Table: family_pact_providers_profile_cy_2021_2022 , provider_business_legal_name like B*

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	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
1003824020	1003824020	1	1	BAYLON, PAUL M MD	01Jan1989	026	PHYSICIANS	G00048547	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	19	Los Angeles	None	3118-3120 E FLORENCE AVE	None	HUNTINGTON PARK	CA	902555830	33.972891	-118.212379	78.2ccc	5332.03
1003867565	1003867565	1	1	BARTON HEALTHCARE SYSTEM	01Dec1977	017	LONG TERM CARE FACILITY	None	None	UNKNOWN	0	In state provider	09	El Dorado	None	2170 SOUTH AVE	None	S LAKE TAHOE	CA	961507026	38.912336	-119.998043	24	304.02
1003902610	1003902610	1	1	BRISTOL-MCFADDEN MED GRP	01Aug1982	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	30	Orange	INC	1212 S BRISTOL ST	STE 16	SANTA ANA	CA	927043439	33.732396	-117.885194	116g	747.02
1023349883	1023349883	1	1	BORREGO COMM HLTH FOUNDATION	10Dec2014	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	37	San Diego	None	1121 E WASHINGTON AVE	None	ESCONDIDO	CA	920252214	33.132290	-117.069344	156e	202.02
1053310326	1053310326	1	1	BARTON HEALTHCARE SYSTEM	02Mar2004	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	09	El Dorado	None	2201 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	961507025	38.912339	-119.996603	24	304.02
1053386565	1053386565	1	1	BETRE, ABRAHAM DO	02Jun2008	026	PHYSICIANS	20A10290	09	Gynecology (D.O. only)	0	In state provider	54	Tulare	None	925 MERRITT AVE	None	TULARE	CA	932742247	36.222009	-119.334354	230	23.03
1053691337	1053691337	1	1	BE, VIET A MD INC	01Sep2000	026	PHYSICIANS	G00048753	None	UNKNOWN	0	In state provider	30	Orange	None	11160 WARNER AVENUE	SUITE 301	FOUNTAIN VALLEY	CA	927084055	33.716327	-117.934948	116j	992.26
1083735203	1083735203	1	1	BATRES, ERIC R MD	09Mar2004	026	PHYSICIANS	G00044726	None	UNKNOWN	0	In state provider	19	Los Angeles	MEDICAL CORP	5101 FLORENCE AVE	STE 4	BELL	CA	902013801	33.969061	-118.176068	78.2ddd	5338.05
1124115431	1124115431	1	1	BLYTHE HEALTH CLINIC	01Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	None	321 W HOBSONWAY	STE C	BLYTHE	CA	922251651	33.610310	-114.599743	126	461.02
1134144165	1134144165	1	1	BORREGO COMMUNITY HEALTH	01Nov2006	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	37	San Diego	FOUNDATION	4343 YAQUI PASS RD	None	BORREGO SPRINGS	CA	920040000	33.193148	-116.330451	152	210
1154480069	1154480069	1	1	BORREGO COMMUNITY HEALTH	22May2008	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	37	San Diego	FOUNDATION	133 WEST MAIN STREET	STE 100	EL CAJON	CA	920203954	32.794864	-116.962732	161h	158.02
1184791998	1184791998	1	1	BAY AREA COMMUNITY HEALTH	27Apr2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	01	Alameda	None	1999 MOWRY AVENUE	None	FREMONT	CA	945381738	37.557757	-121.981042	2j	4419.23
1215100417	1215100417	1	1	BANTA, DANTE A MD INC	01Jul1993	026	PHYSICIANS	A044079	08	Family Practice	0	In state provider	19	Los Angeles	None	875 N WESTERN AVE	None	LOS ANGELES	CA	900293759	34.086121	-118.309136	78.2g	1916.10
1255490819	1255490819	1	1	BORREGO COMM HLTH FNDTN	22May2008	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	CENTRO MEDICO OASIS	88775 AVE 76	STE 1	THERMAL	CA	922749681	33.498948	-116.117237	128	456.05
