Table family_pact_providers_profile_cy

Table: family_pact_providers_profile_cy_2019 , provider_business_legal_name like R*

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
1003920943	1003920943	1	1	RIVERSIDE CO COMM HEALTH	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	HEALTH CENTER	7140 INDIANA AVE	None	RIVERSIDE	CA	92504	33.938979	-117.397706	135c	313
1013035716	1013035716	1	1	REGENTS OF THE UNIV CA	17-Aug-09	Physicians Group (022)	PHYSICIANS GROUP	None	40	Pediatrics, Periodontist (Dentists Only)	In state provider	37	San Diego	UCSD PEDIATRICS ASSOC	7910 FROST ST	STE 350	SAN DIEGO	CA	92123	32.800255	-117.154565	161b	87.02
1023122967	1023122967	1	1	RIVERSIDE CO COMM HEALTH	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	None	47923 OASIS ST	None	INDIO	CA	92201	33.700857	-116.220937	128	455.01
1023179546	1023179546	1	1	RODRIGUEZ, MARIA E INC	28-Apr-97	Physicians (026)	PHYSICIANS	A00043620	1	General Practice	In state provider	19	Los Angeles	INC	2417 WHITTIER BLVD	None	LOS ANGELES	CA	90023	34.034261	-118.215405	78.2h	2047
1043354111	1043354111	1	1	REDLANDS COMMUNITY HOSP	28-Jan-04	Community Hosp Outpatient (015)	COMMUNITY OUTPATIENT HOSPITAL	ZZT40272	99	Unknown (on EDS claims)	In state provider	36	San Bernardino	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	34.037065	-117.204335	151j	83.01
1073788832	1073788832	1	1	REDWIID RYRAK GEAKTG C	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	12	Humboldt	PO BOX 769	100 WESTCOAST RD	None	REDWAY	CA	95560	40.123887	-123.8751	44	115
1083627749	1083627749	1	1	ROYBAL COMPREHENSIVE HLT	28-Apr-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	ROYBAL FAMILY PLANNING	245 S FETTERLY AVE	None	LOS ANGELES	CA	90022	34.034141	-118.160915	78.2d	5304
1083959464	1083959464	1	1	RICE FAMILY HEALTH CENTER	7-Aug-15	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	37	San Diego	SAN DIEGO INC	352 L STREET	None	CHULA VISTA	CA	91911	32.619978	-117.073972	161k	130
1114031051	1114031051	1	1	RIVERSIDE CO COMM HEALTH	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	None	880 N STATE ST	None	HEMET	CA	92543	33.761717	-116.971874	132	435.07
1114032208	1114032208	1	1	ROMERO, JESUSA N MD APC	9-Jun-06	Physicians (026)	PHYSICIANS	A00034299	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	3100 E FLORENCE AVE	STE 5	HUNTINGTON PARK	CA	90255	33.972891	-118.212379	78.2ccc	5332.03
1194839035	1194839035	1	1	RIVERSIDE CO COMM HEALTH	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	None	308 E SAN JACINTO AVE	None	PERRIS	CA	92570	33.786591	-117.221638	133.1	427.19
1225179641	1225179641	1	1	ROLLAND AND KATHRYN LOWE MED	23-Feb-11	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	None	835 WEBSTER ST	None	OAKLAND	CA	94607	37.799511	-122.271239	2c	4030
1235138363	1235138363	1	2	RIOS, JAVIER R MD APC	6-Feb-01	Physicians Group (022)	PHYSICIANS GROUP	FNP027284	1	General Practice	In state provider	33	Riverside	CHICAGO CLINICA MEDICA	4022 CHICAGO AVE	None	RIVERSIDE	CA	92507	33.972376	-117.348514	135a	305.01
1255471868	1255471868	2	1	R & R CLINICAL & MEDICA	17-Oct-05	Physicians Group (022)	PHYSICIANS GROUP	FNP029855	8	Family Practice	In state provider	19	Los Angeles	CLINICA MEDICA NUESTRA	1403 N FAIR OAKS AVE	STE 3	PASADENA	CA	91103	34.170316	-118.150687	78.2hhh	4609
1265538060	1265538060	1	1	REPRODUCTIVE ASSOC MED	28-Apr-97	Physicians Group (022)	PHYSICIANS GROUP	FNP012460	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	GROUP INC	1045 ATLANTIC AVE	STE 508	LONG BEACH	CA	90813	33.779811	-118.18505	78.2kkk	5763.01
1346353679	1346353679	1	1	RIVERSIDE CO COMM HEALTH	1-Sep-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	None	3055 W RAMSEY ST	None	BANNING	CA	92220	33.925769	-116.910767	134	441.01
1346490927	1346490927	1	1	REGIONAL MEDICAL COMM	14-Oct-08	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	10	Fresno	None	2505 E DIVISADERO ST	None	FRESNO	CA	93721	36.743216	-119.781989	35c	5.02
