Table family_pact_providers_profile_cy

Table: family_pact_providers_profile_cy_2019 , provider_business_legal_name like N*

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
1003830258	1003830258	1	1	NIETO, SANDRA MD	23-Nov-10	Physicians (026)	PHYSICIANS	A00084185	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	433 N 4TH ST	STE 211	MONTEBELLO	CA	90640	34.015139	-118.102132	78.2ww	5301.01
1013194810	1013194810	1	1	NORTH EAST MEDICAL SVS	30-Mar-01	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	38	San Francisco	LELAND AVE	82 LELAND AVE	None	SAN FRANCISCO	CA	94134	37.711836	-122.405411	162f	264.03
1043395064	1043395064	1	1	NEWMAN MEDICAL CLINIC	1-Jun-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	INC	1349 MAIN ST	None	NEWMAN	CA	95360	37.315275	-121.022641	213	35
1053655704	1053655704	1	1	NORTH EAST MEDICAL SERVICES	25-Jun-13	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	38	San Francisco	None	1400 NORIEGA ST	None	SAN FRANCISCO	CA	94122	37.754135	-122.478652	162e	328.02
1053725317	1053725317	1	1	NEIGHBORHOOD MEDICAL CLINIC	6-Jun-15	Physicians (026)	PHYSICIANS	20A7522	1	General Practice	In state provider	19	Los Angeles	CORP	5113 S VERMONT AVE	None	LOS ANGELES	CA	90037	33.996409	-118.291513	78.2l	2323
1063616613	1063616613	1	1	NATIVIDAD MEDICAL CTR	1-Mar-97	County Hospital Outpatient (061)	COUNTY HOSPITAL OUTPATIENT	270700831	99	Unknown (on EDS claims)	In state provider	27	Monterey	NATIVIDAD MEDICAL CTR	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	36.696798	-121.62963	109.2	106.08
1063684405	1063684405	1	1	NATIONAL HEALTH SVCS INC	14-Mar-07	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	15	Kern	TEHACHAPI COMM MEDICAL	161 N MILL ST	None	TEHACHAPI	CA	93561	35.133735	-118.452088	62	61
1063699080	1063699080	1	1	NORTHEAST VALLEY HEALTH	28-Apr-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	34.28879	-118.447881	78.2ll	3203
1073529681	1073529681	1	1	NO CO HEALTH PROJECT	6-Jan-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	RAMONA CLINIC	217 EARLHAM ST	None	RAMONA	CA	92065	33.051178	-116.85484	158.1	208.09
1083035505	1083035505	1	1	NORTH EAST MEDICAL SERVICES	30-Dec-13	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	43	Santa Clara	None	1870 LUNDY AVENUE	None	SAN JOSE	CA	95131	37.39265	-121.890281	183o	5043.22
1104819945	1104819945	1	1	NGUYEN, HUNG V MD	17-Oct-07	Physicians (026)	PHYSICIANS	A00042303	1	General Practice	In state provider	19	Los Angeles	None	7227 RESEDA BLVD	None	RESEDA	CA	91335	34.201649	-118.536045	78.2zz	1318
1114104015	1114104015	1	1	NORTHEAST VLY HLTH CORP	29-Mar-02	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	EARLY INTERVENTION	6551 VAN NUYS BLVD	STE 201	VAN NUYS	CA	91402	34.211805	-118.448675	78.2zz	1203
1124205182	1124205182	1	1	NORTH EAST MEDICAL SVCS	29-Sep-06	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	38	San Francisco	NORIEGA	1450 NORIEGA ST	None	SAN FRANCISCO	CA	94122	37.754117	-122.479194	162e	328.02
1124220249	1124220249	1	1	NORTH COAST FAMILY	24-Sep-08	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	23	Mendocino	CARE DISTRICT	721 RIVER DR	SUITES A, B, & C	FORT BRAGG	CA	95437	39.431693	-123.800817	89	105
1124460274	1124460274	1	1	NECC GAGE HEALTH CENTER	2-Dec-15	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	2975 ZOE AVENUE	None	HUNTINGTON PARK	CA	90255	33.979374	-118.215302	78.2ccc	5331.06
1144385766	1144385766	1	2	NGO, HY P MD INC	15-Oct-09	Physicians (026)	PHYSICIANS	A00069736	41	Internal Medicine	In state provider	19	Los Angeles	None	5801 S FIGUEROA STREET	None	LOS ANGELES	CA	90003	33.989727	-118.282663	78.2ggg	2327
1144407487	1144407487	1	1	NORTH EAST MEDICAL SVS	5-Feb-20	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	38	San Francisco	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	37.799729	-122.409086	162a	106
