Table family_pact_providers_profile_cy

Table: family_pact_providers_profile_cy_2019 , provider_business_legal_name like D*

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 *

provider_number	npi_provider_number	owner_number	service_location_number	provider_business_legal_name	enrollment_status_effective_date	provider_type_code	provider_type_code_desc	provider_license_number	provider_specialty_code	provider_specialty_code_desc	out_of_state_ind_desc	provider_address_county_code	provider_address_county_code_description	attention_line	provider_address_line1	provider_address_line2	provider_address_city	provider_address_state	provider_address_zip	provider_address_latitude	provider_address_longitude	mssa_id	tract_id
1043217359	1043217359	1	1	DANG, ALAN MD	14-Mar-13	Physicians (026)	PHYSICIANS	A82876	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	30	Orange	None	2621 S BRISTOL ST	STE 300	SANTA ANA	CA	92704	33.712311	-117.885379	116g	740.05
1104856095	1104856095	1	1	DESERT REGIONAL MEDICAL	31-May-97	Community Hosp Outpatient (015)	COMMUNITY OUTPATIENT HOSPITAL	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	CENTER INC	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	33.838898	-116.545608	129.4	446.06
1184065088	1184065088	1	1	DESERT HOT SPRINGS HEALTH	2-Jan-15	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	FOUNDATION	11750 CHOLLA DRIVE	SUITE B	DESERT HOT SPRING	CA	92240	33.963253	-116.514526	129.4	445.09
1255738423	1255738423	1	1	DEL ROSARIO, GELEN R MD INC	29-Jan-18	Physicians (026)	PHYSICIANS	A113471	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	37	San Diego	None	502 SOUTH EUCLID AVE	SUITE 300	NATIONAL CITY	CA	91950	32.685307	-117.083365	161g	220
1275030009	1275030009	1	1	DR.PAKOUR MEDICAL GROUP	24-Jul-18	Physicians (026)	PHYSICIANS	None	8	Family Practice	In state provider	19	Los Angeles	None	3671 W 6TH ST.	STE.B	LOS ANGELES	CA	90020	34.063571	-118.302245	78.2e	2118.02
1275849283	1275849283	1	1	DESERT HOT SPRINGS COMMUNITY	30-Jan-14	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	FOUNDATION	66675 PIERSON BLVD	None	DESERT HOT SPRING	CA	92240	33.961413	-116.498025	129.4	445.1
1316038169	1316038169	1	2	DARDASHTI, MALIHE MD	18-Aug-99	Physicians (026)	PHYSICIANS	A00041092	1	General Practice	In state provider	19	Los Angeles	SAN PEDRO ADAMS MEDICAL	2530 S SAN PEDRO ST	None	LOS ANGELES	CA	90011	34.021969	-118.261057	78.2mmm	2264.1
1336163898	1336163898	1	1	DOCTORS' OFF/FAIR OAKS	1-Nov-05	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	40	San Luis Obispo	DOCTORS' OFF/FAIR OAKS	1057 E GRAND AVE	None	ARROYO GRANDE	CA	93420	35.118989	-120.595087	171	119.02
1346226693	1346226693	1	1	DIVIDE WELLNESS CENTER	27-May-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	9	El Dorado	None	6065 HIGHWAY 193	None	GEORGETOWN	CA	95634	38.908043	-120.851714	22	306.02
1346244050	1346244050	1	1	DAMEN, AYMAN G MD	26-Mar-97	Physicians (026)	PHYSICIANS	A00048085	1	General Practice	In state provider	34	Sacramento	None	220 MARKET ST	None	GALT	CA	95632	38.253981	-121.299666	136	95.04
1376674770	1376674770	1	1	DR OCHOA FAMILY CLINIC	12-Aug-08	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	10	Fresno	None	3275 MCCALL AVE	STE 102	SELMA	CA	93662	36.582589	-119.610629	30	70.04
1376893420	1376893420	1	1	DUNSMUIR COMMUNITY HEALTH	27-Dec-17	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	47	Siskiyou	INC	4309 STAGECOACH ROAD	None	DUNSMUIR	CA	96025	41.222461	-122.278075	198	11
1386069995	1386069995	1	1	DESERT OASIS WOMENS HEALTH	19-May-16	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	FOUNDATION	1180 N INDIAN CANYON DR	SUITE W-300	PALM SPRINGS	CA	92262	33.839669	-116.545605	129.4	446.06
1386689453	1386689453	1	1	DIEGO, LORAINE V MD INC	16-Oct-01	Physicians (026)	PHYSICIANS	A67445	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	2405 W 8TH ST	STE 105	LOS ANGELES	CA	90057	34.056301	-118.281071	78.2b	2094.01
1417365545	1417365545	1	1	DORNIKA MEDICAL INC	16-Sep-15	Physicians (026)	PHYSICIANS	A76326	1	General Practice	In state provider	19	Los Angeles	None	2121 S SAN PEDRO ST	UNIT E	LOS ANGELES	CA	90011	34.0253	-118.258932	78.2mmm	2264.1
