Table family_pact_providers_profile_cy_2021

Table: family_pact_providers_profile_cy_2021_2022 , provider_business_legal_name like A*

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_desc	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
1003134545	1003134545	1	1	ASIAN HEALTH SERVICES	23Feb2011	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	250 E 18TH ST	2ND FLOOR	OAKLAND	CA	946061729	37.800015	-122.252625	2c	4053.01
1023011632	1023011632	1	1	ALTURA CENTERS FOR HEALTH	28Jul2005	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	54	Tulare	None	1101 N CHERRY ST	None	TULARE	CA	932742231	36.224116	-119.337111	230	23.03
1033267216	1033267216	1	1	ADVANCED FAMILY CARE	02Feb2015	022	PHYSICIANS GROUP	CLA322416	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	MEDICAL GROUP	1201 E FLORENCE AVE	None	LOS ANGELES	CA	900012432	33.974765	-118.254103	78.2fff	5350.01
1053725317	1053725317	1	1	AKHAVAN, PARVIZ DO A MEDICAL	23Dec2013	026	PHYSICIANS	20A7522	01	General Practice	In state provider	19	Los Angeles	CORP	5113 S VERMONT AVE	None	LOS ANGELES	CA	900373515	33.996409	-118.291513	78.2l	2323
1063623387	1063623387	1	1	ALAS-POCASANGRE, JUAN L	22Dec2003	026	PHYSICIANS	A00055051	08	Family Practice	In state provider	19	Los Angeles	ALAS MEDICAL CLINIC INC	545 N SAN GABRIEL AVE	None	AZUSA	CA	917022939	34.130680	-117.908823	78.2qq	4043.01
1073642682	1073642682	1	1	ASIAN PACIFIC HEALTH	01Jan2001	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	CARE VENTURE, INC	1530 HILLHURST AVE	STE 200	LOS ANGELES	CA	900275516	34.098928	-118.287426	78.2a	1953
1073675385	1073675385	1	1	ALIANZA MEDICAL CENTER	10Jun1997	022	PHYSICIANS GROUP	FNP28762	08	Family Practice	In state provider	19	Los Angeles	INC	6907 SEVILLE AVE	None	HUNTINGTON PARK	CA	902554901	33.976879	-118.222534	78.2fff	5331.04
1083851992	1083851992	1	1	ALTAMED HEALTH SERVICES CORP	01Apr2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	30	Orange	GARDEN GROVE, HARBOR	12751 HARBOR BLVD	None	GARDEN GROVE	CA	928405800	33.777546	-117.915085	116r	885.02
1093019051	1093019051	1	1	ALL INCLUSIVE COMMUNITY HLTH	01Dec2012	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	None	1311 N SAN FERNANDO BLVD	None	BURBANK	CA	915044236	34.189332	-118.320301	78.2ttt	3106.01
1114104858	1114104858	1	1	ALTAMED COMM HEALTH CLN	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	EL MONTE	10418 VALLEY BLVD	STE B	EL MONTE	CA	917312402	34.076514	-118.045907	78.2oo	4328.01
1124189212	1124189212	1	1	ARDMORE MED GROUP INC	10Apr1992	022	PHYSICIANS GROUP	FNP030539	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	ARDMORE MED GROUP INC	3518 W 8TH ST	None	LOS ANGELES	CA	900052902	34.057663	-118.307051	78.2e	2125.02
1134206436	1134206436	1	1	ANGEL FAMILY PRACTICE MEDICA	31Oct1991	026	PHYSICIANS	A00050182	None	UNKNOWN	In state provider	19	Los Angeles	MEDICAL GROUP INC	2015 E FLORENCE AVE	None	LOS ANGELES	CA	900012754	33.974782	-118.234728	78.2mmm	5330.02
