/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166262	N/A	N/A	N/A	N/A	N/A	250 E 18TH ST	SECOND FLOOR	OAKLAND	CA	94606	1716	00	06000	37.79999844	-122.2527149	Alameda County
324028	Ordering, Referring, Prescribing	N/A	1205236684	0	0	THOMAS, TIARA T LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89527	N/A	N/A	N/A	N/A	N/A	14140 BEACH BLVD	155	WESTMINISTER	CA	92683	4453	00	06000	33.756966	-117.9894915	Orange County
324047	Ordering, Referring, Prescribing	N/A	1205266947	0	0	TALIB, SAIFUDDIN NP	8/14/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010315	N/A	N/A	N/A	N/A	N/A	52565 CESAR CHAVEZ ST	104	COACHELLA	CA	92236	1534	00	06000	33.66690605	-116.1817556	Riverside County
324057	Ordering, Referring, Prescribing	N/A	1205285046	0	0	TEJADA, STEPHANIE M LMFT	12/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123624	N/A	N/A	N/A	N/A	N/A	101 WIKIUP DR	None	SANTA ROSA	CA	95403	1375	00	06000	38.50788547	-122.7587646	Sonoma County
324062	Ordering, Referring, Prescribing	N/A	1205294543	0	0	TAHBAZ, ASH LMFT	10/10/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT87601	N/A	N/A	N/A	N/A	N/A	7290 EL CAJON BLVD	None	SAN DIEGO	CA	92115	1829	00	06000	32.76884635	-117.0406752	San Diego County
324071	Ordering, Referring, Prescribing	N/A	1205308046	0	0	TAE, THOMAS	12/22/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011784	N/A	N/A	N/A	N/A	N/A	3727 WEST 6TH STREET	STE. 320	LOS ANGELES	CA	90020	0000	00	06000	34.06358655	-118.3037656	Los Angeles County
324120	Ordering, Referring, Prescribing	N/A	1205369899	0	0	THOMPSON, AMANDA N LMFT	2/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124371	N/A	N/A	N/A	N/A	N/A	1414 N CALIFORNIA ST	None	STOCKTON	CA	95202	1515	00	06000	37.96761084	-121.2883234	San Joaquin County
324122	Ordering, Referring, Prescribing	N/A	1205370673	0	0	TRAN, ELIZABETH DDS	7/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	100919	N/A	N/A	N/A	N/A	N/A	6501 GARFIELD AVE	None	BELL GARDENS	CA	90201	1805	00	06000	33.97292523	-118.1475473	Los Angeles County
324143	Ordering, Referring, Prescribing	N/A	1205407095	0	0	TIDIANE, ERICA M CNP	11/9/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95019105	N/A	N/A	N/A	N/A	N/A	7777 SUNRISE BLVD	STE 2500	CITRUS HEIGHTS	CA	95610	2372	00	06000	38.706561	-121.2731145	Sacramento County
324160	Ordering, Referring, Prescribing	N/A	1205455482	0	0	TOPALIS, KATHRYN M MD	8/9/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A186641	N/A	N/A	N/A	N/A	N/A	245 S FETTERLY AVE	None	LOS ANGELES	CA	90022	1605	00	06000	34.03404953	-118.1609476	Los Angeles County
324165	Ordering, Referring, Prescribing	N/A	1205468584	0	0	TRAN, VANESSA E PHARMD	2/2/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	RPH79760	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
324169	Ordering, Referring, Prescribing	N/A	1205468113	0	0	TRAN, SHARON K NP	5/5/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015644	N/A	N/A	N/A	N/A	N/A	661 W 1ST ST	None	TUSTIN	CA	92780	2939	00	06000	33.74578153	-117.831231	Orange County
324195	Ordering, Referring, Prescribing	N/A	1205559150	0	0	TRAN, NHI U PHARMD	9/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86885	N/A	N/A	N/A	N/A	N/A	639 S BERNADO AVE	None	SUNNYVALE	CA	94087	1020	00	06000	37.37252789	-122.0568068	Santa Clara County
324218	Ordering, Referring, Prescribing	N/A	1205690773	0	0	TANNOUS, PETER NP	2/6/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028977	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
324224	Ordering, Referring, Prescribing	N/A	1205814415	0	0	THOMSON, DAVID	10/21/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW6951	N/A	N/A	N/A	N/A	N/A	3569 SACRAMENTO ST	4	SAN FRANCISCO	CA	94118	1866	00	06000	37.78758798	-122.4513948	San Francisco County
324228	Ordering, Referring, Prescribing	N/A	1205873866	0	0	TRAN, DUNG PT	8/27/2017	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	21562	N/A	N/A	N/A	N/A	N/A	5153 HOLT BLVD	STE A1	MONTCLAIR	CA	91763	4837	00	06000	34.0631015	-117.692694	San Bernardino County
324232	Ordering, Referring, Prescribing	N/A	1205902301	0	0	TON-THAT, CHAU	5/1/2017	Taxonomy not applicable	NA	n/a	000	Unknown	7177	N/A	N/A	N/A	N/A	N/A	6B LIBERTY	SUITE 115	ALISO VIEJO	CA	92656	5832	00	06000	33.5595135	-117.7294375	Orange County
324239	Ordering, Referring, Prescribing	N/A	1205917580	0	0	TARNG, YIM-KWAN C LCSW	2/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW18286	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
324262	Ordering, Referring, Prescribing	N/A	1205966421	0	0	TANGHAL, SHARON D LCSW	4/21/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27041	N/A	N/A	N/A	N/A	N/A	2008 N. GAREY AVE.	None	POMONA	CA	91767	2722	00	06000	34.08295003	-117.7528173	Los Angeles County
324267	Ordering, Referring, Prescribing	N/A	1205968922	0	0	THORPE, MALIA LMFT	12/1/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51895	N/A	N/A	N/A	N/A	N/A	1721 GRIFFIN AVE	None	LOS ANGELES	CA	90031	3312	00	06000	34.06331668	-118.2114477	Los Angeles County
324283	Ordering, Referring, Prescribing	N/A	1215006713	0	0	TAM, CAREN T PHARMD	4/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50752	N/A	N/A	N/A	N/A	N/A	1550 TOWN CENTER DRIVE	None	MONTEBELLO	CA	90640	2173	00	06000	34.03650569	-118.0887188	Los Angeles County
324295	Ordering, Referring, Prescribing	N/A	1215018783	0	0	TIEU, HOANG D MD	2/1/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A53438	N/A	N/A	N/A	N/A	N/A	520 E TULARE AVE	None	VISALIA	CA	93292	3629	00	06000	36.320679	-119.2870845	Tulare County
324306	Ordering, Referring, Prescribing	N/A	1215054481	0	0	TRUONG, PHUONG C MD	12/21/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A92179	N/A	N/A	N/A	N/A	N/A	9353 VALLEY BLVD	None	ROSEMEAD	CA	91770	1923	00	06000	34.08115618	-118.0651957	Los Angeles County
324360	Ordering, Referring, Prescribing	N/A	1215145685	0	0	TRAN, VAN T	11/1/2006	Taxonomy not applicable	NA	n/a	099	DENTIST	D48860	N/A	N/A	N/A	N/A	N/A	13945 HARBOR BLVD	None	GARDEN GROVE	CA	92843	4012	00	06000	33.760206	-117.9203675	Orange County
324385	Ordering, Referring, Prescribing	N/A	1215213285	0	0	TRAN, PHUONG N PHARMD	8/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	56146	N/A	N/A	N/A	N/A	N/A	3999 FOOTHILLS BLVD	None	ROSEVILLE	CA	95747	7256	00	06000	38.75127171	-121.3093622	Placer County
324423	Ordering, Referring, Prescribing	N/A	1215273479	0	0	TRAN, TAYLOR T LMFT	1/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT92750	N/A	N/A	N/A	N/A	N/A	200 MICHIGAN AVE	None	VISTA	CA	92084	5424	00	06000	33.2038743	-117.2421678	San Diego County
324428	Ordering, Referring, Prescribing	N/A	1215282785	0	0	TOMLIN, MATTHEW L NP	10/17/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP21689	N/A	N/A	N/A	N/A	N/A	101 GROVE STREET	None	SAN FRANCISCO	CA	94102	4505	00	06000	37.77838012	-122.4187191	San Francisco County
324430	Ordering, Referring, Prescribing	N/A	1215286059	0	0	TORRES, LETICIA U LCSW	4/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88737	N/A	N/A	N/A	N/A	N/A	3208 ROSEMEAD BLVD	200	EL MONTE	CA	91731	2830	00	06000	34.06580258	-118.0676162	Los Angeles County
324431	Ordering, Referring, Prescribing	N/A	1215287867	0	0	THOMPSON, ERA	5/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	83416	N/A	N/A	N/A	N/A	N/A	1501 HUGHES WAY # 150	None	LONG BEACH	CA	90810	1870	00	06000	33.82866146	-118.212984	Los Angeles County
324442	Ordering, Referring, Prescribing	N/A	1215304068	0	0	TUNG, EMMELLIN Y	3/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74380	N/A	N/A	N/A	N/A	N/A	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	00	06000	37.55102172	-121.9759026	Alameda County
324472	Ordering, Referring, Prescribing	N/A	1215338611	0	0	TIANO, KATHRYN PA-C	4/14/2019	Taxonomy not applicable	NA	n/a	000	Unknown	51879	N/A	N/A	N/A	N/A	N/A	1441 N TRACY BLVD	None	TRACY	CA	95376	3445	00	06000	37.744731	-121.4350375	San Joaquin County
324509	Ordering, Referring, Prescribing	N/A	1215386701	0	0	TSE, CAROLYN LMFT	4/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113760	N/A	N/A	N/A	N/A	N/A	1801 VICENTE ST	None	SAN FRANCISCO	CA	94116	2923	00	06000	37.7388459	-122.4861544	San Francisco County
324535	Ordering, Referring, Prescribing	N/A	1215460001	0	0	THRANE, HYEKYUNG NP	9/11/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	669098	N/A	N/A	N/A	N/A	N/A	7212 ORANGETHORPE AVE	STE 9A	BUENA PARK	CA	90621	4667	00	06000	33.85890953	-118.007244	Orange County
324552	Ordering, Referring, Prescribing	N/A	1215479076	0	0	TAYLOR, URSULA MD	12/19/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A55572	N/A	N/A	N/A	N/A	N/A	1350 E LOS ANGELES AVE	100	SIMI VALLEY	CA	93065	2806	00	06000	34.27163453	-118.7729325	Ventura County
324594	Ordering, Referring, Prescribing	N/A	1215538962	0	0	TADANG, ANDREW PHARMD	8/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH83494	N/A	N/A	N/A	N/A	N/A	15480 MAIN ST	None	HESPERIA	CA	92345	3318	00	06000	34.42530462	-117.3256052	San Bernardino County
324595	Ordering, Referring, Prescribing	N/A	1215556766	0	0	TRAN, HUONG T	2/8/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	106813	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
324639	Ordering, Referring, Prescribing	N/A	1215663349	0	0	TRAN, HUNG D PHARMD	8/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84086	N/A	N/A	N/A	N/A	N/A	1801 W 11TH ST	None	TRACY	CA	95376	3727	00	06000	37.73945553	-121.449447	San Joaquin County
324646	Ordering, Referring, Prescribing	N/A	1215705561	0	0	TCHAPANIAN, GEVORK PHARMD	11/6/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88914	N/A	N/A	N/A	N/A	N/A	7223 BALBOA BLVD	None	VAN NUYS	CA	91406	2702	00	06000	34.2022173	-118.5012288	Los Angeles County
324677	Ordering, Referring, Prescribing	N/A	1225013923	0	0	TONG, KATHLEEN L MD	7/23/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A88802	N/A	N/A	N/A	N/A	N/A	6 WOODLAND RD	STE 304	SAINT HELENA	CA	94574	9562	00	06000	38.54297115	-122.4754501	Napa County
324685	Ordering, Referring, Prescribing	N/A	1225080641	0	0	TRAM, ANH T	6/21/2002	Taxonomy not applicable	NA	n/a	099	DENTIST	D39719	N/A	N/A	N/A	N/A	N/A	12859 PALM ST	None	GARDEN GROVE	CA	92840	6401	00	06000	33.776001	-117.9148665	Orange County
324710	Ordering, Referring, Prescribing	N/A	1225154420	0	0	TADEO, ZANDRA J	6/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29578	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE, STE	None	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
324720	Ordering, Referring, Prescribing	N/A	1225161755	0	0	TAYLOR, GUADALUPE M LMFT	2/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50319	N/A	N/A	N/A	N/A	N/A	3333 E AMERICAN AVE	None	FRESNO	CA	93725	9247	00	06000	36.66341855	-119.7304116	Fresno County
324743	Ordering, Referring, Prescribing	N/A	1225196884	0	0	TAMAGNI, JULIETTE PA	11/13/2019	Taxonomy not applicable	NA	n/a	000	Unknown	12447	N/A	N/A	N/A	N/A	N/A	311 WEST I STREET	None	LOS BANOS	CA	93635	3479	00	06000	37.06343055	-120.8570545	Merced County
324752	Ordering, Referring, Prescribing	N/A	1225220007	0	0	TARVINS, DENISE L LMFT	2/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT107650	N/A	N/A	N/A	N/A	N/A	2425 BISSO LN	STE. 100	CONCORD	CA	94520	4897	00	06000	37.98393807	-122.0466953	Contra Costa County
324773	Ordering, Referring, Prescribing	N/A	1225252968	0	0	THAO, GE LCSW	9/11/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	118019	N/A	N/A	N/A	N/A	N/A	847 W CHILDS AVENUE	SUITE A	MERCED	CA	95341	6862	00	06000	37.28825369	-120.4963159	Merced County
324804	Ordering, Referring, Prescribing	N/A	1225327257	0	0	TURINGAN, GENALYN G PA-C	2/9/2022	Taxonomy not applicable	NA	n/a	000	Unknown	16601	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
324815	Ordering, Referring, Prescribing	N/A	1225341027	0	0	TYLKA, CHRISTINE T MD	11/4/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A121753	N/A	N/A	N/A	N/A	N/A	137 N COTTONWOOD ST	None	WOODLAND	CA	95695	6646	00	06000	38.68538399	-121.7933582	Yolo County
324842	Ordering, Referring, Prescribing	N/A	1225400815	0	0	TRI, ANNA K LCSW	6/18/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW123289	N/A	N/A	N/A	N/A	N/A	9353 VALLEY BLVD	SUITE C	ROSEMEAD	CA	91770	1923	00	06000	34.08115618	-118.0651957	Los Angeles County
324860	Ordering, Referring, Prescribing	N/A	1225424302	0	0	THOMAS, CHRISTIE M MD	7/20/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A147182	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
324923	Ordering, Referring, Prescribing	N/A	1225498363	0	0	THIER, ANTONY M LMFT	7/13/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91092	N/A	N/A	N/A	N/A	N/A	2852 CALIFORNIA ST	STE B	SAN FRANISCO	CA	94115	2504	00	06000	37.7879686	-122.4414088	San Francisco County
324932	Ordering, Referring, Prescribing	N/A	1225529167	0	0	THEUS, MARCUS MD	3/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163877	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
324956	Ordering, Referring, Prescribing	N/A	1225558679	0	0	TAN, TERESITA V PHARD	6/26/2017	Taxonomy not applicable	NA	n/a	000	Unknown	47034	N/A	N/A	N/A	N/A	N/A	14427 CHASE STREET	#101	PANORAMA CITY	CA	91402	3020	00	06000	34.22477664	-118.4478733	Los Angeles County
324960	Ordering, Referring, Prescribing	N/A	1225563299	0	0	TSANG, JONATHAN CHUN MING MD	4/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157766	N/A	N/A	N/A	N/A	N/A	802 BREWSTER AVE	None	REDWOOD CITY	CA	94063	1510	00	06000	37.48873991	-122.2339433	San Mateo County
325021	Ordering, Referring, Prescribing	N/A	1225688955	0	0	TRUBOWITCH, REBEKA LCSW	8/25/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	117749	N/A	N/A	N/A	N/A	N/A	290 IOOF AVE	None	GILROY	CA	95020	5204	00	06000	37.01377513	-121.5685719	Santa Clara County
325033	Ordering, Referring, Prescribing	N/A	1225748791	0	0	TYLER, OLGA B NP	1/10/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95023851	N/A	N/A	N/A	N/A	N/A	13118 SHERMAN WAY	None	NORTH HOLLYWOOD	CA	91605	4645	00	06000	34.20117448	-118.4188095	Los Angeles County
325035	Ordering, Referring, Prescribing	N/A	1225741382	0	0	TAM, LONG PA-C	4/15/2024	Taxonomy not applicable	NA	n/a	000	Unknown	62454	N/A	N/A	N/A	N/A	N/A	1206 E 17TH ST	101	SANTA ANA	CA	92701	2641	00	06000	33.75983651	-117.8539425	Orange County
325040	Ordering, Referring, Prescribing	N/A	1225764459	0	0	TRAN, HAYLIE NP	7/28/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022047	N/A	N/A	N/A	N/A	N/A	11100 WARNER AVE	200	FOUNTAIN VALLEY	CA	92708	4006	00	06000	33.716291	-117.9355051	Orange County
325073	Ordering, Referring, Prescribing	N/A	1235197856	0	0	TOULOUIE, ELAHE MD	3/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A73141	N/A	N/A	N/A	N/A	N/A	1580 N 2ND STREET	None	EL CAJON	CA	92020	3447	00	06000	32.816205	-116.935839	San Diego County
325087	Ordering, Referring, Prescribing	N/A	1235227992	0	0	TORRES, RONNA T	6/26/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D55069	N/A	N/A	N/A	N/A	N/A	4816 E 3RD ST	None	LOS ANGELES	CA	90022	1602	00	06000	34.03327647	-118.16037	Los Angeles County
325124	Ordering, Referring, Prescribing	N/A	1235324062	0	0	TAYLOR, CAROL P NP	2/20/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	6299	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
325134	Ordering, Referring, Prescribing	N/A	1235334376	0	0	TALEBIMARANDI, SOHEYLA MD	2/17/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A118460	N/A	N/A	N/A	N/A	N/A	3851 ROSECRANS STREET	None	SAN DIEGO	CA	92110	3115	00	06000	32.75343795	-117.2028528	San Diego County
325150	Ordering, Referring, Prescribing	N/A	1235372640	0	0	TAGORE, SIMRANJEET K	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0683651	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
325171	Ordering, Referring, Prescribing	N/A	1235411331	0	0	TRAN, THUY T	1/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	55087	N/A	N/A	N/A	N/A	N/A	1601 COLEMAN AVE	None	SANTA CLARA	CA	95050	3122	00	06000	37.35814451	-121.93908	Santa Clara County
325189	Ordering, Referring, Prescribing	N/A	1235432592	0	0	TRUONG, CHUNG N DDS	5/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	DDS54983	N/A	N/A	N/A	N/A	N/A	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5212	00	06000	37.30176	-121.9136465	Santa Clara County
325199	Ordering, Referring, Prescribing	N/A	1235456880	0	0	TSANG, CHRISTOPHER LMFT	8/14/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111590	N/A	N/A	N/A	N/A	N/A	1290 RIDDER PARK DR	None	SAN JOSE	CA	95131	2304	00	06000	37.38284451	-121.9009893	Santa Clara County
325214	Ordering, Referring, Prescribing	N/A	1235476722	0	0	TABOADA, MARY K	11/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT129214	N/A	N/A	N/A	N/A	N/A	1669 N E ST	None	SAN BERNARDINO	CA	92405	4405	00	06000	34.129548	-117.2941425	San Bernardino County
325267	Ordering, Referring, Prescribing	N/A	1235562703	0	0	TEP, SAVONN LCSW	1/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW90531	N/A	N/A	N/A	N/A	N/A	631 MAPLE AVE	SUITE C	LOS ANGELES	CA	90014	2211	00	06000	34.04323075	-118.2485358	Los Angeles County
325307	Ordering, Referring, Prescribing	N/A	1235614413	0	0	TRAN, PHUONG T PHARMD	10/1/2018	Taxonomy not applicable	NA	n/a	000	Unknown	79501	N/A	N/A	N/A	N/A	N/A	3365 DEER VALLEY RD	None	ANTIOCH	CA	94531	6664	00	06000	37.98789856	-121.7855921	Contra Costa County
325313	Ordering, Referring, Prescribing	N/A	1235627209	0	0	TORRES, JOE	11/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166541	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
325321	Ordering, Referring, Prescribing	N/A	1235634288	0	0	TABB, ALEXA LCSW	1/31/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	118667	N/A	N/A	N/A	N/A	N/A	2827 CONCORD BLVD	None	CONCORD	CA	94519	2608	00	06000	37.97746145	-122.0253615	Contra Costa County
325334	Ordering, Referring, Prescribing	N/A	1235663006	0	0	TIBBETT, CLYDE E LMFT	1/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113432	N/A	N/A	N/A	N/A	N/A	1650 OREGON STREET	SUITE 111	REDDING	CA	96001	1701	00	06000	40.58198408	-122.3937903	Shasta County
325356	Ordering, Referring, Prescribing	N/A	1235697251	0	0	TRIAMWONG, TOP PHARMD	4/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79511	N/A	N/A	N/A	N/A	N/A	4618 FOUNTAIN AVE	None	LOS ANGELES	CA	90029	1830	00	06000	34.095582	-118.290195	Los Angeles County
325361	Ordering, Referring, Prescribing	N/A	1235710179	0	0	TUNG, TINA T MD	7/25/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A182970	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
325384	Ordering, Referring, Prescribing	N/A	1235773920	0	0	TERRELL, MICHAL J LMFT	11/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129440	N/A	N/A	N/A	N/A	N/A	3031 S VERMONT AVE	None	LOS ANGELES	CA	90007	3033	00	06000	34.02666679	-118.2915608	Los Angeles County
325412	Ordering, Referring, Prescribing	N/A	1235889221	0	0	TRAN, PATRICIA DO	12/2/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21478	N/A	N/A	N/A	N/A	N/A	4094 4TH AVENUE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
325439	Ordering, Referring, Prescribing	N/A	1245091834	0	0	TEDFORD, ASHLEY LCSW	4/10/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114717	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
325457	Ordering, Referring, Prescribing	N/A	1245305614	0	0	TAYLOR, CHRISTA H LCSW	3/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	28663	N/A	N/A	N/A	N/A	N/A	995 SPRUCE ST	None	GRIDLEY	CA	95948	2128	00	06000	39.36551662	-121.6980315	Butte County
325522	Ordering, Referring, Prescribing	N/A	1245421049	0	0	TROIANO GONZALEZ, JO-ANN M	1/8/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D46342	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
325537	Ordering, Referring, Prescribing	N/A	1245437581	0	0	TRAN, TUAN A MD FACS	5/5/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A104823	N/A	N/A	N/A	N/A	N/A	20951 BROOKHURST ST	SUITE 107	HUNTINGTON BEACH	CA	92646	6648	00	06000	33.65836552	-117.9537877	Orange County
325543	Ordering, Referring, Prescribing	N/A	1245450576	0	0	TURNER, RODNEY L	10/18/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D35061	N/A	N/A	N/A	N/A	N/A	250 S G ST	None	SAN BERNARDINO	CA	92410	3320	00	06000	34.09693522	-117.2986838	San Bernardino County
325582	Ordering, Referring, Prescribing	N/A	1245530104	0	0	TAI, CHUN PHARMD	1/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54708	N/A	N/A	N/A	N/A	N/A	2505 SAN RAMON VALLEY BL	None	SAN RAMON	CA	94583	1603	00	06000	37.77418776	-121.9755744	Contra Costa County
325618	Ordering, Referring, Prescribing	N/A	1245593748	0	0	TRAN, MICHELLE LMFT	1/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT104571	N/A	N/A	N/A	N/A	N/A	19401 S VERMONT AVNEUE	L102	TORRANCE	CA	90502	1029	00	06000	33.85486409	-118.2905603	Los Angeles County
325628	Ordering, Referring, Prescribing	N/A	1245607779	0	0	THAI, JULIA PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73266	N/A	N/A	N/A	N/A	N/A	1412 E MUNOZ PL	None	PLACENTIA	CA	92870	7200	00	06000	33.8793034	-117.8367649	Orange County
325639	Ordering, Referring, Prescribing	N/A	1245611995	0	0	THOMAS, DEBI MD	3/16/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151419	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95816	6586	00	06000	38.555181	-121.4566785	Sacramento County
325661	Ordering, Referring, Prescribing	N/A	1245652833	0	0	TRAN, STEPHANIE Y PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	69940	N/A	N/A	N/A	N/A	N/A	4033 W AVENUE L	None	LANCASTER	CA	93536	4213	00	06000	34.66025545	-118.202391	Los Angeles County
325693	Ordering, Referring, Prescribing	N/A	1245710078	0	0	TILDEN, GREGORY M LMFT	3/18/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125005	N/A	N/A	N/A	N/A	N/A	930 SHILOH ROAD	BUILDING 44	WINDSOR	CA	95492	9659	00	06000	38.52572847	-122.794542	Sonoma County
325702	Ordering, Referring, Prescribing	N/A	1245729466	0	0	TOROSYAN, NARE MD	5/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164395	N/A	N/A	N/A	N/A	N/A	6043 HOLLYWOOD BLVD	None	LOS ANGELES	CA	90028	5411	00	06000	34.1016835	-118.321569	Los Angeles County
325746	Ordering, Referring, Prescribing	N/A	1245776855	0	0	THUSTON, AMBER C LPCC	2/22/2023	Taxonomy not applicable	NA	n/a	000	Unknown	13283	N/A	N/A	N/A	N/A	N/A	948 SACRAMENTO AVENUE	None	WEST SACRAMENTO	CA	95605	0061	00	06000	38.58935106	-121.5252207	Yolo County
325748	Ordering, Referring, Prescribing	N/A	1245773514	0	0	TOZBIKIAN, SYLVIA V	11/23/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	100647	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
325756	Ordering, Referring, Prescribing	N/A	1245785351	0	0	TANG, JUDITH C PHARMD	7/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73721	N/A	N/A	N/A	N/A	N/A	10990 WARNER AVE	A	FOUNTAIN VALLEY	CA	92708	3849	00	06000	33.7162557	-117.9373439	Orange County
325771	Ordering, Referring, Prescribing	N/A	1245818293	0	0	TSUI, JESSICA PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH84095	N/A	N/A	N/A	N/A	N/A	3630 SAN PABLO DAM RD	None	EL SOBRANTE	CA	94803	1234	00	06000	37.96423149	-122.317864	Contra Costa County
325784	Ordering, Referring, Prescribing	N/A	1245840198	0	0	TOWNSEND, CAMERON LMFT	11/13/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	142807	N/A	N/A	N/A	N/A	N/A	1303 SAN CARLOS AVE	9	SAN CARLOS	CA	94070	2317	00	06000	37.50572931	-122.2621879	San Mateo County
325788	Ordering, Referring, Prescribing	N/A	1245848332	0	0	TSOI, HOWARD C	12/7/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	104933	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DR	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
325864	Ordering, Referring, Prescribing	N/A	1255056834	0	0	TINUNGKI, PRAISE H NP	9/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022631	N/A	N/A	N/A	N/A	N/A	461 TENNESSEE STREET	C	REDLANDS	CA	92373	8161	00	06000	34.058745	-117.2000975	San Bernardino County
325866	Ordering, Referring, Prescribing	N/A	1255059861	0	0	TANG, SUSANA B OD	8/16/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35175	N/A	N/A	N/A	N/A	N/A	250 N SEE VEE LN.	None	BISHOP	CA	93514	8130	00	06000	37.365066	-118.410912	Inyo County
325889	Ordering, Referring, Prescribing	N/A	1255335733	0	0	TRAN, LAWRENCE D MD	5/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A34193	N/A	N/A	N/A	N/A	N/A	2211 W MAGNOLIA BLVD	230	BURBANK	CA	91506	1762	00	06000	34.1728873	-118.3320905	Los Angeles County
325914	Ordering, Referring, Prescribing	N/A	1255441143	0	0	TRACEY, KELLY L DO	1/27/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A11995	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
325935	Ordering, Referring, Prescribing	N/A	1255474532	0	0	TEAL, JAMES R DDS	2/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	28248	N/A	N/A	N/A	N/A	N/A	740 SOLANO STREET	None	CORNING	CA	96021	3352	00	06000	39.92792649	-122.175513	Tehama County
325995	Ordering, Referring, Prescribing	N/A	1255609095	0	0	THAI, ANH M	8/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49989	N/A	N/A	N/A	N/A	N/A	6012 WARNER AVE	None	HUNTINGTON BEACH	CA	92647	5568	00	06000	33.71536944	-118.023518	Orange County
326028	Ordering, Referring, Prescribing	N/A	1255646030	0	0	TERRILL, VICTORIA M LCSW	1/7/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26103	N/A	N/A	N/A	N/A	N/A	1483 ALVA ST	None	CARPINTERIA	CA	93013	1501	00	06000	34.40325505	-119.509423	Santa Barbara County
326085	Ordering, Referring, Prescribing	N/A	1255745311	0	0	TRAN, JENNIFER DO	11/1/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14342	N/A	N/A	N/A	N/A	N/A	455 O'CONNOR DR	200	SAN JOSE	CA	95128	0001	00	06000	37.326654	-121.939897	Santa Clara County
326094	Ordering, Referring, Prescribing	N/A	1255757795	0	0	TURNER, LAUREN A LCSW	12/3/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81128	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	6TH FLOOR	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
326111	Ordering, Referring, Prescribing	N/A	1255790846	0	0	TAI, VERONICA LCSW	2/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84872	N/A	N/A	N/A	N/A	N/A	3626 BALBOA ST	None	SAN FRANCISCO	CA	94121	2604	00	06000	37.77571711	-122.4980286	San Francisco County
326119	Ordering, Referring, Prescribing	N/A	1255811436	0	0	TATE, DAVID A BSN PHN	2/21/2019	Taxonomy not applicable	NA	n/a	000	Unknown	95068870	N/A	N/A	N/A	N/A	N/A	6521 ENOS LN	None	BAKERSFIELD	CA	93314	8721	00	06000	35.41932	-119.251978	Kern County
326122	Ordering, Referring, Prescribing	N/A	1255799276	0	0	TRAN, KELLY T NP	2/6/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	770299	N/A	N/A	N/A	N/A	N/A	501 S BROOKHURST RD	None	FULLERTON	CA	92833	3207	00	06000	33.865002	-117.959396	Orange County
326127	Ordering, Referring, Prescribing	N/A	1255824637	0	0	TOM, MICHELLE MD	9/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164629	N/A	N/A	N/A	N/A	N/A	555 TECHNOLOGY CT	None	RIVERSIDE	CA	92507	2155	00	06000	34.00024862	-117.32403	Riverside County
326131	Ordering, Referring, Prescribing	N/A	1255826665	0	0	TAVAKKOLI ISFAHANI, SEID AMIR FARZAN PHARMD	12/16/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH72910	N/A	N/A	N/A	N/A	N/A	12555	GARDEN GROVE BLVD #102	GARDEN GROVE	CA	92843	1902	00	06000	33.77450946	-117.913041	Orange County
326132	Ordering, Referring, Prescribing	N/A	1255821633	0	0	TRAN, ANDREW V PHARMD	7/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77912	N/A	N/A	N/A	N/A	N/A	21650 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	0001	00	06000	34.50101847	-117.1914367	San Bernardino County
326150	Ordering, Referring, Prescribing	N/A	1255853255	0	0	TAGGART, CANDACE N LMFT	7/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126763	N/A	N/A	N/A	N/A	N/A	5256 MISSION BLVD.	None	RIVERSIDE	CA	92509	4624	00	06000	33.99261717	-117.3987262	Riverside County
326151	Ordering, Referring, Prescribing	N/A	1255858155	0	0	TSUI, PHILIP S	5/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW11771	N/A	N/A	N/A	N/A	N/A	1500 FRANKLIN STREET	None	SAN FRANCISCO	CA	94109	4523	00	06000	37.78847503	-122.4235955	San Francisco County
326153	Ordering, Referring, Prescribing	N/A	1255858460	0	0	TORMO, SAFIYA LMFT	4/15/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT132305	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
326162	Ordering, Referring, Prescribing	N/A	1255871067	0	0	THEODROS, LOZA D PHARMD	8/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75956	N/A	N/A	N/A	N/A	N/A	3745 S LA BREA AVE	C/D	LOS ANGELES	CA	90016	5357	00	06000	34.018623	-118.355616	Los Angeles County
326167	Ordering, Referring, Prescribing	N/A	1255879953	0	0	TRUJILLO, GABRIELA LCSW	12/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99181	N/A	N/A	N/A	N/A	N/A	155 NORTH OCCIDENTAL BLV	None	LOS ANGELES	CA	90026	4641	00	06000	34.07178779	-118.2787879	Los Angeles County
326179	Ordering, Referring, Prescribing	N/A	1255889887	0	0	TAITZ, ISAAC Y PHD	12/17/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32299	N/A	N/A	N/A	N/A	N/A	4700 VON KARMAN AVE	SUITE 102	NEWPORT BEACH	CA	92660	2194	00	06000	33.66858886	-117.8602527	Orange County
326241	Ordering, Referring, Prescribing	N/A	1255999199	0	0	THOMAS, SHIELA R	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61047	N/A	N/A	N/A	N/A	N/A	25151 SANTA CLARA ST	None	HAYWARD	CA	94544	2109	00	06000	37.64824901	-122.0894106	Alameda County
326316	Ordering, Referring, Prescribing	N/A	1265256051	0	0	TOMASIN, TALIA PA-C	2/4/2025	Taxonomy not applicable	NA	n/a	000	Unknown	PA65871	N/A	N/A	N/A	N/A	N/A	905 CALLE AMANECER	SUITE 115	SAN CLEMENTE	CA	92673	6226	00	06000	33.44951265	-117.6075825	Orange County
326339	Ordering, Referring, Prescribing	N/A	1265494512	0	0	TONGEN, SCOTT W MD	8/19/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	32772	N/A	N/A	N/A	N/A	N/A	333 SMITH AVE N	None	ST PAUL	MN	55102	2344	00	06000	44.94251219	-93.1074995	Ramsey County
326432	Ordering, Referring, Prescribing	N/A	1265702740	0	0	TRAN, LONG P PHARMD	8/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58217	N/A	N/A	N/A	N/A	N/A	17522 BEACH BLVD	None	HUNTINGTON BEACH	CA	92647	6802	00	06000	33.707925	-117.989074	Orange County
326440	Ordering, Referring, Prescribing	N/A	1265709448	0	0	TRUONG, TIANA L PHD	7/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65324	N/A	N/A	N/A	N/A	N/A	1500 E GAGE AVE	None	LOS ANGELES	CA	90001	1724	00	06000	33.98202771	-118.2473747	Los Angeles County
326448	Ordering, Referring, Prescribing	N/A	1265714059	0	0	TRAN, VANESSA L PHARMD	7/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH53360	N/A	N/A	N/A	N/A	N/A	1376 KOOSER RD	None	SAN JOSE	CA	95118	3813	00	06000	37.24617512	-121.8903909	Santa Clara County
326467	Ordering, Referring, Prescribing	N/A	1265733729	0	0	TOR, JUNE-FE	2/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	45606	N/A	N/A	N/A	N/A	N/A	1600 EL CAMINO REAL	None	SOUTH SAN FRANCIS	CA	94080	1206	00	06000	37.66509923	-122.4496367	San Mateo County
326471	Ordering, Referring, Prescribing	N/A	1265747984	0	0	TRILLO, JAMILYN D LCSW	3/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87939	N/A	N/A	N/A	N/A	N/A	6302 THIRTEENTH AVE.	None	LUCERNE	CA	95458	8631	00	06000	39.08779639	-122.79255	Lake County
326486	Ordering, Referring, Prescribing	N/A	1265768378	0	0	TUNE, JENNIFER LCSW	10/31/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	111636	N/A	N/A	N/A	N/A	N/A	9280 W STOCKTON BLVD	SUITE 230	ELK GROVE	CA	95758	8073	00	06000	38.420235	-121.394961	Sacramento County
326580	Ordering, Referring, Prescribing	N/A	1265918908	0	0	TRAN HUYNH, DZUNG PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76821	N/A	N/A	N/A	N/A	N/A	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	00	06000	36.84133078	-119.7824983	Fresno County
326599	Ordering, Referring, Prescribing	N/A	1265955025	0	0	TRUONG, THINH PT	2/8/2023	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT302329	N/A	N/A	N/A	N/A	N/A	5454 EL CAJON BLVD	None	SAN DIEGO	CA	92115	3621	00	06000	32.75809043	-117.0778038	San Diego County
326668	Ordering, Referring, Prescribing	N/A	1275089955	0	0	THEMER, CHERI LCSW	8/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW96501	N/A	N/A	N/A	N/A	N/A	3208 ROSEMEAD BLVD STE 1	STE 100	EL MONTE	CA	91731	2830	00	06000	34.06580258	-118.0676162	Los Angeles County
326674	Ordering, Referring, Prescribing	N/A	1275091746	0	0	TODD, SHANNA D LMFT	8/5/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT127327	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2656	00	06000	35.35413152	-119.058471	Kern County
326679	Ordering, Referring, Prescribing	N/A	1275103053	0	0	TAWALI, ARVIDENCIO NP	8/1/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	1034606	N/A	N/A	N/A	N/A	N/A	555 CREEKSIDE XING	None	NEW BRAUNFELS	TX	78130	2594	00	06000	29.721942	-98.0702055	Comal County
326690	Ordering, Referring, Prescribing	N/A	1275108037	0	0	TRAN, THUHANG C PA-C	10/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63489	N/A	N/A	N/A	N/A	N/A	631 S BROOKHURST ST	213B	ANAHEIM	CA	92804	3510	00	06000	33.823647	-117.9589675	Orange County
326694	Ordering, Referring, Prescribing	N/A	1275142044	0	0	TABILAS-TOVAR, ROWENA LMFT	1/2/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152443	N/A	N/A	N/A	N/A	N/A	290 IOOF AVE	None	GILROY	CA	95020	5204	00	06000	37.01377513	-121.5685719	Santa Clara County
326746	Ordering, Referring, Prescribing	N/A	1275307076	0	0	TANG, MICHELLE CNP	7/25/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026187	N/A	N/A	N/A	N/A	N/A	7740 GARVEY AVE	B100B102	ROSEMEAD	CA	91770	3061	00	06000	34.06259448	-118.10061	Los Angeles County
326755	Ordering, Referring, Prescribing	N/A	1275397390	0	0	TAKLA, SARA	10/13/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88794	N/A	N/A	N/A	N/A	N/A	4080 SAN PABLO AVE	None	HERCULES	CA	94547	3903	00	06000	38.01370523	-122.2728505	Contra Costa County
326789	Ordering, Referring, Prescribing	N/A	1275615874	0	0	THOMPSON, CARRIE A LCSW	1/30/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104487	N/A	N/A	N/A	N/A	N/A	9625 CUYAMACA ST	None	SANTEE	CA	92071	2674	00	06000	32.852385	-116.9833405	San Diego County
326792	Ordering, Referring, Prescribing	N/A	1275629149	0	0	TORRES, VERONICA O LCSW	10/28/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28745	N/A	N/A	N/A	N/A	N/A	10355 SLUSHER DR	None	SANTA FE SPRINGS	CA	90670	7353	00	06000	33.94228286	-118.0779517	Los Angeles County
326799	Ordering, Referring, Prescribing	N/A	1275618712	0	0	TRAN, CYNTHIA C PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57820	N/A	N/A	N/A	N/A	N/A	10990 SAN DIEGO MISSION	None	SAN DIEGO	CA	92108	2417	00	06000	32.7850186	-117.1023292	San Diego County
326805	Ordering, Referring, Prescribing	N/A	1275654709	0	0	TIECHE, JOHN L	5/8/2017	Taxonomy not applicable	NA	n/a	000	Unknown	11717	N/A	N/A	N/A	N/A	N/A	1451 E EL MONTE WY	None	DINUBA	CA	93618	1812	00	06000	36.54552557	-119.3797841	Tulare County
326810	Ordering, Referring, Prescribing	N/A	1275664815	0	0	THOMPSON-BOUDREAU, LISA LCSW	11/12/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS17300	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
326824	Ordering, Referring, Prescribing	N/A	1275672503	0	0	TIYAAMORNWONG, KEVIN PA-C	4/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	17984	N/A	N/A	N/A	N/A	N/A	344 E 6TH ST	None	MADERA	CA	93638	3631	00	06000	36.96288964	-120.0556279	Madera County
326905	Ordering, Referring, Prescribing	N/A	1275851784	0	0	TARKELA, JENNA M	6/15/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	754322	N/A	N/A	N/A	N/A	N/A	18111 NORDHOFF ST	None	NORTHRIDGE	CA	91330	0001	00	06000	34.239213	-118.527768	Los Angeles County
326920	Ordering, Referring, Prescribing	N/A	1275883530	0	0	TAYLOR, KAITLYN LCSW	8/10/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	109811	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
326951	Ordering, Referring, Prescribing	N/A	1275917833	0	0	TOMBO, CRISPIN LCSW	5/23/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28169	N/A	N/A	N/A	N/A	N/A	1301 PIERCE ST	None	SAN FRANCISCO	CA	94115	4005	00	06000	37.78238106	-122.4359186	San Francisco County
326975	Ordering, Referring, Prescribing	N/A	1275955189	0	0	TRAN, CHI V PHARMD	3/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	51855	N/A	N/A	N/A	N/A	N/A	21800 VICTORY BLVD	None	WOODLAND HILLS	CA	91367	2227	00	06000	34.18735254	-118.603418	Los Angeles County
326986	Ordering, Referring, Prescribing	N/A	1275972325	0	0	TIDWELL, TIMOTHY MD	9/22/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A155808	N/A	N/A	N/A	N/A	N/A	5920 WEST MALL	None	ATASCADERO	CA	93422	4232	00	06000	35.48946251	-120.6679881	San Luis Obispo County
326992	Ordering, Referring, Prescribing	N/A	1275984155	0	0	TORREST, AUDREY MD	2/27/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A194228	N/A	N/A	N/A	N/A	N/A	1000 WEST CARSON ST.	N26A	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
327071	Ordering, Referring, Prescribing	N/A	1285082297	0	0	TORRES, ROXANA S LMFT	12/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT123713	N/A	N/A	N/A	N/A	N/A	9310 SIERRA AVE	BLDG. B	FONTANA	CA	92335	5711	00	06000	34.084539	-117.4357355	San Bernardino County
327109	Ordering, Referring, Prescribing	N/A	1285141796	0	0	TORRES, LOURDES A LCSW	5/19/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW115358	N/A	N/A	N/A	N/A	N/A	2525 N CHESTER AVE	None	BAKERSFIELD	CA	93308	1770	00	06000	35.429463	-119.0213795	Kern County
327126	Ordering, Referring, Prescribing	N/A	1285174029	0	0	TAM, TIFFANIE PHARMD	7/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66407	N/A	N/A	N/A	N/A	N/A	4058 WILLOWS RD	None	ALPINE	CA	91901	1668	00	06000	32.836428	-116.7257385	San Diego County
327155	Ordering, Referring, Prescribing	N/A	1285224097	0	0	TAPIA, JENNIFER L NP	3/28/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024733	N/A	N/A	N/A	N/A	N/A	14390 PARK AVE	None	VICTORVILLE	CA	92392	2310	00	06000	34.512453	-117.324936	San Bernardino County
327156	Ordering, Referring, Prescribing	N/A	1285225391	0	0	TORRES, PATRICK JAMES P PHARMD	1/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	83703	N/A	N/A	N/A	N/A	N/A	120 UNIVERSITY AVE	None	SAN DIEGO	CA	92103	3007	00	06000	32.74828048	-117.1634535	San Diego County
327161	Ordering, Referring, Prescribing	N/A	1285230433	0	0	TRAN, TIN T OD	9/15/2020	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT34692	N/A	N/A	N/A	N/A	N/A	2109 HILLHURST AVE	None	LOS ANGELES	CA	90027	2003	00	06000	34.110297	-118.2874495	Los Angeles County
327165	Ordering, Referring, Prescribing	N/A	1285238048	0	0	TEJEDA, JULIA A	5/23/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015513	N/A	N/A	N/A	N/A	N/A	5525 E DEL AMO BLVD	None	LAKEWOOD	CA	90713	0000	00	06000	33.8471395	-118.1244195	Los Angeles County
327200	Ordering, Referring, Prescribing	N/A	1285297192	0	0	TRAN, CECILIA V RN CPNP	10/19/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012270	N/A	N/A	N/A	N/A	N/A	160 E VIRGINIA ST	ST 280	SAN JOSE	CA	95112	5865	00	06000	37.32582868	-121.8777868	Santa Clara County
327203	Ordering, Referring, Prescribing	N/A	1285313767	0	0	TAYAG, MA VERONICA F NP	9/22/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	FP95025604	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DR.	None	LOS ANGELES	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
327258	Ordering, Referring, Prescribing	N/A	1285686808	0	0	TAYLOR, KRISTA L CNP	1/10/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	8530	N/A	N/A	N/A	N/A	N/A	3710 HIGHWAY 45	None	COLUSA	CA	95932	0000	00	06000	39.25060345	-122.0314303	Colusa County
327323	Ordering, Referring, Prescribing	N/A	1285836965	0	0	TE, LENG P PHARMD	2/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH51005	N/A	N/A	N/A	N/A	N/A	19307 SATICOY ST	None	RESEDA	CA	91335	2330	00	06000	34.20838149	-118.5542325	Los Angeles County
327324	Ordering, Referring, Prescribing	N/A	1285829150	0	0	TUSCANO, MARLENE C MD	7/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A97196	N/A	N/A	N/A	N/A	N/A	202 N 8TH ST	None	EL CENTRO	CA	92243	2302	00	06000	32.794335	-115.5614775	Imperial County
327366	Ordering, Referring, Prescribing	N/A	1285920942	0	0	TSE, MICHAEL Y PHARMD	7/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62973	N/A	N/A	N/A	N/A	N/A	500 PARNASSUS AVE	J LEVEL, MU-145	SAN FRANCISCO	CA	94143	2203	00	06000	37.76351054	-122.4579681	San Francisco County
327397	Ordering, Referring, Prescribing	N/A	1285949511	0	0	TER-GRIGORYAN, ARMAN LMFT	7/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT120262	N/A	N/A	N/A	N/A	N/A	851 N OAKLAND AVE	None	PASADENA	CA	91104	4343	00	06000	34.16031813	-118.1403347	Los Angeles County
327445	Ordering, Referring, Prescribing	N/A	1295066801	0	0	TWOBI, CHRISTIAN L NP	2/19/2013	Taxonomy not applicable	NA	n/a	000	Unknown	RN0709641	N/A	N/A	N/A	N/A	N/A	21001 SHERMAN WAY	STE 9	CANOGA PARK	CA	91303	3683	00	06000	34.20113553	-118.5912126	Los Angeles County
327460	Ordering, Referring, Prescribing	N/A	1295101491	0	0	TIEDEMAN, CHRISTINA LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT107504	N/A	N/A	N/A	N/A	N/A	3200 CLAYTON RD	None	CONCORD	CA	94519	2819	00	06000	37.97283909	-122.0196497	Contra Costa County
327487	Ordering, Referring, Prescribing	N/A	1295145779	0	0	TORRECAMPO, JACQUELINE F LMFT	12/16/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108061	N/A	N/A	N/A	N/A	N/A	275 BECK AVE	None	FAIRFIELD	CA	94533	6804	00	06000	38.23532718	-122.0663968	Solano County
327510	Ordering, Referring, Prescribing	N/A	1295197200	0	0	TASHKANDI, PEYMAN DO	2/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16618	N/A	N/A	N/A	N/A	N/A	3250 WILSHIRE BLVD	500	LOS ANGELES	CA	90010	1577	00	06000	34.06176363	-118.2932622	Los Angeles County
327557	Ordering, Referring, Prescribing	N/A	1295256006	0	0	THARA, SAAD MD	7/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163382	N/A	N/A	N/A	N/A	N/A	17871 PARK PLAZA DR	140	CERRITOS	CA	90703	8576	00	06000	33.8692694	-118.0629284	Los Angeles County
327591	Ordering, Referring, Prescribing	N/A	1295314458	0	0	TABARRACCI, AMANDA PA-C	6/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59686	N/A	N/A	N/A	N/A	N/A	9995 CARMEL MOUNTAIN RD	None	SAN DIEGO	CA	92129	2889	00	06000	32.96073738	-117.1119913	San Diego County
327646	Ordering, Referring, Prescribing	N/A	1295493856	0	0	THAI-HANG, KIMBERLY PHARMD	8/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH84510	N/A	N/A	N/A	N/A	N/A	600 S BROADWAY	None	WALNUT CREEK	CA	94596	6703	00	06000	37.89749614	-122.057329	Contra Costa County
327650	Ordering, Referring, Prescribing	N/A	1295519239	0	0	TATRO, ANNA MARIE NP	8/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026651	N/A	N/A	N/A	N/A	N/A	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	00	06000	33.746805	-117.834147	Orange County
327678	Ordering, Referring, Prescribing	N/A	1295765139	0	0	TIGHE, ELIZABETH A	4/4/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0496361	N/A	N/A	N/A	N/A	N/A	1250 16TH ST	STE A425	SANTA MONICA	CA	90404	1200	00	06000	34.02749142	-118.486063	Los Angeles County
327743	Ordering, Referring, Prescribing	N/A	1295928067	0	0	TETENS, DAVORA LMFT	10/15/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52721	N/A	N/A	N/A	N/A	N/A	536 S. MAIN ST.	None	SEBASTOPOL	CA	95472	4261	00	06000	38.39762306	-122.8218051	Sonoma County
327774	Ordering, Referring, Prescribing	N/A	1306002951	0	0	TAGLIAMONTE, SOPHIE PSYD	3/16/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY28171	N/A	N/A	N/A	N/A	N/A	391 TAYLOR BLVD	STE 100	PLEASANT HILL	CA	94523	2289	00	06000	37.96119614	-122.070409	Contra Costa County
327783	Ordering, Referring, Prescribing	N/A	1306008594	0	0	TAM-JOHNSTON, JENNIFER Y	6/26/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D63412	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
327806	Ordering, Referring, Prescribing	N/A	1306084926	0	0	TON, PHONG T PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	51628	N/A	N/A	N/A	N/A	N/A	17284 SLOVER AVE	204	FONTANA	CA	92337	7584	00	06000	34.065396	-117.4277475	San Bernardino County
327834	Ordering, Referring, Prescribing	N/A	1306128681	0	0	TREJO, SERGIO M LMFT	4/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT97196	N/A	N/A	N/A	N/A	N/A	727 SHASTA STREET	None	REDWOOD CITY	CA	94063	2124	00	06000	37.47945362	-122.2230493	San Mateo County
327839	Ordering, Referring, Prescribing	N/A	1306132444	0	0	TORRES, LARA M PA-C	5/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	53811	N/A	N/A	N/A	N/A	N/A	1510 N. LAFAYETTE AVE	None	FRESNO	CA	93728	1123	00	06000	36.763731	-119.837761	Fresno County
327858	Ordering, Referring, Prescribing	N/A	1306156815	0	0	TINOCO, SONYA	5/10/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT99189	N/A	N/A	N/A	N/A	N/A	200 N LA CUMBRE RD	STE H	SANTA BARBARA	CA	93110	1577	00	06000	34.44255908	-119.7510269	Santa Barbara County
327861	Ordering, Referring, Prescribing	N/A	1306159686	0	0	TRUJILLO, RAMIRO A LCSW	4/1/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100900	N/A	N/A	N/A	N/A	N/A	17707 STUDEBAKER DR, AIK	None	CERRITOS	CA	90703	6172	00	06000	33.87008991	-118.0991298	Los Angeles County
327866	Ordering, Referring, Prescribing	N/A	1306174453	0	0	THERNELL, KATRINA L LCSW	3/31/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW90754	N/A	N/A	N/A	N/A	N/A	2259 MYRTLE AVE	None	EUREKA	CA	95501	3325	00	06000	40.78657625	-124.1320429	Humboldt County
327898	Ordering, Referring, Prescribing	N/A	1306222898	0	0	TATE, APRIL LMFT	1/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT116982	N/A	N/A	N/A	N/A	N/A	1965 LIVE OAK BLVD	None	YUBA CITY	CA	95991	8850	00	06000	39.15563037	-121.620091	Sutter County
327923	Ordering, Referring, Prescribing	N/A	1306259080	0	0	TAM, STELLA DMD	6/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	64282	N/A	N/A	N/A	N/A	N/A	12586 AVENUE 408	None	OROSI	CA	93647	9454	00	06000	36.53030229	-119.2915122	Tulare County
327928	Ordering, Referring, Prescribing	N/A	1306261797	0	0	TULI, RAHUL PHARMD	7/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69634	N/A	N/A	N/A	N/A	N/A	988 SIERRA ST	None	KINGSBURG	CA	93631	1554	00	06000	36.51781851	-119.5567515	Fresno County
327948	Ordering, Referring, Prescribing	N/A	1306306204	0	0	TAM, JOLINDA OD	9/15/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34258	N/A	N/A	N/A	N/A	N/A	44651 VILLAGE CT.,	SUITE 102	PALM DESERT	CA	92260	3821	00	06000	33.724692	-116.361236	Riverside County
328001	Ordering, Referring, Prescribing	N/A	1306408034	0	0	TUTERYAN, MARY PA-C	10/29/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA57131	N/A	N/A	N/A	N/A	N/A	3160 E DEL MAR BLVD	100	PASADENA	CA	91107	4601	00	06000	34.14217551	-118.085292	Los Angeles County