1467762294	1467762294	1	1	DUONG, LT MD INC	23-Feb-11	Physicians (026)	PHYSICIANS	A00074045	8	Family Practice	In state provider	30	Orange	None	2708 WESTMINSTER AVENUE	STE 130	SANTA ANA	CA	92706	33.759815	-117.905808	116i	891.04
1497840656	1497840656	1	1	DEL NORTE COMM HLTH CTR	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	8	Del Norte	DEL NORTE COMM HLTH CTR	550 E WASHINGTON BLVD	STE 100	CRESCENT CITY	CA	95531	41.772734	-124.198201	19	1.04
1508222647	1508222647	1	1	DIGNITY HEALTH MEDICAL GROUP	12-Feb-18	Physicians Group (022)	PHYSICIANS GROUP	None	1	General Practice	In state provider	19	Los Angeles	FOUNDATION	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	34.220741	-118.534065	78.2zz	1314
1578685137	1578685137	1	1	DIXON FAMILY PRACTICE	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	48	Solano	HLTH CTRS/DIXON FAMILY	131 W A ST	STE 1	DIXON	CA	95620	38.445522	-121.822871	201	2534.02
1588171383	1588171383	1	1	DINUBA COMMUNITY HEALTH CENT	19-Mar-19	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	54	Tulare	None	888 N ALTA AVE	None	DINUBA	CA	93618	36.551597	-119.395011	227.1	4.02
1629296447	1629296447	1	1	DAVIS COMMUNITY CLINIC	24-Aug-04	Health Access Program (058)	HEALTH ACCESS PROGRAM	30000146	99	Unknown (on EDS claims)	In state provider	57	Yolo	None	2051 JOHN JONES RD	None	DAVIS	CA	95616	38.561423	-121.770387	244	105.05
1639207343	1639207343	1	1	DELANO REGIONAL MED CNTR	19-Jul-11	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	15	Kern	FOUNDATION FOR HEALTH	2300 7TH ST	None	WASCO	CA	93280	35.594264	-119.351512	58.2	44.01
1659335701	1659335701	1	1	DELAROSA, JOSE L MD	28-Apr-97	Physicians (026)	PHYSICIANS	A00043518	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	16415 COLORADO AVE	STE 103	PARAMOUNT	CA	90723	33.88528	-118.161428	78.2m	5538.02
1659419307	1659419307	1	1	DEL ROSARIO MEDICAL	28-Apr-97	Physicians Group (022)	PHYSICIANS GROUP	FNP017692	1	General Practice	In state provider	19	Los Angeles	CLINIC, INC	3400 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	33.97223	-118.205979	78.2ccc	5332.03
1760756860	1760756860	1	1	DR JAMIE A LIPELES APMC	29-Mar-12	Physicians (026)	PHYSICIANS	20A10501	9	Gynecology (D.O. only)	In state provider	19	Los Angeles	None	4560 ADMIRALTY WAY	STE 105	MARINA DEL REY	CA	90292	33.983132	-118.442606	78.2j	7029.01
1780038042	1780038042	1	1	D STREET MEDICAL CENTER	13-Sep-18	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	36	San Bernardino	FOUNDATION	590 NORTH D STREET	None	SAN BERNARDINO	CA	92401	34.109961	-117.291883	151g	57.01
1831513373	1831513373	1	1	DTFHC AT CONNECTIONS	23-Jun-14	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	None	1250 6TH AVE	STE 100	SAN DIEGO	CA	92101	32.71831	-117.159277	161c	53
1851429658	1851429658	1	1	DELANO WOMAN'S CLINIC	23-Dec-03	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	15	Kern	FOUNDATION FOR HEALTH	1201 JEFFERSON ST	None	DELANO	CA	93215	35.771809	-119.244929	60	50.04
1891097176	1891097176	1	1	DR VERONICA ABUSLEME MD INC	6-Jan-12	Physicians (026)	PHYSICIANS	A00038422	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	14621 NORDHOFF ST	STE 2A	PANORAMA CITY	CA	91402	34.235408	-118.451136	78.2ll	1193.4
1912176264	1912176264	1	2	DR M FORGHANI, S CORP	2-Jul-09	Physicians (026)	PHYSICIANS	20A8699	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	30	Orange	None	1515 N BROADWAY	None	SANTA ANA	CA	92706	33.758019	-117.869651	116b	750.03
1972614758	1972614758	1	1	DO, THUTRANG DO	29-May-07	Physicians (026)	PHYSICIANS	20A8885	41	Internal Medicine	In state provider	19	Los Angeles	DO MEDICAL, INC	15735 HAWTHORNE BLVD	STE 111	LAWNDALE	CA	90260	33.888154	-118.352692	78.2t	6039
1972752368	1972752368	1	1	DE NOVO HEALTH CARE	1-Apr-19	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	803 ROSECRANS AVE	None	E RANCHO DOMINGUE	CA	90221	33.903457	-118.215352	78.2bbb	5416.04
1972828085	1972828085	1	1	DURFEE FAMILY CARE MEDICAL	1-Jan-12	Physicians (026)	PHYSICIANS	A453810	8	Family Practice	In state provider	19	Los Angeles	GROUP, APC	2006 DURFEE AVE	None	EL MONTE	CA	91733	34.045825	-118.02981	78.2oo	4339.02