Table family_pact_providers_profile_cy

Table: family_pact_providers_profile_cy_2019 , provider_business_legal_name like G*

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
1003955519	1003955519	1	1	GARCIA-NIQUE, LUIS O MD	6-May-99	Physicians (026)	PHYSICIANS	A00033647	0	General Practioner (Dentists Only)	In state provider	30	Orange	None	3010 W ORANGE AVE	STE 202	ANAHEIM	CA	92804	33.82475	-117.993763	116c	869.02
1033240650	1033240650	1	1	GALDAMEZ, LUIS A MD INC	20-Nov-06	Physicians Group (022)	PHYSICIANS GROUP	FNP020761	2	General Surgery	In state provider	19	Los Angeles	CLINICA MEDICA VIRGEN DE	6831 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	33.97748	-118.222551	78.2fff	5331.04
1043423205	1043423205	1	1	GOLDEN VALLEY HEALTH C	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	GUSTINE-NEWMAN	637 MERCED ST	None	NEWMAN	CA	95360	37.314626	-121.016781	213	35
1083619753	1083619753	1	1	GOMEZ, HAROLD A	21-Oct-99	Certified Pediatric/Family NP (007)	CERTIFIED NURSE PRACTIONER	RN0487974	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	1220 S GLENDORA AVENUE	None	WEST COVINA	CA	91790	34.055234	-117.938703	78.2www	4067.01
1114220357	1114220357	1	1	GLORIA NELSON CENTER FOR	27-Apr-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	15	Kern	HOSPITAL DISTRICT	1500 6TH AVENUE	None	DELANO	CA	93215	35.764977	-119.237689	60	50.03
1124204292	1124204292	1	1	GOLDEN VALLEY HEALTH CTR	9-Jul-07	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	2760 3RD ST	None	CERES	CA	95307	37.591963	-120.954519	214	26.02
1144358748	1144358748	1	1	GARDNER SO CO HEALTH CTR	14-Dec-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	43	Santa Clara	GARDNER SO CO HEALTH CTR	7526 MONTEREY ST	None	GILROY	CA	95020	37.008533	-121.56939	182	5126.03
1194048884	1194048884	1	1	GENESIS CLINICA DE LA MUJER	18-Oct-11	Physicians (026)	PHYSICIANS	G75190	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	43	Santa Clara	INC	244 N JACKSON AVE	STE 209	SAN JOSE	CA	95116	37.364025	-121.848918	183b	5037.12
1215351705	1215351705	1	1	GOLETA NEIGHBORHOOD CLINIC	4-Jun-14	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	42	Santa Barbara	CLINICS	334 S PATTERSON AVE	SUITE 203	GOLETA	CA	93111	34.434188	-119.809268	181a	30.01
1225168024	1225168024	1	1	GALDAMEZ, LUIS A MD INC	29-May-97	Physicians Group (022)	PHYSICIANS GROUP	FNP020761	1	General Practice	In state provider	19	Los Angeles	CLINICA MEDICA VIRGEN DE	2955 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	33.973308	-118.216415	78.2ccc	5331.07
1235342981	1235342981	1	1	GOLDEN VALLEY HEALTH CTR	1-Feb-06	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	PO BOX 7	301 HOWARD RD	None	WESTLEY	CA	95387	37.55006	-121.202124	213	33
1245420660	1245420660	1	1	GEORGE L MEE MEM HOSP	3-Nov-99	Community Hosp Outpatient (015)	COMMUNITY OUTPATIENT HOSPITAL	270700777	99	Unknown (on EDS claims)	In state provider	27	Monterey	None	300 CANAL ST	None	KING CITY	CA	93930	36.207089	-121.132356	105	113.04
1255849238	1255849238	1	1	GOLDEN CARE MEDICAL GROUP	28-Feb-19	Physicians Group (022)	PHYSICIANS GROUP	None	1	General Practice	In state provider	19	Los Angeles	INC APMC	6330 VAN NUYS BLVD	None	VAN NUYS	CA	91401	34.185673	-118.448715	78.2cc	1283.03