328068	Ordering, Referring, Prescribing	N/A	1306565700	0	0	TIBBITS, NICOLE PSYD	8/14/2024	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY35256	N/A	N/A	N/A	N/A	N/A	18350 MOUNT LANGLEY ST	220	FOUNTAIN VALLEY	CA	92708	6900	00	06000	33.69633523	-117.9420534	Orange County
328113	Ordering, Referring, Prescribing	N/A	1306912985	0	0	TRAN, ANH N PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH48262	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
328157	Ordering, Referring, Prescribing	N/A	1316004914	0	0	THAYER, LESLIE PHD	6/22/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY27726	N/A	N/A	N/A	N/A	N/A	1250 MORENA BLVD	None	SAN DIEGO	CA	92110	3815	00	06000	32.76963745	-117.2036361	San Diego County
328159	Ordering, Referring, Prescribing	N/A	1316009285	0	0	TORO, ELIZABETH MD	9/21/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G57660	N/A	N/A	N/A	N/A	N/A	628 MICHELTORENA ST	None	SANTA BARBARA	CA	93101	4131	00	06000	34.41910081	-119.7158618	Santa Barbara County
328189	Ordering, Referring, Prescribing	N/A	1316062672	0	0	TORRES, CYNTHIA P LMFT	6/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42526	N/A	N/A	N/A	N/A	N/A	2200 OUTLET CENTER DR	SUITE 430	OXNARD	CA	93036	0611	00	06000	34.22164581	-119.1483723	Ventura County
328208	Ordering, Referring, Prescribing	N/A	1316102544	0	0	TAHIR, OMAR Z MD	7/8/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C180326	N/A	N/A	N/A	N/A	N/A	15095 AMARGOSA RD	None	VICTORVILLE	CA	92394	1879	00	06000	34.52479785	-117.3303132	San Bernardino County
328215	Ordering, Referring, Prescribing	N/A	1316134067	0	0	TAILOR, REKHA MD	6/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A100441	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR.	STE. 210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
328232	Ordering, Referring, Prescribing	N/A	1316174162	0	0	TORRES, JOSE A	1/7/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D57562	N/A	N/A	N/A	N/A	N/A	476 E WASHINGTON AVE	None	EARLIMART	CA	93219	0000	00	06000	35.88434376	-119.2716517	Tulare County
328261	Ordering, Referring, Prescribing	N/A	1316226111	0	0	TRAN, ADELAIDA MSW LCSW	11/6/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	70111	N/A	N/A	N/A	N/A	N/A	123 W MANCHESTER BLVD	None	INGLEWOOD	CA	90301	1753	00	06000	33.96180447	-118.3565745	Los Angeles County
328271	Ordering, Referring, Prescribing	N/A	1316239114	0	0	TSENTER, MICHAEL LMFT	11/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110028	N/A	N/A	N/A	N/A	N/A	2050 FAIRMONT DR	None	SAN LEANDRO	CA	94578	1001	00	06000	37.710738	-122.1146415	Alameda County
328281	Ordering, Referring, Prescribing	N/A	1316252950	0	0	TRAN, LYNDA DDS	3/6/2024	Taxonomy not applicable	NA	n/a	000	Unknown	DDS59477	N/A	N/A	N/A	N/A	N/A	1830 COMMERCIAL WAY	None	SANTA CRUZ	CA	95065	1819	00	06000	36.98837145	-121.9802206	Santa Cruz County
328316	Ordering, Referring, Prescribing	N/A	1316319320	0	0	TRAN, HELEN P	7/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH73730	N/A	N/A	N/A	N/A	N/A	3507 CANNON RD	None	OCEANSIDE	CA	92056	4977	00	06000	33.17113905	-117.2546316	San Diego County
328368	Ordering, Referring, Prescribing	N/A	1316373152	0	0	TUCKER, JASMINE ANNE	10/15/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0788749	N/A	N/A	N/A	N/A	N/A	11722 S WILMINGTON AVE	None	LOS ANGELES	CA	90059	2543	00	06000	33.9267675	-118.2390104	Los Angeles County
328380	Ordering, Referring, Prescribing	N/A	1316409071	0	0	TANNOUS, ZACHARY	11/19/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	34012	N/A	N/A	N/A	N/A	N/A	4212 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6269	00	06000	38.706228	-120.834891	El Dorado County
328402	Ordering, Referring, Prescribing	N/A	1316442742	0	0	TAMRAZIAN, ANIKA OD	3/4/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34206TLG	N/A	N/A	N/A	N/A	N/A	330 NO. BRAND BLVD.	110	GLENDALE	CA	91203	2308	00	06000	34.15116156	-118.2549512	Los Angeles County
328449	Ordering, Referring, Prescribing	N/A	1316503659	0	0	TRAN, THOMAS PHARMD	6/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH80240	N/A	N/A	N/A	N/A	N/A	217 ALMA ST	SUITE 200	PALO ALTO	CA	94301	0000	00	06000	37.44563438	-122.1673764	Santa Clara County
328480	Ordering, Referring, Prescribing	N/A	1316556152	0	0	TAYLOR, MORGAN V LMFT	6/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT133368	N/A	N/A	N/A	N/A	N/A	208 PROVIDENCE MINE RD	STE 122	NEVADA CITY	CA	95959	2955	00	06000	39.25021269	-121.0300958	Nevada County
328487	Ordering, Referring, Prescribing	N/A	1316583925	0	0	TOLOZA IBARRA, KAREN L LCSW	1/14/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113164	N/A	N/A	N/A	N/A	N/A	1161 BAY BLVD	None	CHULA VISTA	CA	91911	2670	00	06000	32.6050811	-117.0922508	San Diego County
328501	Ordering, Referring, Prescribing	N/A	1316599459	0	0	TAMAYO, DANNA MELISS M	3/11/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	103965	N/A	N/A	N/A	N/A	N/A	1101 N CHERRY ST	None	TULARE	CA	93274	2231	00	06000	36.22333808	-119.337575	Tulare County
328511	Ordering, Referring, Prescribing	N/A	1316617319	0	0	TOPPENBERG, KELLY OT	4/4/2022	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	23530	N/A	N/A	N/A	N/A	N/A	1108 S EL CAMINO REAL	None	SAN MATEO	CA	94402	2804	00	06000	37.55635875	-122.3187345	San Mateo County
328540	Ordering, Referring, Prescribing	N/A	1316909906	0	0	TESKE, MILTON MD	11/10/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G52038	N/A	N/A	N/A	N/A	N/A	330 CAMPUS DRIVE	None	HANFORD	CA	93230	8823	00	06000	36.32674062	-119.6636908	Kings County
328543	Ordering, Referring, Prescribing	N/A	1316950926	0	0	TA, MIKHAI C	10/17/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	102306	N/A	N/A	N/A	N/A	N/A	5734 CANYON VIEW DR	None	PARADISE	CA	95969	5503	00	06000	39.75648234	-121.5692459	Butte County
328556	Ordering, Referring, Prescribing	N/A	1316992951	0	0	THOMPSON, KIRK CRNA	6/12/2023	Taxonomy not applicable	NA	n/a	018	NURSE ANESTHETISTS	3046	N/A	N/A	N/A	N/A	N/A	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43816059	-120.6279677	Lassen County
328576	Ordering, Referring, Prescribing	N/A	1326085713	0	0	THOMPSON, SANDRA A MD	12/16/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G156943	N/A	N/A	N/A	N/A	N/A	4033 3RD AVE	SUITE 200	SAN DIEGO	CA	92103	2117	00	06000	32.75053781	-117.1627168	San Diego County
328593	Ordering, Referring, Prescribing	N/A	1326117763	0	0	TSURUDOME, TIFFANY L	1/31/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D46866	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
328608	Ordering, Referring, Prescribing	N/A	1326161001	0	0	TUCHOLSKA, MARGARET MD	6/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A50241	N/A	N/A	N/A	N/A	N/A	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	00	06000	36.696987	-121.633164	Monterey County
328627	Ordering, Referring, Prescribing	N/A	1326172966	0	0	TERRAZAS, PAUL LCSW	6/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82674	N/A	N/A	N/A	N/A	N/A	850 EAST FOOTHILL BLVD.	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
328634	Ordering, Referring, Prescribing	N/A	1326183641	0	0	TANG, JESSICA Y LMFT	6/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48377	N/A	N/A	N/A	N/A	N/A	6203 SAN IGNACIO AVE	150	SAN JOSE	CA	95119	1371	00	06000	37.23598537	-121.7783065	Santa Clara County
328676	Ordering, Referring, Prescribing	N/A	1326283557	0	0	TIMMONS, TAMEIKA LCSW	3/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW74176	N/A	N/A	N/A	N/A	N/A	1 HOPE DR	None	TUSTIN	CA	92782	0221	00	06000	33.71470753	-117.8323965	Orange County
328677	Ordering, Referring, Prescribing	N/A	1326284522	0	0	TAM, STACY D PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61223	N/A	N/A	N/A	N/A	N/A	1515 N VERMONT AVE	None	LOS ANGELES	CA	90027	5337	00	06000	34.09851639	-118.2918012	Los Angeles County
328690	Ordering, Referring, Prescribing	N/A	1326300302	0	0	TSANG, STEPHANIE OD	3/1/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	14403	N/A	N/A	N/A	N/A	N/A	3251 20TH AVE	STE 231	SAN FRANCISCO	CA	94132	1900	00	06000	37.72750871	-122.4760234	San Francisco County
328713	Ordering, Referring, Prescribing	N/A	1326320466	0	0	TRUONG, ROSE T	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	45007	N/A	N/A	N/A	N/A	N/A	25 POINT LOBOS AVE	None	SAN FRANCISCO	CA	94121	2447	00	06000	37.77965192	-122.503515	San Francisco County
328715	Ordering, Referring, Prescribing	N/A	1326321183	0	0	TRAN, BAO-CHAU H PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62488	N/A	N/A	N/A	N/A	N/A	1919 FRUITRIDGE RD	None	SACRAMENTO	CA	95822	3114	00	06000	38.525283	-121.4959365	Sacramento County
328719	Ordering, Referring, Prescribing	N/A	1326321746	0	0	TRAN, THAO B PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55224	N/A	N/A	N/A	N/A	N/A	1399 W SAN CARLOS ST	None	SAN JOSE	CA	95126	3446	00	06000	37.32360523	-121.9134307	Santa Clara County
328781	Ordering, Referring, Prescribing	N/A	1326420365	0	0	TRINH, CATHERINE G PHARMD	3/28/2018	Taxonomy not applicable	NA	n/a	000	Unknown	53793	N/A	N/A	N/A	N/A	N/A	13270 NEWPORT AVE	None	TUSTIN	CA	92780	3410	00	06000	33.74605628	-117.8139923	Orange County
328806	Ordering, Referring, Prescribing	N/A	1326453119	0	0	THOMAS, ZACHARY S MD	2/26/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145023	N/A	N/A	N/A	N/A	N/A	5454 EL CAJON BLVD	None	SAN DIEGO	CA	92115	3621	00	06000	32.75809043	-117.0778038	San Diego County
328813	Ordering, Referring, Prescribing	N/A	1326464223	0	0	THEBERT, TAMARA LMFT	5/29/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53456	N/A	N/A	N/A	N/A	N/A	490 LAKE PARK AVE	#10554	OAKLAND	CA	94610	8099	00	06000	37.81073404	-122.2473414	Alameda County
328823	Ordering, Referring, Prescribing	N/A	1326465436	0	0	TARIQ, MUSADDIQ	4/2/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A175534	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
328831	Ordering, Referring, Prescribing	N/A	1326484437	0	0	TROYER, EMILY A MD	6/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A149101	N/A	N/A	N/A	N/A	N/A	4065 3RD AVE	None	SAN DIEGO	CA	92103	2184	00	06000	32.75123948	-117.1627318	San Diego County
328883	Ordering, Referring, Prescribing	N/A	1326588583	0	0	TAN, COLLEEN PA	4/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62581	N/A	N/A	N/A	N/A	N/A	916 W BURBANK BLVD	M	BURBANK	CA	91506	1400	00	06000	34.18397121	-118.3225966	Los Angeles County
328938	Ordering, Referring, Prescribing	N/A	1326694480	0	0	TRAMMELL, JASMINE LMFT	7/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121024	N/A	N/A	N/A	N/A	N/A	10170 HUENNEKENS ST	None	SAN DIEGO	CA	92121	2964	00	06000	32.90291536	-117.1839303	San Diego County
328943	Ordering, Referring, Prescribing	N/A	1326695107	0	0	TOVAR, ANDREA M LMFT	6/28/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140213	N/A	N/A	N/A	N/A	N/A	301 E 13TH ST	None	MERCED	CA	95341	6214	00	06000	37.29248035	-120.4730619	Merced County
328947	Ordering, Referring, Prescribing	N/A	1326703240	0	0	TRAN, GINA PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84249	N/A	N/A	N/A	N/A	N/A	25533 MARGUERITE PKWY	None	MISSION VIEJO	CA	92691	1777	00	06000	33.59203067	-117.6600186	Orange County
328952	Ordering, Referring, Prescribing	N/A	1326712076	0	0	TAYLOR, SARAH LCSW	2/26/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW121221	N/A	N/A	N/A	N/A	N/A	301 E 13TH STREET	None	MERCED	CA	95341	6214	00	06000	37.29248035	-120.4730619	Merced County
328969	Ordering, Referring, Prescribing	N/A	1326771551	0	0	TA, QUANG D PHARMD	6/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86191	N/A	N/A	N/A	N/A	N/A	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	00	06000	37.89189148	-122.057999	Contra Costa County
328973	Ordering, Referring, Prescribing	N/A	1326791765	0	0	TRINH, SHANNON LMFT	3/1/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	145470	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	300	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
329007	Ordering, Referring, Prescribing	N/A	1336227065	0	0	TOY, CYNTHIA J PHARMD	4/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH47303	N/A	N/A	N/A	N/A	N/A	3460 E LA PALMA AVE	None	ANAHEIM	CA	92806	2020	00	06000	33.85429451	-117.8446551	Orange County
329008	Ordering, Referring, Prescribing	N/A	1336220151	0	0	TRAN, THUY T LCSW	11/23/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76921	N/A	N/A	N/A	N/A	N/A	4510 E PACIFIC COAST HWY	600	LONG BEACH	CA	90804	3279	00	06000	33.78815204	-118.1400821	Los Angeles County
329026	Ordering, Referring, Prescribing	N/A	1336263862	0	0	TORRES, MONICA LCSW	5/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27296	N/A	N/A	N/A	N/A	N/A	125 W THOUSAND OAKS BLVD	600	THOUSAND OAKS	CA	91360	4402	00	06000	34.17854676	-118.8805015	Ventura County
329029	Ordering, Referring, Prescribing	N/A	1336270198	0	0	TURNER-MUHAMMAD, FELICIA L PA	9/24/2019	Taxonomy not applicable	NA	n/a	000	Unknown	15773	N/A	N/A	N/A	N/A	N/A	1550 SUPERIOR AVE	None	COSTA MESA	CA	92627	3653	00	06000	33.63305341	-117.9266303	Orange County
329088	Ordering, Referring, Prescribing	N/A	1336372531	0	0	TRAN, TIFFANI LCSW	11/17/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29492	N/A	N/A	N/A	N/A	N/A	760 MOUNTAIN VIEW ST	None	ALTADENA	CA	91001	4925	00	06000	34.19178664	-118.1657029	Los Angeles County
329162	Ordering, Referring, Prescribing	N/A	1336506203	0	0	TA, NGA T PHARMD	3/18/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH48406	N/A	N/A	N/A	N/A	N/A	671 RANCHO SANTA FE RD	None	SAN MARCOS	CA	92078	3645	00	06000	33.13300154	-117.2071291	San Diego County
329178	Ordering, Referring, Prescribing	N/A	1336531193	0	0	TA, SYLVIA PHARMD	7/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50924	N/A	N/A	N/A	N/A	N/A	2531 CHESTER AVE	None	BAKERSFIELD	CA	93301	2012	00	06000	35.382582	-119.0188955	Kern County
329180	Ordering, Referring, Prescribing	N/A	1336534106	0	0	TROGGIO, TOREY MD	11/3/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A144731	N/A	N/A	N/A	N/A	N/A	3751 STOCKER ST.	None	LOS ANGELES	CA	90008	4800	00	06000	34.00616017	-118.3385751	Los Angeles County
329182	Ordering, Referring, Prescribing	N/A	1336526649	0	0	TOTH, RYAN LMFT	5/12/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT104478	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
329186	Ordering, Referring, Prescribing	N/A	1336536960	0	0	TUBAT, ERIC NP	6/28/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010580	N/A	N/A	N/A	N/A	N/A	280 17TH ST	None	OAKLAND	CA	94612	4124	00	06000	37.80524764	-122.2655975	Alameda County
329187	Ordering, Referring, Prescribing	N/A	1336537869	0	0	TRAN, TRUNG A PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	63577	N/A	N/A	N/A	N/A	N/A	4067 PERALTA BLVD, FREMO	None	FREMONT	CA	94536	4849	00	06000	37.55736284	-122.0074555	Alameda County
329207	Ordering, Referring, Prescribing	N/A	1336568716	0	0	THOMAS, LEXIE LMFT	9/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121935	N/A	N/A	N/A	N/A	N/A	5325 BRODER BLVD	None	DUBLIN	CA	94568	3309	00	06000	37.71593563	-121.8841457	Alameda County
329213	Ordering, Referring, Prescribing	N/A	1336573484	0	0	TRASK, LAUREN A LCSW	4/23/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74470	N/A	N/A	N/A	N/A	N/A	18880 CHERRY VALLEY BLVD	None	TUOLUMNE	CA	95379	9506	00	06000	37.96511668	-120.2399015	Tuolumne County
329274	Ordering, Referring, Prescribing	N/A	1336662261	0	0	TURANO, BIANCA E LMFT	12/30/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152330	N/A	N/A	N/A	N/A	N/A	840 N AVENUE 66	None	LOS ANGELES	CA	90042	9998	00	06000	34.12110842	-118.1725545	Los Angeles County
329277	Ordering, Referring, Prescribing	N/A	1336670629	0	0	TIMTIM, SARA H MD	3/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A162218	N/A	N/A	N/A	N/A	N/A	3100 PONTE MORINO DR	STE 120	CAMERON PARK	CA	95682	7432	00	06000	38.66252014	-120.9672091	El Dorado County
329296	Ordering, Referring, Prescribing	N/A	1336701002	0	0	TRAN, KEVIN PHARMD	3/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78741	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	DEPT 362	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
329330	Ordering, Referring, Prescribing	N/A	1336778182	0	0	TRINH, CHRISTINE	4/5/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL5436	N/A	N/A	N/A	N/A	N/A	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
329361	Ordering, Referring, Prescribing	N/A	1336890383	0	0	THINDA, ANU PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71682	N/A	N/A	N/A	N/A	N/A	3900 FREEDOM CIR	201	SANTA CLARA	CA	95054	1222	00	06000	37.38769057	-121.9700955	Santa Clara County
329370	Ordering, Referring, Prescribing	N/A	1336971415	0	0	TISSIER, ELIZABETH F NP	5/3/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030021	N/A	N/A	N/A	N/A	N/A	2425 ALHAMBRA BLVD	None	SACRAMENTO	CA	95817	1110	00	06000	38.55627	-121.471875	Sacramento County
329405	Ordering, Referring, Prescribing	N/A	1346275831	0	0	TANG, JENNIFER	1/9/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C160379	N/A	N/A	N/A	N/A	N/A	23413 LYONS AVE	None	SANTA CLARITA	CA	91355	3028	00	06000	34.37974287	-118.5428596	Los Angeles County
329407	Ordering, Referring, Prescribing	N/A	1346280401	0	0	THOMAS, FREDERICK N MD	1/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	G40388	N/A	N/A	N/A	N/A	N/A	2707 S CENTRAL AVE	None	LOS ANGELES	CA	90011	1440	00	06000	34.01754879	-118.2555246	Los Angeles County
329426	Ordering, Referring, Prescribing	N/A	1346337268	0	0	TUCKER, GEORGE H PHD	3/25/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY6783	N/A	N/A	N/A	N/A	N/A	744 N ECKHOFF ST	None	ORANGE	CA	92868	0000	00	06000	33.79926816	-117.8740474	Orange County
329440	Ordering, Referring, Prescribing	N/A	1346373974	0	0	TSENG-BROWN, YU TSUN LMFT	10/26/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	218002	N/A	N/A	N/A	N/A	N/A	6931 VAN NUYS BLVD	102	VAN NUYS	CA	91405	3980	00	06000	34.19649	-118.448787	Los Angeles County
329449	Ordering, Referring, Prescribing	N/A	1346381936	0	0	THURBER, DEBORAH L MD	6/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C52126	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	STE 210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
329488	Ordering, Referring, Prescribing	N/A	1346445418	0	0	TERRONES, JOAHANNA H LCSW	5/31/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108279	N/A	N/A	N/A	N/A	N/A	593 W 6TH ST	None	SAN PEDRO	CA	90731	2521	00	06000	33.73875253	-118.2899475	Los Angeles County
329500	Ordering, Referring, Prescribing	N/A	1346463239	0	0	TOUTANT, LOUISE E NP	5/24/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	11111	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
329518	Ordering, Referring, Prescribing	N/A	1346522000	0	0	TRAN, TUAN Q PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH 61704	N/A	N/A	N/A	N/A	N/A	831 EAST AVE K	None	LANCASTER	CA	93535	3535	00	06000	34.67502951	-118.1131425	Los Angeles County
329528	Ordering, Referring, Prescribing	N/A	1346524626	0	0	THANAWIWAT, OLIVIA	7/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65865	N/A	N/A	N/A	N/A	N/A	1745 UNIVERSITY AVE	None	RIVERSIDE	CA	92507	6001	00	06000	33.97576049	-117.349551	Riverside County
329559	Ordering, Referring, Prescribing	N/A	1346575362	0	0	TAVARES-KUHN, NICOLE PHARMD	10/4/2020	Taxonomy not applicable	NA	n/a	000	Unknown	62563	N/A	N/A	N/A	N/A	N/A	1530 S OLIVE ST	None	LOS ANGELES	CA	90015	3023	00	06000	34.03542552	-118.2652073	Los Angeles County
329583	Ordering, Referring, Prescribing	N/A	1346617651	0	0	TOM, KEVIN G	10/9/2018	Taxonomy not applicable	NA	n/a	000	Unknown	72921	N/A	N/A	N/A	N/A	N/A	2300 MENDOCINO AVE	None	SANTA ROSA	CA	95403	3115	00	06000	38.463345	-122.7173355	Sonoma County
329593	Ordering, Referring, Prescribing	N/A	1346629755	0	0	TUCKER, KEVIN R DO	5/13/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17234	N/A	N/A	N/A	N/A	N/A	18 COUNTY CENTER DR	None	OROVILLE	CA	95965	3335	00	06000	39.52683587	-121.5716851	Butte County
329615	Ordering, Referring, Prescribing	N/A	1346664547	0	0	TRAN, TUAN PHARMD	10/16/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54606	N/A	N/A	N/A	N/A	N/A	1546 N MAIN ST	None	SALINAS	CA	93906	5101	00	06000	36.71242425	-121.6543238	Monterey County
329628	Ordering, Referring, Prescribing	N/A	1346687571	0	0	TROMELLO, KATHERINE E LMFT	6/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT89588	N/A	N/A	N/A	N/A	N/A	169 SAXONY RD	STE 111	ENCINITAS	CA	92024	6779	00	06000	33.050331	-117.285654	San Diego County
329629	Ordering, Referring, Prescribing	N/A	1346692027	0	0	TAMAYO, ALEJANDRO M PA-C	10/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	53500	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
329638	Ordering, Referring, Prescribing	N/A	1346709185	0	0	TATUM, JASMINE MD	6/24/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A179843	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
329659	Ordering, Referring, Prescribing	N/A	1346734134	0	0	TANG, YUE LAC	4/13/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	18026	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
329688	Ordering, Referring, Prescribing	N/A	1346776861	0	0	TRAN, UYEN PHARMD	1/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70086	N/A	N/A	N/A	N/A	N/A	620 DENNERY RD	None	SAN DIEGO	CA	92154	8402	00	06000	32.583033	-117.034668	San Diego County
329769	Ordering, Referring, Prescribing	N/A	1346974011	0	0	THI, DANICA PA-C	7/31/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA64881	N/A	N/A	N/A	N/A	N/A	570 S MT. VERNON AVENUE	#G	SAN BERNARDINO	CA	92410	2737	00	06000	34.090776	-117.3138565	San Bernardino County
329798	Ordering, Referring, Prescribing	N/A	1356099410	0	0	TASHIRO, CINDY T MD	9/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	109377	N/A	N/A	N/A	N/A	N/A	164 KINMAN AVENUE	None	GOLETA	CA	93117	0000	00	06000	34.436277	-119.8222815	Santa Barbara County
329839	Ordering, Referring, Prescribing	N/A	1356418214	0	0	TUSO, PHILIP	3/4/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A44326	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
329843	Ordering, Referring, Prescribing	N/A	1356421523	0	0	TORRES, ROSA LCSW	12/3/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW25491	N/A	N/A	N/A	N/A	N/A	215 E AVENIDA DE LA MERC	ROOM 108	MONTEBELLO	CA	90640	2752	00	06000	34.02362048	-118.0947432	Los Angeles County
329907	Ordering, Referring, Prescribing	N/A	1356573935	0	0	TREDINNICK, SILVANA T	9/2/2009	Taxonomy not applicable	NA	n/a	099	DENTIST	D58530	N/A	N/A	N/A	N/A	N/A	2219 E 1ST ST	None	LOS ANGELES	CA	90033	3901	00	06000	34.04452444	-118.2114844	Los Angeles County
329925	Ordering, Referring, Prescribing	N/A	1356619886	0	0	TADEO, DIANE KARLA U LMFT	4/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT103859	N/A	N/A	N/A	N/A	N/A	640 S. MAIN STREET	None	LOS ANGELES	CA	90014	2004	00	06000	34.04437875	-118.2508159	Los Angeles County
329927	Ordering, Referring, Prescribing	N/A	1356620736	0	0	TIRADO, DIANE D LMFT	11/23/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115473	N/A	N/A	N/A	N/A	N/A	1200 NORTH STATE STREET	1016	LOS ANGELES	CA	90033	1001	00	06000	34.05855992	-118.209755	Los Angeles County
329949	Ordering, Referring, Prescribing	N/A	1356653331	0	0	TRINH, HA B PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	63742	N/A	N/A	N/A	N/A	N/A	3637 CLARINGTON AVE	208	LOS ANGELES	CA	90034	8100	00	06000	34.02607275	-118.4031784	Los Angeles County
329950	Ordering, Referring, Prescribing	N/A	1356648265	0	0	TROUT, JULIANN PHARMD	3/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	43628	N/A	N/A	N/A	N/A	N/A	220 SYLVANIA AVE	None	SANTA CRUZ	CA	95060	2161	00	06000	36.98521615	-122.0347765	Santa Cruz County
330059	Ordering, Referring, Prescribing	N/A	1356805212	0	0	TRAN, JASON PHARMD	7/8/2019	Taxonomy not applicable	NA	n/a	000	Unknown	79212	N/A	N/A	N/A	N/A	N/A	2090 HARBISON DR	None	VACAVILLE	CA	95687	3902	00	06000	38.36230294	-121.9634742	Solano County
330130	Ordering, Referring, Prescribing	N/A	1356950430	0	0	TO, YICK CHUN BERNARD LMFT	12/16/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136559	N/A	N/A	N/A	N/A	N/A	11800 CENTRAL AVE	225	CHINO	CA	91710	7200	00	06000	34.0388092	-117.689654	San Bernardino County
330137	Ordering, Referring, Prescribing	N/A	1356965792	0	0	TRINH, HENRY N PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81767	N/A	N/A	N/A	N/A	N/A	5695 ALTON PKWY	None	IRVINE	CA	92618	4059	00	06000	33.66846665	-117.786127	Orange County
330162	Ordering, Referring, Prescribing	N/A	1366009847	0	0	TWEED, ASHLEY REBEKAH	8/22/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88743	N/A	N/A	N/A	N/A	N/A	1625 N SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
330163	Ordering, Referring, Prescribing	N/A	1366019333	0	0	THAI, CATHY PHARMD	10/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81158	N/A	N/A	N/A	N/A	N/A	2331 MONTPELIER DR.	STE A-10	SAN JOSE	CA	95116	1614	00	06000	37.3649965	-121.8479359	Santa Clara County
330177	Ordering, Referring, Prescribing	N/A	1366054355	0	0	TRANG, JULIE RDH	6/11/2023	Taxonomy not applicable	NA	n/a	000	Unknown	26027	N/A	N/A	N/A	N/A	N/A	50100 GOLSH ROAD	None	VALLEY CENTER	CA	92082	5338	00	06000	33.27715948	-116.9618201	San Diego County
330187	Ordering, Referring, Prescribing	N/A	1366071169	0	0	TU, DARLENE E MD	3/13/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176754	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVE	None	LOS ANGELES	CA	90001	3409	00	06000	33.9664185	-118.2477481	Los Angeles County
330212	Ordering, Referring, Prescribing	N/A	1366104960	0	0	TRAN, CHRIS OD	10/11/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35049	N/A	N/A	N/A	N/A	N/A	2581 CHINO HILLS PKWY	STE C	CHINO HILLS	CA	91709	5117	00	06000	33.98493569	-117.7477262	San Bernardino County
330220	Ordering, Referring, Prescribing	N/A	1366175812	0	0	THIELEN, SCOTT LMFT	12/26/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	143945	N/A	N/A	N/A	N/A	N/A	226 W OJAI AVE	SUITE 101-180	OJAI	CA	93023	3277	00	06000	34.44760276	-119.2488095	Ventura County
330225	Ordering, Referring, Prescribing	N/A	1366184756	0	0	TRAN, CALVIN MD	9/6/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A190136	N/A	N/A	N/A	N/A	N/A	2130 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1337	00	06000	38.557593	-121.4616735	Sacramento County
330249	Ordering, Referring, Prescribing	N/A	1366445157	0	0	TYNDALL, KATHLEEN PA-C	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	12152	N/A	N/A	N/A	N/A	N/A	45104 10TH STREET WEST	None	LANCASTER	CA	93534	2310	00	06000	34.702929	-118.1480935	Los Angeles County
330266	Ordering, Referring, Prescribing	N/A	1366522831	0	0	TURNER, TERRI L DO	11/22/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A6479	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
330272	Ordering, Referring, Prescribing	N/A	1366530339	0	0	TRENADO, ANGELA LCSW	3/31/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27192	N/A	N/A	N/A	N/A	N/A	17707 STUDEBAKER RD.	None	CERRITOS	CA	90703	2640	00	06000	33.87008991	-118.0991298	Los Angeles County
330320	Ordering, Referring, Prescribing	N/A	1366642068	0	0	TRAN, MICHELLE M LCSW	4/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW81278	N/A	N/A	N/A	N/A	N/A	1212 N CALIFORNIA ST	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
330329	Ordering, Referring, Prescribing	N/A	1366671034	0	0	TRAN, SHARON Q PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59630	N/A	N/A	N/A	N/A	N/A	1800 HARRISON ST	None	OAKLAND	CA	94612	3466	00	06000	37.80593773	-122.2656714	Alameda County
330330	Ordering, Referring, Prescribing	N/A	1366675431	0	0	TORUNO, GABRIELA A LMFT	10/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT96700	N/A	N/A	N/A	N/A	N/A	205 PACIFICA AVE	None	BAY POINT	CA	94565	2904	00	06000	38.0339697	-121.9654883	Contra Costa County
330344	Ordering, Referring, Prescribing	N/A	1366709875	0	0	TRAN, TUNG T LMFT	2/25/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	85741	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	STE 300	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
330397	Ordering, Referring, Prescribing	N/A	1366782252	0	0	TILP, VANESSA B	4/2/2013	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	RN0637262	N/A	N/A	N/A	N/A	N/A	200 MEDICAL PLAZA	STE 430	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
330466	Ordering, Referring, Prescribing	N/A	1366904575	0	0	THORSON, AMANDA DO	5/1/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21016	N/A	N/A	N/A	N/A	N/A	1941 JOHNSON AVE	STE 301	SAN LUIS OBISPO	CA	93401	4111	00	06000	35.27804785	-120.649711	San Luis Obispo County
330480	Ordering, Referring, Prescribing	N/A	1366925687	0	0	TORRES, MIREYA MSW LCSW	8/5/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW102952	N/A	N/A	N/A	N/A	N/A	17800 HWY 18	None	APPLE VALLEY	CA	92307	0001	00	06000	34.54007429	-117.2744761	San Bernardino County
330500	Ordering, Referring, Prescribing	N/A	1366962714	0	0	THOMAS, CYNTHIA LMFT	12/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT115317	N/A	N/A	N/A	N/A	N/A	480 E 13TH ST,	None	MERCED	CA	95341	6214	00	06000	37.29194565	-120.4717887	Merced County
330503	Ordering, Referring, Prescribing	N/A	1366963449	0	0	TRAN, LIEM H PHARMD	4/4/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH76516	N/A	N/A	N/A	N/A	N/A	1212 FOREST AVE	None	PACIFIC GROVE	CA	93950	3826	00	06000	36.60510796	-121.9208349	Monterey County
330546	Ordering, Referring, Prescribing	N/A	1376038638	0	0	TRAN, ANNA	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76754	N/A	N/A	N/A	N/A	N/A	1263 E ARQUES AVE	None	SUNNYVALE	CA	94085	4701	00	06000	37.38060846	-121.9896672	Santa Clara County
330567	Ordering, Referring, Prescribing	N/A	1376081158	0	0	TORRES, MARYAN D NP	3/21/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020409	N/A	N/A	N/A	N/A	N/A	3940 SANDPIPER AVENUE	None	MERCED	CA	95340	8319	00	06000	37.33841229	-120.466546	Merced County
330576	Ordering, Referring, Prescribing	N/A	1376091504	0	0	THOMPSON, CAROLYN J	3/29/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	107088	N/A	N/A	N/A	N/A	N/A	201 S HARBOR BLVD	None	LA HABRA	CA	90631	5654	00	06000	33.93029897	-117.9331306	Orange County
330603	Ordering, Referring, Prescribing	N/A	1376160697	0	0	TRAN, ERICA M NP	9/30/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018643	N/A	N/A	N/A	N/A	N/A	903 E DEVONSHIRE AVE	STE D	HEMET	CA	92543	3000	00	06000	33.75116958	-116.9627485	Riverside County
330648	Ordering, Referring, Prescribing	N/A	1376320812	0	0	TOMIKA, TIFFANY OD	6/27/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35552	N/A	N/A	N/A	N/A	N/A	180 OTAY LAKES RD.	102	BONITA	CA	91902	2400	00	06000	32.65928608	-117.0304661	San Diego County
330660	Ordering, Referring, Prescribing	N/A	1376526020	0	0	THORNHILL, REX E DPM	5/23/2017	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	3592	N/A	N/A	N/A	N/A	N/A	806 9TH ST	STE 2C	PASO ROBLES	CA	93446	0227	00	06000	35.62363097	-120.6895907	San Luis Obispo County
330689	Ordering, Referring, Prescribing	N/A	1376632315	0	0	TRAN, THOA K LCSW	3/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW20842	N/A	N/A	N/A	N/A	N/A	12912 BROOKHURST ST	480	GARDEN GROVE	CA	92840	4835	00	06000	33.77487003	-117.9552276	Orange County
330698	Ordering, Referring, Prescribing	N/A	1376663179	0	0	TRIAS-RUIZ, ROSALBA PHD	4/29/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY15380	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
330706	Ordering, Referring, Prescribing	N/A	1376669440	0	0	TAPIA, THERESA A LMFT	8/6/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51958	N/A	N/A	N/A	N/A	N/A	330 E. LAMBERT RD.	STE. 225	BREA	CA	92821	4128	00	06000	33.92494139	-117.8918336	Orange County
330770	Ordering, Referring, Prescribing	N/A	1376803940	0	0	TRAN, HOA N MD	10/31/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A128010	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPRESSWAY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
330785	Ordering, Referring, Prescribing	N/A	1376828863	0	0	TRAN, PHUONG K PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55916	N/A	N/A	N/A	N/A	N/A	1661 W. FLORIDA AVENUE	None	HEMET	CA	92543	0001	00	06000	33.74737153	-116.988629	Riverside County
330790	Ordering, Referring, Prescribing	N/A	1376838508	0	0	TRAN, TRACY T	4/27/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D64386	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
330809	Ordering, Referring, Prescribing	N/A	1376882357	0	0	THOMAS, DIANE R MD	2/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124465	N/A	N/A	N/A	N/A	N/A	797 W CHILDS AVE	None	MERCED	CA	95341	6805	00	06000	37.2882498	-120.4963024	Merced County
330815	Ordering, Referring, Prescribing	N/A	1376867564	0	0	TAIS, SETAREH	11/7/2014	Taxonomy not applicable	NA	n/a	000	Unknown	539	N/A	N/A	N/A	N/A	N/A	6225 N FRESNO ST	10	FRESNO	CA	93710	5268	00	06000	36.82701573	-119.781425	Fresno County
330831	Ordering, Referring, Prescribing	N/A	1376912980	0	0	THAOXAOCHAY, JULA LCSW	4/21/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101208	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
330835	Ordering, Referring, Prescribing	N/A	1376920850	0	0	TRUJILLO, CELIA LCSW	6/1/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101752	N/A	N/A	N/A	N/A	N/A	200 BROADWAY STREET	70	KING CITY	CA	93930	2866	00	06000	36.2133658	-121.1256124	Monterey County
330855	Ordering, Referring, Prescribing	N/A	1376946269	0	0	TRIMBLE, GIOVANNI LMFT	8/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT107074	N/A	N/A	N/A	N/A	N/A	4180 RUFFIN RD	STE 295	SAN DIEGO	CA	92123	1865	00	06000	32.81745555	-117.1246313	San Diego County
330869	Ordering, Referring, Prescribing	N/A	1376970186	0	0	THOMPSON-RISKIN, SHELBY L LCSW	2/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75955	N/A	N/A	N/A	N/A	N/A	1426 FILLMORE ST	301	SAN FRANCISCO	CA	94115	5236	00	06000	37.78283156	-122.432588	San Francisco County
330916	Ordering, Referring, Prescribing	N/A	1386033835	0	0	TURNER, JAD LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT42921	N/A	N/A	N/A	N/A	N/A	3793 N POLK AVE	None	FRESNO	CA	93722	9763	00	06000	36.79083469	-119.8893804	Fresno County
330917	Ordering, Referring, Prescribing	N/A	1386030955	0	0	TANGSOMBATVISIT, STEPHANIE MD	3/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146823	N/A	N/A	N/A	N/A	N/A	2825 50TH ST	None	SACRAMENTO	CA	95817	2310	00	06000	38.549745	-121.4465895	Sacramento County
330946	Ordering, Referring, Prescribing	N/A	1386078566	0	0	TAN, EVELYN Y PHARMD	3/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69364	N/A	N/A	N/A	N/A	N/A	3701 BROADWAY	3RD FLOOR	OAKLAND	CA	94611	5613	00	06000	37.82533768	-122.258094	Alameda County
330993	Ordering, Referring, Prescribing	N/A	1386152650	0	0	TRAN, LAURA T PHARMD	7/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78092	N/A	N/A	N/A	N/A	N/A	16173 HARBOR BLVD	None	FOUNTAIN VALLEY	CA	92708	1305	00	06000	33.7284389	-117.9200265	Orange County
331001	Ordering, Referring, Prescribing	N/A	1386167278	0	0	TAPIA, ALEJANDRA LCSW	10/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97352	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVE	None	LOS ANGELES	CA	90001	3409	00	06000	33.9664185	-118.2477481	Los Angeles County
331005	Ordering, Referring, Prescribing	N/A	1386169035	0	0	TAKEMOTO, DENAE W LMFT	6/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119400	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
331038	Ordering, Referring, Prescribing	N/A	1386204600	0	0	TRAN, LAN K PHARMD	3/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH79293	N/A	N/A	N/A	N/A	N/A	19000 HOMESTEAD RD	BUILDING 2	CUPERTINO	CA	95014	0712	00	06000	37.33773494	-122.0043395	Santa Clara County
331056	Ordering, Referring, Prescribing	N/A	1386235513	0	0	TISHER, CHRISTOPHER R PHARMD	9/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70529	N/A	N/A	N/A	N/A	N/A	1640 R ST	None	MERCED	CA	95340	4527	00	06000	37.30406774	-120.4927895	Merced County
331061	Ordering, Referring, Prescribing	N/A	1386272821	0	0	TRAN, CINDY PHARMD	3/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81412	N/A	N/A	N/A	N/A	N/A	99 N LA CIENEGA BLVD	STE 200	BEVERLY HILLS	CA	90211	2222	00	06000	34.06736471	-118.3763201	Los Angeles County
331084	Ordering, Referring, Prescribing	N/A	1386304178	0	0	TAKESHITA, TASHA	9/25/2023	Taxonomy not applicable	NA	n/a	003	AUDIOLOGISTS	AU3672	N/A	N/A	N/A	N/A	N/A	255 EAST BONITA AVE.	None	POMONA	CA	91769	6001	00	06000	34.097913	-117.7474635	Los Angeles County
331095	Ordering, Referring, Prescribing	N/A	1386360964	0	0	THOM, ADELA C NP	10/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023015	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
331151	Ordering, Referring, Prescribing	N/A	1386672848	0	0	TRIPP, LYNNETTE F NP	6/25/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	9518	N/A	N/A	N/A	N/A	N/A	1700 MCHENRY VILLAGE WAY	11 B	MODESTO	CA	95350	4333	00	06000	37.668096	-120.9900045	Stanislaus County
331159	Ordering, Referring, Prescribing	N/A	1386717486	0	0	TRESSER, JENNIFER L PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47694	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
331172	Ordering, Referring, Prescribing	N/A	1386761492	0	0	TAUSSIG, WESTON J LMFT	2/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	44083	N/A	N/A	N/A	N/A	N/A	66 HURLBUT ST	None	PASADENA	CA	91105	4025	00	06000	34.12993251	-118.1516625	Los Angeles County
331175	Ordering, Referring, Prescribing	N/A	1386760494	0	0	TSUJIUCHI, ADELENE Y LMFT	8/31/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48112	N/A	N/A	N/A	N/A	N/A	401 W. CIVIC CENTER	SUITE 600	SANTA ANA	CA	92701	4515	00	06000	33.75157353	-117.870921	Orange County
331237	Ordering, Referring, Prescribing	N/A	1386845105	0	0	TABIOLO, RENEE ANN S	11/29/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D41682	N/A	N/A	N/A	N/A	N/A	20601 WEST PAOLI LANE	#486	WEIMAR	CA	95736	0486	00	06000	39.03521526	-120.9755343	Placer County
331264	Ordering, Referring, Prescribing	N/A	1386921039	0	0	TAN, CECILIA X PHARMD	7/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47874	N/A	N/A	N/A	N/A	N/A	2238 WESTBOROUGH BLVD	None	SOUTH SAN FRANCIS	CA	94080	5405	00	06000	37.64408241	-122.4516996	San Mateo County
331271	Ordering, Referring, Prescribing	N/A	1386929537	0	0	TRAN, VICKY D PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH50172	N/A	N/A	N/A	N/A	N/A	2105 MORRILL AVE	None	SAN JOSE	CA	95132	1130	00	06000	37.4139393	-121.8742316	Santa Clara County
331293	Ordering, Referring, Prescribing	N/A	1386977999	0	0	TALBOT-GOODRUM, ALYSSA LCSW	1/31/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW100321	N/A	N/A	N/A	N/A	N/A	301 E 13TH ST	None	MERCED	CA	95341	6211	00	06000	37.29248035	-120.4730619	Merced County
331297	Ordering, Referring, Prescribing	N/A	1386991248	0	0	TRAN, TRANYCE N PHARMD	8/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67022	N/A	N/A	N/A	N/A	N/A	1175 COLUMBUS AVE	None	SAN FRANCISCO	CA	94133	1729	00	06000	37.80490869	-122.4168359	San Francisco County
331310	Ordering, Referring, Prescribing	N/A	1396006540	0	0	TREVINO, NATALEE N DDS	1/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	DE61181543	N/A	N/A	N/A	N/A	N/A	2145 5TH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
331325	Ordering, Referring, Prescribing	N/A	1396027090	0	0	TAWFICK, SAMIR F PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55554	N/A	N/A	N/A	N/A	N/A	5451 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5613	00	06000	34.0981319	-118.3087069	Los Angeles County
331335	Ordering, Referring, Prescribing	N/A	1396040218	0	0	TRIPPITELLI, CAROL L MD	4/10/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C161880	N/A	N/A	N/A	N/A	N/A	1000 VALE TERRACE DR	None	VISTA	CA	92084	5218	00	06000	33.20904502	-117.2286439	San Diego County
331354	Ordering, Referring, Prescribing	N/A	1396090213	0	0	TINAJERO-GUERRERO, NANCY LMFT	11/29/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104679	N/A	N/A	N/A	N/A	N/A	205 PASADENA AVE	None	SOUTH PASADENA	CA	91030	9998	00	06000	34.11219143	-118.1709685	Los Angeles County
331368	Ordering, Referring, Prescribing	N/A	1396112553	0	0	TRIGLETH, MICHELLE C LCSW	2/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW91862	N/A	N/A	N/A	N/A	N/A	1055 W HENDERSON AVE	STE. 2	PORTERVILLE	CA	93257	1490	00	06000	36.08036906	-119.0410926	Tulare County
331375	Ordering, Referring, Prescribing	N/A	1396121711	0	0	TORRES, VICTORIA E LCSW	12/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88471	N/A	N/A	N/A	N/A	N/A	43807 10TH ST W	D	LANCASTER	CA	93534	4805	00	06000	34.6788	-118.1479295	Los Angeles County
331379	Ordering, Referring, Prescribing	N/A	1396124830	0	0	TADROS, SHERINE	1/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	44428	N/A	N/A	N/A	N/A	N/A	133 W ROUTE 66	None	GLENDORA	CA	91740	6208	00	06000	34.12882549	-117.8650035	Los Angeles County
331416	Ordering, Referring, Prescribing	N/A	1396175360	0	0	TRUJILLO, ARTURO M LMFT	4/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110586	N/A	N/A	N/A	N/A	N/A	1627 S HARGRAVE ST	None	BANNING	CA	92220	6169	00	06000	33.910425	-116.867936	Riverside County
331435	Ordering, Referring, Prescribing	N/A	1396193389	0	0	TSENG, JOSHUA	6/10/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A141586	N/A	N/A	N/A	N/A	N/A	767 N HILL ST	200	LOS ANGELES	CA	90012	2343	00	06000	34.06255157	-118.2397077	Los Angeles County
331438	Ordering, Referring, Prescribing	N/A	1396205183	0	0	TRAVIS, KATE J MD	5/1/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL975	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94141	0836	00	06000	37.75548534	-122.4065362	San Francisco County
331489	Ordering, Referring, Prescribing	N/A	1396296786	0	0	TAELE, MEGAN G PA-C	8/31/2017	Taxonomy not applicable	NA	n/a	003	AUDIOLOGISTS	53949	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
331499	Ordering, Referring, Prescribing	N/A	1396299525	0	0	TIDIK, JULIA A NP	2/9/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95157097	N/A	N/A	N/A	N/A	N/A	784 HIGH ST	None	SAN LUIS OBISPO	CA	93401	5243	00	06000	35.27225362	-120.6564501	San Luis Obispo County
331503	Ordering, Referring, Prescribing	N/A	1396319471	0	0	TAM, AMANDA K	3/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82063	N/A	N/A	N/A	N/A	N/A	3801 HOWE ST	None	OAKLAND	CA	94611	5312	00	06000	37.8242732	-122.2568561	Alameda County
331507	Ordering, Referring, Prescribing	N/A	1396323648	0	0	TURKIEWICZ, JOANNA V MD	5/20/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A196352	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
331516	Ordering, Referring, Prescribing	N/A	1396339727	0	0	TESFAYE, ABERA NP	12/21/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016770	N/A	N/A	N/A	N/A	N/A	10201 MISSION GORGE RD	None	SANTEE	CA	92071	3027	00	06000	32.83844552	-116.9759925	San Diego County
331533	Ordering, Referring, Prescribing	N/A	1396370326	0	0	TAHAMI, NEDA PA-C	8/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59896	N/A	N/A	N/A	N/A	N/A	905 CALLE AMANECER	SUITE 115	SAN CLEMENTE	CA	92673	6226	00	06000	33.44951265	-117.6075825	Orange County
331552	Ordering, Referring, Prescribing	N/A	1396387304	0	0	TRAN, PETER C PA-C	2/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58961	N/A	N/A	N/A	N/A	N/A	7761 GARDEN GROVE BLVD.	None	GARDEN GROVE	CA	92841	4200	00	06000	33.77387145	-117.9966555	Orange County
331556	Ordering, Referring, Prescribing	N/A	1396389979	0	0	THURA, ZAW PHARMD	3/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80904	N/A	N/A	N/A	N/A	N/A	18417 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	2898	00	06000	33.98841262	-117.9032198	Los Angeles County
331558	Ordering, Referring, Prescribing	N/A	1396409124	0	0	TAYLOR, LINH LAC	5/16/2023	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	19254	N/A	N/A	N/A	N/A	N/A	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5212	00	06000	37.30176	-121.9136465	Santa Clara County
331600	Ordering, Referring, Prescribing	N/A	1396728937	0	0	TURPIN, DAVID W	6/12/1997	Taxonomy not applicable	NA	n/a	099	DENTIST	D43088	N/A	N/A	N/A	N/A	N/A	200 C ST	None	PATTERSON	CA	95363	2701	00	06000	37.46733509	-121.1258615	Stanislaus County
331601	Ordering, Referring, Prescribing	N/A	1396747721	0	0	TAN, STANLEY A MD	7/30/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G23082	N/A	N/A	N/A	N/A	N/A	4455 W 117TH ST	STE 300	HAWTHORNE	CA	90250	2241	00	06000	33.92825048	-118.3539285	Los Angeles County
331653	Ordering, Referring, Prescribing	N/A	1396863502	0	0	THOMPSON-RANDLE, CYNTHIA PHD	11/18/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	17828	N/A	N/A	N/A	N/A	N/A	2121 W TEMPLE ST	None	LOS ANGELES	CA	90026	4915	00	06000	34.07053729	-118.268744	Los Angeles County
331709	Ordering, Referring, Prescribing	N/A	1396968921	0	0	TORRES, CARMEN LMFT	7/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106736	N/A	N/A	N/A	N/A	N/A	201 JOHN ST	SUITE A	SALINAS	CA	93901	3345	00	06000	36.66998788	-121.6497885	Monterey County
331721	Ordering, Referring, Prescribing	N/A	1396997755	0	0	TSCHUMI, PAMELA S OT	2/15/2021	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	15626	N/A	N/A	N/A	N/A	N/A	108 W VICTORIA ST	None	GARDENA	CA	90248	3322	00	06000	33.86509452	-118.2762279	Los Angeles County
331739	Ordering, Referring, Prescribing	N/A	1407032675	0	0	TEMPLETON, SUSAN G LMFT	3/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43884	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	VICTORVILLE	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
331742	Ordering, Referring, Prescribing	N/A	1407037138	0	0	THOMAS, MELANIE R	9/19/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A100852	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
331771	Ordering, Referring, Prescribing	N/A	1407117161	0	0	THIRUVADI, GITANJALI R LMFT	6/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110775	N/A	N/A	N/A	N/A	N/A	2425 BISSO LANE	200	CONCORD	CA	94520	5223	00	06000	37.98393807	-122.0466953	Contra Costa County
331818	Ordering, Referring, Prescribing	N/A	1407210875	0	0	TURNER, ANDIA H MD	1/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A153995	N/A	N/A	N/A	N/A	N/A	1030 W WARNER AVE	None	SANTA ANA	CA	92707	3147	00	06000	33.71597598	-117.8819134	Orange County
331834	Ordering, Referring, Prescribing	N/A	1407242019	0	0	TAHSINI, IZABEL LMFT	3/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98053	N/A	N/A	N/A	N/A	N/A	2151 COLLEGE AVE	None	BAKERSFIELD	CA	93305	4113	00	06000	35.3830369	-118.9680991	Kern County
331852	Ordering, Referring, Prescribing	N/A	1407280803	0	0	TRAN, MELODY L MD	6/13/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145003	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	STE 1100	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
