Table: family_pact_providers_profile_cy_2021_2022 , provider_business_legal_name like M*

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
1003856402	1003856402	1	1	MOAS, OVADIA MD INC	01Jan1982	026	PHYSICIANS	A00035730	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	19	Los Angeles	None	9815 LAS TUNAS DR	None	TEMPLE CITY	CA	917802209	34.107336	-118.056401	78.2dddd	4319
1013088582	1013088582	1	1	MOUNTAIN VALLEYS HEALTH	24Sep2001	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	47	Siskiyou	PO BOX 170	610 W THIRD ST	None	DORRIS	CA	960230000	41.964223	-121.918911	200	2
1013088582	1013088582	1	3	MOUNTAIN VALLEYS HEALTH	07Jun2019	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	47	Siskiyou	INTERMITTENT	101 OLD MCCLOUD ROAD	None	MT SHASTA	CA	960672796	41.305179	-122.311032	197	10
1013088582	1013088582	1	4	MOUNTAIN VALLEYS HEALTH	02Aug2018	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	47	Siskiyou	INTERMITTENT	50 ALAMO AVENUE	None	WEED	CA	960942352	41.427041	-122.385043	197	9
1043593304	1043593304	1	1	MISSION CITY COMMUNITY	15Dec2020	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	NETWORK INC	15210 PARTHENIA STREET	None	NORTH HILLS	CA	913435305	34.228183	-118.463571	78.2kk	1175.30
1104014414	1104014414	1	1	MERCY MEDICAL CENTER	04Mar1993	022	PHYSICIANS GROUP	FNP020342	01	General Practice	0	In state provider	19	Los Angeles	None	16444 PARAMOUNT BLVD	STE 103	PARAMOUNT	CA	907235453	33.884591	-118.159970	78.2m	5539.02
1144273194	1144273194	1	1	MORENO VALLEY URGENT CARE	15Feb2008	026	PHYSICIANS	None	08	Family Practice	0	In state provider	33	Riverside	CLINIC INC	24318 HEMLOCK AVE	SUITE E1	MORENO VALLEY	CA	925577107	33.941954	-117.236551	135g	424.04
1154503399	1154503399	1	1	MARIN COMM CLINIC SAN RAFAEL	09Dec2008	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	21	Marin	None	3110 KERNER BLVD	None	SAN RAFAEL	CA	949015439	37.957757	-122.500253	83b	1122.02
1164428488	1164428488	1	1	MCCLOUD HEALTHCARE CLINIC	03Sep2003	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	0	In state provider	47	Siskiyou	None	116 W MINNESOTA AVE	None	MC CLOUD	CA	960571143	41.252132	-122.137348	199	12
1194866525	1194866525	1	1	MAYER, RALPH MD	08Apr2005	022	PHYSICIANS GROUP	G00069356	08	Family Practice	0	In state provider	19	Los Angeles	None	2568 CLARENDON AVE	None	HUNTINGTON PARK	CA	902554073	33.983576	-118.225815	78.2ccc	5326.05
1245301308	1245301308	1	1	MOUNTAIN VALLEYS HEALTH	01Oct2002	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	45	Shasta	BURNEY HEALTH CENTER	37491 ENTERPRISE DR	None	BURNEY	CA	960134380	40.887165	-121.647469	190	127.01
1245384742	1245384742	1	1	MARSHALL MEDICAL CENTER	03Feb2006	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	09	El Dorado	PRIMARY CARE OB-GYN	3501 PALMER DR	STE 204	CAMERON PARK	CA	956828276	38.661810	-120.966419	23.1	308.03
1275030009	1275030009	1	1	M PAKOUR MD INC	26Apr2018	026	PHYSICIANS	None	08	Family Practice	0	In state provider	19	Los Angeles	None	3671 W 6TH ST.	STE.B	LOS ANGELES	CA	900203026	34.063571	-118.302245	78.2e	2118.02
1285623256	1285623256	1	1	MERCED FACULTY ASSOCIATES ME	01Jan1988	022	PHYSICIANS GROUP	P14747	08	Family Practice	0	In state provider	24	Merced	DICAL GROUP	127 EL PORTAL	None	MERCED	CA	953482853	37.326774	-120.470477	97.1	10.02
1285804948	1285804948	1	1	MARIN CITY HEALTH AND	01Aug2011	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	21	Marin	WELLNESS CENTER	630 DRAKE AVE	None	SAUSALITO	CA	949651107	37.873813	-122.514554	82	1290
1285937631	1285937631	1	1	MIYOCO MEDICAL CENTER INC	02Apr2015	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	30	Orange	None	15975 HARBOR BOULEVARD	None	FOUNTAIN VALLEY	CA	927081303	33.731272	-117.920027	116i	992.02
1346226693	1346226693	1	1	MARSHALL MEDICAL CENTER	27May1997	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	09	El Dorado	None	6065 HIGHWAY 193	None	GEORGETOWN	CA	956340872	38.908043	-120.851714	22	306.02
1356422307	1356422307	2	1	MOUNTAIN COMMUNITIES	02Aug2010	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	53	Trinity	HEALTHCARE DISTRICT	31 EASTER AVENUE	None	WEAVERVILLE	CA	960931229	40.737530	-122.939235	224	1.02
1376674770	1376674770	1	1	MARIO A OCHOA MD INC	12Aug2008	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	08	Family Practice	0	In state provider	10	Fresno	None	3275 MCCALL AVE	STE 102	SELMA	CA	936622505	36.582589	-119.610629	30	70.04