1275753071	1275753071	1	1	GOLDEN VALLEY HEALTH CTR	18-Nov-05	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	24	Merced	None	401 LESHER DR	None	MERCED	CA	95341	37.293741	-120.504168	97.2	15.03
1285658690	1285658690	1	1	GUMBS, JOSLYN MD OB/GYN	22-Nov-13	Physicians (026)	PHYSICIANS	A00087245	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	5255 W SUNSET BLVD	None	LOS ANGELES	CA	90027	34.098107	-118.304455	78.2g	1911.1
1285795773	1285795773	2	1	GOOD SAMARITAN MEDICAL	21-Jan-05	Physicians (026)	PHYSICIANS	None	8	Family Practice	In state provider	30	Orange	CLINIC INC	801 N HARBOR BLVD	None	ANAHEIM	CA	92805	33.842956	-117.922468	116l	866.02
1316150576	1316150576	1	1	GOLDEN VALLEY HEALTH C	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	24	Merced	WOMEN'S HEALTH	797 W CHILDS AVE	None	MERCED	CA	95340	37.288207	-120.496348	97.2	15.03
1316162829	1316162829	1	1	GOLDEN VALLEY HEALTH C	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	24	Merced	None	847 W CHILDS AVE	None	MERCED	CA	95341	37.288202	-120.497174	97.2	16.02
1316393010	1316393010	1	1	GOLDEN VALLEY HEALTH CENTER	1-May-18	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	1920 MEMORIAL DRIVE	None	CERES	CA	95307	37.600357	-120.961059	215c	26.04
1396960563	1396960563	1	1	GARDN GRV WMS HLTH SPEC	27-Apr-01	Physicians (026)	PHYSICIANS	20A7161	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	30	Orange	None	12555 GARDEN GROVE BLVD	STE 301	GARDEN GROVE	CA	92843	33.774488	-117.914305	116r	885.02
1407941586	1407941586	1	1	GANDHI, SHOBHANA MD INC	23-Apr-04	Physicians Group (022)	PHYSICIANS GROUP	A00029540	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	1300 N VERMONT AVE	SUITE 307	LOS ANGELES	CA	90027	34.095557	-118.291741	78.2g	1913.02
1407985534	1407985534	2	1	GARDNER HEALTH CENTER	21-Feb-11	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	43	Santa Clara	NETWORK, INC	195 E VIRGINIA ST	None	SAN JOSE	CA	95112	37.325925	-121.877594	183d	5016
1467672253	1467672253	1	1	GOLDEN VALLEY HEALTH CTR	18-Nov-05	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	24	Merced	None	13161 JEFFERSON ST	None	LE GRAND	CA	95333	37.230464	-120.249626	97.3	19.02
1477610640	1477610640	1	1	GLENDALE MEMORIAL HOSPITAL	3-Jul-01	Community Hosp Outpatient (015)	COMMUNITY OUTPATIENT HOSPITAL	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	34.128432	-118.2578	78.2ee	3024.01
1518187319	1518187319	1	1	GOLDEN VALLEY HLTH CTR	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	24	Merced	LOS BANOS	821 TEXAS AVE	None	LOS BANOS	CA	93635	37.064774	-120.860329	94	22.01
1528350014	1528350014	1	1	GALACARE MEDICAL CLINIC	1-Mar-11	Physicians (026)	PHYSICIANS	A00051997	8	Family Practice	In state provider	19	Los Angeles	None	1410 W. ALONDRA BLVD.	SUITE C	COMPTON	CA	90220	33.888421	-118.244562	78.2uuu	5431
1548568421	1548568421	1	1	GOLDEN VALLEY HEALTH CENTER	22-Jun-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	4150 PATTERSON ROAD	None	RIVERBANK	CA	95367	37.732634	-120.919841	211	4.02
1598984288	1598984288	1	1	GUADALAJARA MED CLIN INC	8-Jun-05	Physicians Group (022)	PHYSICIANS GROUP	FNP030498	0	General Practioner (Dentists Only)	In state provider	19	Los Angeles	GUADALAJARA MED CLIN INC	2705 WHITTIER BLVD	None	LOS ANGELES	CA	90023	34.032548	-118.211588	78.2h	2047