331896	Ordering, Referring, Prescribing	N/A	1407336019	0	0	TAHA, SARAH A LCSW	2/17/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100059	N/A	N/A	N/A	N/A	N/A	1221 E DYER RD	None	SANTA ANA	CA	92705	5600	00	06000	33.70872153	-117.857052	Orange County
331900	Ordering, Referring, Prescribing	N/A	1407337140	0	0	THOMAS, CHINWE PA-C	7/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	55888	N/A	N/A	N/A	N/A	N/A	123 S ALVARADO ST	None	LOS ANGELES	CA	90057	2201	00	06000	34.06593048	-118.2708351	Los Angeles County
331903	Ordering, Referring, Prescribing	N/A	1407338916	0	0	TANG, JENNIFER S	12/3/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	103085	N/A	N/A	N/A	N/A	N/A	520 E HANFORD ARMONA RD	None	LEMOORE	CA	93245	2141	00	06000	36.31351607	-119.7745595	Kings County
331910	Ordering, Referring, Prescribing	N/A	1407352198	0	0	THOMAS, SURAVI G MD MPH	9/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173587	N/A	N/A	N/A	N/A	N/A	410 E PARKCENTER CIR N	None	SAN BERNARDINO	CA	92408	2869	00	06000	34.07631086	-117.276898	San Bernardino County
331942	Ordering, Referring, Prescribing	N/A	1407395874	0	0	TAING, ANNA LMFT	9/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT121521	N/A	N/A	N/A	N/A	N/A	11721 TELEGRAPH RD	None	SANTA FE SPRINGS	CA	90670	3674	00	06000	33.94629336	-118.0832752	Los Angeles County
331952	Ordering, Referring, Prescribing	N/A	1407432198	0	0	THOMAS, MICHELLE	1/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A192696	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
331975	Ordering, Referring, Prescribing	N/A	1407509607	0	0	TSE, CONNOR J PHARMD	6/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	85741	N/A	N/A	N/A	N/A	N/A	950 W HAMILTON AVE	None	CAMPBELL	CA	95008	0406	00	06000	37.29405053	-121.9665695	Santa Clara County
331984	Ordering, Referring, Prescribing	N/A	1407535933	0	0	TURLEA, IRINA NP	1/24/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024007	N/A	N/A	N/A	N/A	N/A	800 E LUGONIA AVE	None	REDLANDS	CA	92374	2550	00	06000	34.07000118	-117.1731789	San Bernardino County
331985	Ordering, Referring, Prescribing	N/A	1407535750	0	0	TORRES, LESLIE NP	8/8/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026560	N/A	N/A	N/A	N/A	N/A	2017 FIRST AVENUE	None	SAN DIEGO	CA	92101	0000	00	06000	32.72646147	-117.1638767	San Diego County
331986	Ordering, Referring, Prescribing	N/A	1407536865	0	0	TAYLOR, JACQUELYN NP	7/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025781	N/A	N/A	N/A	N/A	N/A	2550 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2837	00	06000	33.98915101	-118.2261679	Los Angeles County
331992	Ordering, Referring, Prescribing	N/A	1407566979	0	0	TSE, CHANEL Z PHARMD	10/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	87174	N/A	N/A	N/A	N/A	N/A	2555 HARRIS ST	PHARMACY	EUREKA	CA	95503	4805	00	06000	40.78053517	-124.1380509	Humboldt County
331994	Ordering, Referring, Prescribing	N/A	1407568231	0	0	TAREQ, AHMED	12/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	108457	N/A	N/A	N/A	N/A	N/A	1300 S SUNSET AVE	None	WEST COVINA	CA	91790	3342	00	06000	34.0601054	-117.9474205	Los Angeles County
332046	Ordering, Referring, Prescribing	N/A	1407932924	0	0	TOY, GRACE E PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55084	N/A	N/A	N/A	N/A	N/A	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	00	06000	33.9040752	-118.1328995	Los Angeles County
332053	Ordering, Referring, Prescribing	N/A	1407948474	0	0	TO, BRYAN H MD	9/10/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A84344	N/A	N/A	N/A	N/A	N/A	24910 LAS BRISAS RD	SUITE 120	MURRIETA	CA	92562	4010	00	06000	33.57522424	-117.1828078	Riverside County
332110	Ordering, Referring, Prescribing	N/A	1417074485	0	0	TAIT, CHRISTINA M LCSW	7/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	79089	N/A	N/A	N/A	N/A	N/A	25910 ACERO	SUITE 160	MISSION VIEJO	CA	92691	2790	00	06000	33.61712389	-117.6780482	Orange County
332125	Ordering, Referring, Prescribing	N/A	1417086273	0	0	TSE, TONIA K LCSW	10/26/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24178	N/A	N/A	N/A	N/A	N/A	6957 N. FIGUEROA ST.	None	LOS ANGELES	CA	90042	1245	00	06000	34.12873587	-118.18774	Los Angeles County
332143	Ordering, Referring, Prescribing	N/A	1417109950	0	0	TURNER, GEOFFREY MD	10/21/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C199628	N/A	N/A	N/A	N/A	N/A	444 BRUCE STREET	None	YREKA	CA	96097	3450	00	06000	41.71863548	-122.6458755	Siskiyou County
332149	Ordering, Referring, Prescribing	N/A	1417120460	0	0	TRUONG, ELIZABETH T PHARMD	3/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60312	N/A	N/A	N/A	N/A	N/A	1103 NORTH RD	None	BELMONT	CA	94002	1945	00	06000	37.52677387	-122.2907371	San Mateo County
332164	Ordering, Referring, Prescribing	N/A	1417154824	0	0	TILMON, SHAWNIESE R PHD	6/3/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY27424	N/A	N/A	N/A	N/A	N/A	747 52ND STREET	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
332182	Ordering, Referring, Prescribing	N/A	1417196080	0	0	TRINH, NANCY K LCSW	11/20/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89560	N/A	N/A	N/A	N/A	N/A	3629 SANTA ANITA AVE	SUITE 102	EL MONTE	CA	91731	2450	00	06000	34.07564024	-118.0414325	Los Angeles County
332186	Ordering, Referring, Prescribing	N/A	1417192394	0	0	THACH, NADET LCSW	1/31/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106706	N/A	N/A	N/A	N/A	N/A	27800 MEDICAL CENTER RD	110	MISSION VIEJO	CA	92691	6410	00	06000	33.55952733	-117.6645199	Orange County
332211	Ordering, Referring, Prescribing	N/A	1417230871	0	0	TRAN, ALEXANDRA PHARMD	7/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH47174	N/A	N/A	N/A	N/A	N/A	1795 E CAPITOL EXPY	None	SAN JOSE	CA	95121	1561	00	06000	37.30985957	-121.8089013	Santa Clara County
332282	Ordering, Referring, Prescribing	N/A	1417351909	0	0	TODD, LAURA LPCC	6/17/2020	Taxonomy not applicable	NA	n/a	000	Unknown	6235	N/A	N/A	N/A	N/A	N/A	160 E. VIRGINIA ST.	SUITE 280	SAN JOSE	CA	95112	5865	00	06000	37.32582868	-121.8777868	Santa Clara County
332405	Ordering, Referring, Prescribing	N/A	1417547043	0	0	TIRUNEH, ESUYAWKAL CNP	11/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016151	N/A	N/A	N/A	N/A	N/A	1200 NORTH STATE	None	LOS ANGELES	CA	90033	0000	00	06000	34.05855992	-118.209755	Los Angeles County
332412	Ordering, Referring, Prescribing	N/A	1417590241	0	0	TINOCO, ADELA LCSW	12/18/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	119882	N/A	N/A	N/A	N/A	N/A	11601 S WESTERN AVE	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
332432	Ordering, Referring, Prescribing	N/A	1417627159	0	0	TRAN, CAROLINE H PA-C	3/11/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62489	N/A	N/A	N/A	N/A	N/A	1850 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43814074	-120.6259249	Lassen County
332436	Ordering, Referring, Prescribing	N/A	1417656588	0	0	THIND, GAGANDEEP K	1/27/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT35380TLG	N/A	N/A	N/A	N/A	N/A	4900 PANAMA LN	None	BAKERSFIELD	CA	93313	3479	00	06000	35.297802	-119.058516	Kern County
332447	Ordering, Referring, Prescribing	N/A	1417713975	0	0	TELLEZ ARRIAGA, ALVARO NP	7/12/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95025955	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVENUE	BUILDING 5, 3RD FLOOR, S	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
332453	Ordering, Referring, Prescribing	N/A	1417731233	0	0	TORRES, JOSE PHARMD	8/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84471	N/A	N/A	N/A	N/A	N/A	2395 E LACEY BLVD	None	HANFORD	CA	93230	4740	00	06000	36.325962	-119.606697	Kings County
332479	Ordering, Referring, Prescribing	N/A	1427022979	0	0	TOPLENSZKY, TIBOR J MD	6/21/2022	Taxonomy not applicable	NA	n/a	000	Unknown	C168688	N/A	N/A	N/A	N/A	N/A	41880 KALMIA ST	SUITE 100	MURRIETA	CA	92562	8835	00	06000	33.55740114	-117.2157733	Riverside County
332503	Ordering, Referring, Prescribing	N/A	1427113737	0	0	THAO-LEE, CHIA LMFT	3/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42584	N/A	N/A	N/A	N/A	N/A	88 TABLE MOUNTAIN BLVD	None	OROVILLE	CA	95965	3578	00	06000	39.52148732	-121.5548586	Butte County
332523	Ordering, Referring, Prescribing	N/A	1427145226	0	0	TRIPATHI, IONA MD	10/6/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A67028	N/A	N/A	N/A	N/A	N/A	2434 FLETCHER AVE	None	SANTA BARBARA	CA	93105	4814	00	06000	34.4306438	-119.726056	Santa Barbara County
332566	Ordering, Referring, Prescribing	N/A	1427242916	0	0	TSEGHAI, SEWIT LMFT	5/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90999	N/A	N/A	N/A	N/A	N/A	1625 W OLYMPIC BLVD	600	LOS ANGELES	CA	90015	3809	00	06000	34.04957404	-118.2750068	Los Angeles County
332578	Ordering, Referring, Prescribing	N/A	1427274257	0	0	TAPIA, LAURA LMFT	1/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49928	N/A	N/A	N/A	N/A	N/A	855 N EUCLID AVE	None	ONTARIO	CA	91762	2729	00	06000	34.074063	-117.6514785	San Bernardino County
332596	Ordering, Referring, Prescribing	N/A	1427309806	0	0	TORRES, MIA G LMFT	4/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	101209	N/A	N/A	N/A	N/A	N/A	17800 CA-18	None	APPLE VALLEY	CA	92307	1221	00	06000	34.4719944	-117.115449	San Bernardino County
332598	Ordering, Referring, Prescribing	N/A	1427322650	0	0	TELETEN, LILIYA	4/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	71818	N/A	N/A	N/A	N/A	N/A	7000 AUBURN BLVD	None	CITRUS HEIGHTS	CA	95621	4342	00	06000	38.689875	-121.2975585	Sacramento County
332601	Ordering, Referring, Prescribing	N/A	1427327097	0	0	TRAN, ALI	2/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	48471	N/A	N/A	N/A	N/A	N/A	1616 E HAMMER LN	None	STOCKTON	CA	95210	4119	00	06000	38.018799	-121.29273	San Joaquin County
332626	Ordering, Referring, Prescribing	N/A	1427367507	0	0	TYLOVA-STEIN, HANA LCSW	3/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW73333	N/A	N/A	N/A	N/A	N/A	815 HYDE STREET	# 100	SAN FRANCISCO	CA	94109	5998	00	06000	37.78855	-122.416917	San Francisco County
332650	Ordering, Referring, Prescribing	N/A	1427416841	0	0	THACH, VIVIEN T NP	10/4/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003756	N/A	N/A	N/A	N/A	N/A	9862 CHAPMAN AVE.	None	GARDEN GROVE	CA	92841	2726	00	06000	33.78849558	-117.9607338	Orange County
332658	Ordering, Referring, Prescribing	N/A	1427432509	0	0	TANG, SINKA NP	5/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	NP95002295	N/A	N/A	N/A	N/A	N/A	7060 N RECREATION AVE	None	FRESNO	CA	93720	8022	00	06000	36.8388	-119.7404335	Fresno County
332676	Ordering, Referring, Prescribing	N/A	1427460856	0	0	TUANO, ARISTOTLE	9/29/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000456	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD.	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
332724	Ordering, Referring, Prescribing	N/A	1427525401	0	0	TRUONG, KHA PHARMD	6/25/2023	Taxonomy not applicable	NA	n/a	000	Unknown	79303	N/A	N/A	N/A	N/A	N/A	1900 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2725	00	06000	33.9891357	-118.2389609	Los Angeles County
332727	Ordering, Referring, Prescribing	N/A	1427530880	0	0	TRAN, PHUONG-DIEU L	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78378	N/A	N/A	N/A	N/A	N/A	160 DIAMOND DR	None	LAKE ELSINORE	CA	92530	4401	00	06000	33.658974	-117.3003035	Riverside County
332752	Ordering, Referring, Prescribing	N/A	1427572973	0	0	TRAN, HIEN T PHARMD	9/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67617	N/A	N/A	N/A	N/A	N/A	15010 W WHITESBRIDGE AVE	None	KERMAN	CA	93630	1030	00	06000	36.73495449	-120.060495	Fresno County
332770	Ordering, Referring, Prescribing	N/A	1427592476	0	0	TUMASYAN, YELENA PA-C	5/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	53709	N/A	N/A	N/A	N/A	N/A	5831 FIRESTONE BLVD., SU	None	SOUTH GATE	CA	90280	3705	00	06000	33.95077836	-118.1645843	Los Angeles County
332777	Ordering, Referring, Prescribing	N/A	1427603539	0	0	TERRONES, MIRANDA L PA-C	9/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	58554	N/A	N/A	N/A	N/A	N/A	400 WEST PUEBLO STREET	None	SANTA BARBARA	CA	93105	4390	00	06000	34.42887662	-119.7237878	Santa Barbara County
332821	Ordering, Referring, Prescribing	N/A	1427712736	0	0	TISS, MATTHEW PT	7/5/2022	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	302089	N/A	N/A	N/A	N/A	N/A	434 7TH ST	None	EUREKA	CA	95501	1803	00	06000	40.80022571	-124.1658967	Humboldt County
332856	Ordering, Referring, Prescribing	N/A	1427837665	0	0	TOUKHTARIAN, ALINE G MD	9/26/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	SPI795	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLAZA	3325	LOS ANGELES	CA	90095	0001	00	06000	34.06633051	-118.4452686	Los Angeles County
332882	Ordering, Referring, Prescribing	N/A	1437222130	0	0	TRAN, HIEN-PHUONG T PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	53092	N/A	N/A	N/A	N/A	N/A	411 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	00	06000	33.8531521	-117.8160824	Orange County
332939	Ordering, Referring, Prescribing	N/A	1437316189	0	0	TORRES, ANN M MD	2/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A148644	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
332954	Ordering, Referring, Prescribing	N/A	1437354875	0	0	THICKSTUN, MARY S LCSW	12/6/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW21573	N/A	N/A	N/A	N/A	N/A	2204 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	3615	00	06000	32.69715769	-117.1399272	San Diego County
332969	Ordering, Referring, Prescribing	N/A	1437380573	0	0	TSE, TING PHARMD	1/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH57106	N/A	N/A	N/A	N/A	N/A	5401 KATELLA AVE	None	CYPRESS	CA	90720	2809	00	06000	33.8030835	-118.039581	Orange County
333000	Ordering, Referring, Prescribing	N/A	1437420023	0	0	TORRES, CLAUDIA	2/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92763	N/A	N/A	N/A	N/A	N/A	6736 LAUREL CANYON BOULE	STE 200	LOS ANGELES	CA	91606	1538	00	06000	34.193493	-118.3964925	Los Angeles County
333029	Ordering, Referring, Prescribing	N/A	1437469103	0	0	THOMPSON, JONATHAN W LMFT	8/2/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	134099	N/A	N/A	N/A	N/A	N/A	1236 CHAPALA ST	None	SANTA BARBARA	CA	93101	3116	00	06000	34.42310529	-119.7066629	Santa Barbara County
333075	Ordering, Referring, Prescribing	N/A	1437548393	0	0	THEODOROU, CHRISTINA MD	3/16/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A152980	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1230	00	06000	38.555181	-121.4566785	Sacramento County
333076	Ordering, Referring, Prescribing	N/A	1437549235	0	0	TAKAGI, JENNIFER H NP	4/2/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	763176	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY AVE	None	HEALDSBURG	CA	95448	3314	00	06000	38.62757555	-122.8638141	Sonoma County
333084	Ordering, Referring, Prescribing	N/A	1437562188	0	0	TRESTLER, LAUREN LCSW	3/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87982	N/A	N/A	N/A	N/A	N/A	815 HYDE STREET	SUITE 100	SAN FRANCISCO	CA	94109	5998	00	06000	37.78855	-122.416917	San Francisco County
333096	Ordering, Referring, Prescribing	N/A	1437579786	0	0	TIDWELL, GRACE MD	1/15/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160389	N/A	N/A	N/A	N/A	N/A	4900 CALIFORNIA AVE	100B	BAKERSFIELD	CA	93309	7081	00	06000	35.36440586	-119.0562732	Kern County
333110	Ordering, Referring, Prescribing	N/A	1437592862	0	0	TAN, HUNG-ENN MD	7/18/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A134397	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPWY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
333132	Ordering, Referring, Prescribing	N/A	1437624277	0	0	TRUONG, NHI M PHARMD	4/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79288	N/A	N/A	N/A	N/A	N/A	1440 168TH AVE	None	SAN LEANDRO	CA	94578	2409	00	06000	37.69267082	-122.1070241	Alameda County
333254	Ordering, Referring, Prescribing	N/A	1437838661	0	0	TIAN, XUE MD	7/31/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL11509	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
333274	Ordering, Referring, Prescribing	N/A	1437898350	0	0	TANGUNAN, JONATHAN DDS	8/28/2023	Taxonomy not applicable	NA	n/a	000	Unknown	107455	N/A	N/A	N/A	N/A	N/A	1750 WRIGHT STREET	None	SACRAMENTO	CA	95825	4041	00	06000	38.597742	-121.4057385	Sacramento County
333293	Ordering, Referring, Prescribing	N/A	1437999414	0	0	TOBIN, SARAH LCSW	5/15/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	122542	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
333303	Ordering, Referring, Prescribing	N/A	1447241138	0	0	TIVNON, MICHAEL C MD	9/10/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A24851	N/A	N/A	N/A	N/A	N/A	300 OLD RIVER ROAD	SUITE 150	BAKERSFIELD	CA	93311	9503	00	06000	35.352648	-119.1122505	Kern County
333305	Ordering, Referring, Prescribing	N/A	1447276878	0	0	TATELMAN, JOYCE MD	10/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A60885	N/A	N/A	N/A	N/A	N/A	116 W MINNESOTA AVE	None	MCCLOUD	CA	96057	0001	00	06000	41.25214176	-122.1368284	Siskiyou County
333332	Ordering, Referring, Prescribing	N/A	1447337720	0	0	TAKASHIMA, THOMAS PHARMD	3/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	48281	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPRESSWAY	362	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
333348	Ordering, Referring, Prescribing	N/A	1447370218	0	0	TRAN, TIFFANY U MD FACOG	6/2/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G79948	N/A	N/A	N/A	N/A	N/A	27800 MEDICAL CENTER RD	SUITE 144	MISSION VIEJO	CA	92691	6410	00	06000	33.55952733	-117.6645199	Orange County
333355	Ordering, Referring, Prescribing	N/A	1447382478	0	0	TANG, AUDREY H NP	12/15/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP14451	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVENUE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
333358	Ordering, Referring, Prescribing	N/A	1447393293	0	0	TOLLIVER, ADRIANNE M	2/22/2020	Taxonomy not applicable	NA	n/a	000	Unknown	11787	N/A	N/A	N/A	N/A	N/A	6001-A TRUXTUN AVE	160	BAKERSFIELD	CA	93309	0693	00	06000	35.36252236	-119.072932	Kern County
333379	Ordering, Referring, Prescribing	N/A	1447446927	0	0	TSURUI, JACQUELINE C LMFT	3/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	89612	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
333435	Ordering, Referring, Prescribing	N/A	1447555123	0	0	TUCKER, TIFFANY LMFT	4/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100510	N/A	N/A	N/A	N/A	N/A	474 W VERMONT AVE	None	ESCONDIDO	CA	92025	6584	00	06000	33.10046604	-117.0729623	San Diego County
333449	Ordering, Referring, Prescribing	N/A	1447593033	0	0	TOROSSIAN, MARIAM MD	8/21/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133961	N/A	N/A	N/A	N/A	N/A	201 S BUENA VISTA ST	440	BURBANK	CA	91505	4569	00	06000	34.15978726	-118.3289164	Los Angeles County
333452	Ordering, Referring, Prescribing	N/A	1447600564	0	0	TRAN, TIFFANY	4/1/2023	Taxonomy not applicable	NA	n/a	000	Unknown	80717	N/A	N/A	N/A	N/A	N/A	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	00	06000	37.246896	-121.8040865	Santa Clara County
333458	Ordering, Referring, Prescribing	N/A	1447612676	0	0	TORRES BARBA, DAVID MD	1/7/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151578	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
333475	Ordering, Referring, Prescribing	N/A	1447640214	0	0	TYNAN, CHAD V LMFT	4/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114286	N/A	N/A	N/A	N/A	N/A	1380 HOWARD ST FL 3	FL 3	SAN FRANCISCO	CA	94103	2650	00	06000	37.77424669	-122.4141502	San Francisco County
333514	Ordering, Referring, Prescribing	N/A	1447696471	0	0	TAWDROUS, EBRAM L PHARMD	11/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61051	N/A	N/A	N/A	N/A	N/A	4500 COFFEE RD	None	BAKERSFIELD	CA	93308	5025	00	06000	35.400177	-119.092101	Kern County
333530	Ordering, Referring, Prescribing	N/A	1447691514	0	0	THOMPSON, CHRISTIAN LMFT	11/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132202	N/A	N/A	N/A	N/A	N/A	679 SOUTH NEW HAMPSHIRE	400	LOS ANGELES	CA	90005	1355	00	06000	34.06107902	-118.2929191	Los Angeles County
333532	Ordering, Referring, Prescribing	N/A	1447716535	0	0	TAMAYO, KARINA A LMFT	1/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136981	N/A	N/A	N/A	N/A	N/A	530 W BADILLO ST	None	COVINA	CA	91722	3762	00	06000	34.08625283	-117.8999625	Los Angeles County
333544	Ordering, Referring, Prescribing	N/A	1447733738	0	0	THI, SAMANDA L PA	2/8/2019	Taxonomy not applicable	NA	n/a	000	Unknown	56544	N/A	N/A	N/A	N/A	N/A	2690 PACIFIC AVENUE	SUITE 370	LONG BEACH	CA	90806	2661	00	06000	33.805854	-118.1936805	Los Angeles County
333597	Ordering, Referring, Prescribing	N/A	1447851324	0	0	TORRES, ANNA P NP	1/15/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016437	N/A	N/A	N/A	N/A	N/A	9925 INTERNATIONAL BLVD	SUITE 5	OAKLAND	CA	94603	2558	00	06000	37.74332565	-122.1698542	Alameda County
333599	Ordering, Referring, Prescribing	N/A	1447848247	0	0	TRAN, PHA PA-C	3/14/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62502	N/A	N/A	N/A	N/A	N/A	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
333631	Ordering, Referring, Prescribing	N/A	1447928288	0	0	TOBIN, CYNTHIA	8/19/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	125327	N/A	N/A	N/A	N/A	N/A	11800 CENTRAL AVE	225	CHINO	CA	91710	7201	00	06000	34.0388092	-117.689654	San Bernardino County
333646	Ordering, Referring, Prescribing	N/A	1457003808	0	0	TUCKER, KERRY NP	4/1/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020550	N/A	N/A	N/A	N/A	N/A	1260 MORENA BLVD	SUITE 100	SAN DIEGO	CA	92110	3889	00	06000	32.77077343	-117.2018542	San Diego County
333662	Ordering, Referring, Prescribing	N/A	1457068744	0	0	TRINH, DANIEL	6/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021317	N/A	N/A	N/A	N/A	N/A	1325 N ANAHEIM BLVD	100	ANAHEIM	CA	92801	1202	00	06000	33.85331047	-117.9199617	Orange County
333670	Ordering, Referring, Prescribing	N/A	1457099103	0	0	TAGLYAN, PETROS X PHARMD	5/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	39610	N/A	N/A	N/A	N/A	N/A	5236 SANTA MONICA BLVD	None	LOS ANGELES	CA	90029	1210	00	06000	34.09077051	-118.3046976	Los Angeles County
333696	Ordering, Referring, Prescribing	N/A	1457365587	0	0	TURPIN, SCOTT A MD	9/28/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C54468	N/A	N/A	N/A	N/A	N/A	9226 N HINTON AVE	None	DELHI	CA	95315	8200	00	06000	37.42229366	-120.7771653	Merced County
333704	Ordering, Referring, Prescribing	N/A	1457403198	0	0	THOMAS, SHEILA L NP	10/6/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	383998	N/A	N/A	N/A	N/A	N/A	41820 GARSTIN DR	None	BIG BEAR LAKE	CA	92315	1649	00	06000	34.24651473	-116.8897879	San Bernardino County
333713	Ordering, Referring, Prescribing	N/A	1457429912	0	0	TAYLOR, BONNIE C MD	3/12/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G66891	N/A	N/A	N/A	N/A	N/A	1990 41ST AVENUE	None	SAN FRANCISCO	CA	94116	1101	00	06000	37.74984135	-122.4997872	San Francisco County
333759	Ordering, Referring, Prescribing	N/A	1457532426	0	0	TAPIA, BRENDA Z LCSW	12/1/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW71270	N/A	N/A	N/A	N/A	N/A	17707 STUDEBAKER RD.	None	CERRITOS	CA	90703	7743	00	06000	33.87008991	-118.0991298	Los Angeles County
333764	Ordering, Referring, Prescribing	N/A	1457538753	0	0	TANG, JENNY LCSW	2/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26206	N/A	N/A	N/A	N/A	N/A	12966 EUCLID ST	495	GARDEN GROVE	CA	92840	5200	00	06000	33.77455935	-117.9378298	Orange County
333807	Ordering, Referring, Prescribing	N/A	1457634743	0	0	THAO, VANG S PHARMD	8/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57463	N/A	N/A	N/A	N/A	N/A	6325 FAIR OAKS BLVD	None	CARMICHAEL	CA	95608	4809	00	06000	38.616075	-121.329243	Sacramento County
333830	Ordering, Referring, Prescribing	N/A	1457667685	0	0	THORP, DIANE M LCSW	10/19/2015	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65567	N/A	N/A	N/A	N/A	N/A	1495 N LAKE AVENUE	None	PASADENA	CA	91104	2303	00	06000	34.17164095	-118.1321599	Los Angeles County
333843	Ordering, Referring, Prescribing	N/A	1457693103	0	0	THURMAN, KIMBERLY M LMFT	1/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111787	N/A	N/A	N/A	N/A	N/A	1904 RICHLAND AVE.	None	CERES	CA	95307	4562	00	06000	37.60031128	-120.9658226	Stanislaus County
333879	Ordering, Referring, Prescribing	N/A	1457757650	0	0	THAI, LUONG V PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72037	N/A	N/A	N/A	N/A	N/A	2262 MARKET ST	None	SAN FRANCISCO	CA	94114	1508	00	06000	37.76498914	-122.4322587	San Francisco County
333889	Ordering, Referring, Prescribing	N/A	1457772105	0	0	TOPURIYA, LUIZA NP	9/20/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	681474	N/A	N/A	N/A	N/A	N/A	1122 N BRAND BLVD	None	GLENDALE	CA	91202	2547	00	06000	34.162236	-118.2550335	Los Angeles County
333903	Ordering, Referring, Prescribing	N/A	1457783748	0	0	TEELING, AMY A LCSW	12/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW106214	N/A	N/A	N/A	N/A	N/A	455 1ST STREET	None	WOODLAND	CA	95695	4023	00	06000	38.675781	-121.773122	Yolo County
333904	Ordering, Referring, Prescribing	N/A	1457787392	0	0	TURNIPSEED, CONNIE LMFT	10/23/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113140	N/A	N/A	N/A	N/A	N/A	1170 INDUSTRAIL ST	None	REDDING	CA	96002	0734	00	06000	40.57474549	-122.3503065	Shasta County
333951	Ordering, Referring, Prescribing	N/A	1457855066	0	0	TRUONG, THANH D	3/26/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163474	N/A	N/A	N/A	N/A	N/A	206 CALIFORNIA AVE	None	PALO ALTO	CA	94306	1618	00	06000	37.42831634	-122.1432463	Santa Clara County
333954	Ordering, Referring, Prescribing	N/A	1457855942	0	0	TRAN, PHUC C DMD	11/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	103962	N/A	N/A	N/A	N/A	N/A	45 HAZEL ST	None	WILLITS	CA	95490	4222	00	06000	39.39982145	-123.352308	Mendocino County
334002	Ordering, Referring, Prescribing	N/A	1457913568	0	0	TANG, CATHERINE M	7/19/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	103888	N/A	N/A	N/A	N/A	N/A	4815 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5108	00	06000	38.653245	-121.3836075	Sacramento County
334014	Ordering, Referring, Prescribing	N/A	1457940686	0	0	TAMAYO, ANEL V PA-C	7/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59721	N/A	N/A	N/A	N/A	N/A	7777 SUNRISE BLVD	STE 2500	CITRUS HEIGHTS	CA	95610	2372	00	06000	38.706561	-121.2731145	Sacramento County
334021	Ordering, Referring, Prescribing	N/A	1457962193	0	0	TON-TRAN, TRAM OD	8/13/2020	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34633	N/A	N/A	N/A	N/A	N/A	1668 E 2ND ST	STE B	BEAUMONT	CA	92223	3164	00	06000	33.92359885	-116.9480354	Riverside County
334034	Ordering, Referring, Prescribing	N/A	1457981615	0	0	THOMPSON, NICOLE NP	12/19/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013691	N/A	N/A	N/A	N/A	N/A	300 S STRATFORD AVE	None	SANTA MARIA	CA	93454	0001	00	06000	34.95093895	-120.4146959	Santa Barbara County
334046	Ordering, Referring, Prescribing	N/A	1467006577	0	0	TORBON, TORBERTHA P NP	1/13/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95011304	N/A	N/A	N/A	N/A	N/A	9925 INTERNATIONAL BLVD	SUITE 5	OAKLAND	CA	94603	2558	00	06000	37.74332565	-122.1698542	Alameda County
334047	Ordering, Referring, Prescribing	N/A	1467009126	0	0	TAMAYO, JENNIFER N LCSW	12/12/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112578	N/A	N/A	N/A	N/A	N/A	14632 YORBA ST.	None	TUSTIN	CA	92780	0300	00	06000	33.75056331	-117.8302319	Orange County
334048	Ordering, Referring, Prescribing	N/A	1467000760	0	0	TAYLOR, SHONI NP	11/3/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015850	N/A	N/A	N/A	N/A	N/A	415 EAST AVENUE I	None	LANCASTER	CA	93534	1607	00	06000	34.7041243	-118.1232531	Los Angeles County
334054	Ordering, Referring, Prescribing	N/A	1467018044	0	0	TORRES, JOSEPHINE	1/30/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	144676	N/A	N/A	N/A	N/A	N/A	1414 N. CALIFORNIA	None	STOCKTON	CA	95202	1515	00	06000	37.96761084	-121.2883234	San Joaquin County
334069	Ordering, Referring, Prescribing	N/A	1467021758	0	0	TORRES, DESIREE V LMFT	6/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84778	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD, MAILST	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
334074	Ordering, Referring, Prescribing	N/A	1467080010	0	0	THOMPSON, WISDOM M LCSW	8/8/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW117182	N/A	N/A	N/A	N/A	N/A	157 E VALLEY PKWY	None	ESCONDIDO	CA	92025	2762	00	06000	33.12315955	-117.0809067	San Diego County
334098	Ordering, Referring, Prescribing	N/A	1467109033	0	0	TODD, ROSEMARY LMFT	11/16/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125495	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
334153	Ordering, Referring, Prescribing	N/A	1467529768	0	0	TOWNSEND, JACQUELINE LMFT	6/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52062	N/A	N/A	N/A	N/A	N/A	1441 CONSTITUTION BLVD	200	SALINAS	CA	93906	3100	00	06000	36.696987	-121.633164	Monterey County
334189	Ordering, Referring, Prescribing	N/A	1467617704	0	0	TEJEDA, JACQUELIN LMFT	5/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109794	N/A	N/A	N/A	N/A	N/A	25910 ACERO, SUITE 160	220	MISSION VIEJO	CA	92691	6468	00	06000	33.61712389	-117.6780482	Orange County
334204	Ordering, Referring, Prescribing	N/A	1467646489	0	0	TURNER, ELLEN L LMFT	8/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT42687	N/A	N/A	N/A	N/A	N/A	6765 GREEN VALLEY ROAD	None	PLACERVILLE	CA	95667	8984	00	06000	38.72039732	-120.8664353	El Dorado County
334257	Ordering, Referring, Prescribing	N/A	1467738963	0	0	TAKANG, ERNEST A NP	10/7/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95015637	N/A	N/A	N/A	N/A	N/A	8856 ARLINGTON AVENUE	None	RIVERSIDE	CA	92503	1365	00	06000	33.94647572	-117.4674078	Riverside County
334301	Ordering, Referring, Prescribing	N/A	1467809806	0	0	TEFERI, ALICIA MD	8/21/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A153183	N/A	N/A	N/A	N/A	N/A	15322 LAKESHORE DR	101	CLEARLAKE	CA	95422	9814	00	06000	38.95045805	-122.6255271	Lake County
334385	Ordering, Referring, Prescribing	N/A	1467927350	0	0	THOMAS, NYTASHA A LCSW	11/3/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW102036	N/A	N/A	N/A	N/A	N/A	28078 BAXTER RD	540	MURRIETA	CA	92563	1402	00	06000	33.615	-117.1670265	Riverside County
334386	Ordering, Referring, Prescribing	N/A	1467915959	0	0	TALMADGE, ROJEAN L LMFT	3/20/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT112354	N/A	N/A	N/A	N/A	N/A	1881 COMMERCENTER E	#232	SAN BERNARDINO	CA	92408	3456	00	06000	34.06770327	-117.2822565	San Bernardino County
334535	Ordering, Referring, Prescribing	N/A	1477189769	0	0	TURNER, CAROLINE E LCSW	4/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW107598	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVE.	SUITE 100	LOS ANGELES	CA	90018	1353	00	06000	34.037415	-118.3176815	Los Angeles County
334566	Ordering, Referring, Prescribing	N/A	1477314797	0	0	TOSCANO, ANDREW LCSW	12/27/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	120077	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
334567	Ordering, Referring, Prescribing	N/A	1477329944	0	0	TRAN, PHET NP	11/21/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027932	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
334631	Ordering, Referring, Prescribing	N/A	1477642585	0	0	TRAN, THAO MD	2/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80749	N/A	N/A	N/A	N/A	N/A	729 FILBERT ST	None	SAN FRANCISCO	CA	94133	2760	00	06000	37.80103613	-122.4119083	San Francisco County
334697	Ordering, Referring, Prescribing	N/A	1477801553	0	0	TRAN, DAVINA L PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67637	N/A	N/A	N/A	N/A	N/A	17284 SLOVER AVE	204	FONTANA	CA	92337	7584	00	06000	34.065396	-117.4277475	San Bernardino County
334720	Ordering, Referring, Prescribing	N/A	1477822120	0	0	TON, SON-NAM T PHARMD	7/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58811	N/A	N/A	N/A	N/A	N/A	10992 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	3045	00	06000	33.90464034	-117.4738995	Riverside County
334723	Ordering, Referring, Prescribing	N/A	1477821015	0	0	TANG, LAYHEANG PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58861	N/A	N/A	N/A	N/A	N/A	5829 LAKEWOOD BLVD	None	LAKEWOOD	CA	90712	1001	00	06000	33.86147305	-118.1427711	Los Angeles County
334733	Ordering, Referring, Prescribing	N/A	1477840700	0	0	TECSON, NINA M DDS	11/11/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	61537	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
334756	Ordering, Referring, Prescribing	N/A	1477895860	0	0	TAIWO, ADEFEMI MD	4/9/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A155283	N/A	N/A	N/A	N/A	N/A	210 N CHESTER AVE	None	BAKERSFIELD	CA	93308	4841	00	06000	35.407179	-119.0208925	Kern County
334797	Ordering, Referring, Prescribing	N/A	1477952273	0	0	TREVINO, SILVIA LMFT	8/5/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112609	N/A	N/A	N/A	N/A	N/A	7001A EAST PKWY	None	SACRAMENTO	CA	95823	2501	00	06000	38.497689	-121.4498385	Sacramento County
334815	Ordering, Referring, Prescribing	N/A	1477977098	0	0	TRAN, HENRY PHARMD	7/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68643	N/A	N/A	N/A	N/A	N/A	4172 N FIRST ST	None	FRESNO	CA	93726	0000	00	06000	36.79362	-119.772244	Fresno County
334870	Ordering, Referring, Prescribing	N/A	1487053955	0	0	TRUONG, TAMI PHARMD	8/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	70907	N/A	N/A	N/A	N/A	N/A	1663 BRANHAM LN	None	SAN JOSE	CA	95118	1111	00	06000	37.25190008	-121.9076357	Santa Clara County
334894	Ordering, Referring, Prescribing	N/A	1487077251	0	0	THAO, XEE LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116827	N/A	N/A	N/A	N/A	N/A	3433 W SHAW AVE	107	FRESNO	CA	93711	3229	00	06000	36.806265	-119.854044	Fresno County
334898	Ordering, Referring, Prescribing	N/A	1487080651	0	0	THEODORE, PETER S PHD	6/1/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY22511	N/A	N/A	N/A	N/A	N/A	5901 W OLYMPIC BLVD	500	LOS ANGELES	CA	90036	4667	00	06000	34.05764121	-118.3603115	Los Angeles County
334916	Ordering, Referring, Prescribing	N/A	1487117172	0	0	THEIN, SOE MD	11/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A177754	N/A	N/A	N/A	N/A	N/A	9343 TECH CENTER DR	None	SACRAMENTO	CA	95826	2563	00	06000	38.564091	-121.3509285	Sacramento County
334919	Ordering, Referring, Prescribing	N/A	1487122206	0	0	TATE, SHIVANA G PA-C	2/4/2019	Taxonomy not applicable	NA	n/a	000	Unknown	56539	N/A	N/A	N/A	N/A	N/A	5358 JACKSON DR	SUITE 1	LA MESA	CA	91942	3040	00	06000	32.77670689	-117.0174595	San Diego County
334958	Ordering, Referring, Prescribing	N/A	1487167482	0	0	TILLEY, TRACY NP	12/18/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012213	N/A	N/A	N/A	N/A	N/A	1325 E CHURCH ST	STE 301	SANTA MARIA	CA	93454	0001	00	06000	34.95209265	-120.4147348	Santa Barbara County
334973	Ordering, Referring, Prescribing	N/A	1487193850	0	0	TRAN, MYAN PHARMD	7/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH76248	N/A	N/A	N/A	N/A	N/A	155 NORTHGATE ONE	None	SAN RAFAEL	CA	94903	3417	00	06000	38.0077165	-122.5460228	Marin County
335006	Ordering, Referring, Prescribing	N/A	1487262861	0	0	TAMRAZYAN, DAVID CNP	9/1/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95010159	N/A	N/A	N/A	N/A	N/A	30257 SAN MARTINEZ RD	None	VAL VERDE	CA	91384	2472	00	06000	34.44738769	-118.6644399	Los Angeles County
335007	Ordering, Referring, Prescribing	N/A	1487261459	0	0	TAN, FANNY Y PHARMD	3/6/2024	Taxonomy not applicable	NA	n/a	000	Unknown	82499	N/A	N/A	N/A	N/A	N/A	388 9TH ST	#108	OAKLAND	CA	94607	4287	00	06000	37.80019425	-122.2715222	Alameda County
335012	Ordering, Referring, Prescribing	N/A	1487267381	0	0	THAI, ELAINE S PHARMD	12/26/2020	Taxonomy not applicable	NA	n/a	000	Unknown	83114	N/A	N/A	N/A	N/A	N/A	1291 S VICTORIA BLVD	None	OXNARD	CA	93035	1292	00	06000	34.188363	-119.221387	Ventura County
335024	Ordering, Referring, Prescribing	N/A	1487285011	0	0	TANG, NANXI PHARMD	12/1/2019	Taxonomy not applicable	NA	n/a	000	Unknown	81112	N/A	N/A	N/A	N/A	N/A	9215 E, CA-140	None	PLANADA	CA	95365	8245	00	06000	37.2954507	-120.3209234	Merced County
335041	Ordering, Referring, Prescribing	N/A	1487347597	0	0	TOOMEY, JENNIFER LYNNE	2/9/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024232	N/A	N/A	N/A	N/A	N/A	220 MESCALITA CT	None	OCEANSIDE	CA	92058	7953	00	06000	33.24434948	-117.329364	San Diego County
335043	Ordering, Referring, Prescribing	N/A	1487341574	0	0	TOMAS, LAUREN A OT	4/17/2023	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	24919	N/A	N/A	N/A	N/A	N/A	10431 COMMERCE ST	SUITE A	REDLANDS	CA	92374	0110	00	06000	34.06427678	-117.2416506	San Bernardino County
335070	Ordering, Referring, Prescribing	N/A	1487485934	0	0	TABA, SKYLAR	8/7/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031535	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
335097	Ordering, Referring, Prescribing	N/A	1487715066	0	0	TOLENTINO, DIANA LMFT	11/2/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52761	N/A	N/A	N/A	N/A	N/A	275 BECK AVE	None	FAIRFIELD	CA	94533	6804	00	06000	38.23532718	-122.0663968	Solano County
335114	Ordering, Referring, Prescribing	N/A	1487749131	0	0	TANNO, RONALD L	7/23/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D17397	N/A	N/A	N/A	N/A	N/A	89 PUTNAM WAY	None	ARBUCKLE	CA	95912	9814	00	06000	39.02117456	-122.0619172	Colusa County
335133	Ordering, Referring, Prescribing	N/A	1487779344	0	0	TUROV, JOSHUA N LMFT	3/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47916	N/A	N/A	N/A	N/A	N/A	200 MICHIGAN AVE	None	VISTA	CA	92084	5424	00	06000	33.2038743	-117.2421678	San Diego County
335205	Ordering, Referring, Prescribing	N/A	1487937942	0	0	TONG, ERIC	4/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	63587	N/A	N/A	N/A	N/A	N/A	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	00	06000	38.57535	-121.407633	Sacramento County
335206	Ordering, Referring, Prescribing	N/A	1487935789	0	0	TRIVEDI, URVI K PHARMD	8/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH57805	N/A	N/A	N/A	N/A	N/A	1306 SOUTH MARY AVENUE	66	SUNNYVALE	CA	94087	3130	00	06000	37.35157944	-122.0505128	Santa Clara County
335227	Ordering, Referring, Prescribing	N/A	1487963658	0	0	THOMAS, MYISHA L	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81097	N/A	N/A	N/A	N/A	N/A	11731 TELEGRAPH ROAD	K	SANTA FE SPRINGS	CA	90670	6821	00	06000	33.94630253	-118.0832082	Los Angeles County
335241	Ordering, Referring, Prescribing	N/A	1487995890	0	0	TABOR, AMBER N NP	7/28/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN852151	N/A	N/A	N/A	N/A	N/A	3772 TIBBETTS ST	SUITE A	RIVERSIDE	CA	92506	2605	00	06000	33.94720849	-117.399204	Riverside County
335252	Ordering, Referring, Prescribing	N/A	1497009252	0	0	TSANG, CHEONG PHARMD	3/14/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH74475	N/A	N/A	N/A	N/A	N/A	3680 CROCKER DR	100	SACRAMENTO	CA	95818	5987	00	06000	38.54079	-121.483827	Sacramento County
335254	Ordering, Referring, Prescribing	N/A	1497013817	0	0	TJON, CHRISTOPHER PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66148	N/A	N/A	N/A	N/A	N/A	1761 BROADWAY ST STE 209	STE 209	VALLEJO	CA	94589	2227	00	06000	38.13049234	-122.2522422	Solano County
335293	Ordering, Referring, Prescribing	N/A	1497082739	0	0	TRAN, KRISTINA T	8/9/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	102294	N/A	N/A	N/A	N/A	N/A	1450 FRUITVALE AVE	None	OAKLAND	CA	94601	2313	00	06000	37.77832732	-122.2254462	Alameda County
335294	Ordering, Referring, Prescribing	N/A	1497080642	0	0	TUTUPALLI, LOHIT PHD	3/11/2020	Taxonomy not applicable	NA	n/a	000	Unknown	33436	N/A	N/A	N/A	N/A	N/A	1212 N CALIFORNIA ST	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
335348	Ordering, Referring, Prescribing	N/A	1497164560	0	0	TOLOSA, MARTIN PA-C	12/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	51777	N/A	N/A	N/A	N/A	N/A	1530 HILLHURST AVENUE	None	LOS ANGELES	CA	90027	5516	00	06000	34.098921	-118.287374	Los Angeles County
335360	Ordering, Referring, Prescribing	N/A	1497182398	0	0	TRUJILLO, BRENDA LCSW	9/9/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	125904	N/A	N/A	N/A	N/A	N/A	233 S QUINTANA DR	None	ANAHEIM	CA	92807	4029	00	06000	33.85230249	-117.7739305	Orange County
335373	Ordering, Referring, Prescribing	N/A	1497200141	0	0	TURNER-JOHNSON, JAMAR LMFT	2/18/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131279	N/A	N/A	N/A	N/A	N/A	2035 E. BALL RD	200	ANAHEIM	CA	92806	5159	00	06000	33.81812448	-117.8880075	Orange County
335389	Ordering, Referring, Prescribing	N/A	1497222566	0	0	THOMAS, CRISTY N RN	2/11/2018	Taxonomy not applicable	NA	n/a	000	Unknown	846046	N/A	N/A	N/A	N/A	N/A	1300 BAKER ST	None	BAKERSFIELD	CA	93305	4326	00	06000	35.38256022	-118.990868	Kern County
335415	Ordering, Referring, Prescribing	N/A	1497269864	0	0	TRAN, QUANG D	1/25/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007611	N/A	N/A	N/A	N/A	N/A	2100 EAST ANAHEIM STREET	SUITE B	LONG BEACH	CA	90804	3419	00	06000	33.7825725	-118.1663865	Los Angeles County
335428	Ordering, Referring, Prescribing	N/A	1497296628	0	0	TAPIA, JANETTE LMFT	5/17/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT130497	N/A	N/A	N/A	N/A	N/A	1161 BAY BLVD	SUITE B	CHULA VISTA	CA	91911	2670	00	06000	32.6050811	-117.0922508	San Diego County
335468	Ordering, Referring, Prescribing	N/A	1497389746	0	0	TAMBA, STEVEN NP	8/15/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012488	N/A	N/A	N/A	N/A	N/A	1450 E HOLT AVENUE	None	POMONA	CA	91767	5822	00	06000	34.06299829	-117.7215562	Los Angeles County
335481	Ordering, Referring, Prescribing	N/A	1497399315	0	0	TAYLOR, ALEXANDRA Q NP	6/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014113	N/A	N/A	N/A	N/A	N/A	628 W MICHELTORENA ST	None	SANTA BARBARA	CA	93101	4131	00	06000	34.41910081	-119.7158618	Santa Barbara County
335494	Ordering, Referring, Prescribing	N/A	1497419162	0	0	TRUONG, DANG PHARMD	5/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH84406	N/A	N/A	N/A	N/A	N/A	543 SWEETWATER RD	None	SPRING VALLEY	CA	91977	5627	00	06000	32.708178	-117.008559	San Diego County
335496	Ordering, Referring, Prescribing	N/A	1497434260	0	0	TUAZON, AMANDA E NP	7/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025822	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
335529	Ordering, Referring, Prescribing	N/A	1497748594	0	0	TOMPKINS, JAIME R NP	1/31/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN552651	N/A	N/A	N/A	N/A	N/A	3131 ALUM ROCK AVENUE	None	SAN JOSE	CA	95127	2902	00	06000	37.36639819	-121.8272112	Santa Clara County
335542	Ordering, Referring, Prescribing	N/A	1497812093	0	0	THORSNES, CONSTANCE E LMFT	5/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105452	N/A	N/A	N/A	N/A	N/A	1035 SAN PABLO AVE	SUITE 5	ALBANY	CA	94706	2275	00	06000	37.88531142	-122.2973343	Alameda County
335581	Ordering, Referring, Prescribing	N/A	1497887830	0	0	TANNER, KATHY A LMFT	12/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT39047	N/A	N/A	N/A	N/A	N/A	5225 N LAKE BLVD	None	CARNELIAN BAY	CA	96140	0000	00	06000	39.22688547	-120.078288	Placer County
335585	Ordering, Referring, Prescribing	N/A	1497895197	0	0	TIZNADO, MONICA LMFT	7/26/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	81074	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	STE. 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
335653	Ordering, Referring, Prescribing	N/A	1508076472	0	0	TRAN, NATALIE N	1/8/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	9210	N/A	N/A	N/A	N/A	N/A	1645 LONGVIEW DR	None	DIAMOND BAR	CA	91765	4316	00	06000	33.99169729	-117.795027	Los Angeles County
335670	Ordering, Referring, Prescribing	N/A	1508114943	0	0	TERCERO, JENNIFER V LMFT	12/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112288	N/A	N/A	N/A	N/A	N/A	2130 STOCKTON BLVD.	100	SACRAMENTO	CA	95817	2929	00	06000	38.557593	-121.4616735	Sacramento County
335678	Ordering, Referring, Prescribing	N/A	1508127879	0	0	TALAVERA, YESENIA LMFT	6/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105111	N/A	N/A	N/A	N/A	N/A	3950 REYNOLDS RD	None	RIVERSIDE	CA	92503	3517	00	06000	33.9184159	-117.4562188	Riverside County
335748	Ordering, Referring, Prescribing	N/A	1508239195	0	0	TRAN, TU-HOA T PHARMD	7/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH45462	N/A	N/A	N/A	N/A	N/A	780 E SANTA CLARA ST	None	SAN JOSE	CA	95112	1909	00	06000	37.34353562	-121.8749754	Santa Clara County
335759	Ordering, Referring, Prescribing	N/A	1508254095	0	0	TITTLE, TITIAN NP	2/2/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001687	N/A	N/A	N/A	N/A	N/A	14011 PARK AVE	None	VICTORVILLE	CA	92392	2413	00	06000	34.505647	-117.3265457	San Bernardino County
335809	Ordering, Referring, Prescribing	N/A	1508337387	0	0	TRAN, VICTORIA N NP	10/23/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010316	N/A	N/A	N/A	N/A	N/A	3131 ALUM ROCK AVENUE	None	SAN JOSE	CA	95127	0000	00	06000	37.36639819	-121.8272112	Santa Clara County
335810	Ordering, Referring, Prescribing	N/A	1508340308	0	0	TEMPLETON POE, MONIQUE R LMFT	8/5/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127334	N/A	N/A	N/A	N/A	N/A	2620 INDUSTRY WAY	None	LYNWOOD	CA	90262	4024	00	06000	33.92360701	-118.2254995	Los Angeles County
335821	Ordering, Referring, Prescribing	N/A	1508354028	0	0	TSAI, GRACE L DPM	8/11/2021	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5801	N/A	N/A	N/A	N/A	N/A	575 E HARDY ST	STE 312	INGLEWOOD	CA	90301	4050	00	06000	33.94909392	-118.3477665	Los Angeles County
335888	Ordering, Referring, Prescribing	N/A	1508492471	0	0	TRAN, LISA NP	6/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95016108	N/A	N/A	N/A	N/A	N/A	7655 GREENLEAF AVENUE	None	WHITTIER	CA	90602	1626	00	06000	33.9719973	-118.0374206	Los Angeles County
335893	Ordering, Referring, Prescribing	N/A	1508500729	0	0	TRAN, ASHLEY Q PA-C	12/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA62048	N/A	N/A	N/A	N/A	N/A	3920 EAGLE ROCK BLVD	STE A	LOS ANGELES	CA	90065	3668	00	06000	34.11936223	-118.230111	Los Angeles County
335896	Ordering, Referring, Prescribing	N/A	1508500760	0	0	TAYLOR-MDUBA, TIFFANY S NP	4/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020695	N/A	N/A	N/A	N/A	N/A	58375 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	5813	00	06000	34.13141256	-116.3904357	San Bernardino County
336081	Ordering, Referring, Prescribing	N/A	1518121706	0	0	TORRES-CARRILLO, MINERVA LCSW	3/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87281	N/A	N/A	N/A	N/A	N/A	88 TABLE MOUNTAIN BLVD	None	OROVILLE	CA	95965	3578	00	06000	39.52148732	-121.5548586	Butte County