1134237993	1134237993	1	1	ADVANCED WOMEN'S HEALTHCARE,	05Aug2005	022	PHYSICIANS GROUP	FNP032887	None	UNKNOWN	In state provider	33	Riverside	AMC	1100 N PALM CANYON DR	STE 212	PALM SPRINGS	CA	922624426	33.837621	-116.546779	129.4	446.06
1134421860	1134421860	1	1	AGUILAR, ALEJANDRO F MD INC	08Dec2015	026	PHYSICIANS	A36086	None	UNKNOWN	In state provider	19	Los Angeles	None	3034 E FLORENCE AVENUE	None	HUNTINGTON PARK	CA	902555828	33.973091	-118.214284	78.2ccc	5331.07
1134492937	1134492937	1	1	ALTAMED HEALTH SERVICES CORP	29Jun2012	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	EAST LA 1ST STREET	2219 E 1ST STREET	None	LOS ANGELES	CA	900333901	34.044415	-118.211965	78.2h	2044.20
1154736429	1154736429	1	1	AVENAL COMMUNITY HEALTH CENT	01Dec2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	10	Fresno	None	3554 W MT WHITNEY AVE	None	RIVERDALE	CA	936560000	36.430906	-119.861917	30	77
1174665905	1174665905	1	1	ARROYO VISTA FAMILY	21Oct2005	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	HEALTH CTR-LINCOLN HGHTS	2411 N BROADWAY	None	LOS ANGELES	CA	900312218	34.073633	-118.216200	78.2i	1997
1174700710	1174700710	1	1	ALTAMED MEDICAL GROUP	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	ELA/WHITTIER	5427 WHITTIER BLVD	None	LOS ANGELES	CA	900224101	34.019621	-118.153528	78.2d	5317.01
1174996177	1174996177	1	1	ALL-INCLUSIVE COMMUNITY	26Nov2019	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	HEALTH CENTER	3920 EAGLE ROCK BLVD	SUITE A	LOS ANGELES	CA	900653606	34.119362	-118.230122	78.2ff	1863.02
1225179641	1225179641	1	1	ASIAN HEALTH SERVICE	23Feb2011	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	835 WEBSTER ST	None	OAKLAND	CA	946074219	37.799511	-122.271239	2c	4030
1235299637	1235299637	1	1	ARDMORE MED GROUP INC	10Apr1992	022	PHYSICIANS GROUP	FNP030539	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	2765 E FLORENCE AVE	None	HUNTINGTON PARK	CA	902555750	33.973783	-118.220898	78.2ccc	5331.07
1255350351	1255350351	1	1	AMPLA HEALTH	25Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	51	Sutter	None	355 SAMUEL DR	None	YUBA CITY	CA	959916324	39.123108	-121.609927	216	503.02
1255542601	1255542601	1	1	ALTAMED MEDICAL & DENTAL	05Jan2005	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	GROUP, WHITTIER WEST	3945 WHITTIER BLVD	None	LOS ANGELES	CA	900232440	34.023930	-118.187753	78.2d	5312.02
1275918674	1275918674	1	1	AVENAL COMMUNITY HEALTH	22Jun2016	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	16	Kings	CENTER	304 BECKY PEASE ST	None	KETTLEMAN CITY	CA	932390000	36.008942	-119.960194	68	16.01
1285667758	1285667758	1	1	AMPLA HEALTH	25Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	11	Glenn	& DENTAL	1211 CORTINA DR	None	ORLAND	CA	959631699	39.742278	-122.202481	36.1	101
1295821296	1295821296	1	1	ASPEN MEDICAL GROUP INC	25Feb2005	022	PHYSICIANS GROUP	FNP031995	None	UNKNOWN	In state provider	33	Riverside	None	9041 MAGNOLIA AVE	STE 305	RIVERSIDE	CA	925033957	33.925272	-117.438078	135c	315.01