1154402675	1154402675	1	5	NEWHALL HEALTH CENTER	9-Apr-18	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	23772 NEWHALL AVE	None	NEWHALL	CA	91321	34.376674	-118.526368	76.1b	9203.36
1154786846	1154786846	1	1	NEIGHBORHOOD HEALTHCARE	14-Aug-18	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	None	903 E DEVONSHIRE AVE	STE D	HEMET	CA	92543	33.751209	-116.96298	132	434.01
1164606414	1164606414	1	1	NORTHEAST COMM CLINIC	28-Apr-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	5428 N FIGUEROA ST	None	LOS ANGELES	CA	90042	34.107667	-118.196701	78.2i	1838.1
1194974402	1194974402	1	1	NORTH ORANGE COUNTY REG	16-Oct-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	30	Orange	HEALTH FOUNDATION	901 W ORANGETHORPE AVE	None	FULLERTON	CA	92832	33.859352	-117.940759	116f	111.02
1215246996	1215246996	1	1	NESTOR COMMUNITY HEALTH CTR	27-Jan-11	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	CLINIC	1016 OUTER ROAD	None	SAN DIEGO	CA	92154	32.578619	-117.083338	161j	101.07
1235473984	1235473984	1	1	NORTH EAST MEDICAL SERVICES	2-Apr-13	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	38	San Francisco	None	1033 CLEMENT ST	None	SAN FRANCISCO	CA	94118	37.782707	-122.47015	162h	402
1245246917	1245246917	1	1	NORTH COUNTY HEALTH SERVICES	6-Jan-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	INCORPORATED	150 VALPREDA RD	None	SAN MARCOS	CA	92069	33.141908	-117.156473	156e	200.23
1255347704	1255347704	1	1	NCHS CARLSBAD FAMILY MEDICIN	29-Dec-99	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	INC	1295 CARLSBAD VILLAGE DR	STE 100	CARLSBAD	CA	92008	33.164606	-117.340019	156b	178.01
1255347894	1255347894	1	1	NCHS MISSION MESA COMM	6-Jan-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	INC	2210 MESA DR	STE 300	OCEANSIDE	CA	92069	33.208349	-117.359004	156a	185.1
1295752384	1295752384	1	1	NO VLY INDIAN HEALTH INC	12-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	11	Glenn	HEALTH	207 N BUTTE ST	None	WILLOWS	CA	95988	39.521923	-122.195357	37	104
1346527918	1346527918	1	1	NORTHEAST MEDICAL SERVICES	14-Aug-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	41	San Mateo	None	211 EASTMOOR AVE	None	DALY CITY	CA	94015	37.684799	-122.479069	176d	6014
1356469381	1356469381	2	1	NORTH BROADWAY MED CLINIC	24-Aug-99	Physicians Group (022)	PHYSICIANS GROUP	ZZZ78903Z	41	Internal Medicine	In state provider	19	Los Angeles	INC	2926 N BROADWAY	None	LOS ANGELES	CA	90031	34.073699	-118.211366	78.2i	1998
1356528376	1356528376	1	1	NORTHEAST VALLEY HEALTH	28-Apr-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	12756 VAN NUYS BLVD	None	PACOIMA	CA	91331	34.274345	-118.410738	78.2ppp	1041.05
1356568034	1356568034	1	1	NASSAR, THEODORE R MD	28-Apr-06	Physicians Group (022)	PHYSICIANS GROUP	A00031164	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	20	Madera	FACOG INC	363 E ALMOND AVE	STE 101	MADERA	CA	93637	36.945549	-120.053545	80	5.02
1396852455	1396852455	1	1	NCHS WOMEN'S HEALTH SVS	1-Feb-00	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	NCHS WOMEN'S HEALTH SVS	2210 MESA DR	STE 5&7	OCEANSIDE	CA	92054	33.208349	-117.359004	156a	185.1
1407031693	1407031693	1	1	NEIGHBORHOOD HEALTHCARE - PA	27-Oct-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	None	16650 HIGHWAY 76	None	PAUMA VALLEY	CA	92061	33.292976	-116.969022	153.1	191.01
1417032921	1417032921	1	1	NORTHERN INYO HOSPITAL	10-Jul-13	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	14	Inyo	LOCAL HOSPITAL DISTRICT	153 PIONEER LN	None	BISHOP	CA	93514	37.361988	-118.407362	53	4
1417321746	1417321746	1	1	NCHS PERRIS HEALTH CENTER	22-May-18	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	INC	1675 N PERRIS BLVD	STE G1	PERRIS	CA	92571	33.802522	-117.22603	133.1	426.17
1427220862	1427220862	1	1	NATIONAL HEALTH SERVICES	8-Dec-06	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	15	Kern	HEALTH CENTER	320 JAMES ST	None	SHAFTER	CA	93263	35.503304	-119.277388	58.1	41.01
