Table family_pact_providers_profile_cy

Table: family_pact_providers_profile_cy_2019 , provider_business_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 *

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
1003965658	1003965658	1	2	THE MATERNITY CLINIC	28-Apr-97	Physicians (026)	PHYSICIANS	G00057734	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	THE MATERNITY CLINIC	6618 VAN NUYS BLVD	None	VAN NUYS	CA	91405	34.191	-118.448709	78.2cc	1281.02
1013085778	1013085778	1	1	TECHNICLINIC	10-Jan-07	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	TECHNICLINIC	4351 BROADWAY	None	OAKLAND	CA	94611	37.831449	-122.254346	2b	4012
1023287679	1023287679	1	1	T H E CLINIC AT RUTH	1-Feb-08	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	TEMPLE HEALTH CENTER	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	34.016711	-118.308893	78.2l	2313
1043427388	1043427388	1	1	TEHAMA COUNTY HEALTH CTR	3-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	52	Tehama	None	1850 WALNUT ST	None	RED BLUFF	CA	96080	40.168405	-122.261328	221	4
1073582888	1073582888	1	1	THE REGENTS OF U C	25-May-07	Physicians Group (022)	PHYSICIANS GROUP	ZZZ000000	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	200 MED PLAZA STE 430	None	LOS ANGELES	CA	90095	34.055254	-118.481726	78.2aa	2640
1073676243	1073676243	1	1	T VASQUEZ HLTH CTR, INC	15-Nov-06	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	CENTER-HAYWARD	22331 MISSION BLVD	None	HAYWARD	CA	94541	37.674523	-122.086789	2h	4354
1083903124	1083903124	1	4	TORRANCE MEMORIAL PHYSICIAN	15-Mar-16	Physicians Group (022)	PHYSICIANS GROUP	None	1	General Practice	In state provider	19	Los Angeles	INC	717 SOUTH AVERILL AVENUE	None	SAN PEDRO	CA	90732	33.737454	-118.307745	78.2o	2970
1104247329	1104247329	1	1	TORREBLANCA, JOSE MD INC	9-Nov-17	Physicians Group (022)	PHYSICIANS GROUP	None	1	General Practice	In state provider	19	Los Angeles	None	7128 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	33.974651	-118.222487	78.2fff	5331.04
1134425804	1134425804	1	1	THE CHILDREN'S CLINIC FAMILY	9-Apr-12	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	SERVING CHILDREN & THEIR	2360 PACIFIC AVENUE	None	LONG BEACH	CA	90806	33.800123	-118.193645	78.2lll	5731
1144597477	1144597477	1	1	TIBURCIO VASQUEZ HEALTH	9-Jan-13	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	CENTER INC	680 W TENNYSON RD	None	HAYWARD	CA	94544	37.631794	-122.068714	2n	4382.03
1154315828	1154315828	1	1	TANTAM MEDICAL GRP, INC	7-Mar-97	Physicians Group (022)	PHYSICIANS GROUP	P6081	1	General Practice	In state provider	30	Orange	None	12555 GARDEN GROVE BLVD	STE 504	GARDEN GROVE	CA	92843	33.774488	-117.914305	116r	885.02
1184791998	1184791998	1	1	TRI-CITY HEALTH CENTER	27-Apr-15	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	None	1999 MOWRY AVENUE	None	FREMONT	CA	94538	37.557757	-121.981042	2j	4419.23
1205250263	1205250263	1	1	THE CHILDRENS CLINIC FAMILY	3-Mar-14	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	CHILDREN AND FAMILIES	2125 SANTA FE AVENUE	None	LONG BEACH	CA	90810	33.795733	-118.215523	78.2p	5728
1215103304	1215103304	1	1	TORRES, REBECCA MD AMC	5-Oct-15	Physicians Group (022)	PHYSICIANS GROUP	None	1	General Practice	In state provider	33	Riverside	None	1530 WEST 6TH STREET	SUITE 109	CORONA	CA	92882	33.878466	-117.595001	135f	419.06
1215103304	1215103304	1	3	TORRES, REBECCA MD AMC	5-Oct-15	Physicians Group (022)	PHYSICIANS GROUP	None	1	General Practice	In state provider	36	San Bernardino	None	1605 S RIVERSIDE AVE	STE B	RIALTO	CA	92376	34.072944	-117.370219	151f	36.12
