Table family_pact_providers_profile_cy_2021

Table: family_pact_providers_profile_cy_2021_2022 , provider_business_legal_name like L*

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
1013085778	1013085778	1	1	LA CLINICA DE LA RAZA	10Jan2007	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	TECHNICLINIC	4351 BROADWAY	None	OAKLAND	CA	946114612	37.831449	-122.254346	2b	4012
1023116811	1023116811	1	1	LONG BEACH DEPT OF HLTH	02Jan1976	041	COMMUNITY CLINIC	ZZT11624	None	UNKNOWN	In state provider	19	Los Angeles	AND HUMAN SERVICES	2525 GRAND AVE	None	LONG BEACH	CA	908151765	33.802261	-118.148042	78.2lll	5742.02
1023445780	1023445780	1	1	LA CLINICA DE LA RAZA INC	05Feb2014	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	1700 28TH AVE	None	OAKLAND	CA	946012455	37.782358	-122.227524	2d	4062.02
1053324715	1053324715	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	HUDSON FAMILY PLANNING	2829 S GRAND AVE	None	LOS ANGELES	CA	900073304	34.024316	-118.273658	78.2l	2246
1053526756	1053526756	1	1	LA MAESTRA FAMILY CLINIC INC	02Oct2006	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	37	San Diego	NATIONAL CITY	217 HIGHLAND AVE	None	NATIONAL CITY	CA	919501518	32.683182	-117.100690	161k	118.01
1063426898	1063426898	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	LONG BEACH FAM PLANNING	1333 CHESTNUT AVE	None	LONG BEACH	CA	908132944	33.783223	-118.196371	78.2jjj	5754.01
1063501880	1063501880	1	1	LANTRY, SELENA C MD	01Oct1995	026	PHYSICIANS	G00055968	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	1505 WILSON TER	STE 130	GLENDALE	CA	912064074	34.149530	-118.231281	78.2ee	3010
1083627749	1083627749	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	ROYBAL FAMILY PLANNING	245 S FETTERLY AVE	None	LOS ANGELES	CA	900221605	34.034141	-118.160915	78.2d	5304
1124106646	1124106646	1	1	LANARK FAMILY MED CLINIC	01May2002	082	LICENSED MIDWIVES	None	None	UNKNOWN	In state provider	19	Los Angeles	None	8040 VAN NUYS BLVD	None	PANORAMA CITY	CA	914026010	34.217232	-118.448759	78.2zz	1203
1124300207	1124300207	1	1	LIVINGSTON COMMUNITY HEALTH	25Oct2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	24	Merced	None	7970 N LANDER AVE	SUITE A & B	HILMAR	CA	953248350	37.403898	-120.850126	95	4.02
1134570708	1134570708	1	1	LE, ANHDAO V MD INC	25Jul2016	026	PHYSICIANS	A81117	01	General Practice	In state provider	19	Los Angeles	None	1024 E PACIFIC COAST HWY	None	LONG BEACH	CA	908065017	33.789849	-118.180128	78.2jjj	5752.01
1144336181	1144336181	1	1	LA CLINICA DE LA RAZA	21Aug2006	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	3451 E 12TH ST	None	OAKLAND	CA	946013425	37.775796	-122.223557	2d	4061
1154327138	1154327138	1	1	LIFELONG MEDICAL CARE	11Feb2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	EAST OAKLAND	10700 MACARTHUR BLVD	STE 14B	OAKLAND	CA	946055260	37.742368	-122.151705	2d	4101
1154636793	1154636793	1	1	LOS ANGELES COUNTY	27Dec2010	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	HIGH DESERT HLTH SYSTEMS	44900 60TH ST W	None	LANCASTER	CA	935367618	34.696359	-118.236642	77.5	9012.05
1164503652	1164503652	1	1	LAS PALMAS MEDICAL GROUP	30Mar2004	022	PHYSICIANS GROUP	FNP035097	01	General Practice	In state provider	33	Riverside	CORPORATION	1003 N STATE STREET	None	HEMET	CA	925434435	33.763055	-116.971873	132	435.07