1437335148	1437335148	1	1	NEIGHBORHOOD HEALTHCARE	27-Oct-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	None	41840 ENTERPRISE CIRCLE	NORTH	TEMECULA	CA	92590	33.517198	-117.169596	131c	512
1447267349	1447267349	1	1	NCHS WOMEN'S HEALTH SVS	1-Feb-00	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	NCHS WOMEN'S HEALTH SVS	1130 2ND ST	None	ENCINITAS	CA	92024	33.03762	-117.293663	156a	175.01
1477563518	1477563518	1	1	NORTHEASTERN HEALTH CTR	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	18	Lassen	None	1850 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	40.438386	-120.649774	72	403.05
1487826772	1487826772	1	1	NEIGHBORHOOD HEALTHCARE	27-Oct-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	GRAND AVENUE	1001 E GRAND AVE	None	ESCONDIDO	CA	92025	33.126297	-117.068481	156e	206.02
1497836464	1497836464	1	1	NANAYAKKARA, GAMAGE N MD	2-Oct-06	Physicians (026)	PHYSICIANS	A00035609	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	33	Riverside	None	760 WASHBURN AVE	STE 9	CORONA	CA	92882	33.873859	-117.567848	135d	416
1497889158	1497889158	1	1	NHAN HOA COMPREHENSIVE	1-Nov-13	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	30	Orange	HEALTH CARE CLINIC INC	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	33.773758	-117.997515	116s	998.01
1497889810	1497889810	1	2	NOGALES MEDICAL CLINIC INC	28-Jul-10	Physicians (026)	PHYSICIANS	None	8	Family Practice	In state provider	19	Los Angeles	None	1840 N HACIENDA BLVD	#10	LA PUENTE	CA	91744	34.051605	-117.942759	78.2yyy	4075.01
1497932396	1497932396	1	1	NORTHEAST VALLEY HEALTH	28-Apr-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	LAC-CANOGA PARK	7107 REMMET AVE	None	CANOGA PARK	CA	91303	34.199348	-118.600274	78.2hhhh	1345.2
1528074044	1528074044	1	1	NUEVA ESPERANZA HEALTHCA	15-Dec-05	Physicians (026)	PHYSICIANS	A00056426	1	General Practice	In state provider	19	Los Angeles	INC	1704 W MANCHESTER AVE	# 109	LOS ANGELES	CA	90047	33.959981	-118.306973	78.2k	2381
1538562996	1538562996	1	1	NAPA VALLEY COMMUNITY COLLEG	21-May-15	Exempt from Licensure Clinics (045)	CLINIC EXEMP FROM LICENSURE	None	99	Unknown (on EDS claims)	In state provider	28	Napa	COLLEGE DISTRICT	2277 NAPA VALLEJO HWY	None	NAPA	CA	94558	38.272041	-122.272436	112.1	2009
1578572145	1578572145	1	1	NEW WOMEN MEDICAL CARE	1-Jan-12	Physicians (026)	PHYSICIANS	A00040702	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	16660 PARAMOUNT BLVD	STE 105	PARAMOUNT	CA	90723	33.882563	-118.159974	78.2m	5539.02
1588808547	1588808547	1	1	NUESTRA CLINICA INC	30-Oct-09	Physicians Group (022)	PHYSICIANS GROUP	None	1	General Practice	In state provider	19	Los Angeles	None	4477 WHITTIER BLVD	None	LOS ANGELES	CA	90022	34.023449	-118.171707	78.2d	5315.02
1639171028	1639171028	1	1	NORTH OF THE RIVER	13-Jan-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	15	Kern	COMMUNITY HEALTH CENTER	2525 N CHESTER AVE	None	BAKERSFIELD	CA	93308	35.429211	-119.021322	66a	1.01
1649519646	1649519646	1	1	NORWALK FEMALE MEDICAL	3-Oct-13	Physicians (026)	PHYSICIANS	A21180	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	12311 S NORWALK BLVD	None	NORWALK	CA	90650	33.919733	-118.072712	78.2jjjj	5501
1689778813	1689778813	1	1	NORTHCOUNTRY CLIN-ARCATA	13-Oct-00	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	12	Humboldt	NORTHCOUNTRY CLIN-ARCATA	785 18TH ST	None	ARCATA	CA	95521	40.87618	-124.083992	39	10
1689863516	1689863516	1	1	NATIVE AMERICAN HEALTH CTR	10-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	CENTER INC	2950 INTERNATIONAL BLVD	None	OAKLAND	CA	94601	37.77873	-122.228048	2d	4062.02
1689875478	1689875478	1	1	NEWARK HEALTH CENTER	1-Jul-98	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	NEWARK HEALTH CENTER	6066 CIVIC TERRACE AVE	None	NEWARK	CA	94560	37.536685	-122.028158	2j	4445
1700097540	1700097540	1	1	NORTHEAST COMM CLINIC	18-Sep-08	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	200 E ANAHEIM STREET	None	WILMINGTON	CA	90744	33.780037	-118.261143	78.2p	2947.01