1265572903	1265572903	1	1	BROOKDALE MEDICA CENTER	05Dec2005	022	PHYSICIANS GROUP	None	01	General Practice	0	In state provider	19	Los Angeles	INC	2809 TWEEDY BLVD	None	SOUTH GATE	CA	902805538	33.945986	-118.221942	78.2ccc	5356.06
1275656761	1275656761	1	1	BIR, RAGHBIR S MD	01Jul1998	022	PHYSICIANS GROUP	A00042345	41	Internal Medicine	0	In state provider	36	San Bernardino	None	280 N RIVERSIDE AVE	None	RIALTO	CA	923765924	34.103910	-117.370486	151h	37
1275849283	1275849283	1	1	BORREGO COMMUNITY HEALTH	30Jan2014	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	FOUNDATION	66675 PIERSON BLVD	None	DESERT HOT SPRING	CA	922403737	33.961413	-116.498025	129.4	445.10
1306131545	1306131545	1	1	BORREGO COMMUNITY HEALTH	02Jan2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	FOUNDATION	8856 ARLINGTON AVE	None	RIVERSIDE	CA	925031365	33.946501	-117.467871	135d	411.01
1346353679	1346353679	1	1	BANNING HEALTH CENTER	01Sep1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	None	3055 W RAMSEY ST	None	BANNING	CA	922203781	33.925769	-116.910767	134	441.01
1346492055	1346492055	1	1	BESHAY, ISAAC N MD	12Sep2008	026	PHYSICIANS	A00089039	None	UNKNOWN	0	In state provider	30	Orange	None	2200 HARBOR BLVD	STE B 210	COSTA MESA	CA	926272501	33.654345	-117.919091	116p	639.06
1356438261	1356438261	1	2	BIG VALLEY MEDICAL CTR	01Mar1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	0	In state provider	18	Lassen	PO BOX 277	554-850 MEDICAL CENTER	None	BIEBER	CA	960090000	41.121216	-121.141190	73	401
1376761940	1376761940	1	1	BENEVOLENCE INDUSTRIES INC	01Feb2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	None	3533 W PICO BLVD	None	LOS ANGELES	CA	900194534	34.047164	-118.319297	78.2e	2181.20
1376843771	1376843771	1	1	BRISTOL-MCFADDEN MEDICAL	15Feb2011	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	30	Orange	GROUP INC	1226 E MCFADDEN AVE	None	SANTA ANA	CA	927054106	33.733603	-117.855114	116g	744.03
1386069995	1386069995	1	1	BORREGO COMMUNITY HEALTH	19May2016	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	FOUNDATION	1180 N INDIAN CANYON DR	SUITE W-300	PALM SPRINGS	CA	922624800	33.839669	-116.545605	129.4	446.06
1508109794	1508109794	1	1	BALTAIAN, LILIT MD INC	08Nov2013	026	PHYSICIANS	A00105197	01	General Practice	0	In state provider	19	Los Angeles	None	7412 FOOTHILL BLVD	None	TUJUNGA	CA	910422722	34.251551	-118.293456	78.2rr	1012.10
1528345915	1528345915	1	1	BALDWIN PARK MEDICAL CENTER	25Jun2014	026	PHYSICIANS	20A7473	01	General Practice	0	In state provider	19	Los Angeles	INC	14362 E RAMONA BLVD	None	BALDWIN PARK	CA	917063241	34.086349	-117.960992	78.2zzz	4052.02
1548659105	1548659105	1	1	BEHAVIORAL HEALTH SERVICES	04Sep2017	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	INC	2501 W EL SEGUNDO BLVD	SUITE B	HAWTHORNE	CA	902503317	33.916464	-118.320423	78.2bbbb	6026
1548795453	1548795453	1	1	BORREGO COMMUNITY HEALTH	28Mar2019	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	36	San Bernardino	FOUNDATION	750 E MAIN ST	None	BARSTOW	CA	923110000	34.898790	-117.015867	149	94
1558981381	1558981381	1	1	BLESSING COMMUNITY HEALTH	01Feb2021	041	COMMUNITY CLINIC	550006055	None	UNKNOWN	0	In state provider	36	San Bernardino	CENTER	3972 N WATERMAN AVE	STE 104	SAN BERNARDINO	CA	924041767	34.164306	-117.278699	151k	51
1568585024	1568585024	1	1	BIR, R S MD INC	01Jul2001	022	PHYSICIANS GROUP	None	01	General Practice	0	In state provider	36	San Bernardino	None	9792 SIERRA AVE	None	FONTANA	CA	923356717	34.075913	-117.435763	151f	33.01