1306015425	1306015425	1	1	ALTAMED HEALTH SERVICES CORP	13Feb2008	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	30	Orange	HUNTINGTON BCH COMM CLIN	8041 NEWMAN AVE	None	HUNTINGTON BEACH	CA	926477034	33.704838	-117.988640	116s	992.12
1306047196	1306047196	1	1	ALAMEDA COUNTY MED CTR	01Jul1998	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	01	Alameda	WINTON WELLNESS CENTER	24100 AMADOR ST	None	HAYWARD	CA	945441273	37.658958	-122.094685	2n	4368
1316061674	1316061674	1	1	ABAIAN, ALI MD	01Apr2001	026	PHYSICIANS	A00072830	None	UNKNOWN	In state provider	19	Los Angeles	None	8460 S CENTRAL AVENUE	None	LOS ANGELES	CA	900013761	33.961796	-118.256403	78.2fff	2398.02
1316088479	1316088479	1	1	ARROYO VISTA FAMILY	21Nov2001	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	HEALTH CENTER	4815 VALLEY BLVD	STE C	LOS ANGELES	CA	900323300	34.066174	-118.179911	78.2i	2016.01
1316116221	1316116221	1	1	ALTAMED HEALTH SERVICES CORP	13Feb2008	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	30	Orange	ORANGE, CHAPMAN	4010 E CHAPMAN AVE	None	ORANGE	CA	928693990	33.787757	-117.811405	116h	758.07
1316963606	1316963606	1	1	AMPLA HEALTH	25Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	04	Butte	None	680 COHASSET RD	None	CHICO	CA	959262213	39.752588	-121.845384	7.1	3
1326244096	1326244096	1	1	ALLIANCE MEDICAL CENTER	01Mar1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	49	Sonoma	None	1381 UNIVERSITY ST	None	HEALDSBURG	CA	954483314	38.627712	-122.863743	205.1	1539.02
1336366509	1336366509	1	1	AXIS COMMUNITY HEALTH	01Mar1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	01	Alameda	None	4361 RAILROAD AVE	None	PLEASANTON	CA	945666611	37.661529	-121.873610	2k	4506.07
1346250347	1346250347	1	1	AVALON MEDICAL DEVELOPMENT C	08Jul1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	CENTER	100 FALLS CANYON ROAD	None	AVALON	CA	907041563	33.339766	-118.335504	78.1	5990
1356775878	1356775878	1	1	ALTAMED HEALTH SERVICES CORP	16Dec2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	None	6336 PASSONS BLVD	None	PICO RIVERA	CA	906603355	33.985836	-118.085868	78.2ww	5008
1366419517	1366419517	1	1	ANTELOPE VALLEY HEALTHCARE	01Dec1977	072	MENTAL HEALTH INPATIENT SERVICES	None	None	UNKNOWN	In state provider	19	Los Angeles	HEALTHCARE DISTRICT	1600 W AVENUE J	None	LANCASTER	CA	935342814	34.689378	-118.159814	77.1c	9008.05
1376871566	1376871566	1	1	AGABABIAN MEDICAL CLINIC INC	19Jan2010	026	PHYSICIANS	A93668	None	UNKNOWN	In state provider	19	Los Angeles	None	6608 SAN FERNANDO ROAD	None	GLENDALE	CA	912011703	34.169011	-118.292464	78.2dd	3016.01
1386291466	1386291466	1	1	ALTAMED HEALTH SERVICES	06May2021	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	30	Orange	CORPORATION	1325 N ANAHEIM BLVD	STE 101	ANAHEIM	CA	928011202	33.852950	-117.919900	116l	865.01
1396067500	1396067500	1	1	AAA COMPREHENSIVE HEALTHCARE	26Aug2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	None	7451 N LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	916052803	34.205963	-118.387784	78.2bb	1224.10