1609026285	1609026285	1	1	GARLAND COMMUNITY HEALTH	15-Oct-08	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	10	Fresno	None	3727 N FIRST ST	STE 106	FRESNO	CA	93726	36.78559	-119.772713	35c	51
1639283674	1639283674	1	1	GUPTA, PARUL MD	17-Sep-09	Physicians (026)	PHYSICIANS	A67050	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	54	Tulare	None	858 N CHERRY ST	STE F	TULARE	CA	93274	36.222084	-119.337643	230	23.03
1649292715	1649292715	1	1	GALSTYAN, KEVIN G MD INC	20-Jun-07	Physicians (026)	PHYSICIANS	A00087568	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	34.128432	-118.2578	78.2ee	3024.01
1649386707	1649386707	1	1	GUPTA, PRAVEEN B MD	28-Apr-97	Physicians (026)	PHYSICIANS	A00025680	0	General Practioner (Dentists Only)	In state provider	19	Los Angeles	None	9435 VENICE BLVD	None	CULVER CITY	CA	90232	34.025348	-118.395423	78.2y	2701
1669685467	1669685467	1	1	GOLDEN VALLEY HEALTH CTR	18-Nov-05	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	1130 6TH ST	None	MODESTO	CA	95354	37.638904	-121.005583	215c	17
1699041566	1699041566	1	1	GARDNER DOWNTOWN HEALTH CNTR	18-May-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	43	Santa Clara	NETWORK INC	725 E SANTA CLARA ST	None	SAN JOSE	CA	95112	37.343203	-121.875735	183d	5013
1700915097	1700915097	1	1	GARDNER FMLY HLTH NTWRK	14-Dec-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	43	Santa Clara	None	55 E JULIAN STREET	None	SAN JOSE	CA	95112	37.341105	-121.892644	183d	5010
1730254988	1730254988	1	1	GEDDES, PETER G MD	1-Jan-98	Physicians (026)	PHYSICIANS	G39881	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	30	Orange	None	705 W LA VETA AVE	STE 115	ORANGE	CA	92868	33.78065	-117.860795	116h	760
1740299833	1740299833	2	1	GARVEY HEALTHY FAMILY	20-May-16	Physicians (026)	PHYSICIANS	A54127	1	General Practice	In state provider	19	Los Angeles	MEDICAL CLINIC INC	705 E GARVEY AVE	None	MONTEREY PARK	CA	91755	34.062637	-118.112845	78.2qqq	4817.12
1750434254	1750434254	1	1	GRUPO MEDICO FAMILIAR	28-Apr-97	Physicians Group (022)	PHYSICIANS GROUP	FNP034311	1	General Practice	In state provider	19	Los Angeles	SANTA FE INC	4070 E OLYMPIC BLVD	None	LOS ANGELES	CA	90023	34.018886	-118.186907	78.2d	5313.02
1750733176	1750733176	1	1	GARABEDYAN, TIGRAN DO INC	1-Jun-17	Physicians (026)	PHYSICIANS	20A11397	66	Emergency Medicine (Urgent Care)	In state provider	19	Los Angeles	None	13711 FOOTHILL BLVD	STE B	SYLMAR	CA	91342	34.308737	-118.431951	78.2gg	1061.14
1770703571	1770703571	1	1	GOLDEN VALLEY HEALTH C	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	24	Merced	DOS PALOS	1405 CALIFORNIA AVE	None	DOS PALOS	CA	93620	36.98748	-120.629074	94	24.02
1790100402	1790100402	1	1	GASTON MIDDLE SCHOOL HEALTH	8-Aug-16	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	10	Fresno	None	1120 EAST CHURCH AVENUE	None	FRESNO	CA	93706	36.714143	-119.79521	30	9.02
1790128536	1790128536	1	1	GREENFIELD COMMUNITY HEALTH	19-Aug-13	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	15	Kern	None	9001 SOUTH H STREET	None	BAKERSFIELD	CA	93307	35.274016	-119.021275	66c	32.02