1568747137	1568747137	1	1	BORREGO COMMUNITY HEALTH	19May2016	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	37	San Diego	FOUNDATION	8851 CENTER DR	SUITE 210	LA MESA	CA	919423045	32.782249	-117.005653	161f	150
1568800100	1568800100	1	1	BEST START MIDWIFE SERVICES	02Feb2015	089	ELECTRONIC HEALTH RECORD INCENTIVE PROGRAM	None	None	UNKNOWN	0	In state provider	37	San Diego	None	3630 ENTERPRISE STREET	None	SAN DIEGO	CA	921103212	32.746298	-117.198357	161b	65
1578708285	1578708285	1	1	BIGGS GRIDLEY MEM HOSP	05Apr2002	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	0	In state provider	04	Butte	FAMILY CARE CTR	240 SPRUCE ST	None	GRIDLEY	CA	959482216	39.366966	-121.690577	9	35.02
1578763207	1578763207	1	1	BENEVOLENCE INDUSTRIES INC	02Jan2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	None	3631 CRENSHAW BLVD	SUITE 109	LOS ANGELES	CA	900164869	34.022751	-118.335126	78.2nnn	2200
1619036514	1619036514	1	1	BORREGO COMM HLTH FNDTN	22May2008	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	CENTRO MEDICO CTHDRL CTY	69175 RAMON ROAD	STE A	CATHEDRAL CITY	CA	922343344	33.815899	-116.456507	129.4	9406
1629192133	1629192133	1	1	BEVERLY, SHEREEN L MD	06Oct2004	026	PHYSICIANS	G00068251	None	UNKNOWN	0	In state provider	19	Los Angeles	INC	16812 HAWTHORNE BLVD	None	LAWNDALE	CA	902603218	33.878380	-118.352348	78.2iiii	6041
1669547618	1669547618	1	1	BARARSANI, MOHAMMAD MD	09Oct2012	026	PHYSICIANS	A35392	None	UNKNOWN	0	In state provider	19	Los Angeles	None	18051 CRENSHAW BLVD	SUITE #C	TORRANCE	CA	905045144	33.866761	-118.326468	78.2iiii	6501.02
1710261284	1710261284	1	1	BELLA MEDICAL GROUP INC	26Mar2012	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	19	Los Angeles	None	2933 WHITTIER BLVD	None	LOS ANGELES	CA	900231528	34.030985	-118.208139	78.2h	2047
1710261284	1710261284	1	2	BELLA MEDICAL GROUP INC	02May2013	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	19	Los Angeles	None	9916 SAN JUAN AVE	None	SOUTH GATE	CA	902806108	33.943627	-118.203163	78.2ccc	5358.02
1740303247	1740303247	1	1	BIR, R S MD INC	01Jul1998	022	PHYSICIANS GROUP	A00042345	41	Internal Medicine	0	In state provider	36	San Bernardino	None	11692 CENTRAL AVE	None	CHINO	CA	917101923	34.040964	-117.689596	151l	4.04
1760936884	1760936884	1	2	BEVERLYCARE	21May2020	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	INTERMITTENT	1920 W WHITTIER BLVD	None	MONTEBELLO	CA	906404009	34.012936	-118.121520	78.2ww	5301.02
1760936884	1760936884	1	4	BEVERLYCARE	11Aug2020	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	INTERMITTENT	8862 WHITTIER BLVD	None	PICO RIVERA	CA	906602658	34.001530	-118.084447	78.2ww	5006
1780038042	1780038042	1	1	BORREGO COMMUNITY HEALTH	13Sep2018	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	36	San Bernardino	FOUNDATION	590 NORTH D STREET	None	SAN BERNARDINO	CA	924011352	34.109961	-117.291883	151g	57.01
1780054379	1780054379	1	1	BAY AREA COMMUNITY HEALTH	01Aug2017	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	01	Alameda	None	40910 FREMONT BLVD	None	FREMONT	CA	945384375	37.533942	-121.960851	2j	4423.02
1780958462	1780958462	1	1	BAHARI-NEJAD, PEJAM DO A	21Oct2013	026	PHYSICIANS	20A7938	None	UNKNOWN	0	In state provider	19	Los Angeles	PROFESSIONAL MEDICAL C	20829 VENTURA BLVD	None	WOODLAND HILLS	CA	913642319	34.166363	-118.586542	78.2yy	1375.01