1427123496	1427123496	2	1	ANAND NARAYAN MD INC	01Jan2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	54	Tulare	None	468 VERMONT AVE	None	DINUBA	CA	936181631	36.549079	-119.389343	227.1	4.02
1447353701	1447353701	1	1	ARROYO VISTA FAMILY	09Mar1999	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	HEALTH CENTER	6000 N FIGUEROA ST	None	LOS ANGELES	CA	900424232	34.111407	-118.189096	78.2i	1836.20
1447391719	1447391719	1	1	ASIAN HEALTH SERVICES	14Feb2019	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	818 WEBSTER ST	None	OAKLAND	CA	946074220	37.799398	-122.271306	2c	4030
1457596371	1457596371	1	1	ALLSAFE MEDICAL GROUP INC	17Aug2011	026	PHYSICIANS	None	None	UNKNOWN	In state provider	19	Los Angeles	APC	8077 FLORENCE AVE	STE 112	DOWNEY	CA	902403894	33.952489	-118.127878	78.2eee	5506.02
1457596371	1457596371	1	2	ALLSAFE MEDICAL GROUP INC	17Aug2011	026	PHYSICIANS	None	None	UNKNOWN	In state provider	19	Los Angeles	None	11061 ATLANTIC AVE	None	LYNWOOD	CA	902623048	33.928797	-118.184411	78.2ooo	5401.01
1457596371	1457596371	1	3	ALLSAFE MEDICAL GROUP INC	06Jun2013	022	PHYSICIANS GROUP	A00096862	None	UNKNOWN	In state provider	19	Los Angeles	PROFESSIONAL CORPORATION	4156 S CENTRAL AVE	None	LOS ANGELES	CA	900113154	34.008004	-118.256505	78.2ggg	2283.20
1477586808	1477586808	1	1	AMPLA HEALTH	25Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	06	Colusa	None	555 FREMONT ST	None	COLUSA	CA	959322534	39.207950	-122.011142	15	5
1477647386	1477647386	1	1	ASHOK, NAGASAMUDRA S	07Aug2008	026	PHYSICIANS	A00041589	41	Internal Medicine	In state provider	33	Riverside	MD INC	229 W 7TH ST	None	SAN JACINTO	CA	925834662	33.780353	-116.960315	132	436.02
1477866010	1477866010	1	1	AIRPORT URGENT CARE &	29Dec2011	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	19	Los Angeles	INDUSTRIAL MEDICINE A	1117 W MANCHESTER DR	SUITE K	INGLEWOOD	CA	903011500	33.959892	-118.375593	78.2q	6014.01
1497931828	1497931828	1	1	AMPLA HEALTH	01Jan2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	06	Colusa	MEDICAL & DENTAL	89 PUTNAM WAY	None	ARBUCKLE	CA	959129814	39.019971	-122.061021	16.3	1
1508088840	1508088840	1	1	ABDEL-MALEK, SHAHIRA MD	01Jul1996	022	PHYSICIANS GROUP	A00036609	40	Pediatrics	In state provider	19	Los Angeles	INC	3100 E FLORENCE AVE	STE 1	HUNTINGTON PARK	CA	902555848	33.972891	-118.212379	78.2ccc	5332.03
1518958313	1518958313	1	1	AMARA, DOMINIC P MD	01Mar1999	026	PHYSICIANS	G00076226	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	49	Sonoma	None	181 ANDRIEUX ST	STE 108	SONOMA	CA	954766920	38.288118	-122.461580	208	1502.04
1528365285	1528365285	1	1	AKRAM, TAHIRA MD INC	01Mar2011	026	PHYSICIANS	C00054187	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	36	San Bernardino	None	12588-90 CENTRAL AVE	None	CHINO	CA	917103507	34.024698	-117.689448	151a	6.04
1568449304	1568449304	1	3	ANDERSON VALLEY HEALTH	01Mar1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	23	Mendocino	CENTER	13500 AIRPORT ROAD	None	BOONVILLE	CA	954150338	39.010387	-123.377385	87.1	112