1194709535	1194709535	1	1	LING, DAVID MD	01Jan1979	026	PHYSICIANS	C00029051	None	UNKNOWN	In state provider	19	Los Angeles	None	2031 W ALAMEDA AVE	STE 214	BURBANK	CA	915062959	34.159851	-118.323310	78.2ttt	3117
1205137452	1205137452	1	1	LALEZARI, BAHMAN MD INC	30Sep1995	026	PHYSICIANS	A00051462	01	General Practice	In state provider	19	Los Angeles	None	4944 W PICO BLVD	None	LOS ANGELES	CA	900194228	34.047892	-118.344541	78.2x	2172
1225044662	1225044662	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	WILMINGTON FAM PLANNING	1325 BROAD AVE	None	WILMINGTON	CA	907442604	33.789816	-118.261561	78.2p	2946.10
1225149222	1225149222	1	1	LAGUNA BEACH COMM CLINIC	01Dec2018	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	30	Orange	None	362 3RD ST	None	LAGUNA BEACH	CA	926512307	33.543763	-117.780912	115.2d	626.05
1235245275	1235245275	1	1	LA CLINICA DE LA RAZA	21Aug2006	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	CLINICA ALTA VISTA	1515 FRUITVALE AVE	None	OAKLAND	CA	946012355	37.778916	-122.225196	2d	4062.02
1245671726	1245671726	1	1	LA CLINICA DE LA RAZA INC	16Sep2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	1390 66TH AVE	None	OAKLAND	CA	946213506	37.762067	-122.193395	2d	4088
1255795258	1255795258	1	1	LOS ANGELES COMMUNITY	14Oct2016	055	LOCAL EDUCATION AGENCY	None	None	UNKNOWN	In state provider	19	Los Angeles	COLLEGE DISTRICT	6201 WINNETKA AVENUE	None	WOODLAND HILLS	CA	913710001	34.182912	-118.570945	78.2ii	1393.01
1265440010	1265440010	1	1	LOS ANGELES CO	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	MID VALLEY COMP HLTH CTR	7515 VAN NUYS BLVD	None	VAN NUYS	CA	914051949	34.207156	-118.448789	78.2zz	1272.20
1265539712	1265539712	1	1	LUDMIR, JAIME MD	01Jul1984	026	PHYSICIANS	A00035195	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	30	Orange	None	2810 S BRISTOL ST	None	SANTA ANA	CA	927046204	33.709712	-117.885429	116g	740.05
1295887024	1295887024	2	1	LA LIBERTAD MEDICAL	01Jul2008	022	PHYSICIANS GROUP	FNP024664	None	UNKNOWN	In state provider	19	Los Angeles	CLINIC INC	8225 LONG BEACH BLVD	STE C	SOUTH GATE	CA	902802010	33.963767	-118.225108	78.2ccc	5355.01
1316075062	1316075062	1	1	LASALLE MEDICAL ASSOC	01Apr1998	022	PHYSICIANS GROUP	FNP023625	None	UNKNOWN	In state provider	36	San Bernardino	None	16455 MAIN ST	STE 1	HESPERIA	CA	923453500	34.421826	-117.303329	145.1a	100.14
1316188543	1316188543	1	1	LA CLINICA DE LA RAZA INC	23Jul2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	50 E LEWELLING BLVD	None	SAN LORENZO	CA	945801732	37.686688	-122.122192	2h	4337
1336353721	1336353721	1	1	LA MAESTRA FAMILY CLINIC	09Feb1999	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	37	San Diego	None	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	921051609	32.750726	-117.100866	161d	23.02
1356341671	1356341671	1	1	LETAMENDI, ROBERT F MD	01Aug1995	026	PHYSICIANS	A00050002	01	General Practice	In state provider	44	Santa Cruz	CLINICA MEDICA SANTA MAR	21 BRENNAN ST	STE 21	WATSONVILLE	CA	950764337	36.913352	-121.757620	184	1103
1366467375	1366467375	1	1	LONG VALLEY HEALTH CTR	01Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	23	Mendocino	PO BOX 870	50 BRANSCOMB RD	None	LAYTONVILLE	CA	954540870	39.687775	-123.484850	90	102