1790075315	1790075315	1	1	BORREGO COMMUNITY HEALTH	02Jan2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	FOUNDATION	1970 UNIVERSITY AVE	None	RIVERSIDE	CA	925075202	33.975622	-117.354517	135a	305.01
1790886117	1790886117	1	1	BUTTE COUNTY HLTH DEPT	01Dec1977	048	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	ZZR11557	None	UNKNOWN	0	In state provider	04	Butte	None	78 TABLE MOUNTAIN BLVD	None	OROVILLE	CA	959653578	39.521343	-121.554687	10	25
1790886117	1790886117	1	2	BUTTE COUNTY HLTH DEPT	27Jul2009	045	CLINIC EXEMP FROM LICENSURE	None	None	UNKNOWN	0	In state provider	04	Butte	OF PUBLIC HEALTH CLINICS	695 OLEANDER AVE	None	CHICO	CA	959263924	39.735314	-121.841660	7.1	7
1811279763	1811279763	1	1	BARTZ ALTADONNA COMMUNITY	01Jun2012	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	HEALTH CENTER	43322 GINGHAM AVE	SUITE 104 & 105	LANCASTER	CA	935354569	34.671365	-118.122268	77.1c	9005.04
1841419793	1841419793	1	1	BLACK, ROBIN	07Feb2007	007	CERTIFIED NURSE PRACTIONER	RN0268672	None	UNKNOWN	0	In state provider	30	Orange	None	2077 HARBOR BLVD	STE C	COSTA MESA	CA	926272630	33.649959	-117.919049	116p	637.02
1851577662	1851577662	1	1	BEACH AREA FAMILY HEALTH	02Jan1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	0	In state provider	37	San Diego	CENTER	3705 MISSION BLVD	None	SAN DIEGO	CA	921097104	32.782645	-117.252440	161a	76
1861433526	1861433526	1	1	BRYAN H TRAN MD INC	01Jun1999	026	PHYSICIANS	A00054928	None	UNKNOWN	0	In state provider	30	Orange	None	27800 MEDICAL CENTER RD	STE 230	MISSION VIEJO	CA	926916447	33.560069	-117.665857	115.2a	320.22
1861680712	1861680712	1	1	BIENESTAR MEDICAL CENTER	02Nov2006	022	PHYSICIANS GROUP	FNP030110	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	30	Orange	INC	1125 E 17TH STREET	SUITE N 152	SANTA ANA	CA	927012620	33.759883	-117.854493	116h	754.03
1891862553	1891862553	1	1	BASELINE MEDICAL CLINIC INC	06Apr1984	022	PHYSICIANS GROUP	None	01	General Practice	0	In state provider	36	San Bernardino	None	330 N D ST	STE 300	SAN BERNARDINO	CA	924011522	34.105201	-117.291884	151g	57.01
1922124866	1922124866	1	2	BAYCHILDREN'S PHYSICIANS	01Oct2016	071	LICENSED CLINICAL SOCIAL WORKER GROUP	None	None	UNKNOWN	0	In state provider	01	Alameda	None	1555 DOOLITTLE DRIVE	None	SAN LEANDRO	CA	945772239	37.711890	-122.184754	2g	4324
1932225208	1932225208	1	1	BADYMOGHADDAM, YAGHOUB	09Sep2005	026	PHYSICIANS	A00052570	01	General Practice	0	In state provider	19	Los Angeles	None	5726 E OLYMPIC BLVD	None	LOS ANGELES	CA	900225120	34.013977	-118.147502	78.2c	5323.03
1942623657	1942623657	1	1	BORREGO COMMUNITY HEALTH	19May2016	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	33	Riverside	FOUNDATION	58581 US HIGHWAY 371	SUITE F, G, H	ANZA	CA	925399331	33.557470	-116.638921	130	444.03
1942638978	1942638978	1	1	BRIGHTER BEGINNINGS	01Dec2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	07	Contra Costa	None	2727 MACDONALD AVE	None	RICHMOND	CA	948043006	37.935033	-122.342699	18f	3740
1962560896	1962560896	1	1	BERGANZA, JOSE D MD INC	01Jan1997	022	PHYSICIANS GROUP	None	08	Family Practice	0	In state provider	19	Los Angeles	SAN JOSE MULTISPECIALTY	14514 RAMONA BLVD	STE 3	BALDWIN PARK	CA	917063361	34.086815	-117.958895	78.2zzz	4052.01
1992732192	1992732192	1	1	BOLSA MEDICAL GROUP	08Jul1994	022	PHYSICIANS GROUP	FNP021388	None	UNKNOWN	0	In state provider	30	Orange	None	10362 BOLSA AVE	STE 110	WESTMINSTER	CA	926836763	33.744983	-117.948356	116i	889.04