1568567220	1568567220	1	1	ALL FOR HEALTH, HEALTH	21Nov2005	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	FOR ALL, INC	519 E BROADWAY	None	GLENDALE	CA	912051110	34.146338	-118.249859	78.2ee	3020.02
1568567600	1568567600	1	1	A TU SALUD A MEDICAL	06Oct2008	026	PHYSICIANS	A00091739	08	Family Practice	In state provider	36	San Bernardino	CORPORATION	10563 MILLS AVE	None	MONTCLAIR	CA	917634610	34.062204	-117.717686	151c	3.01
1568798296	1568798296	1	1	AMIR G NASSERI MD PC	19Aug2009	026	PHYSICIANS	A00068974	None	UNKNOWN	In state provider	30	Orange	None	1155 W CENTRAL AVE	STE 214	SANTA ANA	CA	927073165	33.712562	-117.883916	116g	740.05
1568827210	1568827210	1	1	ALTURA CENTERS FOR HEALTH	11Apr2018	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	54	Tulare	None	1500 W TULARE DRIVE	None	TULARE	CA	932743424	36.206312	-119.368597	230	22.02
1578624672	1578624672	1	1	ARDMORE MED GROUP INC	10Apr1992	022	PHYSICIANS GROUP	FNP030539	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	ARDMORE MED GRP INC	3564 SANTA ANITA AVE	STE A	EL MONTE	CA	917312458	34.074056	-118.041644	78.2oo	4327
1578685137	1578685137	1	1	AGRICULTURAL WORKERS	01Mar1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	48	Solano	HLTH CTRS/DIXON FAMILY	131 W A ST	STE 1	DIXON	CA	956203437	38.445522	-121.822871	201	2534.02
1598180655	1598180655	1	1	ADVENTIST HEALTH PHYSICIANS	20Feb2020	045	CLINIC EXEMP FROM LICENSURE	None	None	UNKNOWN	In state provider	23	Mendocino	NETWORK	415 HOSPITAL DR	A	UKIAH	CA	954824545	39.154146	-123.202309	93.1	115
1598984288	1598984288	1	1	AMAVI, A PMC	01Jan1979	022	PHYSICIANS GROUP	FNP030498	01	General Practice	In state provider	19	Los Angeles	GUADALAJARA MED CLIN INC	2705 WHITTIER BLVD	None	LOS ANGELES	CA	900231441	34.032548	-118.211588	78.2h	2047
1609064435	1609064435	1	1	ADV WOMEN'S HEALTHCARE	05Jul2007	022	PHYSICIANS GROUP	FNP032887	None	UNKNOWN	In state provider	33	Riverside	AMC	79-200 CORPORATE CTR DR	STE 201	LA QUINTA	CA	922537245	33.710407	-116.283100	129.1	452.15
1609249994	1609249994	1	1	AXIS COMMUNITY HEALTH INC	05Jul2016	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	5925 W LAS POSITAS BLVD	STE 100	PLEASANTON	CA	945886239	37.683516	-121.899160	2k	4507.43
1629198791	1629198791	1	1	ALFRED LAVI DO PROFESSIONAL	19Mar2012	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	19	Los Angeles	CORPORATION	2324 W PICO BLVD	None	LOS ANGELES	CA	900064002	34.047262	-118.287597	78.2b	2211.10
1629198791	1629198791	1	2	ALFRED LAVI DO PROFESSIONAL	19Mar2012	022	PHYSICIANS GROUP	FNP001534	None	UNKNOWN	In state provider	19	Los Angeles	None	1835 S LA CIENEGA BLVD	STE 205 & 215	LOS ANGELES	CA	900354651	34.043839	-118.376744	78.2x	2696.01
1639194004	1639194004	1	1	AMPLA HEALTH	25Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	04	Butte	None	520 KENTUCKY ST	None	GRIDLEY	CA	959482116	39.363794	-121.696554	9	35.01
1639400260	1639400260	1	1	ASSUTA FAMILY MEDICAL GROUP	18Feb2010	022	PHYSICIANS GROUP	None	01	General Practice	In state provider	19	Los Angeles	APMC	12922 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	916062924	34.186685	-118.414880	78.2bb	1234.20