1376556555	1376556555	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	SAN FERNANDO FAM PLAN	1212 PICO ST	None	SAN FERNANDO	CA	913403503	34.283360	-118.444415	78.2ll	3203
1376565309	1376565309	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	H/UCLA WOMEN CLINIC N28	1000 W CARSON ST	# L4	TORRANCE	CA	905022004	33.831586	-118.293386	78.2aaaa	5435.03
1376610923	1376610923	1	1	LOVATO, ESTEBAN MD	09May2006	026	PHYSICIANS	G00075190	None	UNKNOWN	In state provider	01	Alameda	None	3022 INTERNATIONAL BLVD	STE 210	OAKLAND	CA	946012226	37.778594	-122.227871	2d	4061
1386025773	1386025773	1	1	L A STAR MEDICAL GROUP INC	21Jan2016	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	19	Los Angeles	None	4161 REDONDO BEACH BLVD	SUITE 100	LAWNDALE	CA	902601477	33.876068	-118.347605	78.2iiii	6041
1396817193	1396817193	1	3	LOS ALAMITOS OB GYN MEDICAL	27Jul2020	026	PHYSICIANS	20A6917	None	UNKNOWN	In state provider	30	Orange	GROUP INC	8615 KNOTT	5	BUENA PARK	CA	906203841	33.837742	-118.011124	116a	1102.01
1396836094	1396836094	1	1	LOPEZ, ROBERT MD	01Oct1999	026	PHYSICIANS	G00075281	None	UNKNOWN	In state provider	36	San Bernardino	None	12586 CENTRAL AVE	None	CHINO	CA	917103507	34.024898	-117.689451	151a	6.04
1396859179	1396859179	1	1	LAKE ELSINORE FAMILY	01Sep1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	33	Riverside	CARE CENTER	2499 E LAKESHORE DR	None	LAKE ELSINORE	CA	925304446	33.660351	-117.301362	131a	430.01
1407973043	1407973043	2	1	LIFELONG MEDICAL CARE	07Mar2012	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	07	Contra Costa	None	150 HARBOUR WAY	None	RICHMOND	CA	948013554	37.933302	-122.360005	18f	3770
1417907940	1417907940	1	1	LPCH MEDICAL GROUP DIV OF LU	05Jul2005	082	LICENSED MIDWIVES	None	None	UNKNOWN	In state provider	43	Santa Clara	EN'S HOSPITAL AT STANFOR	725 WELCH RD	None	PALO ALTO	CA	943041601	37.436857	-122.172778	183a	5116.09
1417907940	1417907940	1	2	LPCH MEDICAL GROUP DIV OF LU	22Apr2014	071	LICENSED CLINICAL SOCIAL WORKER GROUP	None	None	UNKNOWN	In state provider	01	Alameda	LUCILE	1359 PARK AVE	None	ALAMEDA	CA	945014511	37.763084	-122.242226	2e	4281
1417907940	1417907940	1	16	LPCH MEDICAL GROUP DIV OF LU	22Apr2014	071	LICENSED CLINICAL SOCIAL WORKER GROUP	None	None	UNKNOWN	In state provider	41	San Mateo	LUCILE	50 S SAN MATEO DR	SUITE 180	SAN MATEO	CA	944013859	37.566377	-122.326053	176f	6063
1417907940	1417907940	1	20	LPCH MEDICAL GROUP DIV OF LU	22Apr2014	071	LICENSED CLINICAL SOCIAL WORKER GROUP	None	None	UNKNOWN	In state provider	07	Contra Costa	LUCILE	1776 YGNACIO VALLEY ROAD	STE 100	WALNUT CREEK	CA	945983100	37.917186	-122.039677	18j	3382.04
1417907940	1417907940	1	21	LPCH MEDICAL GROUP DIV OF LU	22Apr2014	071	LICENSED CLINICAL SOCIAL WORKER GROUP	None	None	UNKNOWN	In state provider	07	Contra Costa	LUCILE	2160 APPIAN WAY	SUITE 100	PINOLE	CA	945642524	37.996790	-122.301668	18a	3591.02
1417907940	1417907940	1	27	LPCH MEDICAL GROUP DIV OF LU	17Nov2014	071	LICENSED CLINICAL SOCIAL WORKER GROUP	None	None	UNKNOWN	In state provider	01	Alameda	None	5720 STONERIDGE MALL RD	#240	PLEASANTON	CA	945882830	37.692504	-121.930127	2k	4506.02
1427070168	1427070168	1	1	LOS ANGELES COUNTY	18Jun2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	19	Los Angeles	HARBOR-UCLA MEDICAL CTR	1000 W CARSON ST	# L4	TORRANCE	CA	905022004	33.831586	-118.293386	78.2aaaa	5435.03