336107	Ordering, Referring, Prescribing	N/A	1518177518	0	0	TO, QUELAN PHARMD	10/9/2018	Taxonomy not applicable	NA	n/a	000	Unknown	52761	N/A	N/A	N/A	N/A	N/A	976 LENZEN AVE	None	SAN JOSE	CA	95126	2737	00	06000	37.33463902	-121.9121497	Santa Clara County
336108	Ordering, Referring, Prescribing	N/A	1518190354	0	0	TOWLER, ANGEL B LCSW	10/26/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61788	N/A	N/A	N/A	N/A	N/A	3200 MOTOR AVE.	None	LOS ANGELES	CA	90034	3710	00	06000	34.03321301	-118.4109122	Los Angeles County
336109	Ordering, Referring, Prescribing	N/A	1518185305	0	0	TRAN, DAN Q MD	12/13/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80816	N/A	N/A	N/A	N/A	N/A	1211 W. LA PALMA AVE.	404	ANAHEIM	CA	92801	2806	00	06000	33.84718298	-117.933758	Orange County
336116	Ordering, Referring, Prescribing	N/A	1518196401	0	0	TUSZYNSKI, ANN E LCSW	2/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28737	N/A	N/A	N/A	N/A	N/A	315 TURK ST.	None	SAN FRANCISCO	CA	94102	3703	00	06000	37.78272091	-122.4143755	San Francisco County
336137	Ordering, Referring, Prescribing	N/A	1518240845	0	0	TOY, KARIN L	8/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH39891	N/A	N/A	N/A	N/A	N/A	15 W HARDING WAY	None	STOCKTON	CA	95204	5716	00	06000	37.96722115	-121.295851	San Joaquin County
336142	Ordering, Referring, Prescribing	N/A	1518241249	0	0	THOMPSON, JOHN	3/28/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	77891	N/A	N/A	N/A	N/A	N/A	1021 S EL CAMINO REAL	None	SAN MATEO	CA	94402	2801	00	06000	37.55684528	-122.31914	San Mateo County
336158	Ordering, Referring, Prescribing	N/A	1518270123	0	0	TU, PATRICK PHARMD	6/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	51958	N/A	N/A	N/A	N/A	N/A	972 GOODRICH BLVD	100	COMMERCE	CA	90022	4114	00	06000	34.01786727	-118.1546159	Los Angeles County
336161	Ordering, Referring, Prescribing	N/A	1518279371	0	0	TURNER, SHEILA LMFT	10/15/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT150658	N/A	N/A	N/A	N/A	N/A	365 TUOLUMNE ST	None	VALLEJO	CA	94590	5700	00	06000	38.10261225	-122.2382555	Solano County
336163	Ordering, Referring, Prescribing	N/A	1518281567	0	0	THRASHER, ABBY OT	5/25/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	11020	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
336172	Ordering, Referring, Prescribing	N/A	1518300466	0	0	TAMONDONG, RONALD ERIC D MD	4/20/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A129664	N/A	N/A	N/A	N/A	N/A	2505 E DIVISADERO ST	None	FRESNO	CA	93721	1401	00	06000	36.74334929	-119.7809344	Fresno County
336184	Ordering, Referring, Prescribing	N/A	1518330042	0	0	TANG, SONTUNG T PHARMD	7/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH73928	N/A	N/A	N/A	N/A	N/A	6199 SUNRISE BLVD	None	CITRUS HEIGHTS	CA	95610	6834	00	06000	38.67786	-121.2722235	Sacramento County
336189	Ordering, Referring, Prescribing	N/A	1518341825	0	0	THOMPSON, MITCHELL A	12/5/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D64735	N/A	N/A	N/A	N/A	N/A	4815 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5108	00	06000	38.653245	-121.3836075	Sacramento County
336201	Ordering, Referring, Prescribing	N/A	1518348465	0	0	TRAN, DANA	3/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	54026	N/A	N/A	N/A	N/A	N/A	260 W.FOOTHILL PARKWAY	None	CORONA	CA	92882	8540	00	06000	33.8448074	-117.5736088	Riverside County
336226	Ordering, Referring, Prescribing	N/A	1518387414	0	0	TAPIAS, RAFAEL E MD	11/5/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A162921	N/A	N/A	N/A	N/A	N/A	3751 STOCKER ST	None	VIEW PARK	CA	90008	5101	00	06000	34.00616017	-118.3385751	Los Angeles County
336261	Ordering, Referring, Prescribing	N/A	1518433127	0	0	TIWARI, RICHA PA-C	9/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	56491	N/A	N/A	N/A	N/A	N/A	316 S STRATFORD AVE	STE B	SANTA MARIA	CA	93454	5908	00	06000	34.95019447	-120.4147816	Santa Barbara County
336286	Ordering, Referring, Prescribing	N/A	1518490218	0	0	THOMAS, SEAN V MD	1/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A171303	N/A	N/A	N/A	N/A	N/A	912 FREMONT STREET	None	DELANO	CA	93215	2713	00	06000	35.76763031	-119.2498143	Kern County
336328	Ordering, Referring, Prescribing	N/A	1518564665	0	0	TRAN, TUONG-VY PA-C	10/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58818	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
336336	Ordering, Referring, Prescribing	N/A	1518627652	0	0	TANG, BRITTANY PHARMD	3/17/2024	Taxonomy not applicable	NA	n/a	000	Unknown	RPH85531	N/A	N/A	N/A	N/A	N/A	388 9TH ST	108	OAKLAND	CA	94607	4287	00	06000	37.80019425	-122.2715222	Alameda County
336339	Ordering, Referring, Prescribing	N/A	1518657394	0	0	TRAN, THAO T NP	8/8/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95026567	N/A	N/A	N/A	N/A	N/A	10251 ARTESIA BLVD	None	BELLFLOWER	CA	90706	6719	00	06000	33.87290452	-118.1154735	Los Angeles County
336347	Ordering, Referring, Prescribing	N/A	1518671684	0	0	TRENTIN, JOHN	1/3/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023795	N/A	N/A	N/A	N/A	N/A	427 S OHIO ST	None	ANAHEIM	CA	92805	3625	00	06000	33.82887864	-117.9229071	Orange County
336373	Ordering, Referring, Prescribing	N/A	1518954684	0	0	TRAN, KIM OANH T PHARMD	9/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH44095	N/A	N/A	N/A	N/A	N/A	14536 BROOKHURST ST	101	WESTMINSTER	CA	92840	5809	00	06000	33.751737	-117.9548845	Orange County
336419	Ordering, Referring, Prescribing	N/A	1528146198	0	0	THOMAS, CHERYL L	9/12/2017	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	489845	N/A	N/A	N/A	N/A	N/A	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	00	06000	36.84133078	-119.7824983	Fresno County
336421	Ordering, Referring, Prescribing	N/A	1528175189	0	0	TUEY, CHARLES K PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55059	N/A	N/A	N/A	N/A	N/A	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
336484	Ordering, Referring, Prescribing	N/A	1528300217	0	0	TRUONG, MINH H LCSW	11/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	77250	N/A	N/A	N/A	N/A	N/A	2800 RIVERSIDE AVE	None	PASO ROBLES	CA	93446	1311	00	06000	35.64351546	-120.6888699	San Luis Obispo County
336490	Ordering, Referring, Prescribing	N/A	1528312477	0	0	TRAN, LENA M PHARMD	4/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66521	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
336529	Ordering, Referring, Prescribing	N/A	1528372257	0	0	TRAN, MARIE PHARMD	4/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	63525	N/A	N/A	N/A	N/A	N/A	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	00	06000	34.07253232	-117.4356028	San Bernardino County
336545	Ordering, Referring, Prescribing	N/A	1528416005	0	0	THOMPSON, CASEY J PA	11/20/2017	Taxonomy not applicable	NA	n/a	000	Unknown	53774	N/A	N/A	N/A	N/A	N/A	4575 COLLEGE AVE	None	SAN DIEGO	CA	92115	4011	00	06000	32.76023438	-117.0667611	San Diego County
336549	Ordering, Referring, Prescribing	N/A	1528419678	0	0	TORRES, VERENICE	3/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	89158	N/A	N/A	N/A	N/A	N/A	525 CABRILLO PARK DR	300	SANTA ANA	CA	92701	5017	00	06000	33.75047365	-117.8404984	Orange County
336597	Ordering, Referring, Prescribing	N/A	1528478112	0	0	TRIEU, JOHN NP	3/4/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000352	N/A	N/A	N/A	N/A	N/A	9808 VENICE BLVD	SUITE 700	CULVER CITY	CA	90232	2732	00	06000	34.0236396	-118.3980847	Los Angeles County
336637	Ordering, Referring, Prescribing	N/A	1528550373	0	0	TURNER, JOHN LMFT	11/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	34643	N/A	N/A	N/A	N/A	N/A	55 HITCHCOCK WAY	STE 106	SANTA BARBARA	CA	93105	3148	00	06000	34.437888	-119.744434	Santa Barbara County
336647	Ordering, Referring, Prescribing	N/A	1528564291	0	0	TA, NAMTRAN N	11/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007829	N/A	N/A	N/A	N/A	N/A	1805 E CLIFPARK WAY	None	ANAHEIM	CA	92805	0001	00	06000	33.82026507	-117.8916882	Orange County
336677	Ordering, Referring, Prescribing	N/A	1528611829	0	0	TRAN, CARNIE M CCC-SLP	11/17/2021	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	28942	N/A	N/A	N/A	N/A	N/A	1070 BROADWAY AVE	None	SAN JOSE	CA	95125	2232	00	06000	37.31153439	-121.9007764	Santa Clara County
336678	Ordering, Referring, Prescribing	N/A	1528612041	0	0	TRAN, JIMMY A	8/14/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	104213	N/A	N/A	N/A	N/A	N/A	2020 J STREET	None	SACRAMENTO	CA	95811	3120	00	06000	38.576331	-121.4791155	Sacramento County
336800	Ordering, Referring, Prescribing	N/A	1538215116	0	0	THURMAN, MICHAEL MD	11/20/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G76855	N/A	N/A	N/A	N/A	N/A	9990 COUNTY FARM RD	None	RIVERSIDE	CA	92503	3542	00	06000	33.9201112	-117.4577963	Riverside County
336814	Ordering, Referring, Prescribing	N/A	1538258694	0	0	TILTON, PETER A	3/11/2020	Taxonomy not applicable	NA	n/a	000	Unknown	G27781	N/A	N/A	N/A	N/A	N/A	5168 HONPIE RD	None	PLACERVILLE	CA	95667	8682	00	06000	38.6943603	-120.9018271	El Dorado County
336833	Ordering, Referring, Prescribing	N/A	1538300652	0	0	TRAN, THERESA U PHARMD	2/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60155	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY	625	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
336858	Ordering, Referring, Prescribing	N/A	1538340948	0	0	TINTOR, JINA LCSW	1/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW85318	N/A	N/A	N/A	N/A	N/A	3741 STOCKER ST	None	VIEW PARK	CA	90008	5109	00	06000	34.00623019	-118.3384304	Los Angeles County
336907	Ordering, Referring, Prescribing	N/A	1538442561	0	0	TRAN, LOAN K PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH53797	N/A	N/A	N/A	N/A	N/A	6316 IRVINE BLVD	None	IRVINE	CA	92620	2102	00	06000	33.69920001	-117.7393832	Orange County
336910	Ordering, Referring, Prescribing	N/A	1538444302	0	0	TRINH, TUYEN T PHARMD	7/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54087	N/A	N/A	N/A	N/A	N/A	13052 NEWPORT AVE	None	TUSTIN	CA	92780	3535	00	06000	33.74896613	-117.8112946	Orange County
336917	Ordering, Referring, Prescribing	N/A	1538450069	0	0	TSAI, JENNIFER LMFT	10/2/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91171	N/A	N/A	N/A	N/A	N/A	1101 S WINCHESTER BLVD	SUITE O-284	SAN JOSE	CA	95128	0000	00	06000	37.305693	-121.950129	Santa Clara County
336924	Ordering, Referring, Prescribing	N/A	1538469580	0	0	THOMAS, MARY L PHARMD	3/16/2018	Taxonomy not applicable	NA	n/a	000	Unknown	57516	N/A	N/A	N/A	N/A	N/A	1080 PLEASANT GROVE BLVD	None	ROSEVILLE	CA	95678	6117	00	06000	38.77629256	-121.2910739	Placer County
336979	Ordering, Referring, Prescribing	N/A	1538554159	0	0	TSENG, JOCELYN M MD	12/12/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146175	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
337001	Ordering, Referring, Prescribing	N/A	1538580170	0	0	TRAN, JENNIFER PHARMD	7/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70040	N/A	N/A	N/A	N/A	N/A	3570 ATLANTIC AVE	None	LONG BEACH	CA	90807	4516	00	06000	33.821568	-118.185003	Los Angeles County
337048	Ordering, Referring, Prescribing	N/A	1538658927	0	0	TOMLINSON, HUNTER C LMFT	7/14/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	140423	N/A	N/A	N/A	N/A	N/A	500 W FOSTER ROAD	None	SANTA MARIA	CA	93455	3620	00	06000	34.88351329	-120.4428974	Santa Barbara County
337052	Ordering, Referring, Prescribing	N/A	1538657317	0	0	THOM, ALYSSA E LCSW	2/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW64801	N/A	N/A	N/A	N/A	N/A	720 WOOD ST	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
337060	Ordering, Referring, Prescribing	N/A	1538677877	0	0	THIK, MELISSA	8/24/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026850	N/A	N/A	N/A	N/A	N/A	6095 N 1ST ST	None	FRESNO	CA	93710	5444	00	06000	36.82524765	-119.7723922	Fresno County
337082	Ordering, Referring, Prescribing	N/A	1538717293	0	0	TRAN, STEVEN LCSW	10/22/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW126876	N/A	N/A	N/A	N/A	N/A	840 N AVENUE 66	None	LOS ANGELES	CA	90042	1508	00	06000	34.12110842	-118.1725545	Los Angeles County
337096	Ordering, Referring, Prescribing	N/A	1538749742	0	0	THIND, JASMINE K NP	6/6/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025481	N/A	N/A	N/A	N/A	N/A	1601 MONTE VISTA AVE	SUITE 240	CLAREMONT	CA	91711	2914	00	06000	34.112259	-117.698539	Los Angeles County
337115	Ordering, Referring, Prescribing	N/A	1538813639	0	0	THOR, KEITH A PHARMD	12/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85716	N/A	N/A	N/A	N/A	N/A	980 E CYPRESS AVE	None	REDDING	CA	96002	1002	00	06000	40.5710705	-122.353722	Shasta County
337127	Ordering, Referring, Prescribing	N/A	1538867098	0	0	THAMMANA, SWETHA DDS	11/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	108598	N/A	N/A	N/A	N/A	N/A	4815 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5108	00	06000	38.653245	-121.3836075	Sacramento County
337132	Ordering, Referring, Prescribing	N/A	1538869748	0	0	TAYLOR, ZACHARY S NP	3/6/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024508	N/A	N/A	N/A	N/A	N/A	161 N MILL ST	None	TEHACHAPI	CA	93561	1347	00	06000	35.13410412	-118.4520157	Kern County
337133	Ordering, Referring, Prescribing	N/A	1538881073	0	0	TRAN, PHOI L PA-C	10/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA61834	N/A	N/A	N/A	N/A	N/A	700 S TUSTIN ST	None	ORANGE	CA	92866	3425	00	06000	33.77685748	-117.8357804	Orange County
337136	Ordering, Referring, Prescribing	N/A	1538890512	0	0	TATIAN, JULIE L NP	6/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021296	N/A	N/A	N/A	N/A	N/A	1752 S VICTORIA AVE	SUITE 250	VENTURA	CA	93003	6152	00	06000	34.25916679	-119.2090522	Ventura County
337150	Ordering, Referring, Prescribing	N/A	1538943113	0	0	TAN, MONY C CNP	6/13/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025619	N/A	N/A	N/A	N/A	N/A	1360 E ANAHEIM ST STE 10	STE 101	LONG BEACH	CA	90813	5515	00	06000	33.78258054	-118.1744415	Los Angeles County
337209	Ordering, Referring, Prescribing	N/A	1548335128	0	0	TAMINAYA, NELIA LMFT	6/5/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51318	N/A	N/A	N/A	N/A	N/A	7001A EAST PKWY	None	SACRAMENTO	CA	95823	2501	00	06000	38.497689	-121.4498385	Sacramento County
337234	Ordering, Referring, Prescribing	N/A	1548399207	0	0	TSE-YEE, KAM-NIN J LCSW	2/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24007	N/A	N/A	N/A	N/A	N/A	11721 TELEGRAPH RD	None	SANTA FE SPRING	CA	90670	3674	00	06000	33.94629336	-118.0832752	Los Angeles County
337247	Ordering, Referring, Prescribing	N/A	1548429335	0	0	TRAUD, JOLENE M LMFT	3/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT90719	N/A	N/A	N/A	N/A	N/A	660 S. FAIR OAKS AVE, 3R	None	SUNNYVALE	CA	94086	7913	00	06000	37.36442862	-122.024102	Santa Clara County
337250	Ordering, Referring, Prescribing	N/A	1548429863	0	0	THOMPSON, CHERYL E MD	12/18/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A102687	N/A	N/A	N/A	N/A	N/A	201 S HARBOR BLVD	None	LA HABRA	CA	90631	5654	00	06000	33.93029897	-117.9331306	Orange County
337260	Ordering, Referring, Prescribing	N/A	1548448236	0	0	TRAN, TAM B NP	8/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	17915	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
337262	Ordering, Referring, Prescribing	N/A	1548459951	0	0	TRUCANO, TRACEY B LMFT	2/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52751	N/A	N/A	N/A	N/A	N/A	801 EMPIRE STREET	None	FAIRFIELD	CA	94533	5702	00	06000	38.25031147	-122.0435415	Solano County
337274	Ordering, Referring, Prescribing	N/A	1548499460	0	0	THOMPSON, LUCIA F NP	5/1/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	584057	N/A	N/A	N/A	N/A	N/A	470 N GREENFIELD AVE	STE 303	HANFORD	CA	93230	3576	00	06000	36.32996137	-119.6580167	Kings County
337345	Ordering, Referring, Prescribing	N/A	1548634744	0	0	TAMAYO-PEREZ, SARAH E NP	4/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95003182	N/A	N/A	N/A	N/A	N/A	16465 SIERRA LAKES PKWY	300	FONTANA	CA	92336	1242	00	06000	34.13805177	-117.4457839	San Bernardino County
337364	Ordering, Referring, Prescribing	N/A	1548654361	0	0	TOWNSEND, GILLIAN MSW LCSW	10/15/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	18566	N/A	N/A	N/A	N/A	N/A	901 MYRTLE AVE	None	EUREKA	CA	95501	1219	00	06000	40.80088276	-124.1502005	Humboldt County
337368	Ordering, Referring, Prescribing	N/A	1548673825	0	0	TORBAY-HOLGUIN, LISSETTE PSYD	8/29/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31281	N/A	N/A	N/A	N/A	N/A	1050 LAKES DR	225	WEST COVINA	CA	91790	2910	00	06000	34.07127962	-117.9226429	Los Angeles County
337376	Ordering, Referring, Prescribing	N/A	1548685274	0	0	TRAN, KEVIN H PHARMD	7/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67151	N/A	N/A	N/A	N/A	N/A	16201 HARBOR BLVD	None	FOUNTAIN VALLEY	CA	92708	1807	00	06000	33.728085	-117.9215595	Orange County
337378	Ordering, Referring, Prescribing	N/A	1548684194	0	0	TRUONG, ANH T PHARMD	9/30/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69574	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
337385	Ordering, Referring, Prescribing	N/A	1548700289	0	0	TESTA, ARINN PSYD	8/7/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	22398	N/A	N/A	N/A	N/A	N/A	4020 CIVIC CENTER DRIVE	None	SAN RAFAEL	CA	94903	4173	00	06000	38.00502899	-122.5393551	Marin County
337387	Ordering, Referring, Prescribing	N/A	1548702319	0	0	TANGONAN, KEVIN DO	6/7/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15061	N/A	N/A	N/A	N/A	N/A	611 S. KINGSLEY DR.	None	LOS ANGELES	CA	90005	1100	00	06000	34.06305793	-118.3028813	Los Angeles County
337397	Ordering, Referring, Prescribing	N/A	1548727159	0	0	TSAI, ALISON LMFT	4/11/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125470	N/A	N/A	N/A	N/A	N/A	851 N OAKLAND AVE	None	PASADENA	CA	91104	4343	00	06000	34.16031813	-118.1403347	Los Angeles County
337399	Ordering, Referring, Prescribing	N/A	1548727332	0	0	TRUITT, AMANDA N NP	8/29/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009772	N/A	N/A	N/A	N/A	N/A	2017 FIRST AVENUE	SUITE 301	SAN DIEGO	CA	92101	0000	00	06000	32.72646147	-117.1638767	San Diego County
337428	Ordering, Referring, Prescribing	N/A	1548766397	0	0	TRUONG, RAYMOND DO	5/1/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	OP61190960	N/A	N/A	N/A	N/A	N/A	2211 NE 139TH ST	None	VANCOUVER	WA	98686	2742	00	06000	45.720117	-122.647986	Clark County
337462	Ordering, Referring, Prescribing	N/A	1548836133	0	0	TAMER, TAMER R MD	6/8/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A196764	N/A	N/A	N/A	N/A	N/A	1188 N EUCLID ST	None	ANAHEIM	CA	92801	1900	00	06000	33.850314	-117.9416115	Orange County
337498	Ordering, Referring, Prescribing	N/A	1548926991	0	0	TONG, TIEN Q PHARMD	10/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85406	N/A	N/A	N/A	N/A	N/A	11950 VALLEY VIEW ST	None	GARDEN GROVE	CA	92845	1239	00	06000	33.7890093	-118.0283611	Orange County
337512	Ordering, Referring, Prescribing	N/A	1558023499	0	0	TRAN, ALBERT PA-C	9/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60101	N/A	N/A	N/A	N/A	N/A	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	00	06000	36.332757	-119.288682	Tulare County
337517	Ordering, Referring, Prescribing	N/A	1558038364	0	0	TO, TOM PHARMD	3/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84853	N/A	N/A	N/A	N/A	N/A	16505 SIERRA LAKES PKWY	None	FONTANA	CA	92336	1256	00	06000	34.13859931	-117.4438742	San Bernardino County
337526	Ordering, Referring, Prescribing	N/A	1558071076	0	0	THAO, NOU P RN	11/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95247822	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DR.	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
337535	Ordering, Referring, Prescribing	N/A	1558096818	0	0	TUNG, MANPREET NP	2/13/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022190	N/A	N/A	N/A	N/A	N/A	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	00	06000	39.23512508	-121.0306878	Nevada County
337553	Ordering, Referring, Prescribing	N/A	1558326371	0	0	TON, KIET A MD	6/3/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C130978	N/A	N/A	N/A	N/A	N/A	14082 MAGNOLIA ST	109	WESTMINSTER	CA	92683	4764	00	06000	33.75832207	-117.9723348	Orange County
337581	Ordering, Referring, Prescribing	N/A	1558447433	0	0	TERCERO, CHRISTIANA LCSW	1/5/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	22751	N/A	N/A	N/A	N/A	N/A	1860 MOWRY AVE	400	FREMONT	CA	94538	1730	00	06000	37.55887933	-121.9797796	Alameda County
337585	Ordering, Referring, Prescribing	N/A	1558447607	0	0	TEKKELIAN, TSOVINAR MD	1/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A52251	N/A	N/A	N/A	N/A	N/A	1251 S GLENDALE AVE	None	GLENDALE	CA	91205	3204	00	06000	34.13049413	-118.2524892	Los Angeles County
337589	Ordering, Referring, Prescribing	N/A	1558444679	0	0	TAMASHIRO, VICKY D LMFT	3/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	25882	N/A	N/A	N/A	N/A	N/A	1245 E SANTA CLARA STREE	444	SAN JOSE	CA	95116	2337	00	06000	37.34780368	-121.8662009	Santa Clara County
337591	Ordering, Referring, Prescribing	N/A	1558466680	0	0	TANABE, JENINE MD	1/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	G47810	N/A	N/A	N/A	N/A	N/A	974 MAGNOLIA ST	None	GRIDLEY	CA	95948	3020	00	06000	39.36238605	-121.6969476	Butte County
337660	Ordering, Referring, Prescribing	N/A	1558630434	0	0	TYSSELAND-MCMINN, SARAH A LCSW	6/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74083	N/A	N/A	N/A	N/A	N/A	1600 PACIFIC HWY	None	SAN DIEGO	CA	92101	2429	00	06000	32.7217581	-117.1711788	San Diego County
337672	Ordering, Referring, Prescribing	N/A	1558644278	0	0	TO, ELLEN	7/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55847	N/A	N/A	N/A	N/A	N/A	1250 E CHAPMAN AVE	None	FULLERTON	CA	92831	3901	00	06000	33.87407154	-117.9059715	Orange County
337746	Ordering, Referring, Prescribing	N/A	1558779249	0	0	TRUJILLO, MACK	7/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50825	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD MS	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
337754	Ordering, Referring, Prescribing	N/A	1558796839	0	0	TAMBOURINE, JASON R PHARMD	3/18/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69675	N/A	N/A	N/A	N/A	N/A	8891 ATLANTA AVE	None	HUNTINGTON BEACH	CA	92646	5937	00	06000	33.65774883	-117.973145	Orange County
337773	Ordering, Referring, Prescribing	N/A	1558818500	0	0	TANG, ALISON T PHARMD	10/7/2020	Taxonomy not applicable	NA	n/a	000	Unknown	75621	N/A	N/A	N/A	N/A	N/A	330 E LIVE OAK AVE	None	ARCADIA	CA	91006	5617	00	06000	34.10850998	-118.0219204	Los Angeles County
337776	Ordering, Referring, Prescribing	N/A	1558825976	0	0	TSAI, JAESUN LMFT	4/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127226	N/A	N/A	N/A	N/A	N/A	17871 PARK PLAZA DR	SUITE 140	CERRITOS	CA	90703	8576	00	06000	33.8692694	-118.0629284	Los Angeles County
337790	Ordering, Referring, Prescribing	N/A	1558845792	0	0	TABIBIAN, MOJDEH PA-C	9/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	56021	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
337803	Ordering, Referring, Prescribing	N/A	1558867531	0	0	TOMAJAN, DAVID MD	4/30/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164996	N/A	N/A	N/A	N/A	N/A	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	00	06000	36.88437894	-119.8003484	Madera County
337887	Ordering, Referring, Prescribing	N/A	1568039758	0	0	TRAN, BRENDAN K DO	2/26/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A22597	N/A	N/A	N/A	N/A	N/A	227 N JACKSON AVE	235	SAN JOSE	CA	95116	1632	00	06000	37.36478223	-121.8497978	Santa Clara County
337902	Ordering, Referring, Prescribing	N/A	1568084275	0	0	TADROS, SOUZAN PHARMD	8/31/2019	Taxonomy not applicable	NA	n/a	000	Unknown	75764	N/A	N/A	N/A	N/A	N/A	2110 TRUXTUN AVE	SUITE 400	BAKERSFIELD	CA	93301	3703	00	06000	35.37344851	-119.0261655	Kern County
337934	Ordering, Referring, Prescribing	N/A	1568185171	0	0	THAYER, KYLE PA-C	10/29/2023	Taxonomy not applicable	NA	n/a	000	Unknown	61833	N/A	N/A	N/A	N/A	N/A	600 B ST	None	SAN DIEGO	CA	92101	4501	00	06000	32.7178265	-117.1587195	San Diego County
337935	Ordering, Referring, Prescribing	N/A	1568188332	0	0	TRAN, JACQUELINE NP	2/13/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029084	N/A	N/A	N/A	N/A	N/A	6840 VIA DEL ORO	STE 210	SAN JOSE	CA	95119	1357	00	06000	37.23194127	-121.7780717	Santa Clara County
337978	Ordering, Referring, Prescribing	N/A	1568507440	0	0	TAYLOR, NICOLE A	9/5/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW74517	N/A	N/A	N/A	N/A	N/A	222 SOUTH HILL STREET/5T	None	LOS ANGELES	CA	90012	3506	00	06000	34.0525918	-118.2482081	Los Angeles County
338002	Ordering, Referring, Prescribing	N/A	1568562825	0	0	TOMESCU, ANDREEA H LMFT	6/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51288	N/A	N/A	N/A	N/A	N/A	14320 PALM DRIVE	None	DESERT HOT SPRING	CA	92240	6874	00	06000	33.94460044	-116.5012511	Riverside County
338029	Ordering, Referring, Prescribing	N/A	1568612943	0	0	TORRES, LAURA LCSW	1/29/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW65059	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
338049	Ordering, Referring, Prescribing	N/A	1568675973	0	0	TEAL, KATHLEEN M LMFT	1/27/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT40468	N/A	N/A	N/A	N/A	N/A	75 DECLARATION DRIVE	SUITE #7	CHICO	CA	95973	4928	00	06000	39.77193449	-121.8722331	Butte County
338097	Ordering, Referring, Prescribing	N/A	1568751816	0	0	TANGLAO, ELEANOR DDS	3/29/2024	Taxonomy not applicable	NA	n/a	000	Unknown	48190	N/A	N/A	N/A	N/A	N/A	2500 MAIN ST	None	RED BLUFF	CA	96080	2336	00	06000	40.19240296	-122.2399354	Tehama County
338133	Ordering, Referring, Prescribing	N/A	1568809762	0	0	TRAN, DON K PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60382	N/A	N/A	N/A	N/A	N/A	1900 DRESDEN DR	None	LINCOLN	CA	95648	8803	00	06000	38.85524393	-121.2946284	Placer County
338176	Ordering, Referring, Prescribing	N/A	1568861342	0	0	TIAN, NANCY NP	8/27/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	22677	N/A	N/A	N/A	N/A	N/A	1870 LUNDY AVE	None	SAN JOSE	CA	95131	1826	00	06000	37.39271022	-121.8903238	Santa Clara County
338181	Ordering, Referring, Prescribing	N/A	1568866473	0	0	TRAN, DAVIS T PHARMD	4/9/2019	Taxonomy not applicable	NA	n/a	000	Unknown	64531	N/A	N/A	N/A	N/A	N/A	5713 N PERSHING AVE	A3	STOCKTON	CA	95207	4942	00	06000	38.00011235	-121.3261426	San Joaquin County
338230	Ordering, Referring, Prescribing	N/A	1568939833	0	0	TRAN, THERESA N NP	10/11/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010331	N/A	N/A	N/A	N/A	N/A	9862 CHAPMAN AVE	None	GARDEN GROVE	CA	92841	2726	00	06000	33.78849558	-117.9607338	Orange County
338280	Ordering, Referring, Prescribing	N/A	1578016465	0	0	TOSCANO-PRISAKAR, MAIRA LMFT	10/20/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128804	N/A	N/A	N/A	N/A	N/A	3725 TAYLOR ROAD	SUITE 1	LOOMIS	CA	95650	9283	00	06000	38.81963826	-121.1950015	Placer County
338286	Ordering, Referring, Prescribing	N/A	1578028700	0	0	TICARAT, ERIN E LCSW	12/4/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87044	N/A	N/A	N/A	N/A	N/A	2145 FIFTH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
338315	Ordering, Referring, Prescribing	N/A	1578078473	0	0	TEAGUE, JOHN P PHARMD	4/2/2018	Taxonomy not applicable	NA	n/a	000	Unknown	61480	N/A	N/A	N/A	N/A	N/A	1560 S IMPERIAL AVE	None	EL CENTRO	CA	92243	4241	00	06000	32.779782	-115.569736	Imperial County
338447	Ordering, Referring, Prescribing	N/A	1578613147	0	0	TRAN, THUHA PHARMD	10/31/2018	Taxonomy not applicable	NA	n/a	000	Unknown	46901	N/A	N/A	N/A	N/A	N/A	3650 S BRISTOL STREET	None	SANTA ANA	CA	92704	7302	00	06000	33.698862	-117.885627	Orange County
338458	Ordering, Referring, Prescribing	N/A	1578639860	0	0	TORMEY, TIMOTHY LMFT	2/14/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	36339	N/A	N/A	N/A	N/A	N/A	137 N. COTTONWOOD	SUITE 2500	WOODLAND	CA	95695	6664	00	06000	38.68538399	-121.7933582	Yolo County
338513	Ordering, Referring, Prescribing	N/A	1578733804	0	0	TAMAYO, MELISSA LCSW	9/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110645	N/A	N/A	N/A	N/A	N/A	11601 S WESTERN AVE	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
338530	Ordering, Referring, Prescribing	N/A	1578762365	0	0	TROTTER, SAUN-TOY LMFT	7/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	46123	N/A	N/A	N/A	N/A	N/A	8711 MACARTHUR BLVD	None	OAKLAND	CA	94605	4000	00	06000	37.75770582	-122.1622017	Alameda County
338531	Ordering, Referring, Prescribing	N/A	1578758041	0	0	TYREE, MARGARET L NP	4/23/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	6462	N/A	N/A	N/A	N/A	N/A	17660 LAKEWOOD BLVD	None	BELLFLOWER	CA	90706	6410	00	06000	33.87138705	-118.142548	Los Angeles County
338555	Ordering, Referring, Prescribing	N/A	1578802088	0	0	TRAN, THI Q PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52524	N/A	N/A	N/A	N/A	N/A	118 E BASELINE RD	None	RIALTO	CA	92376	3607	00	06000	34.12138457	-117.3698386	San Bernardino County
338582	Ordering, Referring, Prescribing	N/A	1578847208	0	0	TRINH, THOA T PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH59145	N/A	N/A	N/A	N/A	N/A	10787 CAMINO RUIZ	None	SAN DIEGO	CA	92126	2304	00	06000	32.91489	-117.1438035	San Diego County
338587	Ordering, Referring, Prescribing	N/A	1578858148	0	0	TURBOW, CYNTHIA R LCSW	3/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW74002	N/A	N/A	N/A	N/A	N/A	1224 VINE ST	None	LOS ANGELES	CA	90038	1612	00	06000	34.093332	-118.326603	Los Angeles County
338592	Ordering, Referring, Prescribing	N/A	1578866497	0	0	TRAN, RYAN	9/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT134595	N/A	N/A	N/A	N/A	N/A	1360 S ANAHEIM BLVD	101	ANAHEIM	CA	92805	6205	00	06000	33.8143261	-117.9066647	Orange County
338593	Ordering, Referring, Prescribing	N/A	1578870010	0	0	TATCHELL, SANDRA L LMFT	10/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104685	N/A	N/A	N/A	N/A	N/A	1515 N SUNRISE WAY	None	PALM SPRINGS	CA	92262	5309	00	06000	33.84324	-116.528209	Riverside County
338611	Ordering, Referring, Prescribing	N/A	1578884656	0	0	THOMAS, ERICA LMFT	11/7/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT77166	N/A	N/A	N/A	N/A	N/A	2 PADRE PARKWAY	SUITE 302A	ROHNERT PARK	CA	94928	2116	00	06000	38.34982429	-122.7083127	Sonoma County
338625	Ordering, Referring, Prescribing	N/A	1578910352	0	0	TAN, DAI PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72998	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY DEPT 3	DEPT 362	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
338653	Ordering, Referring, Prescribing	N/A	1578936340	0	0	TORO, ADRIAN A LMFT	3/26/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131979	N/A	N/A	N/A	N/A	N/A	4200 ASHE RD	None	BAKERSFIELD	CA	93313	2029	00	06000	35.316864	-119.0744405	Kern County
338657	Ordering, Referring, Prescribing	N/A	1578944708	0	0	TRAN, DAT	3/22/2018	Taxonomy not applicable	NA	n/a	000	Unknown	53366	N/A	N/A	N/A	N/A	N/A	3450 MARRON RD	None	OCEANSIDE	CA	92056	4672	00	06000	33.17824695	-117.2957151	San Diego County
338668	Ordering, Referring, Prescribing	N/A	1578947511	0	0	TURNER, SABRINA D NP	11/18/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002467	N/A	N/A	N/A	N/A	N/A	6065 STATE HIGHWAY 193	None	GEORGETOWN	CA	95634	9623	00	06000	38.90808215	-120.8515816	El Dorado County
338690	Ordering, Referring, Prescribing	N/A	1578993788	0	0	TOTH, JESSICA R NP	5/7/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95001050	N/A	N/A	N/A	N/A	N/A	7592 BROADWAY	None	LEMON GROVE	CA	91945	1604	00	06000	32.74274487	-117.0345359	San Diego County
338692	Ordering, Referring, Prescribing	N/A	1578991980	0	0	TOM, ADRIENNE PHARMD	1/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68558	N/A	N/A	N/A	N/A	N/A	735 7TH AVENUE	None	SAN FRANCISCO	CA	94121	0001	00	06000	37.77448821	-122.4649295	San Francisco County
338704	Ordering, Referring, Prescribing	N/A	1588005060	0	0	TUCKER, MARNEL K	10/22/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY30434	N/A	N/A	N/A	N/A	N/A	501 S IDAHO ST	SUITE 250	LA HABRA	CA	90631	6047	00	06000	33.927525	-117.959216	Orange County
338705	Ordering, Referring, Prescribing	N/A	1588004147	0	0	TELLO SUAREZ, ELIZABETH LCSW	10/24/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW80069	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
338708	Ordering, Referring, Prescribing	N/A	1588009666	0	0	TANG, AMY S MD	11/21/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159606	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
338716	Ordering, Referring, Prescribing	N/A	1588024533	0	0	TOOHEY, BLESILDA NP	1/6/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003814	N/A	N/A	N/A	N/A	N/A	1855 W KATELLA AVE	None	ORANGE	CA	92867	3451	00	06000	33.8061655	-117.872442	Orange County
338723	Ordering, Referring, Prescribing	N/A	1588032627	0	0	TASMIN, ALBERT H PHARMD	10/10/2018	Taxonomy not applicable	NA	n/a	000	Unknown	72972	N/A	N/A	N/A	N/A	N/A	5713 N PERSHING AVE	A3	STOCKTON	CA	95207	4942	00	06000	38.00011235	-121.3261426	San Joaquin County
338735	Ordering, Referring, Prescribing	N/A	1588040802	0	0	TAYLOR, JAMULA LMFT	11/8/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129183	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	STE 220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
338736	Ordering, Referring, Prescribing	N/A	1588045405	0	0	TO, KIM PHARMD	8/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	65072	N/A	N/A	N/A	N/A	N/A	19640 BEACH BLVD	None	HUNTINGTON BEACH	CA	92648	2905	00	06000	33.67711421	-117.9884946	Orange County
338785	Ordering, Referring, Prescribing	N/A	1588095426	0	0	TAHA, FIDA LMFT	4/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110096	N/A	N/A	N/A	N/A	N/A	1830 S. CENTRAL STREET	None	VISALIA	CA	93277	4418	00	06000	36.314271	-119.311362	Tulare County
338811	Ordering, Referring, Prescribing	N/A	1588145361	0	0	TRAN, UYEN D PHARMD	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78135	N/A	N/A	N/A	N/A	N/A	495 E HOLT AVE	None	POMONA	CA	91767	5539	00	06000	34.06259846	-117.7425045	Los Angeles County
338885	Ordering, Referring, Prescribing	N/A	1588304281	0	0	TANGUILIG, KARINA ROSELLE V PHARMD	12/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85639	N/A	N/A	N/A	N/A	N/A	4131 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3101	00	06000	37.78096053	-122.4637512	San Francisco County
338902	Ordering, Referring, Prescribing	N/A	1588360127	0	0	TAN, MARILETH NP	3/15/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020289	N/A	N/A	N/A	N/A	N/A	161 N MILL ST	None	TEHACHAPI	CA	93561	1347	00	06000	35.13410412	-118.4520157	Kern County
338917	Ordering, Referring, Prescribing	N/A	1588430888	0	0	TOLEDO, ALEXIS PT	11/9/2023	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	305184	N/A	N/A	N/A	N/A	N/A	4094 4TH AVE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
338927	Ordering, Referring, Prescribing	N/A	1588625404	0	0	THAN, JONALYN R	5/13/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0560249	N/A	N/A	N/A	N/A	N/A	1045 NORTH LAKE AVE	None	PASADENA	CA	91104	4521	00	06000	34.16394511	-118.1324885	Los Angeles County
338941	Ordering, Referring, Prescribing	N/A	1588698534	0	0	TRIPODIS, KONSTANTINOS N MD	4/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A48867	N/A	N/A	N/A	N/A	N/A	12450 VAN NUYS BLVD	200	PACOIMA	CA	91331	1391	00	06000	34.27894489	-118.4044363	Los Angeles County
338984	Ordering, Referring, Prescribing	N/A	1588792170	0	0	TYLER, ELIZABETH R LMFT	6/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51891	N/A	N/A	N/A	N/A	N/A	1870 N MAIN STREET	None	SALINAS	CA	93906	2042	00	06000	36.71784314	-121.6554107	Monterey County
338995	Ordering, Referring, Prescribing	N/A	1588819239	0	0	TRAN, TU PHARMD	4/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61299	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
339017	Ordering, Referring, Prescribing	N/A	1588853840	0	0	TRUONG, PRISCILLA C OD	9/22/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	13158	N/A	N/A	N/A	N/A	N/A	140 W VALLEY BLVD	STE 115	SAN GABRIEL	CA	91776	3784	00	06000	34.07958215	-118.1021957	Los Angeles County
339054	Ordering, Referring, Prescribing	N/A	1588939854	0	0	TUM, KAROLINE PHARMD	4/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66856	N/A	N/A	N/A	N/A	N/A	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	00	06000	37.92699561	-122.0292732	Contra Costa County
339057	Ordering, Referring, Prescribing	N/A	1588940696	0	0	TRAN, ANN	7/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH62991	N/A	N/A	N/A	N/A	N/A	12001 EUCLID ST	None	GARDEN GROVE	CA	92840	3332	00	06000	33.78758768	-117.941271	Orange County
339064	Ordering, Referring, Prescribing	N/A	1588946479	0	0	TRAN, TRANG PHARMD	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52187	N/A	N/A	N/A	N/A	N/A	30192 TOWN CENTER DRIVE	None	LAGUNA NIGUEL	CA	92677	0000	00	06000	33.52498705	-117.7152032	Orange County
339069	Ordering, Referring, Prescribing	N/A	1588962690	0	0	TRAN, SARAH H PHARMD	10/16/2018	Taxonomy not applicable	NA	n/a	000	Unknown	57139	N/A	N/A	N/A	N/A	N/A	16450 BEACH BLVD	None	WESTMINSTER	CA	92683	7859	00	06000	33.72426	-117.9890615	Orange County
339076	Ordering, Referring, Prescribing	N/A	1588970297	0	0	TENA VIEYRA, YADIRA T LCSW	6/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW93126	N/A	N/A	N/A	N/A	N/A	290 IOOF AVE	None	GILROY	CA	95020	5204	00	06000	37.01377513	-121.5685719	Santa Clara County
339084	Ordering, Referring, Prescribing	N/A	1588969844	0	0	TORRES, VALENTINA L LMFT	6/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100739	N/A	N/A	N/A	N/A	N/A	1727 MARTIN LUTHER KING	STE 109	OAKLAND	CA	94612	1327	00	06000	37.80868384	-122.2744362	Alameda County
339107	Ordering, Referring, Prescribing	N/A	1598004483	0	0	TRAN, THUHANG T PHARMD	8/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH48574	N/A	N/A	N/A	N/A	N/A	14291 EUCLID ST #D104	None	GARDEN GROVE	CA	92843	4980	00	06000	33.755166	-117.937627	Orange County
339120	Ordering, Referring, Prescribing	N/A	1598027658	0	0	THOMSON, SHANNA A NP	10/24/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP21890	N/A	N/A	N/A	N/A	N/A	14671 OLYMPIC DR	None	CLEARLAKE	CA	95422	9516	00	06000	38.9618304	-122.6382453	Lake County
339129	Ordering, Referring, Prescribing	N/A	1598032583	0	0	THANTRONG, KATI PHARMD	11/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52883	N/A	N/A	N/A	N/A	N/A	7201 YORKTOWN AVE	None	HUNTINGTON BEACH	CA	92648	2465	00	06000	33.67933951	-118.0027992	Orange County
339131	Ordering, Referring, Prescribing	N/A	1598037533	0	0	TESKE, MARGARET K OT	3/19/2023	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT13808	N/A	N/A	N/A	N/A	N/A	3544 30TH ST	None	SAN DIEGO	CA	92104	4120	00	06000	32.742936	-117.130118	San Diego County
339158	Ordering, Referring, Prescribing	N/A	1598064412	0	0	TUBBS, CHARIS L LMFT	3/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43731	N/A	N/A	N/A	N/A	N/A	3517 CAMINO DEL RIO S	None	SAN DIEGO	CA	92108	4026	00	06000	32.77777042	-117.1179225	San Diego County
339178	Ordering, Referring, Prescribing	N/A	1598106833	0	0	THOMAS, MEGAN E LMFT	1/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	107799	N/A	N/A	N/A	N/A	N/A	485 N 1ST ST	None	SAN JOSE	CA	95112	4067	00	06000	37.34444033	-121.8968517	Santa Clara County
339188	Ordering, Referring, Prescribing	N/A	1598127268	0	0	TO, JENNA D PHARMD	8/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH74442	N/A	N/A	N/A	N/A	N/A	16600 BOLSA CHICA ST	None	HUNTINGTON BEACH	CA	92649	3583	00	06000	33.72120809	-118.041396	Orange County
339204	Ordering, Referring, Prescribing	N/A	1598147050	0	0	THOMPSON, KYLE M MD	3/16/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145817	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
339215	Ordering, Referring, Prescribing	N/A	1598158891	0	0	TORRES, RUTHIE K LMFT	5/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111376	N/A	N/A	N/A	N/A	N/A	1904 RICHLAND AVE	C2	CERES	CA	95307	4562	00	06000	37.60031128	-120.9658226	Stanislaus County
339223	Ordering, Referring, Prescribing	N/A	1598166613	0	0	TORRES, CHRISTINA M LCSW	1/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW83697	N/A	N/A	N/A	N/A	N/A	4565 CALIFORNIA AVE	None	LONG BEACH	CA	90807	1507	00	06000	33.841926	-118.1822395	Los Angeles County
339245	Ordering, Referring, Prescribing	N/A	1598201592	0	0	TUGMAN-MENDEZ, TRISTA L LPCC	5/24/2024	Taxonomy not applicable	NA	n/a	000	Unknown	16639	N/A	N/A	N/A	N/A	N/A	1671 THE ALAMEDA	STE. 201	SAN JOSE	CA	95126	2222	00	06000	37.33686811	-121.9186321	Santa Clara County
339251	Ordering, Referring, Prescribing	N/A	1598208803	0	0	TAYLOR, MATTHEW LMFT	1/21/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT135285	N/A	N/A	N/A	N/A	N/A	2255 CHALLENGER WAY	107	SANTA ROSA	CA	95407	5423	00	06000	38.424924	-122.7512565	Sonoma County
339276	Ordering, Referring, Prescribing	N/A	1598267643	0	0	TAPIA, BONNY J LMFT	7/1/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140259	N/A	N/A	N/A	N/A	N/A	11429 VALLEY BLVD	None	EL MONTE	CA	91731	3229	00	06000	34.06953065	-118.0288485	Los Angeles County
339286	Ordering, Referring, Prescribing	N/A	1598293748	0	0	TRAN, TU-UYEN T PA-C	12/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA54588	N/A	N/A	N/A	N/A	N/A	8788 JAMACHA RD	None	SPRING VALLEY	CA	91977	4035	00	06000	32.71482507	-117.0098243	San Diego County
339287	Ordering, Referring, Prescribing	N/A	1598287021	0	0	TABORDON, TRACI LMFT	7/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127149	N/A	N/A	N/A	N/A	N/A	1470 E VALLEY RD	#5164	SANTA BARBARA	CA	93150	7011	00	06000	34.43702701	-119.6333944	Santa Barbara County
339293	Ordering, Referring, Prescribing	N/A	1598310229	0	0	TIFFANY, MADELINE L PA	2/21/2020	Taxonomy not applicable	NA	n/a	000	Unknown	PA57868	N/A	N/A	N/A	N/A	N/A	20601 WEST PAOLI LANE	None	WEIMAR	CA	95736	0486	00	06000	39.03521526	-120.9755343	Placer County
339309	Ordering, Referring, Prescribing	N/A	1598326811	0	0	TRAN, DIANE OD	6/26/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34244	N/A	N/A	N/A	N/A	N/A	8331 FIRESTONE BLVD	None	DOWNEY	CA	90241	3841	00	06000	33.9396357	-118.1320654	Los Angeles County
339364	Ordering, Referring, Prescribing	N/A	1598487159	0	0	TU, NHAN M PHARMD	9/9/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86786	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRY BLVD	None	JACKSON	CA	95642	9373	00	06000	38.36981229	-120.8002806	Amador County
339375	Ordering, Referring, Prescribing	N/A	1598538597	0	0	TRIVEDI, PRACHI PHARMD	10/25/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88859	N/A	N/A	N/A	N/A	N/A	651 ADDISON ST	APT 318	BERKELEY	CA	94710	1966	00	06000	37.86596622	-122.3009809	Alameda County
339390	Ordering, Referring, Prescribing	N/A	1598766271	0	0	TATEVOSSIAN, ARMEN G PHARMD	2/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47251	N/A	N/A	N/A	N/A	N/A	9250 RESEDA BLVD	UNIT 2C	NORTHRIDGE	CA	91324	3142	00	06000	34.238673	-118.5360535	Los Angeles County
339422	Ordering, Referring, Prescribing	N/A	1598871915	0	0	TRAXLER, TINA K PHD	3/9/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY19137	N/A	N/A	N/A	N/A	N/A	9412 BIG HORN BLVD	6	ELK GROVE	CA	95758	1101	00	06000	38.415861	-121.407957	Sacramento County
339430	Ordering, Referring, Prescribing	N/A	1598874588	0	0	TATTON, BLAIR J PA-C	12/19/2023	Taxonomy not applicable	NA	n/a	000	Unknown	14791	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
339441	Ordering, Referring, Prescribing	N/A	1598913410	0	0	TOUART, JACIE C PA	10/30/2017	Taxonomy not applicable	NA	n/a	000	Unknown	19848	N/A	N/A	N/A	N/A	N/A	1901 W KETTLEMAN LN	None	LODI	CA	95242	4337	00	06000	38.11558533	-121.2964501	San Joaquin County
339480	Ordering, Referring, Prescribing	N/A	1598989261	0	0	TUEROS, VICTORIA S NP	1/9/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP2286	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
339528	Ordering, Referring, Prescribing	N/A	1609112192	0	0	THOMPSON, KENNETH PA-C	8/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	22683	N/A	N/A	N/A	N/A	N/A	8316 FOOTHILL BLVD	None	SUNLAND	CA	91040	2850	00	06000	34.25966652	-118.314342	Los Angeles County
339554	Ordering, Referring, Prescribing	N/A	1609146844	0	0	TRAN, AMY T PHARMD	7/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	48960	N/A	N/A	N/A	N/A	N/A	11950 VALLEY VIEW ST	None	GARDEN GROVE	CA	92845	1239	00	06000	33.7890093	-118.0283611	Orange County
339594	Ordering, Referring, Prescribing	N/A	1609203959	0	0	TERCERO-VELASQUEZ, HAZELL LCSW	2/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76055	N/A	N/A	N/A	N/A	N/A	3200 MOTOR AVE	None	LOS ANGELES	CA	90034	3710	00	06000	34.03321301	-118.4109122	Los Angeles County
339616	Ordering, Referring, Prescribing	N/A	1609236918	0	0	TURNER, DIANA N PHD	11/10/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29783	N/A	N/A	N/A	N/A	N/A	6317 S FIGUEROA ST	None	LOS ANGELES	CA	90003	1025	00	06000	33.981786	-118.282696	Los Angeles County
339636	Ordering, Referring, Prescribing	N/A	1609287440	0	0	TER-PETROSYAN, MARIAM PSYD	2/11/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31182	N/A	N/A	N/A	N/A	N/A	350 N GLENDALE AVE	STE B119	GLENDALE	CA	91206	3794	00	06000	34.15153703	-118.2449116	Los Angeles County
339668	Ordering, Referring, Prescribing	N/A	1609318963	0	0	THOMAS, KRYSTALLE LMFT	12/9/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT136305	N/A	N/A	N/A	N/A	N/A	1411 N. GRAND AVE.	None	COVINA	CA	91724	0600	00	06000	34.105149	-117.87435	Los Angeles County
339694	Ordering, Referring, Prescribing	N/A	1609366459	0	0	TRAN, ANH THU T MD DO	7/26/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19010	N/A	N/A	N/A	N/A	N/A	227 N. JACKSON AVE	SUITE 205	SAN JOSE	CA	95116	1909	00	06000	37.36478223	-121.8497978	Santa Clara County
339728	Ordering, Referring, Prescribing	N/A	1609418458	0	0	TUNNAT, EMILY OT	6/10/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	21266	N/A	N/A	N/A	N/A	N/A	905 E. 8TH STREET	None	LOS ANGELES	CA	90021	1848	00	06000	34.03639545	-118.2465917	Los Angeles County
339753	Ordering, Referring, Prescribing	N/A	1609484658	0	0	TRAN, VY PHARMD	8/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	82510	N/A	N/A	N/A	N/A	N/A	117 MORRISSEY BLVD	None	SANTA CRUZ	CA	95062	1540	00	06000	36.98190559	-122.0068046	Santa Cruz County
339761	Ordering, Referring, Prescribing	N/A	1609501253	0	0	TOOLSON, EMMA PA-C	8/30/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62044	N/A	N/A	N/A	N/A	N/A	905 CALLE AMANECER	SUITE 115	SAN CLEMENTE	CA	92673	6226	00	06000	33.44951265	-117.6075825	Orange County
339790	Ordering, Referring, Prescribing	N/A	1609594456	0	0	THRELFALL, LAWRENCE PA	9/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61686	N/A	N/A	N/A	N/A	N/A	35324 HIGHWAY 41	None	COARSEGOLD	CA	93614	8302	00	06000	37.26242065	-119.6987402	Madera County