1679626436	1679626436	2	1	AZUL MEDICAL CLINIC INC	14Oct2014	022	PHYSICIANS GROUP	None	01	General Practice	In state provider	19	Los Angeles	None	6517 EASTERN AVE	None	BELL GARDENS	CA	902013003	33.974093	-118.163952	78.2c	5341.01
1689011637	1689011637	1	1	ALTURA CENTERS FOR HEALTH	17Sep2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	54	Tulare	None	3035 E BARDSLEY AVE	None	TULARE	CA	932746122	36.196097	-119.505561	230	21
1689699415	1689699415	1	1	AMPLA HEALTH	25Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	11	Glenn	None	278 MAIN STREET	None	HAMILTON CITY	CA	959510000	39.741273	-122.011779	36.2	105.01
1689875478	1689875478	1	1	ALAMEDA COUNTY MED CTR	21Feb2001	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	01	Alameda	NEWARK HEALTH CENTER	6066 CIVIC TERRACE AVE	None	NEWARK	CA	945603746	37.536685	-122.028158	2j	4445
1699883157	1699883157	1	1	APODACA, LEONEL JR MD	31Aug1989	026	PHYSICIANS	G00066374	41	Internal Medicine	In state provider	10	Fresno	None	1165 PHELPS AVE	STE 101	COALINGA	CA	932109665	36.150960	-120.335866	27	79.02
1700087590	1700087590	1	1	ALAMEDA HEALTH SYSTEM	01Jul1971	061	COUNTY HOSPITAL OUTPATIENT	140000046	None	UNKNOWN	In state provider	01	Alameda	None	1411 E 31ST ST	None	OAKLAND	CA	946021018	37.799262	-122.231207	2c	4057
1710105408	1710105408	1	1	AXIS COMMUNITY HEALTH	01Mar1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	01	Alameda	None	3311 PACIFIC AVE	None	LIVERMORE	CA	945507007	37.676150	-121.755169	1.2	4515.01
1710191283	1710191283	1	1	ALTAMED HEALTH SERVICES	28Apr1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	CORPORATION	9436 SLAUSON AVE	None	PICO RIVERA	CA	906604748	33.968332	-118.096522	78.2ww	5026.01
1710218409	1710218409	1	1	ALLIANCE MEDICAL CENTER	24Apr2014	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	49	Sonoma	None	8465 OLD REDWOOD HWY	SUITE 320	WINDSOR	CA	954928090	38.543841	-122.801258	205.2	1538.08
1730119553	1730119553	1	2	AFFILIATED PATHOLOGISTS MEDI	01Apr1998	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	19	Los Angeles	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	900172395	34.053179	-118.265299	78.2ffff	2091.02
1730481318	1730481318	1	1	ALTAMED HEALTH SERVICES	14Dec2011	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	CORPORATION	1300 S SUNSET AVE	None	WEST COVINA	CA	917903342	34.060137	-117.947437	78.2www	4068
1740427657	1740427657	1	1	ALTAMED HEALTH SERVICES CORP	01Apr2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	30	Orange	SANTA ANA, MAIN	1400 N MAIN ST	None	SANTA ANA	CA	927012321	33.756667	-117.867582	116b	750.04
1750582557	1750582557	1	1	ALAMEDA COUNTY MED CTR	07Feb2008	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	01	Alameda	EASTMONT WELLNESS CTR	6955 FOOTHILL BLVD	STE 200	OAKLAND	CA	946052426	37.769479	-122.174806	2d	4086
1760651814	1760651814	1	1	ALTAMED HEALTH SERVICES	09Apr2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	30	Orange	CORPORATION	2720 S BRISTOL STREET	SUITE 110	SANTA ANA	CA	927046210	33.710916	-117.885400	116g	740.05