1427070374	1427070374	1	1	LA CLINICA DE LA RAZA	01Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	SAN ANTONIO NBRHD HLTH	1030 INTERNATIONAL BLVD	None	OAKLAND	CA	946063730	37.791860	-122.249437	2e	4060
1427110329	1427110329	1	1	LIVINGSTON COMMUNITY HEALTH	01Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	24	Merced	None	600 B ST	BUILDING B	LIVINGSTON	CA	953349593	37.385959	-120.728973	95	3.04
1447388251	1447388251	1	1	LASALLE MEDICAL ASSOC	01May2000	022	PHYSICIANS GROUP	FNP023625	None	UNKNOWN	In state provider	36	San Bernardino	None	565 N MOUNT VERNON AVE	None	SAN BERNARDINO	CA	924112661	34.109573	-117.313834	151g	48
1457758724	1457758724	1	1	LIFELONG MEDICAL CARE	22Apr2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	3075 ADELINE ST	SUITE 280	BERKELEY	CA	947032590	37.852694	-122.269722	2a	4239.01
1467442749	1467442749	1	1	LUCILE SALTER PACKARD	03Jul1989	016	COMMUNITY INPATIENT HOSPITAL	None	None	UNKNOWN	In state provider	43	Santa Clara	CHILDRENS HOSP/STANFORD	725 WELCH RD	None	PALO ALTO	CA	943041601	37.436857	-122.172778	183a	5116.09
1467762294	1467762294	1	1	L.T. DUONG, M.D., INC.	23Feb2011	026	PHYSICIANS	A00074045	None	UNKNOWN	In state provider	30	Orange	None	2708 WESTMINSTER AVE	STE 110	SANTA ANA	CA	927062192	33.759815	-117.905808	116i	891.04
1487012779	1487012779	1	1	LIVINGSTON COMMUNITY HEALTH	01Aug2017	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	24	Merced	None	1617 MAIN STREET	None	LIVINGSTON	CA	953341250	37.377435	-120.723449	95	3.04
1487696191	1487696191	2	1	LIFELONG MEDICAL CARE	07Mar2012	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	07	Contra Costa	SAN PABLO	2023 VALE ROAD	#107	SAN PABLO	CA	948063834	37.953560	-122.338006	18f	3690.01
1487764064	1487764064	2	1	LAST FRONTIER HEALTHCARE	08Aug2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	25	Modoc	DISTRICT	1111 N NAGLE ST	None	ALTURAS	CA	961013841	41.487319	-120.552867	98	1
1497761324	1497761324	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	HUMPHREY FAMILY PLANNING	5850 S MAIN ST	None	LOS ANGELES	CA	900031215	33.988724	-118.273922	78.2ggg	2392.02
1518963321	1518963321	1	1	LEE, JAY K MD	01Jul2005	026	PHYSICIANS	A00085767	None	UNKNOWN	In state provider	33	Riverside	None	12980 FREDERICK ST	STE A	MORENO VALLEY	CA	925535263	33.932093	-117.261368	135b	425.13
1518963693	1518963693	1	1	LIFELONG MEDICAL CARE	01Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	BERKELEY PRIMARY CARE	2001 DWIGHT WAY	None	BERKELEY	CA	947042608	37.863641	-122.269858	2a	4235
1528078573	1528078573	1	1	LAC USC MEDICAL CENTER	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	LAC+USC W+C OP RM 4P81	1200 N STATE ST	None	LOS ANGELES	CA	900331083	34.059119	-118.209851	78.2ffff	2033
1528433588	1528433588	1	1	LIVINGSTON COMMUNITY HEALTH	01Aug2017	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	50	Stanislaus	None	12619 BENTLEY ST	None	WATERFORD	CA	953869011	37.640669	-120.761329	214	28.01
1538181482	1538181482	1	1	LA CLINICA DE LA RAZA INC	21Aug2006	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	07	Contra Costa	None	2000 SIERRA ROAD	None	CONCORD	CA	945182905	37.952425	-122.037196	18c	3372
1538183389	1538183389	1	1	LIU, LONG-DEI MD	08Dec1980	026	PHYSICIANS	A00036134	None	UNKNOWN	In state provider	30	Orange	None	12555 GARDEN GROVE BLVD	STE 402	GARDEN GROVE	CA	928431903	33.774488	-117.914305	116r	885.02