1386852416	1386852416	1	1	RIVERSIDE CO REGIONAL	1-Jul-05	County Hospital Outpatient (061)	COUNTY HOSPITAL OUTPATIENT	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	MEDICAL CENTER	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	33.910048	-117.201657	134	487
1396859179	1396859179	1	1	RIVERSIDE CO COMM HEALTH	1-Sep-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	CARE CENTER	2499 E LAKESHORE DR	None	LAKE ELSINORE	CA	92530	33.660351	-117.301362	131a	430.01
1477977973	1477977973	1	1	REDWOOD CITY HEALTH CENTER	24-Jul-17	Community Clinics (041)	COMMUNITY CLINIC	550002728	99	Unknown (on EDS claims)	In state provider	41	San Mateo	INC	2907 EL CAMINO REAL	None	REDWOOD CITY	CA	94061	37.469439	-122.212294	176b	6107
1487787248	1487787248	1	1	RE: C/N SEE GR0055801	6-Jan-97	Physicians Group (022)	PHYSICIANS GROUP	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	37	San Diego	INC	752 MEDICAL CENTER CT	STE 106	CHULA VISTA	CA	91911	32.618955	-117.024857	161s	133.1
1508278359	1508278359	1	1	ROADS COMMUNITY CARE	11-Jan-16	Health Access Program (058)	HEALTH ACCESS PROGRAM	550002986	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	INC	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	33.895597	-118.207927	78.2bbb	5424.01
1528137791	1528137791	1	1	REYES, ADORACION A MD	7-Feb-19	Physicians (026)	PHYSICIANS	A00051639	1	General Practice	In state provider	19	Los Angeles	None	1350 CHESTNUT AVE	None	LONG BEACH	CA	90813	33.783157	-118.19637	78.2jjj	5754.01
1528299849	1528299849	1	1	RAPOZA, RUSSELL P MD APC	28-Sep-15	Physicians (026)	PHYSICIANS	G71959	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	30	Orange	None	11190 WARNER AVENUE	SUITE 410	FOUNTAIN VALLEY	CA	92708	33.716345	-117.933111	116j	992.26
1548301633	1548301633	1	1	RIVERBANK COMMUNITY HLTH	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	None	2603 PATTERSON RD	STE 3	RIVERBANK	CA	95367	37.732702	-120.948196	211	3.02
1558512624	1558512624	1	1	ROSELAND PEDIATRICS	20-Sep-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	49	Sonoma	None	711 STONY POINT ROAD	SUITE 17	SANTA ROSA	CA	95407	38.429307	-122.74156	210.1	1531.04
1578599809	1578599809	1	1	RIALTO CLINICA MEDICA	8-Aug-02	Physicians Group (022)	PHYSICIANS GROUP	FNP028484	1	General Practice	In state provider	36	San Bernardino	RIALTO CLINICA MEDICA	436 S RIVERSIDE AVE	None	RIALTO	CA	92376	34.09342	-117.370336	151h	37
1609803733	1609803733	1	1	RAM, ASHER MD	5-May-98	Physicians (026)	PHYSICIANS	A00045553	6	Cardiovascular Disease (M.D. only)	In state provider	19	Los Angeles	CENTRO MEDICO FAMILIAR	14547 VICTORY BLVD	None	VAN NUYS	CA	91411	34.186659	-118.450019	78.2cc	1283.03
1609972777	1609972777	1	1	RIO HONDO MEDICAL GROUP	4-Mar-99	Physicians Group (022)	PHYSICIANS GROUP	FNP36933	0	General Practioner (Dentists Only)	In state provider	19	Los Angeles	INC	12444 E WASHINGTON BLVD	None	WHITTIER	CA	90602	33.96766	-118.046707	78.2uu	5021
1619144227	1619144227	1	1	ROYAL CARE MEDICAL CENTER	11-Jan-11	Physicians Group (022)	PHYSICIANS GROUP	None	8	Family Practice	In state provider	36	San Bernardino	CENTER INC	653 E E ST	STE 109	ONTARIO	CA	91764	34.068248	-117.642495	151c	15.01
1639168594	1639168594	1	1	REGENTS/UCDPBG/GYNECOLOG	26-May-10	Physicians Group (022)	PHYSICIANS GROUP	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	34	Sacramento	None	4860 Y ST	None	SACRAMENTO	CA	95817	38.5525	-121.448868	139f	17
1669407656	1669407656	1	1	RANCHO MIRAGE CENTER	6-Jan-97	Community Clinics (041)	COMMUNITY CLINIC	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	OF THE PACIFIC SOUTHWEST	71777 SAN JACINTO DR	STE 202&203	RANCHO MIRAGE	CA	92270	33.743334	-116.411813	129.1	451.03
1669548483	1669548483	1	1	ROBERTS, DENNIS F DO	15-Dec-97	Physicians (026)	PHYSICIANS	20A6099	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	33	Riverside	A PROFESSIONAL CORP	81767 DR. CARREON BLVD	STE 200	INDIO	CA	92201	33.707426	-116.238634	128	452.07