339794	Ordering, Referring, Prescribing	N/A	1609650571	0	0	TIBBITTS, DESS J LCSW	10/6/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	109664	N/A	N/A	N/A	N/A	N/A	5125 SKYWAY	None	PARADISE	CA	95969	5624	00	06000	39.74598961	-121.640736	Butte County
339810	Ordering, Referring, Prescribing	N/A	1609896760	0	0	TAYLOR, DENISE E MD	4/5/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G70362	N/A	N/A	N/A	N/A	N/A	77 CASA ST	None	SAN LUIS OBISPO	CA	93405	5803	00	06000	35.29306786	-120.6650709	San Luis Obispo County
339818	Ordering, Referring, Prescribing	N/A	1609908227	0	0	TURJANIS, VIJA A LMFT	3/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	46348	N/A	N/A	N/A	N/A	N/A	3300 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3137	00	06000	35.37353416	-119.0392409	Kern County
339831	Ordering, Referring, Prescribing	N/A	1609919349	0	0	THOMAS, MARK E LMFT	2/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT25892	N/A	N/A	N/A	N/A	N/A	686 E MILL ST	None	SAN BERNARDINO	CA	92408	1610	00	06000	34.09216669	-117.2710544	San Bernardino County
339865	Ordering, Referring, Prescribing	N/A	1609997436	0	0	TAN, MARIA OT	3/29/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT842	N/A	N/A	N/A	N/A	N/A	727 SHASTA STREET	None	REDWOOD CITY	CA	94063	2124	00	06000	37.47945362	-122.2230493	San Mateo County
339877	Ordering, Referring, Prescribing	N/A	1619011947	0	0	TANG, LAUREN N OD	6/13/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT12624	N/A	N/A	N/A	N/A	N/A	10440 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	1812	00	06000	33.91038747	-117.4638633	Riverside County
339892	Ordering, Referring, Prescribing	N/A	1619037504	0	0	TEPPER, ANTHONY LMFT	8/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	31286	N/A	N/A	N/A	N/A	N/A	1500 FRANKLIN STREET	None	SAN FRANCISCO	CA	94109	4523	00	06000	37.78847503	-122.4235955	San Francisco County
339917	Ordering, Referring, Prescribing	N/A	1619095536	0	0	TRACEY, CLAIRE E LCSW	3/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23178	N/A	N/A	N/A	N/A	N/A	1290 COMMODORE DR.	None	SAN BRUNO	CA	94066	2304	00	06000	37.63134914	-122.4260472	San Mateo County
339919	Ordering, Referring, Prescribing	N/A	1619091675	0	0	THOMPSON, RENEE M LMFT	11/10/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	40734	N/A	N/A	N/A	N/A	N/A	510 S. VERMONT AVE	18TH FL	LOS ANGELES	CA	90020	1992	00	06000	34.065	-118.291631	Los Angeles County
339961	Ordering, Referring, Prescribing	N/A	1619178399	0	0	TRAN, MAI	10/11/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0411101	N/A	N/A	N/A	N/A	N/A	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	4200	00	06000	33.77387145	-117.9966555	Orange County
339966	Ordering, Referring, Prescribing	N/A	1619183209	0	0	TERRONES, SALVADOR PA-C	2/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	14092	N/A	N/A	N/A	N/A	N/A	7301 STATE ST	None	HUNTINGTON PARK	CA	90255	5823	00	06000	33.97149395	-118.2097278	Los Angeles County
339984	Ordering, Referring, Prescribing	N/A	1619227964	0	0	THOMAS-FRANKLIN, MARILYN M LCSW	8/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW71194	N/A	N/A	N/A	N/A	N/A	13585 SAN PABLO AVE	None	SAN PABLO	CA	94806	0000	00	06000	37.95651393	-122.3371491	Contra Costa County
340011	Ordering, Referring, Prescribing	N/A	1619264322	0	0	TSENG, JULIE	4/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH62918	N/A	N/A	N/A	N/A	N/A	16505 SIERRA LAKES PKWY	None	FONTANA	CA	92336	1256	00	06000	34.13859931	-117.4438742	San Bernardino County
340034	Ordering, Referring, Prescribing	N/A	1619317211	0	0	TORRES, BRENDA LCSW	5/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82777	N/A	N/A	N/A	N/A	N/A	28490 AVENUE STANFORD	300	VALENCIA	CA	91355	0945	00	06000	34.44085174	-118.5994533	Los Angeles County
340040	Ordering, Referring, Prescribing	N/A	1619328291	0	0	TSAI, MARGARET PA	12/3/2017	Taxonomy not applicable	NA	n/a	000	Unknown	53484	N/A	N/A	N/A	N/A	N/A	18575 GALE AVE	SUITE 128	CITY OF INDUSTRY	CA	91748	1340	00	06000	33.99497471	-117.8986874	Los Angeles County
340100	Ordering, Referring, Prescribing	N/A	1619394160	0	0	TOPICO, MARYANN	5/31/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	23563	N/A	N/A	N/A	N/A	N/A	1014 1/2 N VERMONT AVE	None	LOS ANGELES	CA	90029	2620	00	06000	34.0900257	-118.2916693	Los Angeles County
340138	Ordering, Referring, Prescribing	N/A	1619466166	0	0	THAYER, JOHN C LPT	3/4/2021	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	16978	N/A	N/A	N/A	N/A	N/A	3800 JANES ROAD	None	ARCATA	CA	95521	4742	00	06000	40.89645172	-124.0930637	Humboldt County
340169	Ordering, Referring, Prescribing	N/A	1619522539	0	0	TURICK, ASHLEY LPCC	1/24/2024	Taxonomy not applicable	NA	n/a	000	Unknown	15694	N/A	N/A	N/A	N/A	N/A	1664 BROADWAY	None	EL CAJON	CA	92021	5201	00	06000	32.80772446	-116.9184375	San Diego County
340202	Ordering, Referring, Prescribing	N/A	1619617842	0	0	TARDIFF, ANDREW PSYD	6/17/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31920	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	None	SAN MATEO	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
340211	Ordering, Referring, Prescribing	N/A	1619635414	0	0	TRINH, LUC PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76609	N/A	N/A	N/A	N/A	N/A	3801 HOWE ST	None	OAKLAND	CA	94611	5312	00	06000	37.8242732	-122.2568561	Alameda County
340218	Ordering, Referring, Prescribing	N/A	1619694825	0	0	THAO, MAI H	10/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	87096	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRY BLVD	None	JACKSON	CA	95642	9373	00	06000	38.36981229	-120.8002806	Amador County
340262	Ordering, Referring, Prescribing	N/A	1629082318	0	0	TRAN, NINA OD	8/15/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	13068	N/A	N/A	N/A	N/A	N/A	835 MAIN STREET	None	MARTINEZ	CA	94553	1225	00	06000	38.01807139	-122.135097	Contra Costa County
340272	Ordering, Referring, Prescribing	N/A	1629102603	0	0	TRILLO, LILIANA LMFT	11/30/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT47422	N/A	N/A	N/A	N/A	N/A	1721 GRIFFIN AVE	None	LOS ANGELES	CA	90031	3312	00	06000	34.06331668	-118.2114477	Los Angeles County
340285	Ordering, Referring, Prescribing	N/A	1629119920	0	0	TE, SEANGLONG	1/24/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A106386	N/A	N/A	N/A	N/A	N/A	2148 E ANAHEIM ST	None	LONG BEACH	CA	90804	3408	00	06000	33.78257051	-118.165896	Los Angeles County
340358	Ordering, Referring, Prescribing	N/A	1629278304	0	0	TAYLOR, DONALD J NP	2/25/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	22160	N/A	N/A	N/A	N/A	N/A	160 S. SEVENTH AVE	None	LA PUENTE	CA	91746	3211	00	06000	34.0335863	-117.9760093	Los Angeles County
340364	Ordering, Referring, Prescribing	N/A	1629306329	0	0	TSUHA-MCNIEL, TOMIKO LCSW	3/29/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW100839	N/A	N/A	N/A	N/A	N/A	393 E WALNUT ST	None	PASADENA	CA	91188	0001	00	06000	34.14955087	-118.1422348	Los Angeles County
340375	Ordering, Referring, Prescribing	N/A	1629315296	0	0	THOMPSON, ANGELICA M LMFT	10/29/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102394	N/A	N/A	N/A	N/A	N/A	430 RAILROAD AVE	SUITE# 202	PITTSBURG	CA	94565	2232	00	06000	38.03246265	-121.8837299	Contra Costa County
340387	Ordering, Referring, Prescribing	N/A	1629340419	0	0	TONG, ASHLEY PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57653	N/A	N/A	N/A	N/A	N/A	2331 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	6805	00	06000	34.03684323	-118.147526	Los Angeles County
340388	Ordering, Referring, Prescribing	N/A	1629345525	0	0	TANG, DAO PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59153	N/A	N/A	N/A	N/A	N/A	6325 ROSEMEAD BLVD	None	SAN GABRIEL	CA	91775	1933	00	06000	34.11410169	-118.0737024	Los Angeles County
340393	Ordering, Referring, Prescribing	N/A	1629350319	0	0	TRAN, ANKA H PHARMD	10/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	56556	N/A	N/A	N/A	N/A	N/A	4041 N SIERRA WAY	None	SAN BERNARDINO	CA	92407	3816	00	06000	34.16544	-117.2850005	San Bernardino County
340421	Ordering, Referring, Prescribing	N/A	1629379987	0	0	TORRES, GUSTAVO LCSW	12/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99029	N/A	N/A	N/A	N/A	N/A	815 N EL CENTRO AVE	None	LOS ANGELES	CA	90038	3805	00	06000	34.08577365	-118.3244665	Los Angeles County
340429	Ordering, Referring, Prescribing	N/A	1629406251	0	0	TAN, CYNTHIA PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69322	N/A	N/A	N/A	N/A	N/A	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	00	06000	37.70755227	-121.7149933	Alameda County
340444	Ordering, Referring, Prescribing	N/A	1629427976	0	0	THORBURN, KRYSTAL	6/16/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115930	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
340454	Ordering, Referring, Prescribing	N/A	1629448212	0	0	TRAN, VAN	1/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	73507	N/A	N/A	N/A	N/A	N/A	9404 CENTRAL AVE	None	MONTCLAIR	CA	91763	2421	00	06000	34.082442	-117.6896655	San Bernardino County
340476	Ordering, Referring, Prescribing	N/A	1629492202	0	0	TRAN, LAM PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69101	N/A	N/A	N/A	N/A	N/A	8052 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	3303	00	06000	33.75925468	-117.988843	Orange County
340499	Ordering, Referring, Prescribing	N/A	1629527460	0	0	TA, CHRISTINE K PHD	8/29/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33562	N/A	N/A	N/A	N/A	N/A	1301 PINE AVE	None	LONG BEACH	CA	90813	0400	00	06000	33.782913	-118.192417	Los Angeles County
340509	Ordering, Referring, Prescribing	N/A	1629549654	0	0	TIMMERMAN, PETER PA-C	10/3/2022	Taxonomy not applicable	NA	n/a	000	Unknown	56382	N/A	N/A	N/A	N/A	N/A	1360 N DUTTON AVE STE C	STE C	SANTA ROSA	CA	95401	4668	00	06000	38.450439	-122.733432	Sonoma County
340516	Ordering, Referring, Prescribing	N/A	1629563861	0	0	TRUJILLO, ATHENA L NP	3/25/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009117	N/A	N/A	N/A	N/A	N/A	5400 RALSTON ST	None	VENTURA	CA	93003	6002	00	06000	34.25974984	-119.2179337	Ventura County
340527	Ordering, Referring, Prescribing	N/A	1629575550	0	0	TRUONG, ANH Q PHARMD	7/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78189	N/A	N/A	N/A	N/A	N/A	710 W GRANGEVILLE BLVD	None	HANFORD	CA	93230	2714	00	06000	36.34269351	-119.6558325	Kings County
340543	Ordering, Referring, Prescribing	N/A	1629593777	0	0	TAKAHASHI, DANA LCSW	9/11/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW118022	N/A	N/A	N/A	N/A	N/A	1515 S.BON VIEW AVE	None	ONTARIO	CA	91761	4408	00	06000	34.045335	-117.636444	San Bernardino County
340551	Ordering, Referring, Prescribing	N/A	1629603972	0	0	THONG, SAU S	3/21/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013862	N/A	N/A	N/A	N/A	N/A	1109 W FRANCIS ST	APT D	ONTARIO	CA	91762	6188	00	06000	34.03953	-117.6701265	San Bernardino County
340562	Ordering, Referring, Prescribing	N/A	1629621032	0	0	THOMPSON, BRIANNA N NP	8/28/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026900	N/A	N/A	N/A	N/A	N/A	2001 WILSHIRE BLVD	SUITE 320	SANTA MONICA	CA	90403	5641	00	06000	34.03162362	-118.4829513	Los Angeles County
340573	Ordering, Referring, Prescribing	N/A	1629634530	0	0	TANG, MERCY	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78968	N/A	N/A	N/A	N/A	N/A	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
340577	Ordering, Referring, Prescribing	N/A	1629637285	0	0	TSUCHIYA, KIMIKO DO	5/14/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19610	N/A	N/A	N/A	N/A	N/A	1250 6TH AVE	None	SAN DIEGO	CA	92101	4300	00	06000	32.71854144	-117.1593008	San Diego County
340579	Ordering, Referring, Prescribing	N/A	1629640578	0	0	TSAO, MEGAN PHARMD	7/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84541	N/A	N/A	N/A	N/A	N/A	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	00	06000	33.9040752	-118.1328995	Los Angeles County
340590	Ordering, Referring, Prescribing	N/A	1629655832	0	0	TRAN, NANCY T PHARMD	9/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84797	N/A	N/A	N/A	N/A	N/A	30116 EIGENBRODT WAY	None	UNION CITY	CA	94587	1225	00	06000	37.60846354	-122.0715526	Alameda County
340617	Ordering, Referring, Prescribing	N/A	1629725684	0	0	TON, BAO T PHARMD	7/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66757	N/A	N/A	N/A	N/A	N/A	12001 EUCLID ST	None	GARDEN GROVE	CA	92840	3332	00	06000	33.78758768	-117.941271	Orange County
340646	Ordering, Referring, Prescribing	N/A	1639150782	0	0	TRAVER, DAVID P MD	1/18/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G73440	N/A	N/A	N/A	N/A	N/A	1261 EAST HILLSDALE BLVD	SUITE 5	FOSTER CITY	CA	94404	1236	00	06000	37.56820192	-122.2665723	San Mateo County
340661	Ordering, Referring, Prescribing	N/A	1639214307	0	0	THOELE, CYNTHIA M LCSW	9/17/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW79291	N/A	N/A	N/A	N/A	N/A	15576 MAIN ST	None	HESPERIA	CA	92345	3482	00	06000	34.42464781	-117.322468	San Bernardino County
340709	Ordering, Referring, Prescribing	N/A	1639331614	0	0	TONNU, KIEUTIEN P OD	5/13/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	10429	N/A	N/A	N/A	N/A	N/A	1101 E.HOLT AVE	SUITE D	POMONA	CA	91767	5800	00	06000	34.06297561	-117.7280971	Los Angeles County
340741	Ordering, Referring, Prescribing	N/A	1639405350	0	0	TORRES, CONSUELO Y LCSW	4/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW83754	N/A	N/A	N/A	N/A	N/A	8755 AERO DR	STE 306	SAN DIEGO	CA	92123	1776	00	06000	32.80965252	-117.139383	San Diego County
340742	Ordering, Referring, Prescribing	N/A	1639398456	0	0	TAYLOR, DANA L LCSW	1/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28927	N/A	N/A	N/A	N/A	N/A	720 WOOD STREET	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
340745	Ordering, Referring, Prescribing	N/A	1639408883	0	0	TRAN, KIM NP	6/4/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	10899	N/A	N/A	N/A	N/A	N/A	522 S SAN PEDRO ST	None	LOS ANGELES	CA	90013	2102	00	06000	34.0436196	-118.2442541	Los Angeles County
340763	Ordering, Referring, Prescribing	N/A	1639445471	0	0	THOMAS, STUART J MD	10/31/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A127565	N/A	N/A	N/A	N/A	N/A	2525 GEARY BLVD	M160	SAN FRANCISCO	CA	94117	3358	00	06000	37.78246242	-122.4448129	San Francisco County
340778	Ordering, Referring, Prescribing	N/A	1639455850	0	0	TOM, JOSEPHINE C PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH44219	N/A	N/A	N/A	N/A	N/A	498 CASTRO ST	None	SAN FRANCISCO	CA	94114	2020	00	06000	37.76111969	-122.4350504	San Francisco County
340788	Ordering, Referring, Prescribing	N/A	1639473218	0	0	THAYER, PATRICIA	5/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	13475	N/A	N/A	N/A	N/A	N/A	1 ST. VINCENT'S DR.	None	SAN RAFAEL	CA	94903	1504	00	06000	38.034216	-122.525199	Marin County
340790	Ordering, Referring, Prescribing	N/A	1639482110	0	0	TREJOS, SASHA B LCSW	4/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76424	N/A	N/A	N/A	N/A	N/A	1405 SPRUCE ST	SUITE A	RIVERSIDE	CA	92507	2410	00	06000	33.99027151	-117.34227	Riverside County
340810	Ordering, Referring, Prescribing	N/A	1639504475	0	0	TAMAYO, FRANCES M LCSW	6/21/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW80742	N/A	N/A	N/A	N/A	N/A	160 E VIRGINIA ST	None	SAN JOSE	CA	95112	5857	00	06000	37.32582868	-121.8777868	Santa Clara County
340938	Ordering, Referring, Prescribing	N/A	1639684327	0	0	TORRES-MERCADO, ANA S LMFT	8/19/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127644	N/A	N/A	N/A	N/A	N/A	9343 TECH CENTER DR	None	SACRAMENTO	CA	95826	2563	00	06000	38.564091	-121.3509285	Sacramento County
340939	Ordering, Referring, Prescribing	N/A	1639689474	0	0	THAPA, PRIYANKA NP	3/11/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006144	N/A	N/A	N/A	N/A	N/A	5925 W LAS POSITAS BLVD	None	PLEASANTON	CA	94588	8537	00	06000	37.68360997	-121.8990082	Alameda County
340973	Ordering, Referring, Prescribing	N/A	1639766520	0	0	TOWNSEND, EMMA LMFT	12/19/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123359	N/A	N/A	N/A	N/A	N/A	2433 MARCONI AVE	None	SACRAMENTO	CA	95821	4807	00	06000	38.619405	-121.4045595	Sacramento County
340997	Ordering, Referring, Prescribing	N/A	1639839608	0	0	TRAHAN, ROSLYN LPCC	10/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	12474	N/A	N/A	N/A	N/A	N/A	500B JEFFERSON BLVD STE	None	W SACRAMENTO	CA	95605	2394	00	06000	38.58811316	-121.5270471	Yolo County
340999	Ordering, Referring, Prescribing	N/A	1639819162	0	0	TARAPOREWALLA, ZENA DO	2/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21477	N/A	N/A	N/A	N/A	N/A	4094 4TH AVE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
341012	Ordering, Referring, Prescribing	N/A	1639880321	0	0	THOMAS, SUSAN NP	2/13/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029081	N/A	N/A	N/A	N/A	N/A	14601 S BASCOM AVE	200	LOS GATOS	CA	95032	2043	00	06000	37.25595255	-121.9501405	Santa Clara County
341014	Ordering, Referring, Prescribing	N/A	1639909617	0	0	THIND, SUKHBIR K	1/21/2025	Taxonomy not applicable	NA	n/a	000	Unknown	PA65746	N/A	N/A	N/A	N/A	N/A	2299 MOWRY AVE	STE B	FREMONT	CA	94538	1621	00	06000	37.55671415	-121.9817758	Alameda County
341055	Ordering, Referring, Prescribing	N/A	1649275132	0	0	TUR, MARIANNE E NP	2/26/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	13327	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
341074	Ordering, Referring, Prescribing	N/A	1649319666	0	0	TRAN, DONNY N MD	1/12/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C133199	N/A	N/A	N/A	N/A	N/A	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	4991	00	06000	33.77387145	-117.9966555	Orange County
341077	Ordering, Referring, Prescribing	N/A	1649320508	0	0	THOMPSON, MICHELLE LCSW	5/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	64546	N/A	N/A	N/A	N/A	N/A	1266 14TH STREET	None	OAKLAND	CA	94607	1003	00	06000	37.81022696	-122.2887619	Alameda County
341079	Ordering, Referring, Prescribing	N/A	1649308610	0	0	TINSON, GERALDINE LCSW	10/24/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93477	N/A	N/A	N/A	N/A	N/A	510 S. VERMONT	None	LOS ANGELES	CA	90020	1912	00	06000	34.065	-118.291631	Los Angeles County
341091	Ordering, Referring, Prescribing	N/A	1649352154	0	0	TONG, MARY PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47735	N/A	N/A	N/A	N/A	N/A	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	00	06000	38.38851772	-121.9382798	Solano County
341105	Ordering, Referring, Prescribing	N/A	1649380783	0	0	TAFF, JOSHUA L	2/2/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D58163	N/A	N/A	N/A	N/A	N/A	7501 W DESCHUTES PL	None	KENNEWICK	WA	99336	7719	00	06000	46.2115796	-119.222705	Benton County
341115	Ordering, Referring, Prescribing	N/A	1649408709	0	0	TONG, ELAINE Y	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0706407	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
341137	Ordering, Referring, Prescribing	N/A	1649462326	0	0	TRINGALE, ROLANDO MD	9/4/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A102177	N/A	N/A	N/A	N/A	N/A	5151 STATE UNIVERSITY DR	None	LOS ANGELES	CA	90032	4220	00	06000	34.066206	-118.1683485	Los Angeles County
341159	Ordering, Referring, Prescribing	N/A	1649510306	0	0	THAO, BEE LPCC	11/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	10730	N/A	N/A	N/A	N/A	N/A	800 SCENIC DR	None	MODESTO	CA	95350	6131	00	06000	37.64722447	-120.9836925	Stanislaus County
341161	Ordering, Referring, Prescribing	N/A	1649513409	0	0	TOMPKINS, JOSHUA C MD	12/17/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A131509	N/A	N/A	N/A	N/A	N/A	447 N EL MOLINO AVE	None	PASADENA	CA	91101	1403	00	06000	34.15365596	-118.1370318	Los Angeles County
341198	Ordering, Referring, Prescribing	N/A	1649580192	0	0	TRAN, THERESA M PHARMD	4/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60132	N/A	N/A	N/A	N/A	N/A	7562 CENTER AVE	None	HUNTINGTON BEACH	CA	92647	9998	00	06000	33.7339299	-117.9969861	Orange County
341325	Ordering, Referring, Prescribing	N/A	1649776188	0	0	TRUONG, DUC H PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77252	N/A	N/A	N/A	N/A	N/A	4129 18TH ST	None	SAN FRANCISCO	CA	94114	2407	00	06000	37.7608252	-122.4356669	San Francisco County
341339	Ordering, Referring, Prescribing	N/A	1649797903	0	0	TARNOFF, JESSICA LMFT	9/24/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT132859	N/A	N/A	N/A	N/A	N/A	700 FREDERICK ST	103	SANTA CRUZ	CA	95062	2239	00	06000	36.98031434	-122.004438	Santa Cruz County
341395	Ordering, Referring, Prescribing	N/A	1649924697	0	0	TRINH, ALEXANDER-LINHNAM PHARMD	12/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85673	N/A	N/A	N/A	N/A	N/A	18515 DEVONSHIRE ST	None	NORTHRIDGE	CA	91324	1308	00	06000	34.25728349	-118.536615	Los Angeles County
341425	Ordering, Referring, Prescribing	N/A	1659003473	0	0	TAVENNER, KELLY R LMFT	5/15/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	146902	N/A	N/A	N/A	N/A	N/A	23161 MILL CREEK DR	STE 230	LAGUNA HILLS	CA	92653	7908	00	06000	33.62655796	-117.7352122	Orange County
341446	Ordering, Referring, Prescribing	N/A	1659098192	0	0	TAYLOR, STACEY NP	10/26/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023058	N/A	N/A	N/A	N/A	N/A	1780 E FLORIDA AVE	None	HEMET	CA	92544	4679	00	06000	33.74770382	-116.9532553	Riverside County
341459	Ordering, Referring, Prescribing	N/A	1659140929	0	0	TEOTICO, KIRSTEN ROSE C PHARMD	12/22/2023	Taxonomy not applicable	NA	n/a	000	Unknown	89148	N/A	N/A	N/A	N/A	N/A	2300 16TH ST	None	SAN FRANCISCO	CA	94103	4803	00	06000	37.76569327	-122.4091306	San Francisco County
341464	Ordering, Referring, Prescribing	N/A	1659137909	0	0	TIWANA, RAVNEET K NP	9/29/2023	Taxonomy not applicable	NA	n/a	000	Unknown	95027491	N/A	N/A	N/A	N/A	N/A	655 S CENTRAL VALLEY HWY	None	SHAFTER	CA	93263	2790	00	06000	35.49504475	-119.264496	Kern County
341488	Ordering, Referring, Prescribing	N/A	1659408060	0	0	TRUE, PAUL E LMFT	1/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42710	N/A	N/A	N/A	N/A	N/A	58923 BUSINESS CENTER DR	None	YUCCA VALLEY	CA	92284	7311	00	06000	34.12184824	-116.3781018	San Bernardino County
341535	Ordering, Referring, Prescribing	N/A	1659506673	0	0	TAETZSCH, WILLIAM R LMFT	11/24/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77172	N/A	N/A	N/A	N/A	N/A	11643 GLENOAKS BLVD	None	PACOIMA	CA	91331	1050	00	06000	34.28133474	-118.4198166	Los Angeles County
341540	Ordering, Referring, Prescribing	N/A	1659520922	0	0	TOROSSIAN, SANDRA PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61366	N/A	N/A	N/A	N/A	N/A	1515 N VERMONT AVE	237	LOS ANGELES	CA	90027	5337	00	06000	34.09851639	-118.2918012	Los Angeles County
341544	Ordering, Referring, Prescribing	N/A	1659525806	0	0	TANNAROME, RYANNAH B LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53384	N/A	N/A	N/A	N/A	N/A	1450 CIVIC COURT	SUITE 200	CONCORD	CA	94520	7955	00	06000	37.9718675	-122.0496338	Contra Costa County
341587	Ordering, Referring, Prescribing	N/A	1659624229	0	0	TROUPE, MARSADEZ L LMFT	6/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT126216	N/A	N/A	N/A	N/A	N/A	16350 MOJAVE DRIVE	None	VICTORVILLE	CA	92395	3665	00	06000	34.52901353	-117.3063285	San Bernardino County
341591	Ordering, Referring, Prescribing	N/A	1659627941	0	0	TAYLOR, MARIBEL A LMFT	5/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109068	N/A	N/A	N/A	N/A	N/A	370 W. CRENSHAW BLVD.	E-100	TORRANCE	CA	90503	1727	00	06000	33.84549	-118.3287415	Los Angeles County
341613	Ordering, Referring, Prescribing	N/A	1659655496	0	0	TSAO, DANIELLE J OD	11/5/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	14281	N/A	N/A	N/A	N/A	N/A	500 S ATLANTIC BLVD	STE A	MONTEREY PARK	CA	91754	3870	00	06000	34.05627946	-118.1347926	Los Angeles County
341616	Ordering, Referring, Prescribing	N/A	1659648038	0	0	TEDLA, MERON	8/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	CA44835	N/A	N/A	N/A	N/A	N/A	14100 BLOSSOM HILL RD	None	LOS GATOS	CA	95032	5118	00	06000	37.23621854	-121.914054	Santa Clara County
341617	Ordering, Referring, Prescribing	N/A	1659658235	0	0	THOMAS, RACHELLE M LMFT	4/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104647	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2656	00	06000	35.35413152	-119.058471	Kern County
341626	Ordering, Referring, Prescribing	N/A	1659678258	0	0	TAN, RHONNA LMFT	5/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48957	N/A	N/A	N/A	N/A	N/A	525 TECHNOLOGY CT	SUITE 105	RIVERSIDE	CA	92507	2191	00	06000	33.99998544	-117.3235185	Riverside County
341632	Ordering, Referring, Prescribing	N/A	1659688067	0	0	TANZER, LAUREN E LCSW	5/25/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	92288	N/A	N/A	N/A	N/A	N/A	3800 COOLIDGE AVENUE	None	OAKLAND	CA	94602	3311	00	06000	37.8007257	-122.2064578	Alameda County
341633	Ordering, Referring, Prescribing	N/A	1659686459	0	0	TEETER, CHRISTINA PA-C	4/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	21019	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
341652	Ordering, Referring, Prescribing	N/A	1659720779	0	0	THOMPSON, HYMAN MD	3/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174351	N/A	N/A	N/A	N/A	N/A	3415 S SEPULVEDA BLVD	None	LOS ANGELES	CA	90034	6060	00	06000	34.02086527	-118.4235306	Los Angeles County
341658	Ordering, Referring, Prescribing	N/A	1659722437	0	0	TAM, LEONARD M PHARMD	7/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH73815	N/A	N/A	N/A	N/A	N/A	216 WESTLAKE CENTER	None	DALY CITY	CA	94015	0000	00	06000	37.70123591	-122.4833751	San Mateo County
341681	Ordering, Referring, Prescribing	N/A	1659752707	0	0	TRETTENERO, MICHELLE V LAC	5/7/2020	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC16579	N/A	N/A	N/A	N/A	N/A	5168 HONPIE RD	None	PLACERVILLE	CA	95667	8682	00	06000	38.6943603	-120.9018271	El Dorado County
341685	Ordering, Referring, Prescribing	N/A	1659759462	0	0	TUMANENG, NICKHA LCSW	5/3/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115091	N/A	N/A	N/A	N/A	N/A	9860 SUNNYSIDE ST	None	OAKLAND	CA	94603	9860	00	06000	37.74652707	-122.1618127	Alameda County
341705	Ordering, Referring, Prescribing	N/A	1659790541	0	0	TAKEDA, GEORGE S LMFT	1/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106171	N/A	N/A	N/A	N/A	N/A	265 SAN JACINTO RIVER RD	107	LAKE ELSINORE	CA	92530	4419	00	06000	33.66201142	-117.3001906	Riverside County
341712	Ordering, Referring, Prescribing	N/A	1659805679	0	0	TOPALDJIKIAN, NARINE B MD	7/7/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A170214	N/A	N/A	N/A	N/A	N/A	4835 VAN NUYS BLVD	111	SHERMAN OAKS	CA	91403	2109	00	06000	34.1587068	-118.4487394	Los Angeles County
341742	Ordering, Referring, Prescribing	N/A	1659848596	0	0	THANDI, JASMINE K PA	4/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57953	N/A	N/A	N/A	N/A	N/A	344 E. 6TH STREET	None	MADERA	CA	93638	3631	00	06000	36.96288964	-120.0556279	Madera County
341758	Ordering, Referring, Prescribing	N/A	1659862001	0	0	TRAN, STACY PHARMD	7/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	77101	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	MS SEC2-B	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
341777	Ordering, Referring, Prescribing	N/A	1659888121	0	0	TAYLOR, CHANEL MSW LCSW	12/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99228	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON	SUITE #100	LOS ANGELES	CA	90018	1353	00	06000	34.037415	-118.3176815	Los Angeles County
341930	Ordering, Referring, Prescribing	N/A	1669526174	0	0	TASHJIAN, ANNIE	3/18/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0437707	N/A	N/A	N/A	N/A	N/A	2400 S FLOWER ST	None	LOS ANGELES	CA	90007	2629	00	06000	34.02861627	-118.273964	Los Angeles County
341969	Ordering, Referring, Prescribing	N/A	1669634598	0	0	TAYLOR, CALISE S LMFT	3/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT96316	N/A	N/A	N/A	N/A	N/A	1841 E. MAIN ST	None	BARSTOW	CA	92308	9999	00	06000	34.8901829	-116.9978731	San Bernardino County
341992	Ordering, Referring, Prescribing	N/A	1669711545	0	0	TAPIA, GUILLERMO P PHARMD	11/27/2023	Taxonomy not applicable	NA	n/a	000	Unknown	55211	N/A	N/A	N/A	N/A	N/A	1996 LUNDY AVENUE	B	SAN JOSE	CA	95131	3148	00	06000	37.39521598	-121.8906679	Santa Clara County
341994	Ordering, Referring, Prescribing	N/A	1669710042	0	0	THAI, ANTHONY T LCSW	12/6/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW94690	N/A	N/A	N/A	N/A	N/A	9901 ARTESIA BLVD	None	BELLFLOWER	CA	90701	6713	00	06000	33.87486551	-118.1228445	Los Angeles County
342004	Ordering, Referring, Prescribing	N/A	1669734505	0	0	TRAN, LINDA K	9/6/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D61375	N/A	N/A	N/A	N/A	N/A	1141 PEAR TREE LN	None	NAPA	CA	94558	6484	00	06000	38.32125908	-122.2921523	Napa County
342019	Ordering, Referring, Prescribing	N/A	1669756128	0	0	TURNER, ERIC M PA-C	11/21/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA55067	N/A	N/A	N/A	N/A	N/A	8788 JAMACHA RD	None	SPRING VALLEY	CA	91977	4035	00	06000	32.71482507	-117.0098243	San Diego County
342022	Ordering, Referring, Prescribing	N/A	1669770921	0	0	THAO, GER SUNNIE C PHARMD	3/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	53424	N/A	N/A	N/A	N/A	N/A	4500 W SHAW AVE	None	FRESNO	CA	93722	6200	00	06000	36.80835046	-119.8741095	Fresno County
342115	Ordering, Referring, Prescribing	N/A	1669936894	0	0	TUNG, JUDY PA-C	1/17/2019	Taxonomy not applicable	NA	n/a	000	Unknown	PA56480	N/A	N/A	N/A	N/A	N/A	1578 COLORADO BLVD	13	LOS ANGELES	CA	90041	1451	00	06000	34.13947661	-118.2009328	Los Angeles County
342154	Ordering, Referring, Prescribing	N/A	1679003511	0	0	TARVER, TANDREA N LMFT	11/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123307	N/A	N/A	N/A	N/A	N/A	9220 HAVEN AVE	100	RANCHO CUCAMONGA	CA	91730	8551	00	06000	34.08525	-117.5758875	San Bernardino County
342211	Ordering, Referring, Prescribing	N/A	1679081152	0	0	TEOH, CHIA SHAN PHARMD	1/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	78101	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	SUITE 316B	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
342227	Ordering, Referring, Prescribing	N/A	1679109185	0	0	TU, JENNIFER Y MD	8/22/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A189101	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVE	SUITE 100	LOS ANGELES	CA	90018	1336	00	06000	34.037415	-118.3176815	Los Angeles County
342235	Ordering, Referring, Prescribing	N/A	1679127518	0	0	TALAMAYAN, LIEZL G NP	2/9/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012059	N/A	N/A	N/A	N/A	N/A	1436 GOODRICH BLVD	None	COMMERCE	CA	90022	5111	00	06000	34.01117577	-118.1585527	Los Angeles County
342245	Ordering, Referring, Prescribing	N/A	1679133243	0	0	TRAN, KELLY Q LCSW	8/5/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	124782	N/A	N/A	N/A	N/A	N/A	1635 W. MAIN ST.	SUITE #100	ALHAMBRA	CA	91801	0600	00	06000	34.0915803	-118.1412977	Los Angeles County
342263	Ordering, Referring, Prescribing	N/A	1679191753	0	0	TANJI, KRISTEN LCSW	7/7/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	116300	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVE.	None	LOS ANGELES	CA	90001	3409	00	06000	33.9664185	-118.2477481	Los Angeles County
342314	Ordering, Referring, Prescribing	N/A	1679572911	0	0	TEW, RICHARD H MD	12/19/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	23820	N/A	N/A	N/A	N/A	N/A	2630 1ST AVENUE	None	SAN DIEGO	CA	92103	6599	00	06000	32.73288727	-117.1639712	San Diego County
342379	Ordering, Referring, Prescribing	N/A	1679722078	0	0	TIWANA, HARPREET S DDS	5/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61181	N/A	N/A	N/A	N/A	N/A	8145 ELK GROVE BLVD	18	ELK GROVE	CA	95758	5966	00	06000	38.409795	-121.4068275	Sacramento County
342435	Ordering, Referring, Prescribing	N/A	1679831630	0	0	THERTUS, VALERIE MD	5/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A171256	N/A	N/A	N/A	N/A	N/A	415 KNOLLCREST DR	101	REDDING	CA	96002	0181	00	06000	40.57267376	-122.3643496	Shasta County
342439	Ordering, Referring, Prescribing	N/A	1679840433	0	0	TOBING, JOHN W PHARMD	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58992	N/A	N/A	N/A	N/A	N/A	118 E BASE LINE RD	None	RIALTO	CA	92376	3607	00	06000	34.12138457	-117.3698386	San Bernardino County
342442	Ordering, Referring, Prescribing	N/A	1679841191	0	0	TRUONG, JULIE DUYEN M PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52949	N/A	N/A	N/A	N/A	N/A	946 S BROOKHURST ST	None	ANAHEIM	CA	92804	4305	00	06000	33.818652	-117.958912	Orange County
342474	Ordering, Referring, Prescribing	N/A	1679920060	0	0	TJOE, ASHLEY C OD	7/31/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	33369	N/A	N/A	N/A	N/A	N/A	140 W VALLEY BLVD	115	SAN GABRIEL	CA	91776	3760	00	06000	34.07958215	-118.1021957	Los Angeles County
342505	Ordering, Referring, Prescribing	N/A	1679967996	0	0	THOMAS, EMILY MD	3/19/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A147118	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
342506	Ordering, Referring, Prescribing	N/A	1679974539	0	0	TIEU, MARIE-FLORENCE M NP	6/20/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002927	N/A	N/A	N/A	N/A	N/A	6221 GEARY BLVD	2ND FL	SAN FRANCISCO	CA	94121	1887	00	06000	37.77994312	-122.4862014	San Francisco County
342509	Ordering, Referring, Prescribing	N/A	1679974885	0	0	TATEISHI, AYA LCSW	1/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87051	N/A	N/A	N/A	N/A	N/A	8616 LA TIJERA BLVD.	STE. 200	LOS ANGELES	CA	90045	3945	00	06000	33.95943215	-118.3918599	Los Angeles County
342523	Ordering, Referring, Prescribing	N/A	1679991343	0	0	TRUONG, SEAN T PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH71258	N/A	N/A	N/A	N/A	N/A	3900 BROADWAY	None	OAKLAND	CA	94611	5616	00	06000	37.82664697	-122.25721	Alameda County
342548	Ordering, Referring, Prescribing	N/A	1689038465	0	0	TAN, CATHERINE F	12/6/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	101790	N/A	N/A	N/A	N/A	N/A	4305 UNIVERSITY AVE	STE 150	SAN DIEGO	CA	92105	1690	00	06000	32.74957853	-117.101439	San Diego County
342562	Ordering, Referring, Prescribing	N/A	1689056780	0	0	TRUONG, LINDA N OD	4/6/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT15306	N/A	N/A	N/A	N/A	N/A	625 34TH ST	100 & 200	BAKERSFIELD	CA	93301	2305	00	06000	35.39046051	-119.0092725	Kern County
342597	Ordering, Referring, Prescribing	N/A	1689121303	0	0	TAM, AMY PHARMD	10/11/2018	Taxonomy not applicable	NA	n/a	000	Unknown	73878	N/A	N/A	N/A	N/A	N/A	2300 16TH ST	None	SAN FRANCISCO	CA	94103	4805	00	06000	37.76569327	-122.4091306	San Francisco County
342616	Ordering, Referring, Prescribing	N/A	1689148710	0	0	TRAVIS, TYEISHA LCSW	11/8/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108782	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	STE 220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
342643	Ordering, Referring, Prescribing	N/A	1689190159	0	0	THOMAS, SHEILA L PSYD	4/8/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	31752	N/A	N/A	N/A	N/A	N/A	2540 W SHAW LN	107	FRESNO	CA	93711	2700	00	06000	36.80923946	-119.8386	Fresno County
342652	Ordering, Referring, Prescribing	N/A	1689192460	0	0	TURNER, MIA M	3/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124914	N/A	N/A	N/A	N/A	N/A	3301 E 12TH ST	None	OAKLAND	CA	94601	3424	00	06000	37.77617499	-122.2247899	Alameda County
342659	Ordering, Referring, Prescribing	N/A	1689208936	0	0	THAI, RACHEL T	8/12/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	106495	N/A	N/A	N/A	N/A	N/A	767 N HILL STREET	None	LOS ANGELES	CA	90012	2343	00	06000	34.06255157	-118.2397077	Los Angeles County
342664	Ordering, Referring, Prescribing	N/A	1689211831	0	0	TRAN, TIEN T PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81081	N/A	N/A	N/A	N/A	N/A	8052 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	1234	00	06000	33.75925468	-117.988843	Orange County
342682	Ordering, Referring, Prescribing	N/A	1689252215	0	0	TRIEU, ANTHONY Q PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84229	N/A	N/A	N/A	N/A	N/A	2525 HARRIS ST	None	EUREKA	CA	95503	4805	00	06000	40.780953	-124.139643	Humboldt County
342685	Ordering, Referring, Prescribing	N/A	1689264418	0	0	THAO, JULIE NP	12/29/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016394	N/A	N/A	N/A	N/A	N/A	2042 KERN ST.	None	FRESNO	CA	93721	2008	00	06000	36.73339969	-119.7882967	Fresno County
342776	Ordering, Referring, Prescribing	N/A	1689732687	0	0	TRAN, ANDREW Q	7/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C150320	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE STE 30	None	SAN JOSE	CA	95128	2680	00	06000	37.3160785	-121.937121	Santa Clara County
342786	Ordering, Referring, Prescribing	N/A	1689765380	0	0	THAI, LUONG T PHARMD	7/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH48062	N/A	N/A	N/A	N/A	N/A	3001 TARAVAL STREET	None	SF	CA	94116	2106	00	06000	37.74200588	-122.4987236	San Francisco County
342845	Ordering, Referring, Prescribing	N/A	1689907198	0	0	TYREE, AMANDA E CCC-SLP	3/31/2020	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	18510	N/A	N/A	N/A	N/A	N/A	3250 WILSHIRE BLVD	None	LOS ANGELES	CA	90010	1577	00	06000	34.06176363	-118.2932622	Los Angeles County
342861	Ordering, Referring, Prescribing	N/A	1689933590	0	0	TUCHAN PINEDA, GRISELDA LMFT	11/23/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT112006	N/A	N/A	N/A	N/A	N/A	2820 SOUTH VERMONT AVENU	None	LOS ANGELES	CA	90007	2291	00	06000	34.028991	-118.291524	Los Angeles County
342906	Ordering, Referring, Prescribing	N/A	1699020891	0	0	TANALEGA-GOR, KATHERINE C PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67192	N/A	N/A	N/A	N/A	N/A	1011 SNEATH LN	None	SAN BRUNO	CA	94066	2311	00	06000	37.63437084	-122.4264474	San Mateo County
342935	Ordering, Referring, Prescribing	N/A	1699059386	0	0	TAFOYA, CINDY PSYD	11/11/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27970	N/A	N/A	N/A	N/A	N/A	15210 PARTHENIA ST.	None	NORTH HILLS	CA	91343	5305	00	06000	34.22817263	-118.4636408	Los Angeles County
342959	Ordering, Referring, Prescribing	N/A	1699095034	0	0	TAKAHASHI, ANITA M LCSW	12/30/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81345	N/A	N/A	N/A	N/A	N/A	2025 E. SEVENTH ST.	None	LONG BEACH	CA	90804	4590	00	06000	33.77538146	-118.167057	Los Angeles County
342966	Ordering, Referring, Prescribing	N/A	1699106500	0	0	TOMAS, URSULA S OT	6/1/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	9308	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
342980	Ordering, Referring, Prescribing	N/A	1699126078	0	0	TABIKH, MEHYO MD	9/6/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158432	N/A	N/A	N/A	N/A	N/A	69175 RAMON RD	BUILDING A	CATHEDRAL CITY	CA	92234	3344	00	06000	33.813621	-116.456193	Riverside County
343014	Ordering, Referring, Prescribing	N/A	1699183673	0	0	TRAJANO, CHARMINE OD	11/30/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	14993	N/A	N/A	N/A	N/A	N/A	11717 BERNARDO PLAZA COU	105	SAN DIEGO	CA	92128	2419	00	06000	33.01929872	-117.0777714	San Diego County
343052	Ordering, Referring, Prescribing	N/A	1699260042	0	0	TRAN, ANTOINETTE N PHARMD	1/15/2019	Taxonomy not applicable	NA	n/a	000	Unknown	RPH77167	N/A	N/A	N/A	N/A	N/A	3751 STOCKER ST	None	VIEW PARK	CA	90008	5101	00	06000	34.00616017	-118.3385751	Los Angeles County
343054	Ordering, Referring, Prescribing	N/A	1699270181	0	0	TUR, JAMES MD	3/1/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164179	N/A	N/A	N/A	N/A	N/A	4105 V ST.	1100	SACRAMENTO	CA	95817	1460	00	06000	38.55657183	-121.4570301	Sacramento County
343102	Ordering, Referring, Prescribing	N/A	1699365130	0	0	TRAN, KAITLYNN T PHARMD	5/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60428	N/A	N/A	N/A	N/A	N/A	14211 N EUCLID ST	STE A	GARDEN GROVE	CA	92649	2843	00	06000	33.7572573	-117.9376799	Orange County
343117	Ordering, Referring, Prescribing	N/A	1699391193	0	0	THOMAS, KATHRYN LMFT	7/2/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105544	N/A	N/A	N/A	N/A	N/A	9510 ELK GROVE FLORIN RD	None	ELK GROVE	CA	95624	1801	00	06000	38.413008	-121.372344	Sacramento County
343155	Ordering, Referring, Prescribing	N/A	1699491860	0	0	THOR, DANY NP	7/15/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95021768	N/A	N/A	N/A	N/A	N/A	1855 W KATELLA AVE	None	ORANGE	CA	92867	3451	00	06000	33.8061655	-117.872442	Orange County
343194	Ordering, Referring, Prescribing	N/A	1699800383	0	0	TIDWELL, BRENDA L NP	4/30/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	343836	N/A	N/A	N/A	N/A	N/A	804 W 7TH ST	None	HANFORD	CA	93230	4926	00	06000	36.32523147	-119.656845	Kings County
343197	Ordering, Referring, Prescribing	N/A	1699806745	0	0	TITHERLEY, JANICE L LMFT	3/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT32486	N/A	N/A	N/A	N/A	N/A	17800 HWY 18	None	APPLE VALLEY	CA	92307	1221	00	06000	34.54007429	-117.2744761	San Bernardino County
343215	Ordering, Referring, Prescribing	N/A	1699831263	0	0	TORRES, TATO LMFT	4/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	21005	N/A	N/A	N/A	N/A	N/A	1108 EL CAMINO REAL	None	SAN MATEO	CA	94402	2804	00	06000	37.55635875	-122.3187345	San Mateo County
343285	Ordering, Referring, Prescribing	N/A	1700026101	0	0	TAYLOR, JEFFREY LCSW	3/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74252	N/A	N/A	N/A	N/A	N/A	1521 UNIVERSITY AVE	None	BERKELEY	CA	94703	1422	00	06000	37.87060038	-122.2812128	Alameda County
343302	Ordering, Referring, Prescribing	N/A	1700058591	0	0	TOSCANO, SUZETTE A	5/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	95766	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS STE 22	STE 220	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
343309	Ordering, Referring, Prescribing	N/A	1700081528	0	0	THAY, VICHETH DDS	7/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	DDS46531	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
343316	Ordering, Referring, Prescribing	N/A	1700089141	0	0	TWAMLEY, ELIZABETH PHD	12/11/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY19150	N/A	N/A	N/A	N/A	N/A	1501 IMPERIAL AVE	None	SAN DIEGO	CA	92101	7638	00	06000	32.70625742	-117.1498948	San Diego County
343317	Ordering, Referring, Prescribing	N/A	1700089364	0	0	TZOU, JERRY E	6/6/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D36845	N/A	N/A	N/A	N/A	N/A	8841 GARVEY AVE	None	ROSEMEAD	CA	91770	3358	00	06000	34.06276591	-118.07587	Los Angeles County
343322	Ordering, Referring, Prescribing	N/A	1700086337	0	0	TRABANINO, RENE J MD	1/24/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A101324	N/A	N/A	N/A	N/A	N/A	1414 S GRAND AVE	380	LOS ANGELES	CA	90015	3067	00	06000	34.03661142	-118.2657227	Los Angeles County
343323	Ordering, Referring, Prescribing	N/A	1700106622	0	0	TALBOTT, LAURA LMFT	3/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	99401	N/A	N/A	N/A	N/A	N/A	10717 CAMINO RUIZ	SUITE 207	SAN DIEGO	CA	92126	2360	00	06000	32.91373261	-117.1437822	San Diego County
343346	Ordering, Referring, Prescribing	N/A	1700133683	0	0	TALLEY, ANGELICA T LCSW	8/4/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88908	N/A	N/A	N/A	N/A	N/A	1250 N. LAKEVIEW AVE	SUITE Q	ANAHEIM	CA	92807	1807	00	06000	33.860655	-117.818414	Orange County
343380	Ordering, Referring, Prescribing	N/A	1700180759	0	0	TORRES, JESSICA M LMFT	12/10/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116770	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
343384	Ordering, Referring, Prescribing	N/A	1700182011	0	0	TENORIO, EVELYN LCSW	4/14/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101110	N/A	N/A	N/A	N/A	N/A	905 E 8TH ST	None	LOS ANGELES	CA	90021	1848	00	06000	34.03639545	-118.2465917	Los Angeles County
343405	Ordering, Referring, Prescribing	N/A	1700211166	0	0	THOMASON, SHANNON LCSW	2/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88355	N/A	N/A	N/A	N/A	N/A	365 S RANCHO SANTA FE RD	100	SAN MARCOS	CA	92078	2338	00	06000	33.14154576	-117.2025301	San Diego County
343409	Ordering, Referring, Prescribing	N/A	1700215365	0	0	TAN, CALVIN DDS PHD	10/14/2020	Taxonomy not applicable	NA	n/a	000	Unknown	62874	N/A	N/A	N/A	N/A	N/A	725 WEST I STREET	None	LOS BANOS	CA	93635	3478	00	06000	37.06257631	-120.8618873	Merced County
343445	Ordering, Referring, Prescribing	N/A	1700279429	0	0	TRAN, TIFFANY Y LMFT	3/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84823	N/A	N/A	N/A	N/A	N/A	14140 BEACH BLVD	#223	WESTMINSTER	CA	92683	4453	00	06000	33.756966	-117.9894915	Orange County
343529	Ordering, Referring, Prescribing	N/A	1700399797	0	0	TRAN, HANG M PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77892	N/A	N/A	N/A	N/A	N/A	320 GOLDFIELD PL	None	SAN RAMON	CA	94582	5194	00	06000	37.75456663	-121.9192742	Contra Costa County
343537	Ordering, Referring, Prescribing	N/A	1700413218	0	0	TONEY, CAITLIN I MD	4/19/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A185674	N/A	N/A	N/A	N/A	N/A	3514 30TH ST	None	SAN DIEGO	CA	92104	4120	00	06000	32.74247286	-117.1301067	San Diego County
343662	Ordering, Referring, Prescribing	N/A	1700944121	0	0	TUPPER, CHARLES J MD	6/4/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G185940	N/A	N/A	N/A	N/A	N/A	1212 N. CALIFORNIA ST	None	STOCKTON	CA	95210	9030	00	06000	37.96681769	-121.2881382	San Joaquin County
343678	Ordering, Referring, Prescribing	N/A	1700970951	0	0	TRUE, ELIZABETH CCC-SLP	7/24/2022	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	SP26751	N/A	N/A	N/A	N/A	N/A	2240 OLD RIVER RD	None	UKIAH	CA	95482	6103	00	06000	39.1293897	-123.1645436	Mendocino County
343712	Ordering, Referring, Prescribing	N/A	1710030861	0	0	THACH, TERILYN T OD	2/8/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT11456	N/A	N/A	N/A	N/A	N/A	2419 E VALLEY PARKWAY	None	ESCONDIDO	CA	92027	2932	00	06000	33.14155803	-117.0430009	San Diego County
343749	Ordering, Referring, Prescribing	N/A	1710156245	0	0	TRAN, HUNG MD	10/3/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A44895	N/A	N/A	N/A	N/A	N/A	241 N FIGUEROA ST	None	LOS ANGELES	CA	90012	2601	00	06000	34.05904423	-118.2502018	Los Angeles County
343769	Ordering, Referring, Prescribing	N/A	1710189006	0	0	TA, VINH Q PA-C	11/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA16698	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
343780	Ordering, Referring, Prescribing	N/A	1710217948	0	0	TREJO, SONIA OT	3/26/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT10285	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
343852	Ordering, Referring, Prescribing	N/A	1710325501	0	0	TEWARI, SOWMYA MD	12/23/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A154312	N/A	N/A	N/A	N/A	N/A	1907 BOYS REPUBLIC DR	None	CHINO HILLS	CA	91709	5447	00	06000	33.993846	-117.725661	San Bernardino County
343862	Ordering, Referring, Prescribing	N/A	1710344577	0	0	TOPETE, ASTRID LMFT	4/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125456	N/A	N/A	N/A	N/A	N/A	957 S VILLAGE OAKS DR	350	COVINA	CA	91724	3696	00	06000	34.07216025	-117.8631234	Los Angeles County