1770006728	1770006728	1	1	ALTAMED HEALTH SERVICES	24Oct2018	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	CORPORATION	972 GOODRICH BLVD	None	COMMERCE	CA	900224114	34.018027	-118.154486	78.2c	5323.03
1770649097	1770649097	1	1	ARDMORE MED GROUP INC	10Apr1992	022	PHYSICIANS GROUP	FNP030539	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	3500 WHITTIER BLVD	STE 105	LOS ANGELES	CA	900231746	34.026687	-118.198514	78.2h	2049.10
1790177582	1790177582	1	1	ALTAMED HEALTH SERVICES	23Oct2018	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	CORPORATION	1900 E SLAUSON AVE	None	HUNTINGTON PARK	CA	902552725	33.989207	-118.236549	78.2ccc	5326.03
1801202676	1801202676	1	1	ANPHON CORPORATION	08Oct2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	None	333 E NUTWOOD STREET	SUITE C	INGLEWOOD	CA	903012357	33.960500	-118.351035	78.2q	6010.01
1801829296	1801829296	1	1	AMPLA HEALTH	25Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	58	Yuba	MEDICAL & DENTAL	4941 OLIVEHURST AVE	None	OLIVEHURST	CA	959614225	39.097071	-121.551527	249	405
1811129091	1811129091	1	1	ASIAN PACIFIC HEALTH CARE	31May2011	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	VENTURE INC	1575 W 2ND STREET	None	LOS ANGELES	CA	900265701	34.061229	-118.263118	78.2ffff	2083.02
1811329899	1811329899	1	1	AMPLA HEALTH	15May2019	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	52	Tehama	None	7981 HIGHWAY 99 E	None	LOS MOLINOS	CA	960559782	40.048840	-122.100654	220	1
1821210329	1821210329	1	1	AKHAVAN, AFSHIN DO A	25Aug2009	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	19	Los Angeles	PROFESSIONAL CORPORATION	2409 S VERMONT AVE	None	LOS ANGELES	CA	900071661	34.034219	-118.291535	78.2b	2217.10
1821210329	1821210329	1	2	AKHAVAN, AFSHIN DO A	12Apr2011	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	19	Los Angeles	None	530 E WASHINGTON BLVD	None	LOS ANGELES	CA	900153723	34.033930	-118.271189	78.2ffff	2240.20
1821492836	1821492836	1	1	ADVANCED HEALTHCARE FOR	23Jan2015	010	GROUP CERTIFIED NURSE PRACTITIONER	None	None	UNKNOWN	In state provider	36	San Bernardino	WOMEN AND CHILDREN A	600 NORTH MOUNTAIN AVE	SUITE A104	UPLAND	CA	917864359	34.101605	-117.670115	151d	8.23
1831115070	1831115070	1	1	AMPLA HEALTH	15Sep2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	51	Sutter	CENTER	1000 SUTTER STREET	None	YUBA CITY	CA	959913459	39.140392	-121.609917	216	502.02
1851709406	1851709406	1	1	ASHOK, NAGASAMUDRA S MD INC	03Feb2016	022	PHYSICIANS GROUP	None	01	General Practice	In state provider	36	San Bernardino	None	1520 N MOUNTAIN AVE	BLDG F STE 128	ONTARIO	CA	917621132	34.061468	-117.664432	151c	16
1861711863	1861711863	1	1	AME MEDICAL GROUP, INC.	15Jun2010	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	19	Los Angeles	None	11942 PARAMOUNT BLVD	STE B	DOWNEY	CA	902422306	33.933591	-118.144709	78.2sss	5515.02