1669617197	1669617197	1	11	RADY CHILDRENS SPECIALISTS	28-May-14	Physicians Group (022)	PHYSICIANS GROUP	None	24	Plastic Surgery	In state provider	37	San Diego	SAN DIEGO	7920 FROST STREET	SUITE 200	SAN DIEGO	CA	92123	32.800253	-117.153975	161b	87.02
1669870739	1669870739	1	1	ROHNERT PARK HEALTH CENTER	1-Nov-15	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	49	Sonoma	APCC	5900 STATE FARM DRIVE	STE 200	ROHNERT PARK	CA	94928	38.353106	-122.706941	209.1	1513.08
1740303247	1740303247	1	1	RS BIR MD INC CLINICA MEDIC	16-Aug-02	Physicians Group (022)	PHYSICIANS GROUP	A00042345	41	Internal Medicine	In state provider	36	San Bernardino	None	11692 CENTRAL AVE	None	CHINO	CA	91710	34.040964	-117.689596	151l	4.04
1780008839	1780008839	1	1	RIVERSIDE COMMUNITY COLLEGE	10-Dec-14	Exempt from Licensure Clinics (045)	CLINIC EXEMP FROM LICENSURE	None	99	Unknown (on EDS claims)	In state provider	33	Riverside	DISTRICT	4800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92506	33.971379	-117.384767	135c	307
1801921952	1801921952	1	5	ROY MEDICAL GROUP INC	8-Apr-16	Physicians Group (022)	PHYSICIANS GROUP	None	1	General Practice	In state provider	19	Los Angeles	None	8001 LAUREL CANYON BLVD	STE 109	NORTH HOLLYWOOD	CA	91605	34.215715	-118.396526	78.2ppp	1210.2
1821170044	1821170044	1	1	RAVENSWOOD FAMILY HLTH	21-Dec-01	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	41	San Mateo	HEALTH CENTER INC	1885 BAY ROAD	None	EAST PALO ALTO	CA	94303	37.472764	-122.132391	176b	6118
1831462712	1831462712	1	1	ROMAN, RICARDO MD INC	24-May-12	Physicians (026)	PHYSICIANS	A00079013	41	Internal Medicine	In state provider	19	Los Angeles	None	4708 EAGLE ROCK BLVD	None	EAGLE ROCK	CA	90041	34.130386	-118.216567	78.2dd	1834.02
1851522015	1851522015	1	1	ROOSEVELT HEALTH CENTER	25-Mar-10	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	None	1926 19TH AVE	None	OAKLAND	CA	94606	37.789727	-122.23799	2c	4059.02
1871768200	1871768200	1	1	REDWOOD WOMENS CENTER PC	31-Jan-11	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	12	Humboldt	None	3309 RENNER DR	None	FORTUNA	CA	95540	40.582582	-124.135433	42	109.01
1881703957	1881703957	1	1	RURAL HEALTH CLINIC	21-Jan-09	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	36	San Bernardino	COMMUNITAL HOSPITAL DIST	31900 HILLTOP BLVD	None	RUNNING SPRINGS	CA	92382	34.206947	-117.152437	146	111.01
1902803315	1902803315	1	1	RONALD REAGAN UCLA MED	1-Jul-05	Community Hosp Outpatient (015)	COMMUNITY OUTPATIENT HOSPITAL	930000165	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	CALIFORNIA	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	34.068908	-118.445025	78.2w	2653.01
1912248782	1912248782	1	1	RAINCROSS WOMENS MEDICAL GRP	25-Mar-14	Physicians Group (022)	PHYSICIANS GROUP	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	33	Riverside	None	6767 BROCKTON AVE	None	RIVERSIDE	CA	92506	33.950492	-117.396773	135c	311
1942361548	1942361548	1	2	ROMERO, ELIOTT MD	10-Apr-97	Physicians (026)	PHYSICIANS	G00048383	15	Obstetrics (D.O. only), Endodontist (Dentists Only)	In state provider	30	Orange	None	999 N TUSTIN AVE	STE 220	SANTA ANA	CA	92705	33.75355	-117.834094	116h	755.04
1962530725	1962530725	1	1	REDWOOD COAST MED SVS	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	23	Mendocino	PO BOX 1100	46900 OCEAN DR	None	GUALALA	CA	95445	38.769796	-123.532881	88	111.02
1972813087	1972813087	1	1	RIDGECREST REG HOPSP RHC	25-Aug-10	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	15	Kern	None	1111 N CHINA LAKE BLVD	SUITE 190	RIDGECREST	CA	93555	35.640947	-117.669854	64	53
1992798912	1992798912	1	1	REGENTS/UCDPBG/OB REI	26-May-10	Physicians Group (022)	PHYSICIANS GROUP	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	34	Sacramento	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	38.552264	-121.455925	139f	18