1831188275	1831188275	1	1	GLENDALE ADVENTIST MED	21-Feb-01	Community Hosp Outpatient (015)	COMMUNITY OUTPATIENT HOSPITAL	91909003	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	CENTER	1509 WILSON TER	None	GLENDALE	CA	91206	34.149428	-118.231026	78.2ee	3010
1851465256	1851465256	1	1	GEORGIOU, STEPHEN J MD	27-Aug-12	Physicians (026)	PHYSICIANS	G00081674	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	24	Merced	None	807 ILLINOIS AVE	None	LOS BANOS	CA	93635	37.064419	-120.857751	94	22.01
1871779934	1871779934	1	1	GOLDEN VALLEY HEALTH CTR	9-Jul-07	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	1141 N OLIVE AVE	None	TURLOCK	CA	95380	37.503653	-120.839809	212.1	39.06
1891724993	1891724993	1	1	GHALILI, SAMAN MD	20-Nov-13	Physicians (026)	PHYSICIANS	A00088734	41	Internal Medicine	In state provider	19	Los Angeles	None	2101 S SAN PEDRO ST	None	LOS ANGELES	CA	90011	34.025797	-118.258617	78.2mmm	2264.1
1891839270	1891839270	1	1	GARDENS MEDICAL CENTER INC	15-Aug-12	Physicians Group (022)	PHYSICIANS GROUP	None	8	Family Practice	In state provider	19	Los Angeles	None	7218 GARFIELD AVE	None	BELL GARDENS	CA	90201	33.96621	-118.151108	78.2c	5339.02
1891904686	1891904686	1	1	GAGE MEDICAL CENTER	3-Jun-05	Physicians Group (022)	PHYSICIANS GROUP	FNP033884	40	Pediatrics, Periodontist (Dentists Only)	In state provider	19	Los Angeles	None	2719 E GAGE AVE	None	HUNTINGTON PARK	CA	90255	33.981669	-118.222164	78.2ccc	5326.06
1922249077	1922249077	1	1	GOLDEN VALLEY HEALTH CENTER	2-Jan-10	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	1200 W MAIN ST	None	TURLOCK	CA	95380	37.504718	-120.831871	212.1	39.07
1922297357	1922297357	1	1	GHAYOORI, RAMIN MD	2-Apr-14	Physicians (026)	PHYSICIANS	A00104182	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	34.193908	-118.461948	78.2cc	1278.05
1932399441	1932399441	1	1	GUPTA, ARUNA MD APCE	23-Jun-08	Physicians (026)	PHYSICIANS	A00088415	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	33	Riverside	None	6850 BROCKTON AVE	STE 108	RIVERSIDE	CA	92506	33.949252	-117.396777	135c	311
1942413786	1942413786	1	1	GOLDEN VALLEY HEALTH CTR	18-Nov-05	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	1717 LAS VEGAS ST	None	MODESTO	CA	95358	37.605347	-121.002716	215c	24.02
1942414214	1942414214	1	1	GOLDEN VALLEY HLTH CTR	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	MCHENRY	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	37.665699	-120.996216	215a	13
1952323800	1952323800	1	1	GOODFAITH FAMILY MEDICAL	28-Oct-99	Physicians Group (022)	PHYSICIANS GROUP	None	40	Pediatrics, Periodontist (Dentists Only)	In state provider	19	Los Angeles	GROUP, A MEDICAL CORP	7770 GARVEY AVE	None	ROSEMEAD	CA	91770	34.062585	-118.100159	78.2qqq	4825.02
1962680421	1962680421	1	1	GOLDEN VALLEY HEALTH CENTERS	30-Mar-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	2101 TENAYA DR	None	MODESTO	CA	95354	37.632392	-120.959098	215c	21
1982824785	1982824785	1	1	GOLDEN VALLEY HEALTH CTR	18-Nov-05	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	24	Merced	None	127 WEST PORTAL	STE B	MERCED	CA	95348	37.326774	-120.470477	97.1	10.02
1992713499	1992713499	1	1	GLENDALE HEALTH CTR	28-Apr-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	GLENDALE FAMILY PLANNING	501 N GLENDALE AVE	None	GLENDALE	CA	91206	34.15353	-118.243644	78.2ee	3019