343880	Ordering, Referring, Prescribing	N/A	1710369087	0	0	TUCKER, SARA E LCSW	4/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76686	N/A	N/A	N/A	N/A	N/A	42875 GATEWOOD ST	None	FREMONT	CA	94538	4131	00	06000	37.51965998	-121.9586413	Alameda County
343890	Ordering, Referring, Prescribing	N/A	1710384375	0	0	TONNU, MIMOSA T	12/22/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	695	N/A	N/A	N/A	N/A	N/A	512 WESTLINE DR	SUITE 204	ALAMEDA	CA	94501	7605	00	06000	37.76543497	-122.2715354	Alameda County
343942	Ordering, Referring, Prescribing	N/A	1710463450	0	0	TAYLOR, MARGARET I LCSW	9/25/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW118266	N/A	N/A	N/A	N/A	N/A	10850 GOLD CENTER DR	None	RANCHO CORDOVA	CA	95670	6045	00	06000	38.590353	-121.282488	Sacramento County
343986	Ordering, Referring, Prescribing	N/A	1710537139	0	0	TONG, JANICE KIT YING LMFT	9/27/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT134946	N/A	N/A	N/A	N/A	N/A	307 S B STREET	None	SAN MATEO	CA	94401	4053	00	06000	37.56539871	-122.3222584	San Mateo County
344021	Ordering, Referring, Prescribing	N/A	1710672696	0	0	TRAN, PAUL M MD	1/27/2025	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A200864	N/A	N/A	N/A	N/A	N/A	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	00	06000	37.33578	-121.999329	Santa Clara County
344124	Ordering, Referring, Prescribing	N/A	1720198575	0	0	THOMAS, JANICE MD	6/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G72735	N/A	N/A	N/A	N/A	N/A	4333 E VINEYARD AVE	None	OXNARD	CA	93036	1013	00	06000	34.25498155	-119.1558342	Ventura County
344134	Ordering, Referring, Prescribing	N/A	1720208424	0	0	TAYLOR, TIMOTHY MD	9/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G66724	N/A	N/A	N/A	N/A	N/A	40925 COUNTY CENTER DRIV	200	TEMECULA	CA	92591	0000	00	06000	33.52802214	-117.1605544	Riverside County
344135	Ordering, Referring, Prescribing	N/A	1720223779	0	0	TSE, JUSTIN G PHARMD	4/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61659	N/A	N/A	N/A	N/A	N/A	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	00	06000	37.706364	-122.165163	Alameda County
344153	Ordering, Referring, Prescribing	N/A	1720265614	0	0	TORRES, HECTOR PHD	5/3/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY13309	N/A	N/A	N/A	N/A	N/A	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
344157	Ordering, Referring, Prescribing	N/A	1720271273	0	0	THIBEDEAU, MARK R LCSW	6/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27894	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
344185	Ordering, Referring, Prescribing	N/A	1720330681	0	0	TARDILLO, DORIBETH PSYD	12/22/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33087	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	300	SAN JOSE	CA	95128	0000	00	06000	37.3160785	-121.937121	Santa Clara County
344200	Ordering, Referring, Prescribing	N/A	1720350184	0	0	TUMAN, CHRISTINA LMFT	3/8/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT101321	N/A	N/A	N/A	N/A	N/A	1910 OLYMPIC BLVD	365	WALNUT CREEK	CA	94596	5096	00	06000	37.89453628	-122.0662326	Contra Costa County
344208	Ordering, Referring, Prescribing	N/A	1720354574	0	0	TURNER, STACIE L LMFT	3/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98842	N/A	N/A	N/A	N/A	N/A	777 N 1ST ST	220	SAN JOSE	CA	95112	6337	00	06000	37.35064564	-121.9015633	Santa Clara County
344215	Ordering, Referring, Prescribing	N/A	1720363427	0	0	TON, LETRINH PHARMD	8/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66631	N/A	N/A	N/A	N/A	N/A	2453 S AZUSA AVE	None	WEST COVINA	CA	91792	1536	00	06000	34.03209594	-117.914484	Los Angeles County
344220	Ordering, Referring, Prescribing	N/A	1720364425	0	0	TRIEU, LISA L PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH53689	N/A	N/A	N/A	N/A	N/A	3643 PECK RD	None	EL MONTE	CA	91732	3530	00	06000	34.07273235	-118.0242338	Los Angeles County
344260	Ordering, Referring, Prescribing	N/A	1720419690	0	0	TAPIA, IOHANA LMFT	4/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113894	N/A	N/A	N/A	N/A	N/A	301 E. 13TH ST	SUITE 238	MERCED	CA	95341	6211	00	06000	37.29248035	-120.4730619	Merced County
344274	Ordering, Referring, Prescribing	N/A	1720438674	0	0	TRUJILLO-AGUIRRE, NATALIE MD	8/21/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157691	N/A	N/A	N/A	N/A	N/A	1206 E 17TH ST	SUITE 101	SANTA ANA	CA	92701	2641	00	06000	33.75983651	-117.8539425	Orange County
344293	Ordering, Referring, Prescribing	N/A	1720459423	0	0	TOMM, JASLEEN K	5/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88783	N/A	N/A	N/A	N/A	N/A	1360 E LASSEN AVE	None	CHICO	CA	95973	7823	00	06000	39.77359746	-121.8420053	Butte County
344294	Ordering, Referring, Prescribing	N/A	1720458342	0	0	TANG, DANNY L PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73485	N/A	N/A	N/A	N/A	N/A	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	00	06000	37.33773494	-122.0043395	Santa Clara County
344295	Ordering, Referring, Prescribing	N/A	1720464084	0	0	THORBURN, JOSHUA N	5/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	68720	N/A	N/A	N/A	N/A	N/A	8408 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3402	00	06000	34.07601949	-118.373409	Los Angeles County
344296	Ordering, Referring, Prescribing	N/A	1720464142	0	0	TSENG, ROGER PHARMD	2/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54745	N/A	N/A	N/A	N/A	N/A	2034 W PICO BLVD	None	LOS ANGELES	CA	90006	5011	00	06000	34.04706445	-118.2822723	Los Angeles County
344300	Ordering, Referring, Prescribing	N/A	1720461890	0	0	TROUPE, PATRICIA J LCSW	11/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	98335	N/A	N/A	N/A	N/A	N/A	18 COUNTY CENTER DR	None	OROVILLE	CA	95965	3335	00	06000	39.52683587	-121.5716851	Butte County
344312	Ordering, Referring, Prescribing	N/A	1720487515	0	0	TROUGHTON, BRITTNY M LCSW	1/29/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	128220	N/A	N/A	N/A	N/A	N/A	242 N VILLA AVE	None	WILLOWS	CA	95988	2641	00	06000	39.52243848	-122.208844	Glenn County
344320	Ordering, Referring, Prescribing	N/A	1720499577	0	0	TANDON, NEHA PHARMD	4/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69568	N/A	N/A	N/A	N/A	N/A	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2087	00	06000	37.48948529	-122.2232468	San Mateo County
344335	Ordering, Referring, Prescribing	N/A	1720518418	0	0	TOMIYAMA, ERIN	11/16/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35285	N/A	N/A	N/A	N/A	N/A	5460 E LA PALMA AVE	None	ANAHEIM	CA	92807	2023	00	06000	33.85983003	-117.7966383	Orange County
344352	Ordering, Referring, Prescribing	N/A	1720541311	0	0	TRUONG, MINDY DMD	8/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	104955	N/A	N/A	N/A	N/A	N/A	1009 N AVALON BLVD	None	WILMINGTON	CA	90744	4505	00	06000	33.78320457	-118.2627263	Los Angeles County
344359	Ordering, Referring, Prescribing	N/A	1720544091	0	0	THOMPSON BELL, GRACE NP	8/2/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031483	N/A	N/A	N/A	N/A	N/A	715 TANK FARM RD	STE C	SAN LUIS OBISPO	CA	93401	7008	00	06000	35.24853234	-120.642458	San Luis Obispo County
344368	Ordering, Referring, Prescribing	N/A	1720560840	0	0	TRAN, TIFFANY W LCSW	5/5/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107953	N/A	N/A	N/A	N/A	N/A	905 E. 8TH STREET	None	LOS ANGELES	CA	90021	1805	00	06000	34.03639545	-118.2465917	Los Angeles County
344374	Ordering, Referring, Prescribing	N/A	1720572019	0	0	TRAN, CHENA L LCSW	12/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99107	N/A	N/A	N/A	N/A	N/A	3530 ATLANTIC AVE	#210	LONG BEACH	CA	90807	4569	00	06000	33.820875	-118.1850035	Los Angeles County
344375	Ordering, Referring, Prescribing	N/A	1720572704	0	0	TORRES, ALEJANDRO MD	7/2/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173512	N/A	N/A	N/A	N/A	N/A	6810 N MILBURN AVE	None	FRESNO	CA	93722	2102	00	06000	36.83655963	-119.8788638	Fresno County
344385	Ordering, Referring, Prescribing	N/A	1720590003	0	0	TRAN, STEPHANIE	11/3/2017	Taxonomy not applicable	NA	n/a	000	Unknown	MT4660571	N/A	N/A	N/A	N/A	N/A	1550 SUPERIOR AVE	None	COSTA MESA	CA	92627	3653	00	06000	33.63305341	-117.9266303	Orange County
344401	Ordering, Referring, Prescribing	N/A	1720615578	0	0	TURNER, ALISON G LMFT	6/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT114187	N/A	N/A	N/A	N/A	N/A	401 IMPERIAL HWY	None	FULLERTON	CA	92835	1145	00	06000	33.91748848	-117.925704	Orange County
344449	Ordering, Referring, Prescribing	N/A	1720699432	0	0	THAI, EMILY OD	4/5/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34649	N/A	N/A	N/A	N/A	N/A	11717 BERNARDO PLAZA COU	STE 105	SAN DIEGO	CA	92128	2419	00	06000	33.01929872	-117.0777714	San Diego County
344470	Ordering, Referring, Prescribing	N/A	1720783301	0	0	TOMY, MERIL MD MPH	7/1/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197226	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
344476	Ordering, Referring, Prescribing	N/A	1720817505	0	0	TRINH, ANH K NP	11/1/2024	Taxonomy not applicable	NA	n/a	000	Unknown	95032801	N/A	N/A	N/A	N/A	N/A	8070 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	3396	00	06000	33.75926549	-117.98829	Orange County
344517	Ordering, Referring, Prescribing	N/A	1730218140	0	0	TI, ELAINE C	5/10/2023	Taxonomy not applicable	NA	n/a	000	Unknown	DDS39898	N/A	N/A	N/A	N/A	N/A	10414 VACCO ST	None	SOUTH EL MONTE	CA	91733	3350	00	06000	34.04731781	-118.0443923	Los Angeles County
344524	Ordering, Referring, Prescribing	N/A	1730229469	0	0	TURCIOS, VANESSA LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT78728	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	None	OXNARD	CA	93036	2612	00	06000	34.219566	-119.1539365	Ventura County
344527	Ordering, Referring, Prescribing	N/A	1730229832	0	0	TAN, WINNIE DDS	7/26/2023	Taxonomy not applicable	NA	n/a	000	Unknown	46333	N/A	N/A	N/A	N/A	N/A	3945 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2440	00	06000	34.02394552	-118.187748	Los Angeles County
344532	Ordering, Referring, Prescribing	N/A	1730230756	0	0	TRUONG, DIANE Q OD	4/26/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	11336	N/A	N/A	N/A	N/A	N/A	13916 BROOKHURST ST.	SUITE F	GARDEN GROVE	CA	92843	4331	00	06000	33.761034	-117.954832	Orange County
344567	Ordering, Referring, Prescribing	N/A	1730318528	0	0	TSAI, KATHERINE PHD	11/18/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27331	N/A	N/A	N/A	N/A	N/A	867 N FAIR OAKS AVE	None	PASADENA	CA	91103	3050	00	06000	34.160877	-118.1506375	Los Angeles County
344574	Ordering, Referring, Prescribing	N/A	1730339607	0	0	TANSEY, LYNN LMFT	2/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52583	N/A	N/A	N/A	N/A	N/A	2502 E HUNTINGTON DR,	None	DUARTE	CA	91010	2221	00	06000	34.13967149	-117.9511686	Los Angeles County
344582	Ordering, Referring, Prescribing	N/A	1730369356	0	0	THOM, FRANCES M NP	2/27/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	17796	N/A	N/A	N/A	N/A	N/A	1340 ARNOLD DR	None	MARTINEZ	CA	94553	4189	00	06000	37.99250264	-122.0983907	Contra Costa County
344595	Ordering, Referring, Prescribing	N/A	1730384181	0	0	TABACARU, DANIELA M MD	2/21/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A98545	N/A	N/A	N/A	N/A	N/A	19531 MCLANE ST.	SUITE B	PALM SPRINGS	CA	92262	6219	00	06000	33.90666798	-116.5523429	Riverside County
344617	Ordering, Referring, Prescribing	N/A	1730437740	0	0	THORBS, SHALETA LMFT	7/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110410	N/A	N/A	N/A	N/A	N/A	233 BASELINE ROAD	None	LA VERNE	CA	91750	2353	00	06000	34.12068064	-117.7523547	Los Angeles County
344618	Ordering, Referring, Prescribing	N/A	1730419037	0	0	TROTTER, KENISHA LCSW	6/27/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	67601	N/A	N/A	N/A	N/A	N/A	8300 S VERMONT	None	LOS ANGELES	CA	90047	5313	00	06000	33.963021	-118.291474	Los Angeles County
344628	Ordering, Referring, Prescribing	N/A	1730456229	0	0	TAGHDIS, ROZITA PHARMD	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH61208	N/A	N/A	N/A	N/A	N/A	2245 S EUCLID AVE	None	ONTARIO	CA	91762	6519	00	06000	34.032942	-117.6499755	San Bernardino County
344682	Ordering, Referring, Prescribing	N/A	1730536384	0	0	TUPAS-ORTEGA, NERISSA M	10/13/2018	Taxonomy not applicable	NA	n/a	000	Unknown	49152	N/A	N/A	N/A	N/A	N/A	475 W MAIN ST	None	BRAWLEY	CA	92227	2244	00	06000	32.97865516	-115.5503473	Imperial County
344700	Ordering, Referring, Prescribing	N/A	1730568163	0	0	TELMO, MARIEL L DPM	6/4/2019	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5366	N/A	N/A	N/A	N/A	N/A	250 NORTHGATE DR	None	MANTECA	CA	95336	3161	00	06000	37.81869269	-121.2190817	San Joaquin County
344709	Ordering, Referring, Prescribing	N/A	1730596768	0	0	TUCKER-ASHTON, SHIRLEY	1/27/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000475	N/A	N/A	N/A	N/A	N/A	1701 MISSION AVE	None	OCEANSIDE	CA	92058	7103	00	06000	33.20296571	-117.3666126	San Diego County
344721	Ordering, Referring, Prescribing	N/A	1730604414	0	0	TAYLOR, KAYLA L NP	4/23/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006792	N/A	N/A	N/A	N/A	N/A	3544 30TH ST	None	SAN DIEGO	CA	92104	4120	00	06000	32.742936	-117.130118	San Diego County
344750	Ordering, Referring, Prescribing	N/A	1730656786	0	0	TAYLOR, MELINDA L RN	2/13/2018	Taxonomy not applicable	NA	n/a	000	Unknown	502093	N/A	N/A	N/A	N/A	N/A	1530 E 19TH ST	None	BAKERSFIELD	CA	93305	5406	00	06000	35.37150365	-118.9798847	Kern County
344797	Ordering, Referring, Prescribing	N/A	1730738220	0	0	THATCHER, LEONNE H LMFT	3/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131612	N/A	N/A	N/A	N/A	N/A	2406 ARMSTRONG ST	None	LIVERMORE	CA	94551	7617	00	06000	37.699371	-121.812038	Alameda County
344800	Ordering, Referring, Prescribing	N/A	1730742040	0	0	TADEO, ERICA LMFT	4/30/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT132095	N/A	N/A	N/A	N/A	N/A	23115 RIDER ST	None	PERRIS	CA	92570	9732	00	06000	33.83001797	-117.2609381	Riverside County
344821	Ordering, Referring, Prescribing	N/A	1730791096	0	0	THARAYIL, HANNAH B PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84411	N/A	N/A	N/A	N/A	N/A	2900 N MAIN ST	None	WALNUT CREEK	CA	94597	2035	00	06000	37.92721212	-122.0621121	Contra Costa County
344830	Ordering, Referring, Prescribing	N/A	1730838889	0	0	TRAN, DANIELLE T MD	8/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A188558	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
344856	Ordering, Referring, Prescribing	N/A	1730928342	0	0	TORRES, JONATHAN PA	2/14/2025	Taxonomy not applicable	NA	n/a	000	Unknown	PA65969	N/A	N/A	N/A	N/A	N/A	10418 VALLEY BLVD STE A	STE A	EL MONTE	CA	91731	3600	00	06000	34.07647884	-118.0458956	Los Angeles County
344876	Ordering, Referring, Prescribing	N/A	1740210657	0	0	THOMPSON GALLEGO, JULIA A NP	2/11/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP15870	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
344907	Ordering, Referring, Prescribing	N/A	1740311398	0	0	TINAGON, RATTANAKLAO LMFT	7/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	39960	N/A	N/A	N/A	N/A	N/A	16350 FILBERT STREET	None	SYLMAR	CA	91342	1002	00	06000	34.31595736	-118.4853828	Los Angeles County
344924	Ordering, Referring, Prescribing	N/A	1740338763	0	0	TILLEY, KIMBERLY B MD	5/6/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A95702	N/A	N/A	N/A	N/A	N/A	1031 W 34TH ST	None	LOS ANGELES	CA	90089	3602	00	06000	34.024005	-118.2895875	Los Angeles County
344947	Ordering, Referring, Prescribing	N/A	1740414424	0	0	TORRES, YESENIA MSW LCSW	6/17/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76186	N/A	N/A	N/A	N/A	N/A	1601 E CHESTNUT AVE	None	SANTA ANA	CA	92701	6322	00	06000	33.74262565	-117.8470706	Orange County
344953	Ordering, Referring, Prescribing	N/A	1740431881	0	0	TRIEU, PHUONG PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60222	N/A	N/A	N/A	N/A	N/A	1800 HARRISON ST	13TH FLOOR	OAKLAND	CA	94612	3466	00	06000	37.80593773	-122.2656714	Alameda County
344985	Ordering, Referring, Prescribing	N/A	1740522119	0	0	TADDEI, LIA A LMFT	3/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	96685	N/A	N/A	N/A	N/A	N/A	1420 WILLOW PASS RD	None	CONCORD	CA	94520	5823	00	06000	37.96956948	-122.0507563	Contra Costa County
344989	Ordering, Referring, Prescribing	N/A	1740523398	0	0	TRUE, ALAN N PHARMD	3/15/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH42755	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
344991	Ordering, Referring, Prescribing	N/A	1740531581	0	0	TRAN, AMY V LMFT	3/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT98864	N/A	N/A	N/A	N/A	N/A	12966 EUCLID ST	SUITE 495	GARDEN GROVE	CA	92840	5200	00	06000	33.77455935	-117.9378298	Orange County
345095	Ordering, Referring, Prescribing	N/A	1740697937	0	0	THOMAS, MARK D NP	1/14/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000964	N/A	N/A	N/A	N/A	N/A	134 GOLDEN GATE AVENUE	None	SAN FRANCISCO	CA	94102	3810	00	06000	37.78204768	-122.4129337	San Francisco County
345099	Ordering, Referring, Prescribing	N/A	1740701481	0	0	TOUBIA, ELIAS A OD	11/22/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT33758	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
345129	Ordering, Referring, Prescribing	N/A	1740733484	0	0	TRAPP, KELLEY L AU	11/12/2023	Taxonomy not applicable	NA	n/a	003	AUDIOLOGISTS	AU3256	N/A	N/A	N/A	N/A	N/A	1220 E 4TH ST.	None	LONG BEACH	CA	90802	1831	00	06000	33.77171549	-118.175652	Los Angeles County
345143	Ordering, Referring, Prescribing	N/A	1740759224	0	0	TUTHILL HOOVER, DIANA LMFT	10/9/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48604	N/A	N/A	N/A	N/A	N/A	1515 W MISSION RD	None	ALHAMBRA	CA	91803	1618	00	06000	34.08224297	-118.1404375	Los Angeles County
345153	Ordering, Referring, Prescribing	N/A	1740778786	0	0	TITH, MELISSA S LCSW	7/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	95373	N/A	N/A	N/A	N/A	N/A	1801 PARK COURT PL	BLDG H	SANTA ANA	CA	92701	5002	00	06000	33.74986153	-117.8429355	Orange County
345161	Ordering, Referring, Prescribing	N/A	1740794593	0	0	TORRES, VANESSA LMFT	6/8/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133143	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	STE 220	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
345164	Ordering, Referring, Prescribing	N/A	1740800010	0	0	TUCKER, ALICIA L LMFT	5/11/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT132740	N/A	N/A	N/A	N/A	N/A	49211 GRAPEFRUIT BLVD	SUITE 5 & 6	COACHELLA	CA	92236	1480	00	06000	33.69171437	-116.184351	Riverside County
345181	Ordering, Referring, Prescribing	N/A	1740817691	0	0	TRINIDAD, MARISSA D MD	3/17/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A184932	N/A	N/A	N/A	N/A	N/A	1414 S GRAND AVE	200	LOS ANGELES	CA	90015	3067	00	06000	34.03661142	-118.2657227	Los Angeles County
345205	Ordering, Referring, Prescribing	N/A	1740882794	0	0	TACSION, MARIA PRIMZA LIANE P PHARMD	10/13/2020	Taxonomy not applicable	NA	n/a	000	Unknown	83286	N/A	N/A	N/A	N/A	N/A	6445 N PACIFIC AVE	None	STOCKTON	CA	95207	0001	00	06000	38.00885138	-121.3198384	San Joaquin County
345215	Ordering, Referring, Prescribing	N/A	1740898808	0	0	TORRES, MARIBEL PHARMD	3/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82598	N/A	N/A	N/A	N/A	N/A	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
345261	Ordering, Referring, Prescribing	N/A	1750059374	0	0	TOMAS, JOANNA NP	3/1/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029317	N/A	N/A	N/A	N/A	N/A	837 ADDISON ST	None	BERKELEY	CA	94710	2047	00	06000	37.86680859	-122.2969443	Alameda County
345269	Ordering, Referring, Prescribing	N/A	1750135885	0	0	TREJO, SARAH LPCC	12/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC12759	N/A	N/A	N/A	N/A	N/A	23311 DRACAEA AVE	None	MORENO VALLEY	CA	92553	3201	00	06000	33.92807348	-117.258489	Riverside County
345299	Ordering, Referring, Prescribing	N/A	1750400602	0	0	TRAN, SEAN D LCSW	8/29/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW22317	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
345342	Ordering, Referring, Prescribing	N/A	1750474169	0	0	TAM, VANESSA S	3/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58492	N/A	N/A	N/A	N/A	N/A	900 VETERANS BLVD	400	REDWOOD CITY	CA	94063	1715	00	06000	37.49009082	-122.2276816	San Mateo County
345373	Ordering, Referring, Prescribing	N/A	1750476438	0	0	TRUE, WENDY M LMFT	1/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	44262	N/A	N/A	N/A	N/A	N/A	8950 CAL CENTER DR	STE 340	SACRAMENTO	CA	95826	3259	00	06000	38.555721	-121.3745985	Sacramento County
345384	Ordering, Referring, Prescribing	N/A	1750590600	0	0	TAGHIZADEH, MAJID DC	2/2/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC30121	N/A	N/A	N/A	N/A	N/A	4094 4TH AVE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
345527	Ordering, Referring, Prescribing	N/A	1750825329	0	0	TROLIO, KELSI R LMFT	9/29/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT129210	N/A	N/A	N/A	N/A	N/A	1401 L ST	None	BAKERSFIELD	CA	93301	4522	00	06000	35.37071435	-119.0164657	Kern County
345548	Ordering, Referring, Prescribing	N/A	1750864377	0	0	TRUEBLOOD, GRACE	1/20/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130704	N/A	N/A	N/A	N/A	N/A	9837 FOLSOM BLVD	None	SACRAMENTO	CA	95827	1356	00	06000	38.575764	-121.330647	Sacramento County
345572	Ordering, Referring, Prescribing	N/A	1750905840	0	0	THAKKAR, RINKAL B	7/16/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	104903	N/A	N/A	N/A	N/A	N/A	6501 GARFIELD AVE	None	BELL GARDENS	CA	90201	1805	00	06000	33.97292523	-118.1475473	Los Angeles County
345573	Ordering, Referring, Prescribing	N/A	1750910089	0	0	TIN, VICTOR A DO	8/30/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21876	N/A	N/A	N/A	N/A	N/A	7515 VAN NUYS BLVD	None	VAN NUYS	CA	91405	1949	00	06000	34.207344	-118.4487995	Los Angeles County
345590	Ordering, Referring, Prescribing	N/A	1750931606	0	0	THOMPSON, GABRIELLE	3/21/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013640	N/A	N/A	N/A	N/A	N/A	1968 S COAST HWY	#634	LAGUNA BEACH	CA	92651	3681	00	06000	33.52764466	-117.7698095	Orange County
345596	Ordering, Referring, Prescribing	N/A	1750962460	0	0	TSIEAPAN, CYNTHIA PHARMD	8/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH56703	N/A	N/A	N/A	N/A	N/A	2600 MOWRY AVE	None	FREMONT	CA	94538	1619	00	06000	37.55561189	-121.9825927	Alameda County
345617	Ordering, Referring, Prescribing	N/A	1760009989	0	0	TRAN, LILI PA-C	9/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58611	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
345646	Ordering, Referring, Prescribing	N/A	1760046924	0	0	TABUNGAR, VANESSA E NP	7/28/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95011053	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM AVE STE	None	LANCASTER	CA	93535	4576	00	06000	34.67013731	-118.1222748	Los Angeles County
345668	Ordering, Referring, Prescribing	N/A	1760129134	0	0	TAGLYAN, KARINE PHARMD	6/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47137	N/A	N/A	N/A	N/A	N/A	5236 SANTA MONICA BLVD	None	LOS ANGELES	CA	90029	1210	00	06000	34.09077051	-118.3046976	Los Angeles County
345702	Ordering, Referring, Prescribing	N/A	1760423560	0	0	THU, AUNG MD	10/27/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A70925	N/A	N/A	N/A	N/A	N/A	245 N. LAURSEN STREET	None	HEMET	CA	92543	4437	00	06000	33.750954	-116.960839	Riverside County
345730	Ordering, Referring, Prescribing	N/A	1760519805	0	0	THAN, HUY T	10/20/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D54589	N/A	N/A	N/A	N/A	N/A	10418 VALLEY BLVD	STE B	EL MONTE	CA	91731	3600	00	06000	34.07647884	-118.0458956	Los Angeles County
345799	Ordering, Referring, Prescribing	N/A	1760686265	0	0	TORRES, XOLEDAD A LMFT	6/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90998	N/A	N/A	N/A	N/A	N/A	51 MARINA BLVD	STE. D	PITTSBURG	CA	94565	2068	00	06000	38.0354387	-121.8837345	Contra Costa County
345815	Ordering, Referring, Prescribing	N/A	1760715783	0	0	TUALA, LORRAINE LCSW	11/8/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86045	N/A	N/A	N/A	N/A	N/A	552 E. CARSON ST	104-432	CARSON	CA	90745	9998	00	06000	33.83155254	-118.266417	Los Angeles County
345870	Ordering, Referring, Prescribing	N/A	1760816334	0	0	TOSSOUN, NADER M PHARMD	11/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	69633	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
345896	Ordering, Referring, Prescribing	N/A	1760845465	0	0	TORREZ ANDIA, ESTEVAN A MD	9/2/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160194	N/A	N/A	N/A	N/A	N/A	4455 W. 117TH	200	HAWTHORNE	CA	90250	2240	00	06000	33.92825048	-118.3539285	Los Angeles County
345903	Ordering, Referring, Prescribing	N/A	1760851687	0	0	TURK, MICHELLE L LMFT	4/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110187	N/A	N/A	N/A	N/A	N/A	3636 N 1ST ST	135 & 154	FRESNO	CA	93726	6800	00	06000	36.78322578	-119.7724022	Fresno County
345909	Ordering, Referring, Prescribing	N/A	1760855217	0	0	TYRRELL, REBECCA	2/9/2020	Taxonomy not applicable	NA	n/a	000	Unknown	5794	N/A	N/A	N/A	N/A	N/A	6051 N FRESNO ST	201	FRESNO	CA	93710	5280	00	06000	36.823905	-119.781436	Fresno County
345991	Ordering, Referring, Prescribing	N/A	1760975833	0	0	TRUONG, NHA K DO	11/16/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17836	N/A	N/A	N/A	N/A	N/A	4094 4TH AVE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
346010	Ordering, Referring, Prescribing	N/A	1770010662	0	0	THOMAS, DEBBIE A LMFT	5/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	97716	N/A	N/A	N/A	N/A	N/A	1430 WILLOW PASS ROAD	SUITE 100	CONCORD	CA	94520	7946	00	06000	37.97055112	-122.0492933	Contra Costa County
346035	Ordering, Referring, Prescribing	N/A	1770061202	0	0	TIET, KATHLEEN LCSW	7/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	116576	N/A	N/A	N/A	N/A	N/A	2933 N. EL NIDO DRIVE	None	ALTADENA	CA	91001	4529	00	06000	34.19549106	-118.1655134	Los Angeles County
346072	Ordering, Referring, Prescribing	N/A	1770142036	0	0	TRINH, EMILY T PHARMD	7/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78650	N/A	N/A	N/A	N/A	N/A	5005 BALL ROAD	None	CYPRESS	CA	90630	3643	00	06000	33.81701014	-118.0450115	Orange County
346106	Ordering, Referring, Prescribing	N/A	1770226268	0	0	TASOFF, TAMARA DDS	10/14/2024	Taxonomy not applicable	NA	n/a	000	Unknown	DDS110937	N/A	N/A	N/A	N/A	N/A	175 W COURT ST	None	WOODLAND	CA	95695	2913	00	06000	38.67889514	-121.7923678	Yolo County
346131	Ordering, Referring, Prescribing	N/A	1770366585	0	0	TURINGAN, MEIKELA	8/11/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH88234	N/A	N/A	N/A	N/A	N/A	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
346221	Ordering, Referring, Prescribing	N/A	1770761538	0	0	THOMSEN, MARY BETH PHD	4/16/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY13950	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
346252	Ordering, Referring, Prescribing	N/A	1770832842	0	0	TRISTANT, VANESSA N LCSW	3/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW101793	N/A	N/A	N/A	N/A	N/A	50 W MAIN ST	None	WOODLAND	CA	95695	1234	00	06000	38.67757843	-121.7858144	Yolo County
346253	Ordering, Referring, Prescribing	N/A	1770835829	0	0	TANG, YUXI LCSW	4/11/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80922	N/A	N/A	N/A	N/A	N/A	1855 N FAIR OAKS AVE	None	PASADENA	CA	91103	1620	00	06000	34.177806	-118.1507985	Los Angeles County
346256	Ordering, Referring, Prescribing	N/A	1770851669	0	0	TRUONG, HAI B PHARMD	7/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66284	N/A	N/A	N/A	N/A	N/A	7299 LAGUNA BLVD	None	ELK GROVE	CA	95758	5059	00	06000	38.424105	-121.418532	Sacramento County
346288	Ordering, Referring, Prescribing	N/A	1770893398	0	0	TONG, NANCY PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64834	N/A	N/A	N/A	N/A	N/A	3000 S ROBERTSON BLVD	416	LOS ANGELES	CA	90034	3158	00	06000	34.03262164	-118.3900457	Los Angeles County
346299	Ordering, Referring, Prescribing	N/A	1770911794	0	0	TAKATA, LINDSEY PHARMD	4/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	69991	N/A	N/A	N/A	N/A	N/A	1325 N ANAHEIM BLVD	None	ANAHEIM	CA	92801	1202	00	06000	33.85331047	-117.9199617	Orange County
346317	Ordering, Referring, Prescribing	N/A	1770939225	0	0	TRAYNHAM, VALERIE LPCC	4/19/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC5792	N/A	N/A	N/A	N/A	N/A	1812 W PARK AVE	None	REDLANDS	CA	92373	0011	00	06000	34.05931058	-117.216243	San Bernardino County
346352	Ordering, Referring, Prescribing	N/A	1770989410	0	0	TOUSSAINT, TRACY NP	12/26/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002385	N/A	N/A	N/A	N/A	N/A	2201 COURAGE DR	None	FAIRFIELD	CA	94533	6733	00	06000	38.23727106	-122.0692856	Solano County
346390	Ordering, Referring, Prescribing	N/A	1780054551	0	0	TON, CHRISTINA	8/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	72703	N/A	N/A	N/A	N/A	N/A	15 MARINA BLVD	None	SAN FRANCISCO	CA	94123	4952	00	06000	37.80508602	-122.4330005	San Francisco County
346394	Ordering, Referring, Prescribing	N/A	1780055657	0	0	TRAN, YEN H	7/25/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	851438	N/A	N/A	N/A	N/A	N/A	1032 A ST	None	HAYWARD	CA	94541	4106	00	06000	37.67439519	-122.0831733	Alameda County
346418	Ordering, Referring, Prescribing	N/A	1780100933	0	0	TRAN, TRINA M PHARMD	12/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73278	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
346421	Ordering, Referring, Prescribing	N/A	1780102319	0	0	TRAN, TRAN N PHARMD	7/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76103	N/A	N/A	N/A	N/A	N/A	14102 RAMONA BLVD	None	BALWIN PARK	CA	91706	3138	00	06000	34.08514059	-117.965948	Los Angeles County
346423	Ordering, Referring, Prescribing	N/A	1780103689	0	0	TATE, TIKEREA L LCSW	6/25/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108765	N/A	N/A	N/A	N/A	N/A	22245 MAIN ST	SUITE 200	HAYWARD	CA	94541	4028	00	06000	37.67674766	-122.0863181	Alameda County
346437	Ordering, Referring, Prescribing	N/A	1780116848	0	0	TARKEY, MICHAEL T MD	12/13/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A192306	N/A	N/A	N/A	N/A	N/A	200 E ANAHEIM ST	None	WILMINGTON	CA	90744	4516	00	06000	33.78003976	-118.2608958	Los Angeles County
346450	Ordering, Referring, Prescribing	N/A	1780135624	0	0	THU, KEVIN PHARMD	3/15/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH 74191	N/A	N/A	N/A	N/A	N/A	2101 N ROSE AVE	None	OXNARD	CA	93036	2682	00	06000	34.221969	-119.1618045	Ventura County
346499	Ordering, Referring, Prescribing	N/A	1780253450	0	0	TAKEYAMA, TREVOR DPM	1/24/2022	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5828	N/A	N/A	N/A	N/A	N/A	300 N EUCLID ST	None	FULLERTON	CA	92832	1623	00	06000	33.87250373	-117.9419615	Orange County
346544	Ordering, Referring, Prescribing	N/A	1780387860	0	0	TRAN, THU TRAN MD	7/1/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197265	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
346609	Ordering, Referring, Prescribing	N/A	1780751321	0	0	TORLAK, EDINA S	5/31/2013	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C00054332	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD RD	None	AUBURN	CA	95063	9522	00	06000	38.93485327	-121.0988193	Placer County
346610	Ordering, Referring, Prescribing	N/A	1780754051	0	0	TAMURA, TOM H LMFT	4/11/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT31178	N/A	N/A	N/A	N/A	N/A	3800 COOLIDGE AVE	None	OAKLAND	CA	94602	3311	00	06000	37.8007257	-122.2064578	Alameda County
346625	Ordering, Referring, Prescribing	N/A	1780792234	0	0	TEVENDALE, ROBERT W MD	9/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A65065	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
346632	Ordering, Referring, Prescribing	N/A	1780813675	0	0	TOSTADO, LUKE A	8/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	120946	N/A	N/A	N/A	N/A	N/A	4000 W METROPOLITAN DR	SUITE 403	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
346648	Ordering, Referring, Prescribing	N/A	1780834093	0	0	THURMAN, SARA E	4/11/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0718224	N/A	N/A	N/A	N/A	N/A	518 GARDEN ST	None	SANTA BARBARA	CA	93101	1606	00	06000	34.42054634	-119.6928135	Santa Barbara County
346692	Ordering, Referring, Prescribing	N/A	1780939066	0	0	THISSEN, GISELE M NP	9/18/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	652294	N/A	N/A	N/A	N/A	N/A	925 G ST	None	REEDLEY	CA	93654	2626	00	06000	36.59806483	-119.4526979	Fresno County
346703	Ordering, Referring, Prescribing	N/A	1780951947	0	0	TOOLE, AARON PA-C	10/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA19372	N/A	N/A	N/A	N/A	N/A	16465 SIERRA LAKES PKWY	300	FONTANA	CA	92336	1242	00	06000	34.13805177	-117.4457839	San Bernardino County
346706	Ordering, Referring, Prescribing	N/A	1780960526	0	0	TRIEU, HANH PHARMD	7/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54717	N/A	N/A	N/A	N/A	N/A	1424 BROADWAY	None	EUREKA	CA	95501	0134	00	06000	40.79342569	-124.1772984	Humboldt County
346731	Ordering, Referring, Prescribing	N/A	1780991968	0	0	TSE, CECILIA	10/31/2018	Taxonomy not applicable	NA	n/a	000	Unknown	46128	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
346766	Ordering, Referring, Prescribing	N/A	1790060408	0	0	TRUONG, MINH-HANH T PHARMD	8/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55148	N/A	N/A	N/A	N/A	N/A	2020 W CLEVELAND AVE	None	MADERA	CA	93637	8759	00	06000	36.97450854	-120.0811275	Madera County
346773	Ordering, Referring, Prescribing	N/A	1790067445	0	0	TRAN, THO H PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58517	N/A	N/A	N/A	N/A	N/A	1919 FRUITRIDGE RD	None	SACRAMENTO	CA	95822	3114	00	06000	38.525283	-121.4959365	Sacramento County
346829	Ordering, Referring, Prescribing	N/A	1790153187	0	0	TRAN, JUDY PHARMD	3/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73247	N/A	N/A	N/A	N/A	N/A	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
346849	Ordering, Referring, Prescribing	N/A	1790165793	0	0	TRAN, CATHERINE T OD	2/5/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	15448	N/A	N/A	N/A	N/A	N/A	10872 WESTMINSTER AVE	None	GARDEN GROVE	CA	92843	4981	00	06000	33.75955452	-117.938637	Orange County
346886	Ordering, Referring, Prescribing	N/A	1790218089	0	0	TOOMASIAN, CORY MD	3/1/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157060	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
346887	Ordering, Referring, Prescribing	N/A	1790226033	0	0	TODD, BROOKE MD	2/20/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	183258	N/A	N/A	N/A	N/A	N/A	2930 2ND AVE	None	MARINA	CA	93933	6244	00	06000	36.66646512	-121.8075702	Monterey County
346945	Ordering, Referring, Prescribing	N/A	1790305332	0	0	TOSCANO, BEATRIZ J LMFT	12/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136260	N/A	N/A	N/A	N/A	N/A	4148 TOWN CENTER BOULEVA	None	FRESNO	CA	93636	9108	00	06000	0	0	None
346960	Ordering, Referring, Prescribing	N/A	1790323012	0	0	TRAN, THAO L PHARMD	4/11/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81119	N/A	N/A	N/A	N/A	N/A	3250 W GRANT LINE RD	None	TRACY	CA	95304	8427	00	06000	37.750995	-121.4752365	San Joaquin County
346964	Ordering, Referring, Prescribing	N/A	1790339687	0	0	TRAN, ALLEN V PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80637	N/A	N/A	N/A	N/A	N/A	1721 TECHNOLOGY DR	None	SAN JOSE	CA	95110	1305	00	06000	37.36464282	-121.9163895	Santa Clara County
346976	Ordering, Referring, Prescribing	N/A	1790382760	0	0	TRAN, CHRISTOPHER CNP	6/7/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	665002	N/A	N/A	N/A	N/A	N/A	11441 HEACOCK ST	STE F	MORENO VALLEY	CA	92557	7907	00	06000	33.954858	-117.243978	Riverside County
347020	Ordering, Referring, Prescribing	N/A	1790535144	0	0	TRAN, PHIHUNG T NP	8/16/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026706	N/A	N/A	N/A	N/A	N/A	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	4200	00	06000	33.77387145	-117.9966555	Orange County
347041	Ordering, Referring, Prescribing	N/A	1790777019	0	0	TERNUS, PETER A DPM	2/21/2018	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	4010	N/A	N/A	N/A	N/A	N/A	13847 E 14TH ST	STE 210	SAN LEANDRO	CA	94578	2626	00	06000	37.71457844	-122.1418551	Alameda County
347048	Ordering, Referring, Prescribing	N/A	1790804805	0	0	TIJERINA, JOSE B LCSW	6/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW72500	N/A	N/A	N/A	N/A	N/A	500 N 9TH ST	B	MODESTO	CA	95350	5814	00	06000	37.65145793	-121.0156971	Stanislaus County
347105	Ordering, Referring, Prescribing	N/A	1790926392	0	0	TANSEK, JOSEPH A LMFT	6/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47964	N/A	N/A	N/A	N/A	N/A	621 E CAMPBELL AVE	8	CAMPBELL	CA	95008	2126	00	06000	37.28710676	-121.9386967	Santa Clara County
347108	Ordering, Referring, Prescribing	N/A	1790937316	0	0	TYLER, PATRICIA MD	2/2/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G57416	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	None	SANTA ROSA	CA	95407	5478	00	06000	38.425266	-122.749875	Sonoma County
347117	Ordering, Referring, Prescribing	N/A	1790955300	0	0	TA, WILLIAM C MD	6/22/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A118947	N/A	N/A	N/A	N/A	N/A	7600 HOSPITAL DRIVE	SUITE G	SACRAMENTO	CA	95823	0000	00	06000	38.463876	-121.414698	Sacramento County
347133	Ordering, Referring, Prescribing	N/A	1790977726	0	0	TEIMOORI NOBANDEGANI, SEEYAM MD	6/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A118840	N/A	N/A	N/A	N/A	N/A	2008 N GAREY AVE	None	POMONA	CA	91767	2722	00	06000	34.08295003	-117.7528173	Los Angeles County
347140	Ordering, Referring, Prescribing	N/A	1790982494	0	0	TRAN, KELLY T LMFT	10/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118859	N/A	N/A	N/A	N/A	N/A	12912 BROOKHURST ST	480	GARDEN GROVE	CA	92840	4835	00	06000	33.77487003	-117.9552276	Orange County
347171	Ordering, Referring, Prescribing	N/A	1801052006	0	0	TOUTOUNCHI, HALEH DPM	9/4/2017	Taxonomy not applicable	NA	n/a	000	Unknown	4804	N/A	N/A	N/A	N/A	N/A	3631 CRENSHAW BLVD	STE 109	LOS ANGELES	CA	90016	4869	00	06000	34.023177	-118.3351475	Los Angeles County
347196	Ordering, Referring, Prescribing	N/A	1801102389	0	0	TUNGOL, DIANNE M	10/17/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	59685	N/A	N/A	N/A	N/A	N/A	250 S G ST	None	SAN BERNARDINO	CA	92410	3320	00	06000	34.09693522	-117.2986838	San Bernardino County
347206	Ordering, Referring, Prescribing	N/A	1801128160	0	0	TOGNOTTI, ANGELA M LMFT	7/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38680	N/A	N/A	N/A	N/A	N/A	1682 NOVATO BLVD	105	NOVATO	CA	94947	7000	00	06000	38.10598003	-122.5782662	Marin County
347248	Ordering, Referring, Prescribing	N/A	1801175880	0	0	TATUM MARTINEZ, KELSIE J PSYD	12/8/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY25975	N/A	N/A	N/A	N/A	N/A	1722 S LEWIS RD	None	CAMARILLO	CA	93012	8520	00	06000	34.18921316	-119.0340743	Ventura County
347250	Ordering, Referring, Prescribing	N/A	1801182860	0	0	TABBA, LARAIB MD	3/3/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124240	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
347298	Ordering, Referring, Prescribing	N/A	1801260088	0	0	TRAN, THU THAO	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH74143	N/A	N/A	N/A	N/A	N/A	226 RESERVATION RD	None	MARINA	CA	93933	3083	00	06000	36.68634976	-121.7972217	Monterey County
347313	Ordering, Referring, Prescribing	N/A	1801275532	0	0	TAYLOR, GRACE O LMFT	9/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128220	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
347353	Ordering, Referring, Prescribing	N/A	1801329966	0	0	THOMAS, SHERINE S MD	11/15/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A199989	N/A	N/A	N/A	N/A	N/A	1441 CONSTITUTION BLVD	BLDG 400 STE 202	SALINAS	CA	93906	3195	00	06000	36.696987	-121.633164	Monterey County
347409	Ordering, Referring, Prescribing	N/A	1801423769	0	0	THORPE, JONATHAN	1/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL4221	N/A	N/A	N/A	N/A	N/A	161 THE CITY DR S	None	ORANGE	CA	92856	0000	00	06000	33.78663422	-117.8906701	Orange County
347432	Ordering, Referring, Prescribing	N/A	1801491501	0	0	TERVARDANYAN, VAZGEN	10/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	234	N/A	N/A	N/A	N/A	N/A	23772 NEWHALL AVE	None	NEWHALL	CA	91321	3125	00	06000	34.37160007	-118.5160227	Los Angeles County
347436	Ordering, Referring, Prescribing	N/A	1801493267	0	0	TAYLOR, DOUGLAS R DC	10/27/2019	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	18254	N/A	N/A	N/A	N/A	N/A	912 FREMONT ST	None	DELANO	CA	93215	2713	00	06000	35.76763031	-119.2498143	Kern County
347471	Ordering, Referring, Prescribing	N/A	1801668389	0	0	TRAN, AN V PHARMD	10/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88826	N/A	N/A	N/A	N/A	N/A	1071 EL CAMINO REAL	None	REDWOOD CITY	CA	94063	1689	00	06000	37.48446	-122.230134	San Mateo County
347490	Ordering, Referring, Prescribing	N/A	1801906979	0	0	TRUONG, THU A PHARMD	8/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54798	N/A	N/A	N/A	N/A	N/A	3752 MISSION AVE	None	OCEANSIDE	CA	92058	1417	00	06000	33.22514029	-117.3318383	San Diego County
347536	Ordering, Referring, Prescribing	N/A	1811013071	0	0	THOMPSON, JENNIFER L CRNA	11/25/2019	Taxonomy not applicable	NA	n/a	018	NURSE ANESTHETISTS	3271	N/A	N/A	N/A	N/A	N/A	23861 MCBEAN PKWY	STE. A1	VALENCIA	CA	91355	4489	00	06000	34.39567343	-118.5542698	Los Angeles County
347538	Ordering, Referring, Prescribing	N/A	1801978374	0	0	TRUJILLO, JORGE L	8/15/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	18983	N/A	N/A	N/A	N/A	N/A	1920 MARENGO	None	LOS ANGELES	CA	90033	1317	00	06000	34.05751768	-118.2095235	Los Angeles County
347606	Ordering, Referring, Prescribing	N/A	1811180227	0	0	TOLBERT, CARLY LCSW	12/4/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26932	N/A	N/A	N/A	N/A	N/A	1533 EUCLID ST.	None	SANTA MONICA	CA	90404	3331	00	06000	34.02126733	-118.4842564	Los Angeles County
347614	Ordering, Referring, Prescribing	N/A	1811189269	0	0	THIPPESWAMY, TEJASWI B MD	2/19/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132344	N/A	N/A	N/A	N/A	N/A	847 W CHILDS AVE	None	MERCED	CA	95341	6862	00	06000	37.28825369	-120.4963159	Merced County
347637	Ordering, Referring, Prescribing	N/A	1811225519	0	0	TOUCH, SARUON T LMFT	8/9/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT86116	N/A	N/A	N/A	N/A	N/A	3303 N BROADWAY	None	LOS ANGELES	CA	90031	1314	00	06000	34.07380397	-118.20586	Los Angeles County
347676	Ordering, Referring, Prescribing	N/A	1811277528	0	0	TAN, ALEXANDER C PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55898	N/A	N/A	N/A	N/A	N/A	2331 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	6805	00	06000	34.03684323	-118.147526	Los Angeles County
347682	Ordering, Referring, Prescribing	N/A	1811293368	0	0	TORRES, YONCOLI A	11/25/2013	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	SP0019674	N/A	N/A	N/A	N/A	N/A	18700 BEACH BLVD	STE 120	HUNTINGTON BEACH	CA	92648	2089	00	06000	33.69070037	-117.9886896	Orange County
347696	Ordering, Referring, Prescribing	N/A	1811320260	0	0	TAYLOR, ASHLEY LMFT	1/10/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132689	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
347704	Ordering, Referring, Prescribing	N/A	1811332091	0	0	TAYLOR, SARAH LCSW	9/26/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	69893	N/A	N/A	N/A	N/A	N/A	1000 BROADWAY	460	OAKLAND	CA	94607	4099	00	06000	37.80185548	-122.2726866	Alameda County
347713	Ordering, Referring, Prescribing	N/A	1811359342	0	0	THOMPSON, RODERICK M MD	7/24/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150518	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
347716	Ordering, Referring, Prescribing	N/A	1811363815	0	0	TRUONG, KHIET	7/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT120216	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
347723	Ordering, Referring, Prescribing	N/A	1811365638	0	0	TEPAZ, NANCY LCSW	6/2/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101798	N/A	N/A	N/A	N/A	N/A	1400 S GRAND AVE	600	LOS ANGELES	CA	90015	3048	00	06000	34.03692236	-118.2655238	Los Angeles County
347725	Ordering, Referring, Prescribing	N/A	1811370232	0	0	THOMAS, RALPH J	5/29/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	100530	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
347769	Ordering, Referring, Prescribing	N/A	1811420326	0	0	TANK, SIKANDRA MD	9/27/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166289	N/A	N/A	N/A	N/A	N/A	1325 E CHURCH ST	STE 202	SANTA MARIA	CA	93454	5915	00	06000	34.95209265	-120.4147348	Santa Barbara County
347776	Ordering, Referring, Prescribing	N/A	1811434509	0	0	TRAGARZ, SHANNON LMFT	11/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112144	N/A	N/A	N/A	N/A	N/A	1849 SAWTELLE BLVD	SUITE 610	LOS ANGELES	CA	90025	7006	00	06000	34.04266851	-118.4451527	Los Angeles County
347784	Ordering, Referring, Prescribing	N/A	1811447683	0	0	TERRY, CHARLENE M LCSW	6/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94344	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
347843	Ordering, Referring, Prescribing	N/A	1811563174	0	0	TAM, ANDREA Y OD	3/25/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35112	N/A	N/A	N/A	N/A	N/A	7739 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90046	6207	00	06000	34.09084477	-118.3579017	Los Angeles County
347848	Ordering, Referring, Prescribing	N/A	1811567597	0	0	TARANTINI, ELIZABETH B LCSW	8/23/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW21194	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	00	06000	34.41078438	-118.510775	Los Angeles County
347882	Ordering, Referring, Prescribing	N/A	1811669963	0	0	TABEEFAR, HAMED	8/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81506	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
347919	Ordering, Referring, Prescribing	N/A	1821017294	0	0	THOMAS, SHAN MD	12/15/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G79405	N/A	N/A	N/A	N/A	N/A	292 POSADA LN	None	TEMPLETON	CA	93465	4054	00	06000	35.5531447	-120.7214979	San Luis Obispo County
347922	Ordering, Referring, Prescribing	N/A	1821022583	0	0	TIGER, PAUL	8/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C158178	N/A	N/A	N/A	N/A	N/A	47825 OASIS ST	None	INDIO	CA	92201	6950	00	06000	33.70112861	-116.2209066	Riverside County
347936	Ordering, Referring, Prescribing	N/A	1821073297	0	0	TRAN, KIEN DO	10/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A18536	N/A	N/A	N/A	N/A	N/A	475 BRUCE STREET	None	YREKA	CA	96097	3474	00	06000	41.71860037	-122.6467317	Siskiyou County
347952	Ordering, Referring, Prescribing	N/A	1821116336	0	0	THANGARATNAM, KESHINI LMFT	4/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT47077	N/A	N/A	N/A	N/A	N/A	6601 N STEPHENS RANCH RD	None	LA VERNE	CA	91750	1146	00	06000	34.154775	-117.740052	Los Angeles County