1861796161	1861796161	1	1	ARLINGTON PHYSICIANS CHOICE	30Mar2011	022	PHYSICIANS GROUP	None	08	Family Practice	In state provider	33	Riverside	A MEDICAL CORPORATION	8151 ARLINGTON AVE	STE U-V	RIVERSIDE	CA	925030437	33.946358	-117.459837	135d	411.01
1881847424	1881847424	1	1	ADVANCE URGENT MED GROUP INC	07Oct2009	022	PHYSICIANS GROUP	None	41	Internal Medicine	In state provider	30	Orange	None	1401 W 1ST STREET	STE 101	SANTA ANA	CA	927033757	33.745446	-117.886918	116b	748.01
1881941409	1881941409	1	1	ALESSANDRO MEDICAL	28Jan2013	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	33	Riverside	PROFESSIONAL CORPORATION	13925 INDIAN ST	None	MORENO VALLEY	CA	925535718	33.918406	-117.234983	135g	425.21
1891795613	1891795613	1	1	AZAD, JACK MD INC	01Oct1996	026	PHYSICIANS	A00054433	08	Family Practice	In state provider	19	Los Angeles	TRI-CITY MEDICAL GROUP	11900 AVALON BLVD	STE 100	LOS ANGELES	CA	900612837	33.924665	-118.265174	78.2uuu	2410.02
1902267479	1902267479	1	1	ALTAMED HEALTH SERVICES	03Jul2017	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	CORPORATION	8627 ATLANTIC AVENUE	None	SOUTH GATE	CA	902803501	33.954724	-118.183830	78.2sss	5360
1902453731	1902453731	1	1	ALTAMED HEALTH SERVICES	21Apr2020	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	CORPORATION	2100 W 3RD STREET	STE 400	LOS ANGELES	CA	900572290	34.062959	-118.272688	78.2ffff	2088.01
1912312273	1912312273	1	1	AVENAL COMMUNITY HEALTH	01Dec2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	16	Kings	CENTER	148 E KINGS STREET	None	AVENAL	CA	932041529	36.002543	-120.136991	67	17.01
1922490960	1922490960	1	1	AGHABY COMPREHENSIVE	01Sep2017	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	COMMUNITY HEALTH CENTER	349 W COMPTON BLVD	None	COMPTON	CA	902203110	33.895943	-118.227565	78.2bbb	5425.02
1932756764	1932756764	1	1	ALTAMED HEALTH SERVICES	06May2021	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	30	Orange	CORPORATION	1325 N ANAHEIM BLVD	STE 200	ANAHEIM	CA	928011202	33.852950	-117.919900	116l	865.01
1952333635	1952333635	1	1	AMPLA HEALTH	25Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	04	Butte	MEDICAL & DENTAL	2800 LINCOLN BLVD	None	OROVILLE	CA	959665961	39.502499	-121.551712	10	30.02
1952628273	1952628273	1	1	ARANEZ, JOSE T MD INC	08Jun2010	026	PHYSICIANS	C00051587	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	2701 W ALAMEDA AVE	STE 407	BURBANK	CA	915054409	34.157535	-118.330146	78.2ttt	3116
1982179008	1982179008	1	1	ALL-INCLUSIVE COMMUNITY	01Jul2020	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	HEALTH CENTER	17114 DEVONSHIRE STREET	SUITE 200	NORTHRIDGE	CA	913251619	34.257552	-118.505989	78.2hh	1113.01
1982663795	1982663795	1	1	AHN, EDWARD S MD	01Jul2003	026	PHYSICIANS	A00040196	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	4620 BEVERLY BLVD	None	LOS ANGELES	CA	900043102	34.076258	-118.309618	78.2g	1924.20
1992873947	1992873947	1	1	ARDMORE MEDICAL GROUP INC	03Sep2003	022	PHYSICIANS GROUP	FNP030539	08	Family Practice	In state provider	19	Los Angeles	None	4528 SLAUSON AVE	None	MAYWOOD	CA	902702934	33.987116	-118.184956	78.2c	5337.01