1720031388	1720031388	1	1	NOVAK, ADAM J MD	7-Apr-97	Physicians (026)	PHYSICIANS	A00044835	1	General Practice	In state provider	36	San Bernardino	None	9625 MONTE VISTA AVE	STE 108	MONTCLAIR	CA	91763	34.079041	-117.698241	151c	2.03
1720264641	1720264641	1	1	NEIGHBORHOOD HEALTHCARE	17-Dec-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	WOMENS CENTER	401 E VALLEY PKWY	None	ESCONDIDO	CA	92025	33.12463	-117.078041	156e	202.02
1720347149	1720347149	1	1	NORTH FINE COMMUNITY HEALTH	16-Mar-16	Health Access Program (058)	HEALTH ACCESS PROGRAM	550002558	99	Unknown (on EDS claims)	In state provider	10	Fresno	None	1945 N FINE AVENUE	STE 100	FRESNO	CA	93727	36.768481	-119.728929	35b	31.04
1720387640	1720387640	1	1	NORTH EAST MED SVCS TARAVAL	14-Aug-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	38	San Francisco	None	2308 TARAVAL ST	None	SAN FRANCISCO	CA	94116	37.742429	-122.490831	162e	329.01
1760667950	1760667950	1	1	NEIGHBORHOOD HEALTHCARE	6-Jan-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	EL CAJON	855 E MADISON AVENUE	None	EL CAJON	CA	92020	32.800293	-116.951663	161h	163.01
1760669667	1760669667	1	1	NORTHEAST VALLEY HEALTH	28-Apr-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	LAC-VALENCIA	23763 VALENCIA BLVD	None	VALENCIA	CA	91355	34.414766	-118.550458	76.1a	9203.29
1801214853	1801214853	1	1	NILOO MEDICAL GROUP INC	5-Jul-17	Physicians (026)	PHYSICIANS	A112671	1	General Practice	In state provider	19	Los Angeles	None	4075 WHITTIER BLVD	None	LOS ANGELES	CA	90023	34.023929	-118.183597	78.2d	5312.02
1811174022	1811174022	1	1	NE VALLEY HLTH-HOMELESS	7-Feb-00	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	CORPORATION	7843 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91605	34.212866	-118.387804	78.2ppp	1218.02
1841217866	1841217866	1	1	NIPOMO COMM MED CTR	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	40	San Luis Obispo	OF THE CENTRAL COAST	150 TEJAS PL	None	NIPOMO	CA	93444	35.026495	-120.498724	171	124.02
1841617958	1841617958	1	1	NEIGHBORHOOD HEALTHCARE	5-Oct-15	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	None	26926 CHERRY HILLS BLVD	SUITE B	MENIFEE	CA	92586	33.711116	-117.189081	133.1	427.11
1861501025	1861501025	1	1	NAMBIAR, MANI MD	14-Apr-00	Physicians (026)	PHYSICIANS	A00040026	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	33	Riverside	None	130 S BUENA VISTA ST	None	HEMET	CA	92543	33.747008	-116.967353	132	434.01
1881104313	1881104313	1	1	NEWHALL HEALTH CENTER	9-Oct-18	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	CORPORATION	23413 LYONS AVE	None	SANTA CLARITA	CA	91355	34.37967	-118.543938	76.1a	9203.22
1881825305	1881825305	1	1	N E MED SRVCS SAN BRUNO	3-Jan-10	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	38	San Francisco	None	2574 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	37.729162	-122.404263	162f	257.02
1891028171	1891028171	1	1	NORTHEAST COMMUNITY CLINIC	20-Sep-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	CLINIC	4455 W 117 ST	SUITE 300	HAWTHORNE	CA	90250	33.928245	-118.353821	78.2q	6021.03
1932622446	1932622446	1	1	NEIGHBORHOOD HEALTCARE-PREN	28-Jan-19	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	None	488 EAST VALLEY PARKWAY	SUITE 404	ESCONDIDO	CA	92025	33.125652	-117.076448	156e	202.14
1952641136	1952641136	1	1	NECC HARBOR CITY HEALTH	12-Aug-13	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	1403 LOMITA BLVD	STE 100,101, & 106	HARBOR CITY	CA	90710	33.79783	-118.30132	78.2aaaa	2933.02
1982938213	1982938213	1	1	NORTHEAST COMMUNITY CLINIC	20-Sep-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	1400 S GRAND AVE	STE 700	LOS ANGELES	CA	90015	34.03718	-118.265408	78.2ffff	2240.1
1992983472	1992983472	1	1	NORTH PARK FAMILY HEALTH	6-Jan-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	DIEGO INC	3544 30TH ST	None	SAN DIEGO	CA	92104	32.743078	-117.130067	161d	14