347980	Ordering, Referring, Prescribing	N/A	1821168634	0	0	TAWATARI, ARTHUR T	11/13/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D34779	N/A	N/A	N/A	N/A	N/A	1211 CORTINA DR	None	ORLAND	CA	95963	1699	00	06000	39.74167912	-122.201695	Glenn County
348039	Ordering, Referring, Prescribing	N/A	1821300138	0	0	THAKUR, YOGITA B	8/11/2011	Taxonomy not applicable	NA	n/a	099	DENTIST	D57319	N/A	N/A	N/A	N/A	N/A	1807 BAY RD	None	EAST PALO ALTO	CA	94303	1312	00	06000	37.47199121	-122.1344629	San Mateo County
348074	Ordering, Referring, Prescribing	N/A	1821365909	0	0	TRAN, ADRIENE D PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58014	N/A	N/A	N/A	N/A	N/A	795 E FOOTHILL BLVD	None	POMONA	CA	91767	1223	00	06000	34.10721485	-117.7372912	Los Angeles County
348086	Ordering, Referring, Prescribing	N/A	1821371089	0	0	TANG, ANGIE PHARMD	7/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59512	N/A	N/A	N/A	N/A	N/A	399 EL CAMINO	None	SOUTH SAN FRANCIS	CA	94080	5923	00	06000	37.62146989	-122.4117178	San Mateo County
348130	Ordering, Referring, Prescribing	N/A	1821448655	0	0	TRAN, CAROLINE V PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66984	N/A	N/A	N/A	N/A	N/A	14536 BROOKHURST ST	101	WESTMINSTER	CA	92840	5809	00	06000	33.751737	-117.9548845	Orange County
348141	Ordering, Referring, Prescribing	N/A	1821465519	0	0	TRINH, ANDREW P PHARMD	4/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73090	N/A	N/A	N/A	N/A	N/A	4900 RIVERGRADE RD	C110	IRWINDALE	CA	91706	1458	00	06000	34.10201565	-117.9802967	Los Angeles County
348142	Ordering, Referring, Prescribing	N/A	1821469529	0	0	TAGAWA, STACI PHARMD	4/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72987	N/A	N/A	N/A	N/A	N/A	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	00	06000	34.072245	-117.4319685	San Bernardino County
348149	Ordering, Referring, Prescribing	N/A	1821477894	0	0	TRAN, HANH T PHARMD	10/23/2018	Taxonomy not applicable	NA	n/a	000	Unknown	51943	N/A	N/A	N/A	N/A	N/A	27702 CROWN VALLEY PKWY	None	LADERA RANCH	CA	92694	0609	00	06000	33.56422147	-117.6458007	Orange County
348164	Ordering, Referring, Prescribing	N/A	1821509654	0	0	THOM, RYAN C LMFT	7/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT127134	N/A	N/A	N/A	N/A	N/A	406 SUNRISE AVE.	300	ROSEVILLE	CA	95661	4106	00	06000	38.73944898	-121.2720559	Placer County
348168	Ordering, Referring, Prescribing	N/A	1821511486	0	0	TEPLEY, KARLIE LCSW	9/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	ASW63764	N/A	N/A	N/A	N/A	N/A	29632 HWY 299 E	None	ROUND MOUNTAIN	CA	96084	0228	00	06000	40.80385331	-121.9397745	Shasta County
348173	Ordering, Referring, Prescribing	N/A	1821518333	0	0	TABARSI, HOOMAN MD	2/1/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A172682	N/A	N/A	N/A	N/A	N/A	3420 COLLEGE AVE	None	SAN DIEGO	CA	92115	7134	00	06000	32.74405281	-117.0538025	San Diego County
348201	Ordering, Referring, Prescribing	N/A	1821566001	0	0	TARPEY, ERIN L	9/4/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	3643	N/A	N/A	N/A	N/A	N/A	819 W IOWA AVE	None	SUNNYVALE	CA	94086	5926	00	06000	37.37432124	-122.0405899	Santa Clara County
348221	Ordering, Referring, Prescribing	N/A	1821589490	0	0	TANG, YEN K PHARMD	3/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75610	N/A	N/A	N/A	N/A	N/A	3801 HOWE ST	None	OAKLAND	CA	94611	5312	00	06000	37.8242732	-122.2568561	Alameda County
348248	Ordering, Referring, Prescribing	N/A	1821641630	0	0	TSE, BARRY PHARMD	8/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80427	N/A	N/A	N/A	N/A	N/A	2590 N TEXAS ST	None	FAIRFIELD	CA	94533	1606	00	06000	38.27606445	-122.0340458	Solano County
348255	Ordering, Referring, Prescribing	N/A	1821661737	0	0	TEJADA, ELIUD LMFT	3/31/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	154303	N/A	N/A	N/A	N/A	N/A	625 FAIR OAKS AVE	S300	SOUTH PASADENA	CA	91030	2630	00	06000	34.117947	-118.1503575	Los Angeles County
348256	Ordering, Referring, Prescribing	N/A	1821662016	0	0	TOBIAS, SHANNON W LMFT	9/30/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109787	N/A	N/A	N/A	N/A	N/A	32823 TEMECULA PKWY	None	TEMECULA	CA	92592	8348	00	06000	33.48473563	-117.0839704	Riverside County
348259	Ordering, Referring, Prescribing	N/A	1821662198	0	0	TOPCHYAN, YERVAND CNP	3/16/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020347	N/A	N/A	N/A	N/A	N/A	18250 ROSCOE BLVD	200	NORTHRIDGE	CA	91325	4226	00	06000	34.22076142	-118.5313223	Los Angeles County
348343	Ordering, Referring, Prescribing	N/A	1831224088	0	0	TAPIA, MARY J LCSW	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80284	N/A	N/A	N/A	N/A	N/A	954 N VERMONT AVE	None	LOS ANGELES	CA	90029	3529	00	06000	34.08896256	-118.2917211	Los Angeles County
348361	Ordering, Referring, Prescribing	N/A	1831269877	0	0	TAYLOR, DONALD P LCSW	5/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24535	N/A	N/A	N/A	N/A	N/A	2625 ZANKER RD	201	SAN JOSE	CA	95134	2130	00	06000	37.38865356	-121.9250552	Santa Clara County
348399	Ordering, Referring, Prescribing	N/A	1831355569	0	0	THAKUR, SHANTANU K MD	8/18/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A119550	N/A	N/A	N/A	N/A	N/A	9449 SAN FERNANDO ROAD	None	SUN VALLEY	CA	91352	1421	00	06000	34.24087386	-118.3954268	Los Angeles County
348430	Ordering, Referring, Prescribing	N/A	1831445949	0	0	TIMS, ALLISON M DO	12/5/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15887	N/A	N/A	N/A	N/A	N/A	1441 LIBERTY STREET	None	REDDING	CA	96001	0000	00	06000	40.5857177	-122.3870781	Shasta County
348436	Ordering, Referring, Prescribing	N/A	1831448430	0	0	THOMAS, KELLY M NP	1/24/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	21088	N/A	N/A	N/A	N/A	N/A	1001 POTRERO STREET	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
348447	Ordering, Referring, Prescribing	N/A	1831470731	0	0	TURNER, DONIELLE LMFT	9/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117892	N/A	N/A	N/A	N/A	N/A	9820 WILLOW CREEK RD	245	SAN DIEGO	CA	92131	1116	00	06000	32.90116656	-117.1142859	San Diego County
348466	Ordering, Referring, Prescribing	N/A	1831504513	0	0	TAI, SEAN DO	11/21/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15918	N/A	N/A	N/A	N/A	N/A	12555 WEST JEFFERSON BLV	301	LOS ANGELES	CA	90066	7032	00	06000	33.97964924	-118.4131504	Los Angeles County
348467	Ordering, Referring, Prescribing	N/A	1831508696	0	0	TRAGER, ADRIENNE PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69572	N/A	N/A	N/A	N/A	N/A	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
348513	Ordering, Referring, Prescribing	N/A	1831580141	0	0	TJHIN-KEOPHIPHAT, KATHERINE	6/21/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030708	N/A	N/A	N/A	N/A	N/A	965 EL CAMINO AVE	None	SACRAMENTO	CA	95815	2530	00	06000	38.611638	-121.4444745	Sacramento County
348522	Ordering, Referring, Prescribing	N/A	1831592732	0	0	TOROK, JULI F LMFT	3/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	99228	N/A	N/A	N/A	N/A	N/A	2425 BISSO LN	STE. 100	CONCORD	CA	94520	4817	00	06000	37.98393807	-122.0466953	Contra Costa County
348523	Ordering, Referring, Prescribing	N/A	1831590884	0	0	TURNER, LACIE LMFT	5/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110577	N/A	N/A	N/A	N/A	N/A	2280 N VALENTINE	None	FRESNO	CA	93722	5553	00	06000	36.76966023	-119.8532997	Fresno County
348535	Ordering, Referring, Prescribing	N/A	1831610864	0	0	TAYLOR, MISTY S LCSW	6/28/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW75383	N/A	N/A	N/A	N/A	N/A	5442 SYCUAN RD	None	EL CAJON	CA	92019	1816	00	06000	32.78885903	-116.8320996	San Diego County
348543	Ordering, Referring, Prescribing	N/A	1831625193	0	0	TRAN, ANNIE PHARMD	4/6/2018	Taxonomy not applicable	NA	n/a	000	Unknown	71408	N/A	N/A	N/A	N/A	N/A	2495 TRUXTUN RD	STE 100	SAN DIEGO	CA	92106	6159	00	06000	32.73722316	-117.2163815	San Diego County
348576	Ordering, Referring, Prescribing	N/A	1831662477	0	0	TAN, MARIA CECILIA S NP	4/24/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011241	N/A	N/A	N/A	N/A	N/A	7275 E SOUTHGATE DR	STE 204	SACRAMENTO	CA	95823	2629	00	06000	38.493576	-121.436559	Sacramento County
348579	Ordering, Referring, Prescribing	N/A	1831668508	0	0	TRINH, PETER T PA-C	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59749	N/A	N/A	N/A	N/A	N/A	3833 WORSHAM AVE	300	LONG BEACH	CA	90808	1766	00	06000	33.828552	-118.1462755	Los Angeles County
348590	Ordering, Referring, Prescribing	N/A	1831679489	0	0	TRAN, MAILYNN LMFT	9/15/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	134741	N/A	N/A	N/A	N/A	N/A	1500 HUGHES WAY STE	C100	LONG BEACH	CA	90810	1870	00	06000	33.82860528	-118.2124528	Los Angeles County
348611	Ordering, Referring, Prescribing	N/A	1831702018	0	0	THAI, HENRY H PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH82192	N/A	N/A	N/A	N/A	N/A	1435 HIGH ST	None	DELANO	CA	93215	1714	00	06000	35.77502393	-119.2484146	Kern County
348627	Ordering, Referring, Prescribing	N/A	1831735281	0	0	TRUONG, EMILY PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80879	N/A	N/A	N/A	N/A	N/A	6100 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2923	00	06000	33.984981	-118.2251735	Los Angeles County
348658	Ordering, Referring, Prescribing	N/A	1831787159	0	0	TANG, VAN M PHARMD	11/9/2020	Taxonomy not applicable	NA	n/a	000	Unknown	83700	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
348668	Ordering, Referring, Prescribing	N/A	1831819929	0	0	TRAN, CARLIN OD	8/30/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35225	N/A	N/A	N/A	N/A	N/A	27451B LA PAZ RD.	None	LAGUNA NIGUEL	CA	92677	4082	00	06000	33.56420948	-117.7080189	Orange County
348670	Ordering, Referring, Prescribing	N/A	1831808690	0	0	TRUONG, DEBBY PHARMD	9/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86942	N/A	N/A	N/A	N/A	N/A	128 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	2921	00	06000	33.840252	-117.889103	Orange County
348695	Ordering, Referring, Prescribing	N/A	1831941939	0	0	TAMSATIT, CHRISTINA NP	11/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027566	N/A	N/A	N/A	N/A	N/A	7515 VAN NUYS BLVD	None	VAN NUYS	CA	91405	0000	00	06000	34.207344	-118.4487995	Los Angeles County
348737	Ordering, Referring, Prescribing	N/A	1841278108	0	0	TRIGLETH, JAN L PA-C	10/6/2019	Taxonomy not applicable	NA	n/a	000	Unknown	PA17965	N/A	N/A	N/A	N/A	N/A	380 N RESERVATION RD	None	PORTERVILLE	CA	93257	9673	00	06000	36.02996779	-118.7882551	Tulare County
348758	Ordering, Referring, Prescribing	N/A	1841338555	0	0	TUASON, NORBERTO M MD	11/24/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A53601	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
348763	Ordering, Referring, Prescribing	N/A	1841348026	0	0	TARMAN, JASON B LMFT	2/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50166	N/A	N/A	N/A	N/A	N/A	401 E OCEAN AVE	None	LOMPOC	CA	93436	6828	00	06000	34.6389765	-120.4537095	Santa Barbara County
348770	Ordering, Referring, Prescribing	N/A	1841361037	0	0	TUFAIL, KALSOOM MD	10/29/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A56009	N/A	N/A	N/A	N/A	N/A	1500 S MCDONNELL AVE	None	COMMERCE	CA	90040	5623	00	06000	34.01248474	-118.1699451	Los Angeles County
348776	Ordering, Referring, Prescribing	N/A	1841380201	0	0	THOMAS, CHANDRA A LMFT	11/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	41447	N/A	N/A	N/A	N/A	N/A	15430 FOOTHILL BLVD.	None	SAN LEANDRO	CA	94578	0000	00	06000	37.7069698	-122.1191104	Alameda County
348787	Ordering, Referring, Prescribing	N/A	1841389947	0	0	TANNER, ALLISON CCC-SLP	9/24/2022	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	25365	N/A	N/A	N/A	N/A	N/A	20 SPRUCE STREET	None	WILLITS	CA	95490	0150	00	06000	39.41200972	-123.3606791	Mendocino County
348790	Ordering, Referring, Prescribing	N/A	1841401908	0	0	TSAO, STEPHANIE	12/19/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	15278	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVENUE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
348809	Ordering, Referring, Prescribing	N/A	1841424728	0	0	TERRY, JONATHAN DO	5/17/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A12657	N/A	N/A	N/A	N/A	N/A	2311 LOVERIDGE RD	None	PITTSBURG	CA	94565	5117	00	06000	38.00694767	-121.8712439	Contra Costa County
348815	Ordering, Referring, Prescribing	N/A	1841449485	0	0	TILGHMAN, MYRES W MD	9/24/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A96339	N/A	N/A	N/A	N/A	N/A	3851 ROSECRANS ST	S	SAN DIEGO	CA	92110	3115	00	06000	32.75343795	-117.2028528	San Diego County
348816	Ordering, Referring, Prescribing	N/A	1841449790	0	0	TRUJILLO-MORENO, ABIGAIL LMFT	12/9/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT103977	N/A	N/A	N/A	N/A	N/A	1200 WILSHIRE BLVD	200	LOS ANGELES	CA	90017	1908	00	06000	34.05307427	-118.2651099	Los Angeles County
348825	Ordering, Referring, Prescribing	N/A	1841465721	0	0	TRAN, DIENAN N	6/25/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D56867	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
348831	Ordering, Referring, Prescribing	N/A	1841466406	0	0	TJANDRA, CORNELIA CNP	2/28/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	17905	N/A	N/A	N/A	N/A	N/A	1700 W HILLSDALE BLVD	STUDENT WELLNESS CENTER	SAN MATEO	CA	94402	3757	00	06000	37.53183837	-122.3352514	San Mateo County
348840	Ordering, Referring, Prescribing	N/A	1841502523	0	0	TANDON, MARY C	1/29/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	D59754	N/A	N/A	N/A	N/A	N/A	1166 K ST	None	BRAWLEY	CA	92227	2737	00	06000	32.97308651	-115.5228885	Imperial County
348850	Ordering, Referring, Prescribing	N/A	1841513751	0	0	TAYLOR, ROBIN C LCSW	2/9/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW23931	N/A	N/A	N/A	N/A	N/A	2001 28TH STREET	None	BAKERSFIELD	CA	93301	1924	00	06000	35.38486605	-119.0251102	Kern County
348853	Ordering, Referring, Prescribing	N/A	1841507027	0	0	TYLER, MYRA I LCSW	1/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76160	N/A	N/A	N/A	N/A	N/A	6601 STEPHENS RANCH RD	None	LA VERNE	CA	91750	1146	00	06000	34.154775	-117.740052	Los Angeles County
348896	Ordering, Referring, Prescribing	N/A	1841575271	0	0	TUN, YIN PHARMD	7/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59667	N/A	N/A	N/A	N/A	N/A	825 MARKET ST	None	SAN FRANCISCO	CA	94103	1901	00	06000	37.78516779	-122.4065094	San Francisco County
348906	Ordering, Referring, Prescribing	N/A	1841576741	0	0	TAYLOR, NAEEMAH J NP	7/13/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025991	N/A	N/A	N/A	N/A	N/A	1990 CONCORD AVE	None	CHICO	CA	95928	9518	00	06000	39.72768476	-121.7912855	Butte County
348907	Ordering, Referring, Prescribing	N/A	1841580636	0	0	TALWAR, AMOL PHARMD	1/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68887	N/A	N/A	N/A	N/A	N/A	1100 EL CAMINO REAL	None	BELMONT	CA	94002	3904	00	06000	37.51941385	-122.2748458	San Mateo County
348915	Ordering, Referring, Prescribing	N/A	1841591526	0	0	TRAN, JENNY Q LMFT	8/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84471	N/A	N/A	N/A	N/A	N/A	3303 N. BROADWAY	4TH FL.	LOS ANGELES	CA	90031	2803	00	06000	34.07380397	-118.20586	Los Angeles County
348923	Ordering, Referring, Prescribing	N/A	1841615481	0	0	TSANG, LINDA J	2/2/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	D64798	N/A	N/A	N/A	N/A	N/A	2051 JOHN JONES RD	None	DAVIS	CA	95616	9701	00	06000	38.56371578	-121.7691963	Yolo County
348929	Ordering, Referring, Prescribing	N/A	1841623535	0	0	TIANO, MARK A LCSW	4/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88442	N/A	N/A	N/A	N/A	N/A	2975 TREAT BLVD	BUILDING C, SUITE 5	CONCORD	CA	94518	3601	00	06000	37.93808829	-122.0263617	Contra Costa County
348952	Ordering, Referring, Prescribing	N/A	1841664711	0	0	TRAN, CHRISTINA K PA-C	12/3/2018	Taxonomy not applicable	NA	n/a	000	Unknown	53000	N/A	N/A	N/A	N/A	N/A	700 S TUSTIN ST	None	ORANGE	CA	92866	3425	00	06000	33.77685748	-117.8357804	Orange County
348992	Ordering, Referring, Prescribing	N/A	1841728169	0	0	TAKEUCHI, SAWAKO S	7/3/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	103158	N/A	N/A	N/A	N/A	N/A	620 E ALVIN DR	STE G	SALINAS	CA	93906	3054	00	06000	36.70361129	-121.6321051	Monterey County
348993	Ordering, Referring, Prescribing	N/A	1841725686	0	0	TANG, KAI EN	1/26/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A18297	N/A	N/A	N/A	N/A	N/A	1530 HILLHURST AVE	None	LOS ANGELES	CA	90027	5516	00	06000	34.098921	-118.287374	Los Angeles County
349011	Ordering, Referring, Prescribing	N/A	1841753761	0	0	TORO BEJARANO, MARCELA MD	1/17/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A192997	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	None	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
349021	Ordering, Referring, Prescribing	N/A	1841761244	0	0	TRUONG, NHU Y LMFT	6/21/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133355	N/A	N/A	N/A	N/A	N/A	18350 MOUNT LANGLEY ST.	#220	FOUNTAIN VALLEY	CA	92708	9271	00	06000	33.69633523	-117.9420534	Orange County
349032	Ordering, Referring, Prescribing	N/A	1841781150	0	0	TRAN, KATHERINE PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77771	N/A	N/A	N/A	N/A	N/A	2238 GEARY BLVD	8TH FL ONCOLOGY PHARMACY	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
349042	Ordering, Referring, Prescribing	N/A	1841798410	0	0	TRAN, LIEN T PA-C	3/26/2018	Taxonomy not applicable	NA	n/a	000	Unknown	PA55315	N/A	N/A	N/A	N/A	N/A	8825 WHITTIER BLVD	None	PICO RIVERA	CA	90660	2657	00	06000	34.00181371	-118.0847275	Los Angeles County
349063	Ordering, Referring, Prescribing	N/A	1841838554	0	0	TARACENA, EDDIE LMFT	10/31/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT142479	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
349081	Ordering, Referring, Prescribing	N/A	1841888765	0	0	THONG, BRIAN LCSW	11/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	98552	N/A	N/A	N/A	N/A	N/A	5120 W GOLDLEAF CIR	300	LOS ANGELES	CA	90056	1292	00	06000	33.988266	-118.3673743	Los Angeles County
349111	Ordering, Referring, Prescribing	N/A	1841990553	0	0	TIWANA, DILJOT NP	12/27/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023707	N/A	N/A	N/A	N/A	N/A	420 W ACACIA ST	1	STOCKTON	CA	95203	2450	00	06000	37.96135715	-121.2996632	San Joaquin County
349149	Ordering, Referring, Prescribing	N/A	1851138689	0	0	TIEU, VINH DMD	7/9/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110309	N/A	N/A	N/A	N/A	N/A	215 W BEAMER ST	None	WOODLAND	CA	95695	2510	00	06000	38.68483629	-121.7937301	Yolo County
349153	Ordering, Referring, Prescribing	N/A	1851174106	0	0	TRAN, PATRICIA CCC-SLP	10/19/2022	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	13854	N/A	N/A	N/A	N/A	N/A	1840 WEST DR	None	VISTA	CA	92083	6115	00	06000	33.1901697	-117.2808305	San Diego County
349178	Ordering, Referring, Prescribing	N/A	1851421671	0	0	TORRES BASTIDAS, NADIA I LCSW	3/2/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88277	N/A	N/A	N/A	N/A	N/A	50249 CESAR CHAVEZ ST	K	COACHELLA	CA	92236	1530	00	06000	33.68245553	-116.1816607	Riverside County
349187	Ordering, Referring, Prescribing	N/A	1851422802	0	0	TODHUNTER, MARK D LMFT	4/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT37866	N/A	N/A	N/A	N/A	N/A	17800 HIGHWAY 18	None	APPLE VALLEY	CA	92397	1544	00	06000	34.54007429	-117.2744761	San Bernardino County
349197	Ordering, Referring, Prescribing	N/A	1851442529	0	0	TORRE-IGWE, LISA M NP	6/8/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95005881	N/A	N/A	N/A	N/A	N/A	847 W CHILDS AVENUE	None	MERCED	CA	95341	6862	00	06000	37.28825369	-120.4963159	Merced County
349211	Ordering, Referring, Prescribing	N/A	1851466908	0	0	TRAN, ANH V LCSW	12/7/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW24682	N/A	N/A	N/A	N/A	N/A	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	00	06000	33.806097	-118.151378	Los Angeles County
349212	Ordering, Referring, Prescribing	N/A	1851468375	0	0	TAN, TAMMY M PHARMD	4/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49100	N/A	N/A	N/A	N/A	N/A	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	00	06000	37.48948529	-122.2232468	San Mateo County
349217	Ordering, Referring, Prescribing	N/A	1851472310	0	0	TAYLOR, KARI R LMFT	4/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125382	N/A	N/A	N/A	N/A	N/A	2929 MEADE AVE	None	SAN DIEGO	CA	92116	4251	00	06000	32.75725047	-117.130662	San Diego County
349236	Ordering, Referring, Prescribing	N/A	1851526834	0	0	TYNER, AMBER L LMFT	12/26/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117101	N/A	N/A	N/A	N/A	N/A	100 W. WALNUT ST.	SUITE 375	PASADENA	CA	91124	3312	00	06000	34.14963648	-118.1522925	Los Angeles County
349275	Ordering, Referring, Prescribing	N/A	1851613400	0	0	TANG, LISA PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58990	N/A	N/A	N/A	N/A	N/A	1721 TECHNOLOGY DR	None	SAN JOSE	CA	95110	1305	00	06000	37.36464282	-121.9163895	Santa Clara County
349291	Ordering, Referring, Prescribing	N/A	1851641179	0	0	TRUONG, KATHY M PHARMD	3/29/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67659	N/A	N/A	N/A	N/A	N/A	22451 ANTONIO PKWY	None	RANCHO SANTA MARG	CA	92688	2813	00	06000	33.63642761	-117.5907276	Orange County
349319	Ordering, Referring, Prescribing	N/A	1851675854	0	0	TABAMO, JOY D PHARMD	7/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63841	N/A	N/A	N/A	N/A	N/A	2647 SPRINGS RD	None	VALLEJO	CA	94591	5712	00	06000	38.10591447	-122.2076385	Solano County
349334	Ordering, Referring, Prescribing	N/A	1851704399	0	0	TORRES, STEPHANIE LMFT	8/14/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114991	N/A	N/A	N/A	N/A	N/A	4050 KATELLA AVE	213	LOS ALAMITOS	CA	90720	3434	00	06000	33.80296949	-118.061964	Orange County
349348	Ordering, Referring, Prescribing	N/A	1851717854	0	0	THAI, ANDREW PHARMD	8/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	54591	N/A	N/A	N/A	N/A	N/A	5638 E KINGS CANYON RD	None	FRESNO	CA	93727	4627	00	06000	36.73578229	-119.6985397	Fresno County
349349	Ordering, Referring, Prescribing	N/A	1851720148	0	0	TEO, MARINA LMFT	11/30/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111257	N/A	N/A	N/A	N/A	N/A	897 GRANITE DR	None	PASADENA	CA	91101	3501	00	06000	34.13703447	-118.1317905	Los Angeles County
349378	Ordering, Referring, Prescribing	N/A	1851755805	0	0	TOSCHI, ROBIN PHARMD	3/14/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH39809	N/A	N/A	N/A	N/A	N/A	1 CAMINO ALTO	None	MILL VALLEY	CA	94941	0123	00	06000	37.89413915	-122.5301214	Marin County
349422	Ordering, Referring, Prescribing	N/A	1851821888	0	0	TRIEU, ANGIE OD	9/7/2020	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	33689	N/A	N/A	N/A	N/A	N/A	2280 E. CARSON ST	None	LONG BEACH	CA	90807	3044	00	06000	33.83241248	-118.164456	Los Angeles County
349442	Ordering, Referring, Prescribing	N/A	1851851836	0	0	TORRES, MARIO A MD	5/15/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A196235	N/A	N/A	N/A	N/A	N/A	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	00	06000	33.67110839	-117.8658914	Orange County
349445	Ordering, Referring, Prescribing	N/A	1851858708	0	0	TABRIZI, SYAMAK LCSW	3/26/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW121734	N/A	N/A	N/A	N/A	N/A	286 EUCLID AVE	302	SAN DIEGO	CA	92114	3610	00	06000	32.70706919	-117.0850896	San Diego County
349474	Ordering, Referring, Prescribing	N/A	1851913107	0	0	TRAN, KELLY L PHARMD	4/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	81415	N/A	N/A	N/A	N/A	N/A	17900 NEWHOPE ST	None	FOUNTAIN VALLEY	CA	92708	5422	00	06000	33.70347	-117.9311985	Orange County
349477	Ordering, Referring, Prescribing	N/A	1851909121	0	0	THAKKAR, ABHI D DDS PC	4/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	DDS105056	N/A	N/A	N/A	N/A	N/A	124 S A ST	None	MADERA	CA	93638	3619	00	06000	36.96397997	-120.0545315	Madera County
349482	Ordering, Referring, Prescribing	N/A	1851932321	0	0	TREANOR, KAYLA NP	10/4/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013002	N/A	N/A	N/A	N/A	N/A	3810 ROSIN CT	SUITE 100	SACRAMENTO	CA	95834	1656	00	06000	38.637702	-121.474773	Sacramento County
349487	Ordering, Referring, Prescribing	N/A	1851936546	0	0	TAI, JENNIFER W OT	3/2/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	19412	N/A	N/A	N/A	N/A	N/A	499 LOMA ALTA AVE	None	LOS GATOS	CA	95030	6227	00	06000	37.21747493	-121.9662128	Santa Clara County
349545	Ordering, Referring, Prescribing	N/A	1861051997	0	0	TULLOCH, YVONNE RN PHN	5/4/2019	Taxonomy not applicable	NA	n/a	000	Unknown	RN446952	N/A	N/A	N/A	N/A	N/A	1302 N A ST	None	LOMPOC	CA	93436	3516	00	06000	34.65909135	-120.4488001	Santa Barbara County
349554	Ordering, Referring, Prescribing	N/A	1861103202	0	0	TRAN, NINA PA-C	11/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61932	N/A	N/A	N/A	N/A	N/A	303 W LINCOLN AVE	SUITE 105	ANAHEIM	CA	92805	2936	00	06000	33.83508976	-117.9177981	Orange County
349569	Ordering, Referring, Prescribing	N/A	1861152746	0	0	TRINH, CATHERINE	3/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH82046	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY STE 62	STE 625	SAN JOSE	CA	95119	1141	00	06000	37.23951066	-121.8013511	Santa Clara County
349612	Ordering, Referring, Prescribing	N/A	1861519233	0	0	TANIGUCHI, CAROL S	8/30/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	14321	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
349624	Ordering, Referring, Prescribing	N/A	1861540486	0	0	TOUB, DANIEL MD	8/21/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A66495	N/A	N/A	N/A	N/A	N/A	3569 ROUND BARN CIR	None	SANTA ROSA	CA	95403	5781	00	06000	38.479743	-122.729625	Sonoma County
349705	Ordering, Referring, Prescribing	N/A	1861726242	0	0	TURNBULL, ANDREA M LCSW	8/20/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	73401	N/A	N/A	N/A	N/A	N/A	1400 EMELINE AVE	None	SANTA CRUZ	CA	95060	1976	00	06000	36.99276804	-122.0178271	Santa Cruz County
349748	Ordering, Referring, Prescribing	N/A	1861779019	0	0	TRAN, LIEM Q	3/14/2018	Taxonomy not applicable	NA	n/a	000	Unknown	43421	N/A	N/A	N/A	N/A	N/A	150 E EL CAMINO REAL	None	SUNNYVALE	CA	94087	1936	00	06000	37.36500202	-122.0290606	Santa Clara County
349754	Ordering, Referring, Prescribing	N/A	1861792251	0	0	TING, HIU PHARMD	10/13/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55200	N/A	N/A	N/A	N/A	N/A	735 7TH AVENUE	None	SAN FRANCISCO	CA	94118	3808	00	06000	37.77448821	-122.4649295	San Francisco County
349762	Ordering, Referring, Prescribing	N/A	1861808214	0	0	TORRES, MEGHANN E LCSW	12/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87304	N/A	N/A	N/A	N/A	N/A	115 S LA CUMBRE LN	200	SANTA BARBARA	CA	93105	5102	00	06000	34.43809964	-119.7511604	Santa Barbara County
349776	Ordering, Referring, Prescribing	N/A	1861829475	0	0	TY, LUCILLE C NP	11/16/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	761462	N/A	N/A	N/A	N/A	N/A	2633 16TH ST	None	BAKERSFIELD	CA	93301	3348	00	06000	35.37232854	-119.0327985	Kern County
349779	Ordering, Referring, Prescribing	N/A	1861836942	0	0	TREFFLICH, DAVID K MD	3/22/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A170337	N/A	N/A	N/A	N/A	N/A	430 S BLOSSER RD	None	SANTA MARIA	CA	93458	4908	00	06000	34.94869196	-120.4537258	Santa Barbara County
349780	Ordering, Referring, Prescribing	N/A	1861835811	0	0	TANGANYIKA, KUNDAI K MD	11/17/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A183306	N/A	N/A	N/A	N/A	N/A	15230 LAKESHORE DR	None	CLEARLAKE	CA	95422	8107	00	06000	38.95005226	-122.6264492	Lake County
349811	Ordering, Referring, Prescribing	N/A	1861891897	0	0	TABORA, HANZ K PT	5/9/2022	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	302035	N/A	N/A	N/A	N/A	N/A	1401 BAILEY AVE	None	NEEDLES	CA	92363	3103	00	06000	34.832997	-114.618293	San Bernardino County
349815	Ordering, Referring, Prescribing	N/A	1861892523	0	0	TAMBOURINE, JUDY PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71196	N/A	N/A	N/A	N/A	N/A	1900 E. 4TH STREET	None	SANTA ANA	CA	92705	3910	00	06000	33.74805463	-117.8400671	Orange County
349869	Ordering, Referring, Prescribing	N/A	1861967622	0	0	TEVES SIERRA, LILIANA NP	1/23/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008423	N/A	N/A	N/A	N/A	N/A	837 ADDISON ST	None	BERKELEY	CA	94710	2006	00	06000	37.86680859	-122.2969443	Alameda County
349880	Ordering, Referring, Prescribing	N/A	1861990376	0	0	THOMPSON, LEWIS R LMFT	2/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124285	N/A	N/A	N/A	N/A	N/A	12188 HESPERIA RD	None	VICTORVILLE	CA	92395	5822	00	06000	34.47266362	-117.2918133	San Bernardino County
349883	Ordering, Referring, Prescribing	N/A	1861990822	0	0	TU, HOANG YEN T PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH77613	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
349900	Ordering, Referring, Prescribing	N/A	1871022673	0	0	TSANG, JESSY DO	7/7/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17109	N/A	N/A	N/A	N/A	N/A	107 NORTH MCKINLEY AVENU	None	CORONA	CA	92879	6561	00	06000	33.88230027	-117.5145319	Riverside County
349929	Ordering, Referring, Prescribing	N/A	1871060699	0	0	TYSON, TINA M RN	2/6/2018	Taxonomy not applicable	NA	n/a	000	Unknown	95088316	N/A	N/A	N/A	N/A	N/A	1530 E 19TH STREET	None	BAKERSFIELD	CA	93305	5406	00	06000	35.37150365	-118.9798847	Kern County
349932	Ordering, Referring, Prescribing	N/A	1871065755	0	0	TESHALE, TIGIST M CNP	6/3/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95010070	N/A	N/A	N/A	N/A	N/A	5300 TUJUNGA AVE	None	NORTH HOLLYWOOD	CA	91601	3121	00	06000	34.167276	-118.3789445	Los Angeles County
349939	Ordering, Referring, Prescribing	N/A	1871073965	0	0	TANG, YIN S	10/22/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	103084	N/A	N/A	N/A	N/A	N/A	4646 N 1ST ST	None	FRESNO	CA	93726	0973	00	06000	36.802161	-119.7722105	Fresno County
349974	Ordering, Referring, Prescribing	N/A	1871128595	0	0	TIRADO, GABRIELA A CNM	12/20/2019	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236095	N/A	N/A	N/A	N/A	N/A	1735 JEFFERSON STREET	None	NAPA	CA	94559	1702	00	06000	38.30356022	-122.2943872	Napa County
350003	Ordering, Referring, Prescribing	N/A	1871192922	0	0	TRAINER, JASON DC	3/1/2021	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC33422	N/A	N/A	N/A	N/A	N/A	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
350058	Ordering, Referring, Prescribing	N/A	1871527317	0	0	TAYABA, ROLAND G MD	11/6/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C162327	N/A	N/A	N/A	N/A	N/A	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
350123	Ordering, Referring, Prescribing	N/A	1871689810	0	0	TEDJA-LEE, LINA L PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50620	N/A	N/A	N/A	N/A	N/A	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	00	06000	33.904782	-117.469323	Riverside County
350128	Ordering, Referring, Prescribing	N/A	1871705251	0	0	TILLEY, DENA D CNP	5/6/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	8147	N/A	N/A	N/A	N/A	N/A	1827 S. COURT ST.	SUITE A	VISALIA	CA	93277	5469	00	06000	36.314424	-119.2922235	Tulare County
350147	Ordering, Referring, Prescribing	N/A	1871753699	0	0	TSANG, JANET M MD	6/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A109116	N/A	N/A	N/A	N/A	N/A	1990 41ST AVENUE	None	SAN FRANCISCO	CA	94116	1101	00	06000	37.74984135	-122.4997872	San Francisco County
350197	Ordering, Referring, Prescribing	N/A	1871837583	0	0	TRAN, ANGIE C PHARMD	7/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH56704	N/A	N/A	N/A	N/A	N/A	1661 W FLORIDA AVE	None	HEMET	CA	92543	3818	00	06000	33.74737153	-116.988629	Riverside County
350218	Ordering, Referring, Prescribing	N/A	1871865931	0	0	TRINH, JINNIE PHARMD	10/7/2018	Taxonomy not applicable	NA	n/a	000	Unknown	43094	N/A	N/A	N/A	N/A	N/A	976 LENZEN AVE	#1400	SAN JOSE	CA	95126	2737	00	06000	37.33463902	-121.9121497	Santa Clara County
350253	Ordering, Referring, Prescribing	N/A	1871918169	0	0	TITO, SAMANTHA K LMFT	2/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	78358	N/A	N/A	N/A	N/A	N/A	1908 BUSINESS CENTER DR	220	SAN BERNARDINO	CA	92408	3468	00	06000	34.06732096	-117.2801085	San Bernardino County
350309	Ordering, Referring, Prescribing	N/A	1871994285	0	0	TRIGUEIRO, PALEI LMFT	1/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	120183	N/A	N/A	N/A	N/A	N/A	800 SCENIC DR	None	MODESTO	CA	95350	6131	00	06000	37.64722447	-120.9836925	Stanislaus County
350378	Ordering, Referring, Prescribing	N/A	1881078434	0	0	THAO, MAI L	3/20/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114380	N/A	N/A	N/A	N/A	N/A	480 E 13TH ST	None	MERCED	CA	95341	6214	00	06000	37.29194565	-120.4717887	Merced County
350379	Ordering, Referring, Prescribing	N/A	1881082915	0	0	TU, COLLEEN PHARMD	3/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69159	N/A	N/A	N/A	N/A	N/A	1800 HARRISON STREET	None	OAKLAND	CA	94612	3466	00	06000	37.80593773	-122.2656714	Alameda County
350392	Ordering, Referring, Prescribing	N/A	1881104321	0	0	THOMPSON, CELESTE LCSW	7/10/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	116396	N/A	N/A	N/A	N/A	N/A	265 SAN JACINTO RIVER RD	None	LAKE ELSINORE	CA	92530	4419	00	06000	33.66201142	-117.3001906	Riverside County
350444	Ordering, Referring, Prescribing	N/A	1881182327	0	0	THORDARSON, DANIELLE N MD	3/23/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165731	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
350446	Ordering, Referring, Prescribing	N/A	1881183192	0	0	TOKESHI-NITTA, JENNA LMFT	4/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125676	N/A	N/A	N/A	N/A	N/A	5445 LAUREL HILLS DR	None	SACRAMENTO	CA	95841	3105	00	06000	38.662227	-121.3378965	Sacramento County
350447	Ordering, Referring, Prescribing	N/A	1881190288	0	0	THOMAS, RYAN A MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165513	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
350448	Ordering, Referring, Prescribing	N/A	1881189264	0	0	TAING, FELICIA T LCSW	11/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	111926	N/A	N/A	N/A	N/A	N/A	12141 BROOKHURST ST	101	GARDEN GROVE	CA	92840	2865	00	06000	33.78614503	-117.9587915	Orange County
350454	Ordering, Referring, Prescribing	N/A	1881191591	0	0	TIPTON, LAUREN A MD	7/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166413	N/A	N/A	N/A	N/A	N/A	2001 THE ALAMEDA	None	SAN JOSE	CA	95127	1439	00	06000	37.34293689	-121.9270392	Santa Clara County
350468	Ordering, Referring, Prescribing	N/A	1881236891	0	0	TELLA, CATHLEEN	10/11/2018	Taxonomy not applicable	NA	n/a	000	Unknown	37950	N/A	N/A	N/A	N/A	N/A	70 W HEDDING ST	None	SAN JOSE	CA	95110	1705	00	06000	37.35249294	-121.9050815	Santa Clara County
350477	Ordering, Referring, Prescribing	N/A	1881241511	0	0	TUCK, RICHELLE A RN PHN	12/18/2018	Taxonomy not applicable	NA	n/a	000	Unknown	846224	N/A	N/A	N/A	N/A	N/A	2950 SOUTH BEAR VALLEY P	None	ESCONDIDO	CA	92025	7446	00	06000	33.08417545	-117.0562727	San Diego County
350491	Ordering, Referring, Prescribing	N/A	1881270387	0	0	TANG, JENNIFER MD	4/24/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A195747	N/A	N/A	N/A	N/A	N/A	12100 S. EUCLID ST	None	GARDEN GROVE	CA	92840	3304	00	06000	33.786882	-117.9410535	Orange County
350546	Ordering, Referring, Prescribing	N/A	1881646248	0	0	TARANATH, DHEERAJ DO	7/12/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21462	N/A	N/A	N/A	N/A	N/A	3340 PERIMETER HILL DR	None	NASHVILLE	TN	37211	4123	00	06000	36.08481789	-86.69408797	Davidson County
350547	Ordering, Referring, Prescribing	N/A	1881642742	0	0	TAM, JENNIFER W PHARMD	1/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55134	N/A	N/A	N/A	N/A	N/A	388 9TH ST	108	OAKLAND	CA	94607	4287	00	06000	37.80019425	-122.2715222	Alameda County
350574	Ordering, Referring, Prescribing	N/A	1881728293	0	0	TYLER, BECKY LMFT	12/20/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49446	N/A	N/A	N/A	N/A	N/A	1620 CUMMINS DR	None	MODESTO	CA	95358	6400	00	06000	37.658709	-121.036333	Stanislaus County
350593	Ordering, Referring, Prescribing	N/A	1881771657	0	0	TRAN, ANGELINE-NGA M PHARMD	3/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH50412	N/A	N/A	N/A	N/A	N/A	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	00	06000	33.9040752	-118.1328995	Los Angeles County
350600	Ordering, Referring, Prescribing	N/A	1881772796	0	0	TRUONG, THUHONG MD	2/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A88296	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
350615	Ordering, Referring, Prescribing	N/A	1881831030	0	0	TAN-TRUONG, SOPHIA T MD	9/4/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A105263	N/A	N/A	N/A	N/A	N/A	22310 WARDHAM AVE	None	HAWAIIAN GARDENS	CA	90716	1740	00	06000	33.82667708	-118.0650149	Los Angeles County
350618	Ordering, Referring, Prescribing	N/A	1881835122	0	0	TURNER, BECKIE L NP	3/17/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95002248	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
350683	Ordering, Referring, Prescribing	N/A	1881976322	0	0	TAN, JANET	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59515	N/A	N/A	N/A	N/A	N/A	1065 FORTUNA BLVD	None	FORTUNA	CA	95540	3010	00	06000	40.579398	-124.1466635	Humboldt County
350698	Ordering, Referring, Prescribing	N/A	1881994788	0	0	TRAN, THU A PHARMD	3/17/2018	Taxonomy not applicable	NA	n/a	000	Unknown	52867	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD. M	None	BOISE	ID	83706	1000	00	06000	43.59860438	-116.1806635	Ada County
350767	Ordering, Referring, Prescribing	N/A	1891116513	0	0	THURSTON, LISA LCSW	11/20/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27484	N/A	N/A	N/A	N/A	N/A	474 W VERMONT AVE	None	ESCONDIDO	CA	92025	6584	00	06000	33.10046604	-117.0729623	San Diego County
350787	Ordering, Referring, Prescribing	N/A	1891145322	0	0	TORIGOE-LAI, TIFFANY K PHD	3/12/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31571	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	MS#53	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
350796	Ordering, Referring, Prescribing	N/A	1891149613	0	0	TREZIA, MARK DPM	6/5/2019	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	5572	N/A	N/A	N/A	N/A	N/A	311 N VERDUGO RD	None	GLENDALE	CA	91206	3944	00	06000	34.15041479	-118.2362431	Los Angeles County
350891	Ordering, Referring, Prescribing	N/A	1891320719	0	0	TUCKER, BREANNA L LCSW	4/30/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101340	N/A	N/A	N/A	N/A	N/A	3100 BRISTOL	SUITE 150	COSTA MESA	CA	92626	7329	00	06000	33.6865398	-117.885491	Orange County
350909	Ordering, Referring, Prescribing	N/A	1891351656	0	0	TAN, EVELYN LMFT	1/14/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	137212	N/A	N/A	N/A	N/A	N/A	18623 GALE AVE	None	CITY OF INDUSTRY	CA	91748	1342	00	06000	33.9945603	-117.8965305	Los Angeles County
350917	Ordering, Referring, Prescribing	N/A	1891373510	0	0	TUROCY, MARY J MD	8/20/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL6687	N/A	N/A	N/A	N/A	N/A	455 OCONNOR DR	SUITE 200	SAN JOSE	CA	95128	1632	00	06000	37.326654	-121.939897	Santa Clara County
350918	Ordering, Referring, Prescribing	N/A	1891372868	0	0	THARAYIL, JITHIL L MD	4/15/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A195503	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
350934	Ordering, Referring, Prescribing	N/A	1891424370	0	0	TAN, LUHONG PA-C	1/10/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA63915	N/A	N/A	N/A	N/A	N/A	1661 HANOVER RD	103	ROWLAND HEIGHTS	CA	91748	1796	00	06000	33.99109665	-117.920988	Los Angeles County
350968	Ordering, Referring, Prescribing	N/A	1891700274	0	0	TIPPETT, CHRISTINE L LCSW	2/28/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW7698	N/A	N/A	N/A	N/A	N/A	1382 BLUE OAKS BLVD	STE 213	ROSEVILLE	CA	95678	7052	00	06000	38.79554586	-121.3118864	Placer County
350985	Ordering, Referring, Prescribing	N/A	1891808762	0	0	TSAI, JULIE S	5/28/2013	Taxonomy not applicable	NA	n/a	000	Unknown	PA16832	N/A	N/A	N/A	N/A	N/A	22 SAN ANTONIO RD	None	MOUNTAIN VIEW	CA	94040	1209	00	06000	37.40774389	-122.1089656	Santa Clara County
350988	Ordering, Referring, Prescribing	N/A	1891813762	0	0	TONG, SIO M	4/6/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26278	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	None	SAN MATEO	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
351006	Ordering, Referring, Prescribing	N/A	1891834362	0	0	TREMBLAY, JOHN MD	11/13/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A70443	N/A	N/A	N/A	N/A	N/A	15339 SATICOY STREET	None	VAN NUYS	CA	91406	3345	00	06000	34.2084865	-118.4678505	Los Angeles County
351009	Ordering, Referring, Prescribing	N/A	1891841227	0	0	TAPIA, ANA M LCSW	2/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27120	N/A	N/A	N/A	N/A	N/A	4565 CALIFORNIA AVE	None	LONG BEACH	CA	90807	1507	00	06000	33.841926	-118.1822395	Los Angeles County
351011	Ordering, Referring, Prescribing	N/A	1891847059	0	0	THOM, DARROW J MD	11/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G49313	N/A	N/A	N/A	N/A	N/A	1039 MURRAY AVENUE	220	SAN LUIS OBISPO	CA	93405	2058	00	06000	35.29091981	-120.665741	San Luis Obispo County
351033	Ordering, Referring, Prescribing	N/A	1891910527	0	0	TAYLOR, THOMAS A LCSW	1/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	17355	N/A	N/A	N/A	N/A	N/A	1393 BAILEY DRIVE	None	HANFORD	CA	93230	5922	00	06000	36.32726257	-119.6663418	Kings County
351036	Ordering, Referring, Prescribing	N/A	1891912424	0	0	TAMAYO, MONICA LMFT	11/3/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49594	N/A	N/A	N/A	N/A	N/A	158 GENTRY ST	None	POMONA	CA	91767	2100	00	06000	34.09147818	-117.7506278	Los Angeles County
351047	Ordering, Referring, Prescribing	N/A	1891943833	0	0	TAN, MIN LMFT	5/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51376	N/A	N/A	N/A	N/A	N/A	1309 EVANS AVE	A/B	SAN FRANCISCO	CA	94124	1705	00	06000	37.74005234	-122.3834106	San Francisco County
351053	Ordering, Referring, Prescribing	N/A	1891950564	0	0	THOMAS, SARAH S LMFT	11/8/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	135741	N/A	N/A	N/A	N/A	N/A	643 E SAMPLE AVE	None	FRESNO	CA	93710	5428	00	06000	36.82724954	-119.775807	Fresno County
351075	Ordering, Referring, Prescribing	N/A	1891997581	0	0	TSAI, STEPHEN LAC	4/22/2020	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC3694	N/A	N/A	N/A	N/A	N/A	515 E COMMONWEALTH AVE	None	FULLERTON	CA	92832	2020	00	06000	33.87044143	-117.9149896	Orange County
351077	Ordering, Referring, Prescribing	N/A	1902000367	0	0	TAPANES, VIRGINIA LCSW	10/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	9968	N/A	N/A	N/A	N/A	N/A	4001 MISSION OAKS BLVD	SUITE I	CAMARILLO	CA	93012	5121	00	06000	34.21641579	-119.0166203	Ventura County
351089	Ordering, Referring, Prescribing	N/A	1902016439	0	0	TORGERSON, KRISHA I MD	2/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A96376	N/A	N/A	N/A	N/A	N/A	9727 ELK GROVE FLORIN RO	None	ELK GROVE	CA	95624	2290	00	06000	38.404503	-121.370994	Sacramento County
351104	Ordering, Referring, Prescribing	N/A	1902060015	0	0	TENKEI, TIMEA LMFT	3/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50507	N/A	N/A	N/A	N/A	N/A	875 CRESSENT WAY	None	ARCATA	CA	95521	6741	00	06000	40.8590691	-124.072535	Humboldt County
351123	Ordering, Referring, Prescribing	N/A	1902098502	0	0	TORRES-GONZALEZ, KAREN A LCSW	2/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW26674	N/A	N/A	N/A	N/A	N/A	658 E. BRIER DRIVE	200	SAN BERNARDINO	CA	92408	2880	00	06000	34.07137738	-117.2702805	San Bernardino County
351165	Ordering, Referring, Prescribing	N/A	1902170350	0	0	THIBEAU, NICOLE D PHARD	10/19/2017	Taxonomy not applicable	NA	n/a	000	Unknown	63226	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
351284	Ordering, Referring, Prescribing	N/A	1902356413	0	0	TANG, HIENG U PHARMD	11/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH52322	N/A	N/A	N/A	N/A	N/A	737 COLUSA AVE	None	YUBA CITY	CA	95991	3734	00	06000	39.14175898	-121.6268906	Sutter County
351328	Ordering, Referring, Prescribing	N/A	1902458763	0	0	THAI, THANH K PHARMD	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78924	N/A	N/A	N/A	N/A	N/A	1600 OWENS STREET	6TH FLOOR	SAN FRANCISCO	CA	94158	2261	00	06000	37.76850146	-122.3949365	San Francisco County
351330	Ordering, Referring, Prescribing	N/A	1902456577	0	0	TAMAYO, RAYANNE R LPCC	4/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC11465	N/A	N/A	N/A	N/A	N/A	500 N 9TH ST	None	MODESTO	CA	95350	5814	00	06000	37.65145793	-121.0156971	Stanislaus County
351331	Ordering, Referring, Prescribing	N/A	1902464878	0	0	TRAN, HELEN P PHARMD	2/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	74146	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	SUITE 220A	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
351340	Ordering, Referring, Prescribing	N/A	1902504111	0	0	THARP, REBECCA M NP	6/4/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	51552	N/A	N/A	N/A	N/A	N/A	2521 E 15TH ST	None	CASPER	WY	82609	4126	00	06000	42.834753	-106.2938295	Natrona County
351351	Ordering, Referring, Prescribing	N/A	1902562606	0	0	THAI, KATELYNN H PHARMD	5/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64356	N/A	N/A	N/A	N/A	N/A	10084 CHAPMAN AVE	None	GARDEN GROVE	CA	92840	2821	00	06000	33.78856195	-117.9573359	Orange County
351361	Ordering, Referring, Prescribing	N/A	1902637325	0	0	TINDOGAN, MICHELLE	4/29/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029951	N/A	N/A	N/A	N/A	N/A	7215 55TH ST	B	SACRAMENTO	CA	95823	2659	00	06000	38.495196	-121.440681	Sacramento County
351368	Ordering, Referring, Prescribing	N/A	1902804230	0	0	TRAN, DAVID D DPM	8/30/2021	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E4274	N/A	N/A	N/A	N/A	N/A	240 SHOTWELL STREET	None	SAN FRANCISCO	CA	94110	1323	00	06000	37.76460716	-122.416335	San Francisco County
351379	Ordering, Referring, Prescribing	N/A	1902868847	0	0	TYLER, MICHAEL J	5/30/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C156207	N/A	N/A	N/A	N/A	N/A	2145 FIFTH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
351412	Ordering, Referring, Prescribing	N/A	1902934706	0	0	THORNTON, SHEILA LCSW	11/3/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW11464	N/A	N/A	N/A	N/A	N/A	897 GRANITE DR.	None	PASADENA	CA	91101	3501	00	06000	34.13703447	-118.1317905	Los Angeles County
351470	Ordering, Referring, Prescribing	N/A	1912045113	0	0	TING, PEGGY K	12/2/2000	Taxonomy not applicable	NA	n/a	099	DENTIST	D48040	N/A	N/A	N/A	N/A	N/A	1101 N CHERRY ST	None	TULARE	CA	93274	2231	00	06000	36.22333808	-119.337575	Tulare County
351519	Ordering, Referring, Prescribing	N/A	1912156555	0	0	TUGBENYOH, JONATHAN B LMFT	5/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53809	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	1309	00	06000	37.76047483	-122.157608	Alameda County