1538240908	1538240908	1	1	LOPEZ, IRMA MD	17Jan2008	026	PHYSICIANS	G57022	08	Family Practice	In state provider	36	San Bernardino	None	527 N PALM AVE	SUITE 106	ONTARIO	CA	917623215	34.068542	-117.653605	151c	14
1558527572	1558527572	1	1	LEW, PO LONG DO	01Jan1988	026	PHYSICIANS	20A5380	08	Family Practice	In state provider	19	Los Angeles	A MEDICAL CORPORATION	9308 VALLEY BLVD	None	ROSEMEAD	CA	917701924	34.081055	-118.066612	78.2qqq	4329.01
1568598829	1568598829	1	1	LIFELONG MEDICAL CARE-	11Feb2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	DOWNTOWN OAKLAND CLINIC	616 16TH ST	None	OAKLAND	CA	946121205	37.807251	-122.274341	2c	4028
1578834164	1578834164	1	1	LA CLINICA DE LA RAZA INC	29Oct2012	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	07	Contra Costa	None	2021 MAIN ST	None	OAKLEY	CA	945613302	38.002703	-121.732358	18e	3020.05
1619056926	1619056926	1	1	LA CLINICA DE LA RAZA	10Jan2007	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	TIGER HEALTH CLINIC	4610 FOOTHILL BLVD	None	OAKLAND	CA	946014618	37.774134	-122.210633	2d	4074
1619145307	1619145307	1	1	LIFELONG MEDICAL CARE	01Apr2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	9933 MACARTHUR BLVD	None	OAKLAND	CA	946054853	37.746523	-122.156651	2d	4101
1629070461	1629070461	1	1	LAMONT COMMUNITY HEALTH	13Jan2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	15	Kern	CENTER	8787 HALL RD	None	LAMONT	CA	932411953	35.259734	-118.907169	61	64.01
1669513222	1669513222	1	1	LA SIERRA MEDICAL CORPORATIO	28Jul2005	022	PHYSICIANS GROUP	FNP032530	01	General Practice	In state provider	33	Riverside	None	10600 MAGNOLIA AVE	I	RIVERSIDE	CA	925051819	33.908375	-117.467435	135d	414.08
1679024467	1679024467	1	1	LA CLINIQUITA, INC	19Dec2016	026	PHYSICIANS	A123276	01	General Practice	In state provider	19	Los Angeles	None	6505 ROSEMEAD BLVD	STE 106	PICO RIVERA	CA	906603542	33.986991	-118.094339	78.2ww	5007
1689687345	1689687345	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	LA PUENTE FAM PLANNING	15930 CENTRAL AVE	None	LA PUENTE	CA	917445410	34.019862	-117.951064	78.2yyy	4077.02
1710077961	1710077961	2	1	L AND P MEDICAL GROUP INC	31Oct1994	026	PHYSICIANS	A00046128	01	General Practice	In state provider	19	Los Angeles	None	1107 S ALVARADO ST	None	LOS ANGELES	CA	900064184	34.050166	-118.280829	78.2b	2098.10
1720084163	1720084163	1	1	LIFELONG MEDICAL CARE	10Mar1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	WEST BERKELEY FAMILY	2031 6TH ST	None	BERKELEY	CA	947102006	37.867562	-122.297568	2a	4232
1720234701	1720234701	1	1	LEE, CHANG L MD INC	14Oct2008	026	PHYSICIANS	A00099010	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	36	San Bernardino	None	399 E HIGHLAND AVE	SUITE 223	SAN BERNARDINO	CA	924043864	34.135924	-117.277300	151k	63.01
1720243454	1720243454	1	1	LA CLINICA DE LA RAZA	10Feb2009	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	48	Solano	None	220 HOSPITAL DRIVE	None	VALLEJO	CA	945892517	38.131074	-122.239758	204	2519.01
1730530254	1730530254	1	1	LIVINGSTON COMMUNITY HEALTH	30Aug2018	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	24	Merced	None	16233 KING STREET	None	DELHI	CA	953159460	37.433512	-120.780637	95	2.03