1316983877	1316983877	1	1	TRAN, TIFFANY U MD INC	11-Mar-00	Physicians (026)	PHYSICIANS	G00079948	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	30	Orange	None	27800 MEDICAL CENTER RD	STE 230	MISSION VIEJO	CA	92691	33.560069	-117.665857	115.2a	320.22
1356422307	1356422307	2	1	TRINITY COMMUNITY HEALTH CLI	2-Aug-10	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	53	Trinity	HEALTHCARE DISTRICT	31 EASTER AVENUE	None	WEAVERVILLE	CA	96093	40.73753	-122.939235	224	1.02
1366476764	1366476764	1	1	TSAI, HENRY H MD	21-Aug-98	Physicians (026)	PHYSICIANS	A00060125	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	201 W GARVEY AVE	STE 310	MONTEREY PARK	CA	91754	34.062555	-118.124424	78.2nn	4817.14
1396076147	1396076147	1	1	TARZANA TREATMENT CENTER	9-Sep-13	Community Clinics (041)	COMMUNITY CLINIC	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	None	18646 OXNARD STREET	None	TARZANA	CA	91356	34.179947	-118.538994	78.2ii	1393.02
1447321120	1447321120	1	1	THE CENTER FOR HEALTH	1-Mar-97	Community Clinics (041)	COMMUNITY CLINIC	ZZT11858	99	Unknown (on EDS claims)	In state provider	40	San Luis Obispo	OF SAN LUIS OBISPO	705 GRAND AVE	None	SAN LUIS OBISPO	CA	93401	35.289849	-120.652925	172	110.02
1447501507	1447501507	1	1	TESSEMA, SINAFIKISH T NP	27-Apr-15	Certified Pediatric/Family NP (007)	CERTIFIED NURSE PRACTIONER	757060	99	Unknown (on EDS claims)	In state provider	37	San Diego	None	8554 LA MESA BLVD	None	LA MESA	CA	91942	32.777526	-117.004734	161f	150
1447556170	1447556170	1	1	THE CHILDRENS CLINIC FAMILY	16-Dec-11	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	19	Los Angeles	SERVING CHILDREN & THEIR	17660 LAKEWOOD BLVD	None	BELLFLOWER	CA	90706	33.872403	-118.142527	78.2m	5544.03
1457385163	1457385163	1	1	TULARE COUNTY HLTH SVS	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	54	Tulare	None	2611 N DINUBA BLVD	None	VISALIA	CA	93291	36.351142	-119.296956	233	10.04
1497021109	1497021109	1	1	TRI CITY HEALTH CENTER	12-Dec-16	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	None	3607 MAIN STREET	SUITE B	FREMONT	CA	94538	37.533912	-121.954841	2j	4423.02
1508865528	1508865528	1	9	TAHOE CARSON VALLEY	1-Dec-11	Physicians Group (022)	PHYSICIANS GROUP	FNP033738	41	Internal Medicine	In state provider	9	El Dorado	None	2175 SOUTH AVENUE	None	SOUTH LAKE TAHOE	CA	96150	38.912337	-119.997457	24	304.02
1528072527	1528072527	1	2	TIPTON MEDICAL CLIN	18-Dec-03	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	54	Tulare	None	575 N THOMPSON ROAD	None	TIPTON	CA	93272	36.064744	-119.312348	230	32
1538265780	1538265780	1	1	TAHOE FOREST HOSPITAL	5-Mar-98	Community Hosp Outpatient (015)	COMMUNITY OUTPATIENT HOSPITAL	ZZR00494	99	Unknown (on EDS claims)	In state provider	29	Nevada	None	10121 PINE AVE	None	TRUCKEE	CA	96161	39.324497	-120.201227	114	12.06
1548302144	1548302144	1	1	TORMED WOMENS MED GRP IN	28-Apr-97	Physicians Group (022)	PHYSICIANS GROUP	ZZZ49548	0	General Practioner (Dentists Only)	In state provider	19	Los Angeles	None	3400 LOMITA BLVD	STE 602	TORRANCE	CA	90505	33.813241	-118.345161	78.2aaaa	6511.01
1548344625	1548344625	1	1	TAN, BENITA B MD INC	4-Jun-97	Physicians (026)	PHYSICIANS	A53599	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	1	Alameda	None	19682 HESPERIAN BLVD	SUITE 202	HAYWARD	CA	94541	37.668216	-122.119524	2n	4362
1568449304	1568449304	1	3	TYLICKI, STEPHEN	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	23	Mendocino	CENTER	13500 AIRPORT ROAD	None	BOONVILLE	CA	95415	39.010387	-123.377385	87.1	112
1619056926	1619056926	1	1	TIGER HEALTH CLINIC	10-Jan-07	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	TIGER HEALTH CLINIC	4610 FOOTHILL BLVD	None	OAKLAND	CA	94601	37.774134	-122.210633	2d	4074