351535	Ordering, Referring, Prescribing	N/A	1912196445	0	0	THARAYIL, PRIYA R LCSW	3/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	28224	N/A	N/A	N/A	N/A	N/A	658 E BRIER DR	200	SAN BERNARDINO	CA	92408	2880	00	06000	34.07137738	-117.2702805	San Bernardino County
351598	Ordering, Referring, Prescribing	N/A	1912290172	0	0	TRAN, DANIELLE N PHARMD	2/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	41555	N/A	N/A	N/A	N/A	N/A	600 SOUTH BROADWAY	None	WALNUT CREEK	CA	94596	0001	00	06000	37.89749614	-122.057329	Contra Costa County
351600	Ordering, Referring, Prescribing	N/A	1912299124	0	0	THOMAS, LEVON J PA	10/15/2018	Taxonomy not applicable	NA	n/a	000	Unknown	21535	N/A	N/A	N/A	N/A	N/A	255 TERRACINA BLVD	None	REDLANDS	CA	92373	4870	00	06000	34.03788441	-117.2055761	San Bernardino County
351606	Ordering, Referring, Prescribing	N/A	1912307463	0	0	THOMPSON, BRIAN W LMFT	9/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124166	N/A	N/A	N/A	N/A	N/A	13585 SAN PABLO AVE.	None	SAN PABLO	CA	94806	3804	00	06000	37.95651393	-122.3371491	Contra Costa County
351624	Ordering, Referring, Prescribing	N/A	1912324468	0	0	THOMAS, MELANIE A	1/26/2018	Taxonomy not applicable	NA	n/a	000	Unknown	51481	N/A	N/A	N/A	N/A	N/A	2020 J ST	None	SACRAMENTO	CA	95811	3120	00	06000	38.576331	-121.4791155	Sacramento County
351626	Ordering, Referring, Prescribing	N/A	1912333642	0	0	TRAN, MAI T PHARMD	3/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	69642	N/A	N/A	N/A	N/A	N/A	13111 PEYTON DR	None	CHINO HILLS	CA	91709	6002	00	06000	34.014636	-117.741339	San Bernardino County
351635	Ordering, Referring, Prescribing	N/A	1912343948	0	0	TRUONG, JOTIKA H	10/4/2018	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC15419	N/A	N/A	N/A	N/A	N/A	9862 CHAPMAN AVE	None	GARDEN GROVE	CA	92841	2726	00	06000	33.78849558	-117.9607338	Orange County
351681	Ordering, Referring, Prescribing	N/A	1912401332	0	0	TRAORE, FATIMA MD	4/1/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165324	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
351682	Ordering, Referring, Prescribing	N/A	1912410531	0	0	TRIFUNOVIC, JELENA LMFT	3/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125184	N/A	N/A	N/A	N/A	N/A	3300 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3137	00	06000	35.37353416	-119.0392409	Kern County
351694	Ordering, Referring, Prescribing	N/A	1912430059	0	0	TRANE, ASHLEY L MD	7/29/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174180	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
351720	Ordering, Referring, Prescribing	N/A	1912466848	0	0	TRAN, MICHAEL NP	9/26/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011192	N/A	N/A	N/A	N/A	N/A	1625 N SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
351743	Ordering, Referring, Prescribing	N/A	1912496605	0	0	TROVATO, OLIVIA A LMFT	1/11/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT137112	N/A	N/A	N/A	N/A	N/A	323 N PRAIRIE AVE	SUITE 350	INGLEWOOD	CA	90301	4523	00	06000	33.966333	-118.3439975	Los Angeles County
351765	Ordering, Referring, Prescribing	N/A	1912542903	0	0	TYSON, JILLIAN L LMFT	1/31/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT128916	N/A	N/A	N/A	N/A	N/A	1170 INDUSTRIAL STREET	1170 INDUSTRIAL STREET	REDDING	CA	96002	0734	00	06000	40.57474549	-122.3503065	Shasta County
351767	Ordering, Referring, Prescribing	N/A	1912545161	0	0	TRAXLER, SYDNEY S LCSW	7/6/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108941	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	None	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
351813	Ordering, Referring, Prescribing	N/A	1912672635	0	0	TRUONG, HILLARY A PHARMD	9/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84364	N/A	N/A	N/A	N/A	N/A	25011 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	4312	00	06000	33.91720845	-117.2256545	Riverside County
351828	Ordering, Referring, Prescribing	N/A	1912688144	0	0	TANG, SHAOQING	9/26/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026259	N/A	N/A	N/A	N/A	N/A	767 N. HILL ST.	400B	LOS ANGELES	CA	90012	2343	00	06000	34.06255157	-118.2397077	Los Angeles County
351837	Ordering, Referring, Prescribing	N/A	1912789991	0	0	TANG, MICHELLE C	7/28/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88152	N/A	N/A	N/A	N/A	N/A	2300 16TH ST	None	SAN FRANCISCO	CA	94103	4803	00	06000	37.76569327	-122.4091306	San Francisco County
351841	Ordering, Referring, Prescribing	N/A	1922013614	0	0	TREUNER, JULIE A PA-C	2/19/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA17478	N/A	N/A	N/A	N/A	N/A	2325 COMMERCIAL ST	SUITE 1400	SAN DIEGO	CA	92113	1189	00	06000	32.70514724	-117.1429916	San Diego County
351870	Ordering, Referring, Prescribing	N/A	1922136027	0	0	TRYON, DWIGHT M	6/6/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D37944	N/A	N/A	N/A	N/A	N/A	20615 COMMERCE WAY	None	BURNEY	CA	96013	4380	00	06000	40.88827968	-121.6525394	Shasta County
351881	Ordering, Referring, Prescribing	N/A	1922158914	0	0	TON, ANH PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54921	N/A	N/A	N/A	N/A	N/A	3240 ARDEN WAY	None	SACRAMENTO	CA	95825	2015	00	06000	38.594898	-121.3884765	Sacramento County
351883	Ordering, Referring, Prescribing	N/A	1922163310	0	0	TO, SEAN S MD	12/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A75204	N/A	N/A	N/A	N/A	N/A	5562 PHILADELPHIA ST STE	None	CHINO	CA	91710	5537	00	06000	34.03370384	-117.6837291	San Bernardino County
351886	Ordering, Referring, Prescribing	N/A	1922165778	0	0	TURNER, JOSEPH A PHD	4/5/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	22453	N/A	N/A	N/A	N/A	N/A	1380 HOWARD ST	None	SAN FRANCISCO	CA	94103	2638	00	06000	37.77424669	-122.4141502	San Francisco County
351902	Ordering, Referring, Prescribing	N/A	1922201631	0	0	TOROK-MANGASARIAN, JULIE M LMFT	3/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47212	N/A	N/A	N/A	N/A	N/A	1470 W. HERNDON AVENUE	100	FRESNO	CA	93711	0552	00	06000	36.83746879	-119.8186401	Fresno County
351910	Ordering, Referring, Prescribing	N/A	1922217496	0	0	TOMMANEY, ANN M PSYD	10/7/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32120	N/A	N/A	N/A	N/A	N/A	1272 HAYES ST	STE 300	NAPA	CA	95128	2631	00	06000	38.30442969	-122.2936442	Napa County
351914	Ordering, Referring, Prescribing	N/A	1922245331	0	0	THOMAS, DEMETRA A LCSW	8/6/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25069	N/A	N/A	N/A	N/A	N/A	2116 ARABIAN DRIVE	None	FAIRFIELD	CA	94534	7442	00	06000	38.16440785	-122.1293094	Solano County
351969	Ordering, Referring, Prescribing	N/A	1922355114	0	0	TORRES, DIANE B PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH50729	N/A	N/A	N/A	N/A	N/A	5829 LAKEWOOD BLVD	None	LAKEWOOD	CA	90712	1001	00	06000	33.86147305	-118.1427711	Los Angeles County
351973	Ordering, Referring, Prescribing	N/A	1922371004	0	0	TYLER, MEGAN M NP	4/23/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	21585	N/A	N/A	N/A	N/A	N/A	1510 FLORIDA AVE	None	MODESTO	CA	95350	4437	00	06000	37.666053	-120.996222	Stanislaus County
351987	Ordering, Referring, Prescribing	N/A	1922386945	0	0	TRAEDER, TAMARA LMFT	2/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50853	N/A	N/A	N/A	N/A	N/A	1100 LINCOLN AVE	SUITE 108	NAPA	CA	94558	4908	00	06000	38.3085749	-122.2949243	Napa County
351990	Ordering, Referring, Prescribing	N/A	1922390921	0	0	TRAN, TERISA H PHARMD	4/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62806	N/A	N/A	N/A	N/A	N/A	1200 DISCOVERY DR	250	BAKERSFIELD	CA	93309	7032	00	06000	35.36397746	-119.0589062	Kern County
352003	Ordering, Referring, Prescribing	N/A	1922407733	0	0	TRUONG, NHU-MINH N PHARMD	1/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73263	N/A	N/A	N/A	N/A	N/A	22280 E FOOTHILL BLVD	None	HAYWARD	CA	94541	2731	00	06000	37.67922752	-122.0844431	Alameda County
352019	Ordering, Referring, Prescribing	N/A	1922430578	0	0	TEJEDA, MARIA G LMFT	9/21/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100621	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	STE 1100	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
352038	Ordering, Referring, Prescribing	N/A	1922470087	0	0	TRAN, LONG	9/21/2020	Taxonomy not applicable	NA	n/a	000	Unknown	52630	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRY BLVD	None	JACKSON	CA	95642	9373	00	06000	38.36981229	-120.8002806	Amador County
352040	Ordering, Referring, Prescribing	N/A	1922471945	0	0	TRAN, BAO PHUOC D PHARMD	6/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59832	N/A	N/A	N/A	N/A	N/A	14262 BEACH BLVD	None	WESTMINSTER	CA	92683	4562	00	06000	33.75494511	-117.9894376	Orange County
352050	Ordering, Referring, Prescribing	N/A	1922481795	0	0	TERCERO, SYNTHIA J LMFT	11/16/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115930	N/A	N/A	N/A	N/A	N/A	12450 VAN NUYS BLVD	100	PACOIMA	CA	91331	1391	00	06000	34.27894489	-118.4044363	Los Angeles County
352091	Ordering, Referring, Prescribing	N/A	1922526862	0	0	TERRANCE, EBONI M PHARMD	6/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61970	N/A	N/A	N/A	N/A	N/A	1339 N DAVIS RD	None	SALINAS	CA	93907	1988	00	06000	36.70358481	-121.6669768	Monterey County
352106	Ordering, Referring, Prescribing	N/A	1922549542	0	0	TRAN, ANNIE PHARMD	4/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75732	N/A	N/A	N/A	N/A	N/A	17284 SLOVER AVE	None	FONTANA	CA	92337	7584	00	06000	34.065396	-117.4277475	San Bernardino County
352109	Ordering, Referring, Prescribing	N/A	1922554971	0	0	TRAN, VIET	4/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	69077	N/A	N/A	N/A	N/A	N/A	5417 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4101	00	06000	34.01967692	-118.1536948	Los Angeles County
352133	Ordering, Referring, Prescribing	N/A	1922584234	0	0	TORRES MORALES, MONTSERRAT M LMFT	5/25/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT126145	N/A	N/A	N/A	N/A	N/A	10155 COLIMA RD	None	WHITTIER	CA	90603	2042	00	06000	33.94349601	-118.0106968	Los Angeles County
352153	Ordering, Referring, Prescribing	N/A	1922645019	0	0	TU, HARRISON	3/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81316	N/A	N/A	N/A	N/A	N/A	129 BERNAL ROAD	None	SAN JOSE	CA	95119	1303	00	06000	37.232892	-121.774725	Santa Clara County
352193	Ordering, Referring, Prescribing	N/A	1922774728	0	0	TRISTAN, GEMINESSE LMFT	4/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125284	N/A	N/A	N/A	N/A	N/A	8776 ARCHIBALD AVE.	None	RANCHO CUCAMONGA	CA	91730	4634	00	06000	34.094223	-117.593508	San Bernardino County
352199	Ordering, Referring, Prescribing	N/A	1922775766	0	0	TANWANSENG, MEGAN PHARMD	8/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84665	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DRIVE	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
352200	Ordering, Referring, Prescribing	N/A	1922826791	0	0	TRINH, SABRINA PA-C	10/16/2024	Taxonomy not applicable	NA	n/a	000	Unknown	65256	N/A	N/A	N/A	N/A	N/A	905 CALLE AMANECER	SUITE 115	SAN CLEMENTE	CA	92673	6226	00	06000	33.44951265	-117.6075825	Orange County
352210	Ordering, Referring, Prescribing	N/A	1922885482	0	0	TRAN, NGOC-CHAU N PHARMD	10/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH84228	N/A	N/A	N/A	N/A	N/A	6521 VAN NUYS BLVD.	None	VAN NUYS	CA	91401	1425	00	06000	34.189497	-118.448759	Los Angeles County
352295	Ordering, Referring, Prescribing	N/A	1932354396	0	0	TAVOLACCI-ARISTA, NANCY E LCSW	3/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27307	N/A	N/A	N/A	N/A	N/A	3800 COOLIDGE AVE.	None	OAKLAND	CA	94602	3311	00	06000	37.8007257	-122.2064578	Alameda County
352301	Ordering, Referring, Prescribing	N/A	1932356953	0	0	TUTULUGDZIJA, RANKO S LAC	5/23/2022	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	12049	N/A	N/A	N/A	N/A	N/A	661 W 1ST ST	G	TUSTIN	CA	92780	2939	00	06000	33.74578153	-117.831231	Orange County
352339	Ordering, Referring, Prescribing	N/A	1932447075	0	0	TAYLOR, SARA E	1/25/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	23580	N/A	N/A	N/A	N/A	N/A	6095 N 1ST STREET	None	FRESNO	CA	93710	0000	00	06000	36.82524765	-119.7723922	Fresno County
352374	Ordering, Referring, Prescribing	N/A	1932508777	0	0	TORRES, DEYSI LCSW	7/3/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	116242	N/A	N/A	N/A	N/A	N/A	6800 OWENSMOUTH AVE	160	CANOGA PARK	CA	91303	3159	00	06000	34.194276	-118.6014945	Los Angeles County
352396	Ordering, Referring, Prescribing	N/A	1932537511	0	0	TANNER, SUSAN B NP	7/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	23395	N/A	N/A	N/A	N/A	N/A	11499 BARTLETT AVE	None	ADELANTO	CA	92301	1902	00	06000	34.57915154	-117.414216	San Bernardino County
352429	Ordering, Referring, Prescribing	N/A	1932573391	0	0	TREBIZO, MARISA G LMFT	6/3/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111352	N/A	N/A	N/A	N/A	N/A	815 DR MARTIN LUTHER KIN	None	BAKERSFIELD	CA	93307	1365	00	06000	35.3655	-118.985202	Kern County
352455	Ordering, Referring, Prescribing	N/A	1932618121	0	0	TOBIAS, EMILY C NP	2/8/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009934	N/A	N/A	N/A	N/A	N/A	203 WESTERLY RD	None	NEW BERN	NC	28560	9503	00	06000	35.006499	-76.983984	Craven County
352462	Ordering, Referring, Prescribing	N/A	1932627411	0	0	TIDRICK, KATHERINE E LMFT	10/30/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128979	N/A	N/A	N/A	N/A	N/A	948 SACRAMENTO AVE	None	WEST SACRAMENTO	CA	95605	0000	00	06000	38.58935106	-121.5252207	Yolo County
352481	Ordering, Referring, Prescribing	N/A	1932666732	0	0	TRAN, MICHAEL LMFT	3/26/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT146018	N/A	N/A	N/A	N/A	N/A	160 E VIRGINIA ST	100	SAN JOSE	CA	95112	5857	00	06000	37.32582868	-121.8777868	Santa Clara County
352483	Ordering, Referring, Prescribing	N/A	1932671435	0	0	TRAN, JENNIFER L NP	12/13/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010681	N/A	N/A	N/A	N/A	N/A	400 WEST 30TH STREET	None	LOS ANGELES	CA	90007	0000	00	06000	34.0239409	-118.2755606	Los Angeles County
352510	Ordering, Referring, Prescribing	N/A	1932718574	0	0	TRAN, MEIJI T NP	11/20/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016029	N/A	N/A	N/A	N/A	N/A	437 N EUCLID AVENUE	None	ONTARIO	CA	91762	3456	00	06000	34.067988	-117.6521805	San Bernardino County
352522	Ordering, Referring, Prescribing	N/A	1932703899	0	0	THOMAS, SAMANTHA A NP	11/12/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95015897	N/A	N/A	N/A	N/A	N/A	200 MEDICAL PLAZA	#530	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
352528	Ordering, Referring, Prescribing	N/A	1932736303	0	0	TUNG, ANDREW MD	5/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A177751	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	SUITE 200	ANAHEIM	CA	92806	5159	00	06000	33.81812448	-117.8880075	Orange County
352548	Ordering, Referring, Prescribing	N/A	1932772290	0	0	TSAI, ZOE L	8/20/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	106475	N/A	N/A	N/A	N/A	N/A	210 N GARFIELD AVE	STE 203D	MONTEREY PARK	CA	91754	1746	00	06000	34.064181	-118.122834	Los Angeles County
352568	Ordering, Referring, Prescribing	N/A	1932837168	0	0	TAN, PEI SHAN NP	6/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95021262	N/A	N/A	N/A	N/A	N/A	437 N EUCLID AVE	None	ONTARIO	CA	91762	3456	00	06000	34.067988	-117.6521805	San Bernardino County
352628	Ordering, Referring, Prescribing	N/A	1942326178	0	0	TRUJILLO, LILIA LCSW	5/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26903	N/A	N/A	N/A	N/A	N/A	828 W VENTURA ST	STE 240	FILLMORE	CA	93015	1882	00	06000	34.39581413	-118.9207744	Ventura County
352639	Ordering, Referring, Prescribing	N/A	1942341920	0	0	TERRAZANO, MAUREEN C MD	4/13/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G73113	N/A	N/A	N/A	N/A	N/A	450 E SAN JACINTO AVE	100	PERRIS	CA	92571	2833	00	06000	33.78662816	-117.2164923	Riverside County
352675	Ordering, Referring, Prescribing	N/A	1942406640	0	0	TORRES, ERIKA LMFT	3/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52064	N/A	N/A	N/A	N/A	N/A	1255 KENDALL RD	None	SAN LUIS OBISPO	CA	93401	8750	00	06000	35.2372881	-120.6292313	San Luis Obispo County
352683	Ordering, Referring, Prescribing	N/A	1942446554	0	0	TORNQUIST, STACI C LCSW	2/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19903	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	SUITE 220	MISSION VIEJO	CA	92691	6441	00	06000	33.56536541	-117.670334	Orange County
352686	Ordering, Referring, Prescribing	N/A	1942455811	0	0	TRINIDAD, DEBBIE LMFT	5/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112985	N/A	N/A	N/A	N/A	N/A	4444 CALLE REAL	None	SANTA BARBARA	CA	93110	1002	00	06000	34.44240122	-119.7765542	Santa Barbara County
352717	Ordering, Referring, Prescribing	N/A	1942502745	0	0	TAM, ALAIN C PHARMD	1/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	39143	N/A	N/A	N/A	N/A	N/A	2350 NORIEGA ST	None	SAN FRANCISCO	CA	94122	4240	00	06000	37.75371991	-122.4888992	San Francisco County
352749	Ordering, Referring, Prescribing	N/A	1942583190	0	0	TRUONG, JENNY T PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60130	N/A	N/A	N/A	N/A	N/A	5504 BALBOA AVE	None	SAN DIEGO	CA	92111	0000	00	06000	32.81973233	-117.1810836	San Diego County
352775	Ordering, Referring, Prescribing	N/A	1942619200	0	0	TU, MY LMFT	3/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT112767	N/A	N/A	N/A	N/A	N/A	251 LLEWELLYN AVE	None	CAMPBELL	CA	95008	1940	00	06000	37.29173129	-121.9584335	Santa Clara County
352799	Ordering, Referring, Prescribing	N/A	1942653092	0	0	TERRY, BRITTANY LMFT	6/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119313	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
352821	Ordering, Referring, Prescribing	N/A	1942680533	0	0	TRAN, AN T	1/24/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002415	N/A	N/A	N/A	N/A	N/A	661 W 1ST ST	G	TUSTIN	CA	92780	2939	00	06000	33.74578153	-117.831231	Orange County
352832	Ordering, Referring, Prescribing	N/A	1942696810	0	0	TRAN, NHUT G MD MPH	4/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A168575	N/A	N/A	N/A	N/A	N/A	631B MAPLE AVE	None	LOS ANGELES	CA	90014	2211	00	06000	34.04327665	-118.2485423	Los Angeles County
352895	Ordering, Referring, Prescribing	N/A	1942788047	0	0	THOMSON, ANNIE L NP	7/20/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009543	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
352902	Ordering, Referring, Prescribing	N/A	1942797824	0	0	TOVAR CASTRO, MAYRA A MD	8/5/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174375	N/A	N/A	N/A	N/A	N/A	815 DR MARTIN LUTHER KIN	None	BAKERSFIELD	CA	93307	1365	00	06000	35.3655	-118.985202	Kern County
352913	Ordering, Referring, Prescribing	N/A	1942845318	0	0	TASARZ, JACQUELINE J MD	1/2/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A187751	N/A	N/A	N/A	N/A	N/A	2204 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	3615	00	06000	32.69715769	-117.1399272	San Diego County
352917	Ordering, Referring, Prescribing	N/A	1942853627	0	0	TUCKER, CHRISTOPHER R PA-C	7/19/2019	Taxonomy not applicable	NA	n/a	000	Unknown	57033	N/A	N/A	N/A	N/A	N/A	1414 S GRAND AVE	380	LOS ANGELES	CA	90015	3067	00	06000	34.03661142	-118.2657227	Los Angeles County
352926	Ordering, Referring, Prescribing	N/A	1942878228	0	0	TABLA, SARAH T	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83930	N/A	N/A	N/A	N/A	N/A	1826 W ORANGETHORPE AVE	None	FULLERTON	CA	92833	4406	00	06000	33.85917352	-117.96057	Orange County
352945	Ordering, Referring, Prescribing	N/A	1942935861	0	0	TRAN, Y N PHARMD	7/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH86308	N/A	N/A	N/A	N/A	N/A	8052 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	3303	00	06000	33.75925468	-117.988843	Orange County
352971	Ordering, Referring, Prescribing	N/A	1952011710	0	0	TON, JUSTIN PHARMD	11/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	87457	N/A	N/A	N/A	N/A	N/A	3365 DEER VALLEY RD	None	ANTIOCH	CA	94531	6664	00	06000	37.98789856	-121.7855921	Contra Costa County
352979	Ordering, Referring, Prescribing	N/A	1952054876	0	0	TAYLOR-CEBALLOS, CANDY LCSW	5/29/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101734	N/A	N/A	N/A	N/A	N/A	9460 N NAME UNO	110	GILROY	CA	95020	3537	00	06000	37.037781	-121.570965	Santa Clara County
352990	Ordering, Referring, Prescribing	N/A	1952078776	0	0	THAI, HANH N PHARMD	8/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84782	N/A	N/A	N/A	N/A	N/A	1070 E CYPRESS AVE	None	REDDING	CA	96002	1114	00	06000	40.57107349	-122.3512425	Shasta County
353098	Ordering, Referring, Prescribing	N/A	1952563793	0	0	THOMAS-TORRES, TIFFANY C LMFT	12/8/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	78001	N/A	N/A	N/A	N/A	N/A	12188 HESPERIA RD	None	VICTORVILLE	CA	92395	5822	00	06000	34.47266362	-117.2918133	San Bernardino County
353128	Ordering, Referring, Prescribing	N/A	1952585416	0	0	TREFTZ, KRISTIE J PSYD	9/23/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	21655	N/A	N/A	N/A	N/A	N/A	602 E. SANTA CLARA STREE	None	SAN JOSE	CA	95112	0001	00	06000	37.34219766	-121.8778507	Santa Clara County
353130	Ordering, Referring, Prescribing	N/A	1952631327	0	0	TIONG, JESSICA PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61936	N/A	N/A	N/A	N/A	N/A	1200 65TH ST	APT 217	EMERYVILLE	CA	94608	1134	00	06000	37.84737107	-122.2887179	Alameda County
353131	Ordering, Referring, Prescribing	N/A	1952640997	0	0	THAO, VICKI LMFT	1/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	109609	N/A	N/A	N/A	N/A	N/A	811 GRAND AVE.	D	SACRAMENTO	CA	95838	3466	00	06000	38.637621	-121.4470125	Sacramento County
353148	Ordering, Referring, Prescribing	N/A	1952665036	0	0	TEK, ROTANA S DO	5/15/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	13698	N/A	N/A	N/A	N/A	N/A	301 N. PRAIRIE AVENUE	None	INGLEWOOD	CA	90301	5054	00	06000	33.965712	-118.3439965	Los Angeles County
353160	Ordering, Referring, Prescribing	N/A	1952687329	0	0	TRAN, LYNDE PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58814	N/A	N/A	N/A	N/A	N/A	9031 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2046	00	06000	33.9038495	-118.1420904	Los Angeles County
353163	Ordering, Referring, Prescribing	N/A	1952682106	0	0	TENNISON, ALEXANDREA D PHARMD	7/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65491	N/A	N/A	N/A	N/A	N/A	45 CASTRO ST	SUITE 124	SAN FRANCISCO	CA	94114	1039	00	06000	37.76829732	-122.4357056	San Francisco County
353170	Ordering, Referring, Prescribing	N/A	1952716565	0	0	TAUBMAN, ABIGAIL C LCSW	7/28/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	97265	N/A	N/A	N/A	N/A	N/A	611 S KINGSLEY DR.	None	LOS ANGELES	CA	90005	2319	00	06000	34.06305793	-118.3028813	Los Angeles County
353226	Ordering, Referring, Prescribing	N/A	1952798670	0	0	TJHO, STEPHANIE H MD	12/12/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146339	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
353239	Ordering, Referring, Prescribing	N/A	1952821472	0	0	TAPIA, ASHLEY LCSW	10/31/2023	Taxonomy not applicable	NA	n/a	000	Unknown	LCSW118965	N/A	N/A	N/A	N/A	N/A	1666 PRECISION PARK LN	None	SAN YSIDRO	CA	92173	1346	00	06000	32.5659146	-117.059667	San Diego County
353241	Ordering, Referring, Prescribing	N/A	1952820524	0	0	TO, IRENE H	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76972	N/A	N/A	N/A	N/A	N/A	550 16TH STREET	1200	SAN FRANCISCO	CA	94158	2545	00	06000	37.769553	-122.390109	San Francisco County
353242	Ordering, Referring, Prescribing	N/A	1952819831	0	0	TUCKER, DONNA NP	9/26/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025272	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE #A, B, C	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
353283	Ordering, Referring, Prescribing	N/A	1952876237	0	0	TUNG, ERICA PHARMD	3/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71310	N/A	N/A	N/A	N/A	N/A	1200 EL CAMINO REAL	None	SOUTH SAN FRANCIS	CA	94080	3208	00	06000	37.65894608	-122.440161	San Mateo County
353300	Ordering, Referring, Prescribing	N/A	1952913022	0	0	TORRES, SANDRA I NP	8/13/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015155	N/A	N/A	N/A	N/A	N/A	385 W MAIN ST	None	EL CENTRO	CA	92243	3040	00	06000	32.79279125	-115.5519032	Imperial County
353303	Ordering, Referring, Prescribing	N/A	1952922742	0	0	TEDJAKESUMA, NICHOLAS A PHARMD	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82043	N/A	N/A	N/A	N/A	N/A	6100 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2923	00	06000	33.984981	-118.2251735	Los Angeles County
353312	Ordering, Referring, Prescribing	N/A	1952927907	0	0	TABANGCURA, DEMY PA-C	10/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58534	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
353314	Ordering, Referring, Prescribing	N/A	1952932923	0	0	TANG, TIA	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81554	N/A	N/A	N/A	N/A	N/A	3800 DALE RD	None	MODESTO	CA	95356	8627	00	06000	37.69395556	-121.0499498	Stanislaus County
353326	Ordering, Referring, Prescribing	N/A	1952960189	0	0	TRUONG, TRACY PSYD	9/25/2024	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY35359	N/A	N/A	N/A	N/A	N/A	680 LANGSDORF DRIVE	200	FULLERTON	CA	92831	3702	00	06000	33.87673088	-117.8824577	Orange County
353388	Ordering, Referring, Prescribing	N/A	1962103853	0	0	TUNG, VANESSA S	3/8/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024535	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DR	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
353404	Ordering, Referring, Prescribing	N/A	1962145672	0	0	TABRIZIZADEH, JESSICA K NP	11/8/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95019095	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DRIVE	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
353435	Ordering, Referring, Prescribing	N/A	1962455576	0	0	TAFALLA, CECILLE K DMD	6/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	51307	N/A	N/A	N/A	N/A	N/A	31180 ROAD 72	None	VISALIA	CA	93291	9672	00	06000	36.35594779	-119.4124242	Tulare County
353452	Ordering, Referring, Prescribing	N/A	1962520791	0	0	TEJEDA, IVANA LMFT	11/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50001	N/A	N/A	N/A	N/A	N/A	15339 SATICOY ST	None	VAN NUYS	CA	91406	3345	00	06000	34.2084865	-118.4678505	Los Angeles County
353478	Ordering, Referring, Prescribing	N/A	1962579524	0	0	TERRA, MARY I LCSW	5/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24310	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
353482	Ordering, Referring, Prescribing	N/A	1962583336	0	0	TRETIAKOVA, TATIANA M MD	1/8/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A63465	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLES	#220	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
353524	Ordering, Referring, Prescribing	N/A	1962669234	0	0	TOMPKINS, LISA A LMFT	6/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53022	N/A	N/A	N/A	N/A	N/A	101 WIKIUP DR	None	SANTA ROSA	CA	95403	1375	00	06000	38.50788547	-122.7587646	Sonoma County
353548	Ordering, Referring, Prescribing	N/A	1962713453	0	0	THOMAS, JESSICA K PSYD	6/29/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	28457	N/A	N/A	N/A	N/A	N/A	5757 WILSHIRE BLVD	200	LOS ANGELES	CA	90036	3682	00	06000	34.0624504	-118.3534253	Los Angeles County
353584	Ordering, Referring, Prescribing	N/A	1962770214	0	0	TAKEBA, KALLEN PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66141	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
353602	Ordering, Referring, Prescribing	N/A	1962784561	0	0	TSAO, TE-YUN PHARMD	7/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47226	N/A	N/A	N/A	N/A	N/A	1201 TARAVAL ST	None	SAN FRANCISCO	CA	94116	2442	00	06000	37.74286716	-122.4791345	San Francisco County
353639	Ordering, Referring, Prescribing	N/A	1962832063	0	0	TANSOPON, MELINDA L PHARMD	11/4/2022	Taxonomy not applicable	NA	n/a	000	Unknown	70243	N/A	N/A	N/A	N/A	N/A	1099 E HOSPITALITY LN	None	SAN BERNARDINO	CA	92408	2813	00	06000	34.06887134	-117.2625206	San Bernardino County
353682	Ordering, Referring, Prescribing	N/A	1962881466	0	0	TANG, MARTIN M DO	4/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16127	N/A	N/A	N/A	N/A	N/A	410 E PARKCENTER CIR N	None	SAN BERNARDINO	CA	92408	2869	00	06000	34.07631086	-117.276898	San Bernardino County
353684	Ordering, Referring, Prescribing	N/A	1962889188	0	0	TRAN, TIEN M PHARMD	4/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71235	N/A	N/A	N/A	N/A	N/A	8241 E STOCKTON BLVD	None	SACRAMENTO	CA	95828	8200	00	06000	38.459826	-121.408569	Sacramento County
353735	Ordering, Referring, Prescribing	N/A	1962987149	0	0	TAVAREZ, CONNIE RN	10/30/2017	Taxonomy not applicable	NA	n/a	000	Unknown	558650	N/A	N/A	N/A	N/A	N/A	5000 W CYPRESS	None	VISALIA	CA	93277	8300	00	06000	36.324207	-119.3463225	Tulare County
353750	Ordering, Referring, Prescribing	N/A	1972007425	0	0	TREVIZO, DANIEL MD	7/14/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163932	N/A	N/A	N/A	N/A	N/A	500B JEFFERSON BLVD STE	None	W SACRAMENTO	CA	95605	2394	00	06000	38.58811316	-121.5270471	Yolo County
353768	Ordering, Referring, Prescribing	N/A	1972034411	0	0	TRESSAN, AMY A MD	7/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159959	N/A	N/A	N/A	N/A	N/A	700 S TUSTIN ST	None	ORANGE	CA	92866	3425	00	06000	33.77685748	-117.8357804	Orange County
353819	Ordering, Referring, Prescribing	N/A	1972134252	0	0	TRAN, SON PHARMD	4/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	81766	N/A	N/A	N/A	N/A	N/A	3801 PELANDALE AVE	None	MODESTO	CA	95356	8300	00	06000	37.70013907	-121.0663275	Stanislaus County
353837	Ordering, Referring, Prescribing	N/A	1972174498	0	0	TA, NHI T PHARMD	5/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84363	N/A	N/A	N/A	N/A	N/A	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
353891	Ordering, Referring, Prescribing	N/A	1972516821	0	0	THOMPSON, CATHLENE A NP	11/28/2017	Taxonomy not applicable	NA	n/a	000	Unknown	7626	N/A	N/A	N/A	N/A	N/A	590 N D STREET	None	SAN BERNARDINO	CA	92409	1352	00	06000	34.1099197	-117.2919257	San Bernardino County
353910	Ordering, Referring, Prescribing	N/A	1972625440	0	0	TORALES, SHIANNE	4/28/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49779	N/A	N/A	N/A	N/A	N/A	11927 ELLIOTT AVE	None	EL MONTE	CA	91732	3740	00	06000	34.05798002	-118.0258994	Los Angeles County
353933	Ordering, Referring, Prescribing	N/A	1972646214	0	0	TUCKER, TENNILLE L	3/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS28200	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
353993	Ordering, Referring, Prescribing	N/A	1972768612	0	0	TESTO, KRISTIN LMFT	12/29/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77144	N/A	N/A	N/A	N/A	N/A	12966 EUCLID ST	SUITE 280	GARDEN GROVE	CA	92840	9202	00	06000	33.77455935	-117.9378298	Orange County
354066	Ordering, Referring, Prescribing	N/A	1972897999	0	0	TEAL, JOHN M MD	8/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A156807	N/A	N/A	N/A	N/A	N/A	592 RIO LINDO AVE	None	CHICO	CA	95926	1817	00	06000	39.75427022	-121.8482553	Butte County
354082	Ordering, Referring, Prescribing	N/A	1972920312	0	0	TANG, ERIC C MD	7/18/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A137980	N/A	N/A	N/A	N/A	N/A	2525 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78246242	-122.4448129	San Francisco County
354092	Ordering, Referring, Prescribing	N/A	1972928810	0	0	TAPPON, WENDY E LMFT	9/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	96874	N/A	N/A	N/A	N/A	N/A	2255 CHALLENGER WAY	107	SANTA ROSA	CA	95407	5423	00	06000	38.424924	-122.7512565	Sonoma County
354093	Ordering, Referring, Prescribing	N/A	1972936961	0	0	TURI, VERA I	5/5/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D47672	N/A	N/A	N/A	N/A	N/A	8932 WOODMAN AVE	None	ARLETA	CA	91331	8021	00	06000	34.23207547	-118.4379725	Los Angeles County
354095	Ordering, Referring, Prescribing	N/A	1972931087	0	0	TRAN, TOAN K	6/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH70045	N/A	N/A	N/A	N/A	N/A	12001 EUCLID ST.	None	GARDEN GROVE	CA	92840	3332	00	06000	33.78758768	-117.941271	Orange County
354124	Ordering, Referring, Prescribing	N/A	1972966703	0	0	TO, SIMON PHARMD	9/24/2018	Taxonomy not applicable	NA	n/a	000	Unknown	74589	N/A	N/A	N/A	N/A	N/A	989 AVENIDA PICO	None	SAN CLEMENTE	CA	92673	3908	00	06000	33.45544491	-117.6024147	Orange County
354135	Ordering, Referring, Prescribing	N/A	1972972396	0	0	THANNICKAL, BINCY R	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60683	N/A	N/A	N/A	N/A	N/A	17010 CHATSWORTH ST	None	GRANADA HILLS	CA	91344	5844	00	06000	34.26477352	-118.503045	Los Angeles County
354144	Ordering, Referring, Prescribing	N/A	1972990208	0	0	THOMAS, HILLARY LPCC	5/24/2020	Taxonomy not applicable	NA	n/a	000	Unknown	6465	N/A	N/A	N/A	N/A	N/A	12810 HEACOCK ST	B-202	MORENO VALLEY	CA	92553	2854	00	06000	33.934851	-117.2437635	Riverside County
354157	Ordering, Referring, Prescribing	N/A	1982007787	0	0	TINSLY, ALEJANDRO I NP	4/30/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	19832	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	100	VENTURA	CA	93004	1378	00	06000	34.29321532	-119.1597424	Ventura County
354164	Ordering, Referring, Prescribing	N/A	1982026613	0	0	TANG, JIM R LCSW	10/12/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW104671	N/A	N/A	N/A	N/A	N/A	15305 RAYEN ST	None	NORTH HILLS	CA	91343	5117	00	06000	34.23191048	-118.4657625	Los Angeles County
354184	Ordering, Referring, Prescribing	N/A	1982060836	0	0	TERZIAN, MARIANNA PA-C	1/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA59056	N/A	N/A	N/A	N/A	N/A	1311 N SAN FERNANDO BLVD	None	BURBANK	CA	91504	4236	00	06000	34.18947282	-118.3206362	Los Angeles County
354197	Ordering, Referring, Prescribing	N/A	1982074852	0	0	TOLENTINO, ELEANOR A PHARMD	4/11/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH62286	N/A	N/A	N/A	N/A	N/A	7251 CAMINO ARROYO	None	GILROY	CA	95020	7340	00	06000	37.00917535	-121.5548666	Santa Clara County
354218	Ordering, Referring, Prescribing	N/A	1982120499	0	0	TOLEDO, TEREZA LCSW	6/21/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	102091	N/A	N/A	N/A	N/A	N/A	2629 CLARENDON AVE	2ND FLOOR	HUNTINGTON PARK	CA	90255	4119	00	06000	33.98356476	-118.2241387	Los Angeles County
354220	Ordering, Referring, Prescribing	N/A	1982121968	0	0	TURNER, JAZMIN A LMFT	10/4/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT135054	N/A	N/A	N/A	N/A	N/A	3300 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3137	00	06000	35.37353416	-119.0392409	Kern County
354252	Ordering, Referring, Prescribing	N/A	1982169827	0	0	TAN, STELLA LCSW	7/29/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	124653	N/A	N/A	N/A	N/A	N/A	1950 MARKET ST	None	RIVERSIDE	CA	92501	3691	00	06000	34.00316496	-117.3767967	Riverside County
354260	Ordering, Referring, Prescribing	N/A	1982185336	0	0	TORRES, CLAUDIA M LMFT	3/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116251	N/A	N/A	N/A	N/A	N/A	6301 BEACH BLVD	SUITE 245	BUENA PARK	CA	90621	2840	00	06000	33.86880928	-117.9983013	Orange County
354275	Ordering, Referring, Prescribing	N/A	1982201430	0	0	TOROSSIAN, ANTHONY V PHARMD	2/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83045	N/A	N/A	N/A	N/A	N/A	2110 TRUXTUN AVE	SUITE 400	BAKERSFIELD	CA	93301	3703	00	06000	35.37344851	-119.0261655	Kern County
354286	Ordering, Referring, Prescribing	N/A	1982225843	0	0	TRAN, DANG MD	10/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A199532	N/A	N/A	N/A	N/A	N/A	3400 DOUGLAS BLVD.	STE. 170	ROSEVILLE	CA	95661	4278	00	06000	38.74390969	-121.2319271	Placer County
354302	Ordering, Referring, Prescribing	N/A	1982242590	0	0	TRAN, AMY PHARMD	1/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81023	N/A	N/A	N/A	N/A	N/A	481 OLD MAMMOTH RD	None	MAMMOTH LAKES	CA	93546	0142	00	06000	37.63851578	-118.9666226	Mono County
354351	Ordering, Referring, Prescribing	N/A	1982479556	0	0	TANOUS, CHRISTINE NP	10/3/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027517	N/A	N/A	N/A	N/A	N/A	901 OAK PARK BLVD	STE 101	PISMO BEACH	CA	93449	3409	00	06000	35.13460775	-120.6050814	San Luis Obispo County
354381	Ordering, Referring, Prescribing	N/A	1982727715	0	0	TORDILLA, NELSON E	11/17/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D46700	N/A	N/A	N/A	N/A	N/A	1830 COMMERCIAL WAY	None	SANTA CRUZ	CA	95065	1819	00	06000	36.98837145	-121.9802206	Santa Cruz County
354409	Ordering, Referring, Prescribing	N/A	1982766382	0	0	TAN, TERENCE T MD	10/25/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A47880	N/A	N/A	N/A	N/A	N/A	3301 BEECHWOOD AVE	None	LYNWOOD	CA	90262	3301	00	06000	33.92961073	-118.2111703	Los Angeles County
354427	Ordering, Referring, Prescribing	N/A	1982814349	0	0	TIEU, PHUNG G PSYD	6/30/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26928	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVENUE	SUITE 300	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
354442	Ordering, Referring, Prescribing	N/A	1982838223	0	0	TRENTZ, CHRISTINA LMFT	8/12/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52372	N/A	N/A	N/A	N/A	N/A	1400 W STANFORD RANCH RD	None	ROCKLIN	CA	95765	3750	00	06000	38.81536853	-121.2856121	Placer County
354464	Ordering, Referring, Prescribing	N/A	1982882890	0	0	TIBBS, ROSEANN CNM	8/10/2015	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	319497	N/A	N/A	N/A	N/A	N/A	1152 E GRAND AVE	None	ARROYO GRANDE	CA	93420	2583	00	06000	35.11993829	-120.5977282	San Luis Obispo County
354473	Ordering, Referring, Prescribing	N/A	1982904280	0	0	TRAN, NGOC B	3/28/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58243	N/A	N/A	N/A	N/A	N/A	1201 AVOCADO AVE	None	EL CAJON	CA	92020	7704	00	06000	32.778864	-116.9579805	San Diego County
354475	Ordering, Referring, Prescribing	N/A	1982886743	0	0	THOMPSON, GIANNA L	2/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53105	N/A	N/A	N/A	N/A	N/A	2751 NAPA VALLEY CORPORA	211	NAPA	CA	94558	6216	00	06000	38.24829023	-122.2745626	Napa County
354498	Ordering, Referring, Prescribing	N/A	1982924718	0	0	TEHRANI, BENYAMIN S PHARMD	9/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58058	N/A	N/A	N/A	N/A	N/A	11980 SAN VICENTE BOULEV	STE 104	LOS ANGELES	CA	90049	6602	00	06000	34.05221538	-118.4721745	Los Angeles County
354511	Ordering, Referring, Prescribing	N/A	1982973582	0	0	TAVEROS, MEL R MD	2/21/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A139158	N/A	N/A	N/A	N/A	N/A	1500 6TH AVENUE	None	DELANO	CA	93215	3011	00	06000	35.76504054	-119.236779	Kern County
354515	Ordering, Referring, Prescribing	N/A	1982975553	0	0	TUMEH, YARA	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60872	N/A	N/A	N/A	N/A	N/A	3001 FOOTHIL BLVD	1606	LA CRESCENTA	CA	91214	2714	00	06000	34.22747229	-118.2452305	Los Angeles County
354528	Ordering, Referring, Prescribing	N/A	1982983581	0	0	TAM, REBECCA PHARMD	12/15/2020	Taxonomy not applicable	NA	n/a	000	Unknown	52331	N/A	N/A	N/A	N/A	N/A	13847 E 14TH ST	SUITE 103	SAN LEANDRO	CA	94578	2632	00	06000	37.71457844	-122.1418551	Alameda County
354533	Ordering, Referring, Prescribing	N/A	1982990354	0	0	TRAN, TIEN N PHARMD	3/20/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH50970	N/A	N/A	N/A	N/A	N/A	2851 DEL PASO RD	None	SACRAMENTO	CA	95835	2304	00	06000	38.657124	-121.5246015	Sacramento County
354537	Ordering, Referring, Prescribing	N/A	1992005490	0	0	TOOMEY, PETE S	11/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	41646	N/A	N/A	N/A	N/A	N/A	262 N EL CAMINO REAL	None	ENCINITAS	CA	92024	9001	00	06000	33.05214504	-117.2611506	San Diego County
354552	Ordering, Referring, Prescribing	N/A	1992013544	0	0	THIGPEN, DIANN D LCSW	12/17/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LCSW85196	N/A	N/A	N/A	N/A	N/A	21101 DALES EVANS PARKWA	None	APPLE VALLEY	CA	92307	9356	00	06000	34.636896	-117.2026665	San Bernardino County
354559	Ordering, Referring, Prescribing	N/A	1992052138	0	0	THOMAES, SUSAN P LCSW	1/14/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99275	N/A	N/A	N/A	N/A	N/A	1430 WILLOW PASS RD	None	CONCORD	CA	94520	7928	00	06000	37.97055112	-122.0492933	Contra Costa County
354570	Ordering, Referring, Prescribing	N/A	1992068332	0	0	TEIXEIRA, JANE	1/3/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT97192	N/A	N/A	N/A	N/A	N/A	1382 BLUE OAKS BLVD	STE 213	ROSEVILLE	CA	95678	7019	00	06000	38.79554586	-121.3118864	Placer County
354590	Ordering, Referring, Prescribing	N/A	1992087126	0	0	TRIPLETT, CAROL I LCSW	3/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW80418	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	SUITE 200	ANAHEIM	CA	92806	5159	00	06000	33.81812448	-117.8880075	Orange County
354611	Ordering, Referring, Prescribing	N/A	1992117949	0	0	TABANGCURA, ANN LMFT	7/28/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109008	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
354650	Ordering, Referring, Prescribing	N/A	1992183008	0	0	TYAGI, VINEET MD	1/13/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166436	N/A	N/A	N/A	N/A	N/A	2350 E ALLUVIAL AVE	None	FRESNO	CA	93720	0478	00	06000	36.8448055	-119.741058	Fresno County
354652	Ordering, Referring, Prescribing	N/A	1992184535	0	0	TOHIDIAN, NILOUFAR B LMFT	12/9/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86065	N/A	N/A	N/A	N/A	N/A	410 GODDARD	None	IRVINE	CA	92618	4610	00	06000	33.6324555	-117.7401004	Orange County
354666	Ordering, Referring, Prescribing	N/A	1992209134	0	0	TOM, WESTIN R MD	1/29/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166502	N/A	N/A	N/A	N/A	N/A	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
354713	Ordering, Referring, Prescribing	N/A	1992310353	0	0	TAN, TINA Y PHARMD	9/11/2020	Taxonomy not applicable	NA	n/a	000	Unknown	83138	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRY BLVD	None	JACKSON	CA	95642	9373	00	06000	38.36981229	-120.8002806	Amador County
354726	Ordering, Referring, Prescribing	N/A	1992334957	0	0	TRAN, NICHOLAS MD	3/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL5374	N/A	N/A	N/A	N/A	N/A	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
354729	Ordering, Referring, Prescribing	N/A	1992338271	0	0	TURNER, JERRY PSYD	3/4/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	2966	N/A	N/A	N/A	N/A	N/A	1425 W FOOTHILL BLVD	None	UPLAND	CA	91786	3637	00	06000	34.10713879	-117.676213	San Bernardino County
354732	Ordering, Referring, Prescribing	N/A	1992347942	0	0	TRAN, KARRAH PHARMD	4/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	81116	N/A	N/A	N/A	N/A	N/A	4605 MORENA BLVD	None	SAN DIEGO	CA	92117	3650	00	06000	32.82186082	-117.2264619	San Diego County
354779	Ordering, Referring, Prescribing	N/A	1992451736	0	0	TRAN, THUC LINH PHARMD	3/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH85941	N/A	N/A	N/A	N/A	N/A	51 WELLNESS WAY	None	VALLEY SPRINGS	CA	95252	9736	00	06000	38.168667	-120.840039	Calaveras County
354781	Ordering, Referring, Prescribing	N/A	1992455109	0	0	TRACY, HAYLEE PA-C	5/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61147	N/A	N/A	N/A	N/A	N/A	1150 E LERDO HWY	None	SHAFTER	CA	93263	9419	00	06000	35.49996992	-119.2613936	Kern County
354782	Ordering, Referring, Prescribing	N/A	1992450829	0	0	TAGLE, HANNA NP	7/18/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017801	N/A	N/A	N/A	N/A	N/A	38440 5TH ST W	None	PALMDALE	CA	93551	4498	00	06000	34.58068723	-118.1384686	Los Angeles County
354784	Ordering, Referring, Prescribing	N/A	1992455216	0	0	TAROIAN, CHRISTOPHER Z LCSW	3/12/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW129176	N/A	N/A	N/A	N/A	N/A	1200 WILSHIRE BLVD.	200	LOS ANGELES	CA	90017	1930	00	06000	34.05307427	-118.2651099	Los Angeles County
354796	Ordering, Referring, Prescribing	N/A	1992530885	0	0	TAPPER, KAREN D OT	5/21/2024	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	26472	N/A	N/A	N/A	N/A	N/A	522 S. SAN PEDRO STREET	None	LOS ANGELES	CA	90013	2101	00	06000	34.0436196	-118.2442541	Los Angeles County
354797	Ordering, Referring, Prescribing	N/A	1992533749	0	0	TRAN, NGOC HAN PA	7/30/2024	Taxonomy not applicable	NA	n/a	000	Unknown	64873	N/A	N/A	N/A	N/A	N/A	1510 CAPITOLA RD	None	SANTA CRUZ	CA	95062	2912	00	06000	36.97627773	-121.9846375	Santa Cruz County
354805	Ordering, Referring, Prescribing	N/A	1992734701	0	0	TRAUGHBER, CHRISTOPHER MD	7/19/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G42264	N/A	N/A	N/A	N/A	N/A	1647 W ANAHEIM ST	None	HARBOR CITY	CA	90710	3213	00	06000	33.78621735	-118.3058946	Los Angeles County
354815	Ordering, Referring, Prescribing	N/A	1992760573	0	0	THOMAS, CHERYL A MD	12/2/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G66547	N/A	N/A	N/A	N/A	N/A	27725 SANTA MARGARITA PK	101	MISSION VIEJO	CA	92691	6706	00	06000	33.65386492	-117.6476716	Orange County
354854	Ordering, Referring, Prescribing	N/A	1992851570	0	0	TERRY, CAREY R MD	2/28/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A125631	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3314	00	06000	38.62729851	-122.8637785	Sonoma County
354862	Ordering, Referring, Prescribing	N/A	1992866628	0	0	TEJADA, VICKY A LCSW	12/15/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW25314	N/A	N/A	N/A	N/A	N/A	140 MAYHEW WAY	300	PLEASANT HILL	CA	94523	4328	00	06000	37.93664097	-122.0572179	Contra Costa County
354870	Ordering, Referring, Prescribing	N/A	1992874093	0	0	TSE, YUCHAI LCSW	11/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25538	N/A	N/A	N/A	N/A	N/A	17707 STUDEBAKER RD	None	CERRITOS	CA	90703	2640	00	06000	33.87008991	-118.0991298	Los Angeles County
354881	Ordering, Referring, Prescribing	N/A	1992897375	0	0	THAI, THIEN A PHARMD	2/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55162	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	362	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
354901	Ordering, Referring, Prescribing	N/A	1992950844	0	0	TEKESTE, MINA K NP	6/11/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	683650	N/A	N/A	N/A	N/A	N/A	1442 ETHAN WAY	None	SACRAMENTO	CA	95825	2232	00	06000	38.592126	-121.4190765	Sacramento County
354904	Ordering, Referring, Prescribing	N/A	1992958441	0	0	TEVIS, DAYNA L LMFT	10/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	45292	N/A	N/A	N/A	N/A	N/A	11800 CENTRAL AVE	225	CHINO	CA	91710	7200	00	06000	34.0388092	-117.689654	San Bernardino County
354912	Ordering, Referring, Prescribing	N/A	1992968648	0	0	TAKAYAMA, CHRISTIAN M MD	9/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A111163	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
354914	Ordering, Referring, Prescribing	N/A	1992963961	0	0	TARASOFF, GREGORY J MD	8/26/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A60464	N/A	N/A	N/A	N/A	N/A	1500 FRANKLIN ST	None	SAN FRANCISCO	CA	94109	4523	00	06000	37.78847503	-122.4235955	San Francisco County