1750503017	1750503017	1	1	LONG BEACH MEMORIAL MED	01Aug2000	022	PHYSICIANS GROUP	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	In state provider	19	Los Angeles	None	2865 ATLANTIC AVE	STE 110	LONG BEACH	CA	908067408	33.809325	-118.185091	78.2lll	5722.02
1770663551	1770663551	1	1	LAS PALMAS MEDICAL GROUP	14May2003	022	PHYSICIANS GROUP	FNP030643	01	General Practice	In state provider	37	San Diego	CORPORATION	750 E GRAND AVE	STE B&C	ESCONDIDO	CA	920254460	33.125149	-117.072137	156e	202.02
1780899484	1780899484	1	1	LA MAESTRA FAMILY CLINIC	01Oct2006	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	37	San Diego	None	165 S 1ST ST	None	EL CAJON	CA	920194795	32.794038	-116.944599	161h	157.03
1790701514	1790701514	1	1	LATINO HEALTH SERVICES MEDIC	01Dec2003	022	PHYSICIANS GROUP	G37709	None	UNKNOWN	In state provider	30	Orange	ANTA ANA	517 N MAIN ST	STE 100	SANTA ANA	CA	927014619	33.749393	-117.867605	116b	750.02
1841476553	1841476553	1	1	LOGAN HEIGHTS FAMILY	02Jan1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	37	San Diego	HEALTH CENTER	1809 NATIONAL AVE	None	SAN DIEGO	CA	921132113	32.701685	-117.146601	161c	50
1851522015	1851522015	1	1	LA CLINICA DE RAZA, INC	25Mar2010	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	01	Alameda	None	1926 19TH AVE	None	OAKLAND	CA	946064126	37.789727	-122.237990	2c	4059.02
1861882946	1861882946	1	1	LA LIBERTAD MEDICAL CLINIC	08Dec2015	022	PHYSICIANS GROUP	None	None	UNKNOWN	In state provider	19	Los Angeles	INC	7900 PACIFIC BLVD	SUITE C AND D	WALNUT PARK	CA	902556662	33.966707	-118.225207	78.2fff	5348.03
1871627166	1871627166	1	1	LAMONT COMMUNITY HEALTH	14Jan2002	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	15	Kern	PO BOX 457	8787 HALL RD	None	LAMONT	CA	932411953	35.259734	-118.907169	61	64.01
1881607547	1881607547	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	EL MONTE FAMILY PLANNING	10953 RAMONA BLVD	None	EL MONTE	CA	917312629	34.072049	-118.037139	78.2oo	4327
1881697381	1881697381	1	1	LAKE COUNTY TRIBAL HLTH	20Jul2010	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	17	Lake	PO BOX 1950	925 BEVINS CT	None	LAKEPORT	CA	954539754	39.037772	-122.922507	70.1	4
1932115375	1932115375	1	1	LOS ANGELES COUNTY	28Apr1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	In state provider	19	Los Angeles	BELLFLOWER FAM PLANNING	10005 E FLOWER AVE	None	BELLFLOWER	CA	907060000	33.882105	-118.120765	78.2m	5542.03
1962442012	1962442012	1	1	LONG BEACH MEMORIAL	01Mar1982	016	COMMUNITY INPATIENT HOSPITAL	190900525	None	UNKNOWN	In state provider	19	Los Angeles	MEDICAL CENTER	2801 ATLANTIC AVE	None	LONG BEACH	CA	908061701	33.808011	-118.185097	78.2lll	5722.02
1972525822	1972525822	1	1	LA CLINICA DE LA RAZA	10Jul2000	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	07	Contra Costa	LA CLINICA PITTBURG-MED	2240 GLADSTONE DR	None	PITTSBURG	CA	945655126	38.006542	-121.866438	18d	3131.02
1992811392	1992811392	1	1	LA CLINICA VALLEJO	28May2003	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	48	Solano	None	415 GEORGIA ST	None	VALLEJO	CA	945906004	38.101112	-122.256391	204	2509
1992863096	1992863096	1	1	LA CLINICA DE LA RAZA INC	21Aug2007	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	In state provider	48	Solano	GREAT BEGINNINGS	210 HOSPITAL DR	None	VALLEJO	CA	945892517	38.131072	-122.239836	204	2519.01