1639271935	1639271935	1	1	TUOLUMNE CO HEALTH DEPT	1-Mar-97	County Clinics not assoc w/hosp (048)	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	None	99	Unknown (on EDS claims)	In state provider	55	Tuolumne	None	20111 CEDAR RD N	None	SONORA	CA	95370	37.985782	-120.365421	236	41
1679645121	1679645121	1	1	TULELAKE HEALTH CENTER	25-Feb-02	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	47	Siskiyou	TULELAKE HEALTH CENTER	850 MAIN ST	None	TULELAKE	CA	96134	41.947527	-121.47653	196	1
1720405491	1720405491	1	1	TIBURCIO VASQUEZ HEALTH	12-Oct-15	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	CENTER INC	16110 E 14TH ST	None	SAN LEANDRO	CA	94578	37.697844	-122.117864	2h	4339
1760689715	1760689715	1	2	TOTALCARE WALK IN CLINIC	30-May-18	Physicians Group (022)	PHYSICIANS GROUP	None	6	Cardiovascular Disease (M.D. only)	In state provider	33	Riverside	None	13334 LIMONITE AVE.	130	EASTVALE	CA	92880	33.983053	-117.565635	135e	406.07
1770638033	1770638033	1	1	TAM, THOMAS MD	30-Sep-98	Physicians (026)	PHYSICIANS	A00024893	0	General Practioner (Dentists Only)	In state provider	19	Los Angeles	None	455 N GARFIELD AVE	STE 101	MONTEREY PARK	CA	91754	34.066821	-118.122898	78.2nn	4817.13
1780054379	1780054379	1	1	TRI-CITY HEALTH CENTER IRVIN	1-Aug-17	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	None	40910 FREMONT BLVD	None	FREMONT	CA	94538	37.533942	-121.960851	2j	4423.02
1801861190	1801861190	1	1	TRI-CITY MEDICAL CENTER	1-May-11	Community Hosp Outpatient (015)	COMMUNITY OUTPATIENT HOSPITAL	ZZT40128	99	Unknown (on EDS claims)	In state provider	37	San Diego	DISTRICT	4002 VISTA WAY	None	OCEANSIDE	CA	92056	33.183699	-117.29234	156d	185.18
1831394998	1831394998	1	1	TURLOCK MEDICAL OFFICE	20-Sep-07	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	50	Stanislaus	TURLOCK MEDICAL OFFICE	800 DELBON AVE	None	TURLOCK	CA	95382	37.510478	-120.839859	212.1	39.07
1851389696	1851389696	1	1	TIBURCIO VASQUEZ HTLH CT	1-Mar-97	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	None	33255 9TH ST	None	UNION CITY	CA	94587	37.603184	-122.02637	2n	4402
1861433526	1861433526	1	1	TRAN, BRYAN H MD INC	11-Mar-00	Physicians (026)	PHYSICIANS	A00054928	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	30	Orange	None	27800 MEDICAL CENTER RD	STE 230	MISSION VIEJO	CA	92691	33.560069	-117.665857	115.2a	320.22
1861860306	1861860306	1	1	TIBURCIO VASQUEZ HEALTH CENT	30-Mar-16	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	CENTER INC	28300 HUNTWOOD AVE	None	HAYWARD	CA	94544	37.632037	-122.063468	2n	4382.04
1891795613	1891795613	1	1	TRI-CITY MEDICAL GROUP	27-Jan-98	Physicians (026)	PHYSICIANS	A00054433	8	Family Practice	In state provider	19	Los Angeles	TRI-CITY MEDICAL GROUP	11900 AVALON BLVD	STE 100	LOS ANGELES	CA	90061	33.924665	-118.265174	78.2uuu	2410.02
1942424106	1942424106	1	1	TRI-CITY HEALTH CENTER	24-Dec-99	Health Access Program (058)	HEALTH ACCESS PROGRAM	None	99	Unknown (on EDS claims)	In state provider	1	Alameda	LIBERTY	39500 LIBERTY ST	None	FREMONT	CA	94538	37.548418	-121.977297	2j	4419.27
1962685966	1962685966	1	1	TWEETY FAMILY CLINIC INC	30-Jun-08	Physicians Group (022)	PHYSICIANS GROUP	FNP034796	40	Pediatrics, Periodontist (Dentists Only)	In state provider	19	Los Angeles	INC	3050 TWEETY BLVD	None	SOUTH GATE	CA	90280	33.945511	-118.21745	78.2ccc	5356.07
1972776540	1972776540	1	1	TRAN FAMILY MED CLINIC INC	18-Feb-05	Physicians (026)	PHYSICIANS	A00079019	8	Family Practice	In state provider	30	Orange	None	1714 N BUSH ST	None	SANTA ANA	CA	92706	33.760244	-117.86635	116b	750.04