1376893420	1376893420	1	1	MCCLOUD HEALTHCARE CLINIC	27Dec2017	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	47	Siskiyou	INC	4309 STAGECOACH ROAD	None	DUNSMUIR	CA	960251812	41.222461	-122.278075	198	11
1386065480	1386065480	1	1	MARSHALL MEDICAL CENTER	09Jun2015	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	09	El Dorado	None	4341 GOLDEN CENTER DR	BLDG A	PLACERVILLE	CA	956676260	38.705981	-120.827051	23.3	315.02
1407029259	1407029259	1	1	MISION AREA HLTH ASSOC	01Mar1997	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	0	In state provider	38	San Francisco	HEALTH CTR	240 SHOTWELL ST	None	SAN FRANCISCO	CA	941101323	37.764620	-122.416380	162a	177
1447223326	1447223326	1	1	MUSINSKI, SCOTT E	01Jun2000	026	PHYSICIANS	G00085560	None	UNKNOWN	0	In state provider	37	San Diego	None	310 SANTA FE DR	STE 112	ENCINITAS	CA	920245123	33.036204	-117.284300	156c	174.01
1467599605	1467599605	1	1	MBAGWU, K N SOLOMON MD	31Oct1991	026	PHYSICIANS	G00042217	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	19	Los Angeles	None	1218 S INGLEWOOD AVE	None	INGLEWOOD	CA	903013649	33.946609	-118.361324	78.2q	6014.02
1487795753	1487795753	1	1	MORAN, JORGE L MD INC	02Jan2007	026	PHYSICIANS	A63662	None	UNKNOWN	0	In state provider	19	Los Angeles	CLINICA MEDICA SAN FELIP	210 S LOCUST ST	None	INGLEWOOD	CA	903012304	33.961652	-118.350368	78.2q	6010.01
1528172541	1528172541	1	2	MCH MEDICAL CLINIC	18Sep2006	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	0	In state provider	36	San Bernardino	PO BOX 70	29099 HOSPITAL RD	STE 200	LAKE ARROWHEAD	CA	923520072	34.265922	-117.167117	147	109.02
1538482286	1538482286	1	1	MINEVICH, GREGORY A MD PMC	26Jan2010	026	PHYSICIANS	A00093150	None	UNKNOWN	0	In state provider	01	Alameda	None	1290 B ST	STE 305	HAYWARD	CA	945412967	37.676347	-122.077819	2h	4354
1588012124	1588012124	1	1	MOKADEM, HESHAM EL MD INC	30Sep2016	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	33	Riverside	None	3975 JACKSON STREET	SUITE 110	RIVERSIDE	CA	925033946	33.927349	-117.441424	135c	316.02
1609062389	1609062389	1	1	MARSHALL MEDICAL CENTER	29Nov2004	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	09	El Dorado	None	1095 MARSHALL WAY	2N FL	PLACERVILLE	CA	956675722	38.725203	-120.790637	23.3	312
1609899087	1609899087	1	1	MOJTAHEDIAN, EMMANUEL MD	06Mar1995	026	PHYSICIANS	A00039395	01	General Practice	0	In state provider	19	Los Angeles	INC.	6425 WHITTIER BLVD	None	LOS ANGELES	CA	900224603	34.015439	-118.133723	78.2c	5318
1619232808	1619232808	1	1	MARILOU G. CRUZ, MD, INC.	30Nov1989	026	PHYSICIANS	A44484	None	UNKNOWN	0	In state provider	19	Los Angeles	None	9317 FIRESTONE BLVD	None	DOWNEY	CA	902415322	33.932286	-118.117214	78.2eee	5511.02
1629018817	1629018817	1	2	MEYER, BRUCE D MD	01Apr1990	026	PHYSICIANS	CLM322111	30	Radiology	0	In state provider	36	San Bernardino	MEYER, BRUCE D MD	1996 NORTH D ST	None	SAN BERNARDINO	CA	924053912	34.133793	-117.291922	151g	54
1669617783	1669617783	1	1	MOUNTAIN COMM HEALTHCARE DST	03Jan2011	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	53	Trinity	None	6961 HIGHWAY 3	None	HAYFORK	CA	960410220	40.504781	-123.175191	225	3
1669673646	1669673646	1	1	MADERA COMMUNITY HOSPIT	01Dec1977	016	COMMUNITY INPATIENT HOSPITAL	200491281	None	UNKNOWN	0	In state provider	20	Madera	None	1250 E ALMOND AVE	None	MADERA	CA	936375696	36.945447	-120.045618	80	5.02
1689760316	1689760316	1	1	MOY, CARL K MD INC	01Jan1994	022	PHYSICIANS GROUP	G43977	None	UNKNOWN	0	In state provider	19	Los Angeles	None	711 W COLLEGE ST	SUITE M88	LOS ANGELES	CA	900121163	34.065427	-118.241528	78.2ffff	2071.03
1699767517	1699767517	2	1	M ZARRABI MEDICAL	13May2013	022	PHYSICIANS GROUP	None	01	General Practice	0	In state provider	19	Los Angeles	CORPORATION	4827 GAGE AVENUE	None	BELL	CA	902011424	33.977217	-118.179412	78.2ddd	5338.04
1700092137	1700092137	1	1	MAD RIVER COMM HOSPITAL	15Mar1974	015	COMMUNITY OUTPATIENT HOSPITAL	ZZR00028F	None	UNKNOWN	0	In state provider	12	Humboldt	PO BOX 1115	3800 JANES RD	None	ARCATA	CA	955214788	40.903600	-124.090373	39	13
1710029616	1710029616	1	1	MATERNAL- FETAL MEDICINE	06Aug2004	022	PHYSICIANS GROUP	FNP029465	None	UNKNOWN	0	In state provider	19	Los Angeles	ASSOCIATES AMC	401 W MANCHESTER BLVD	None	INGLEWOOD	CA	903011109	33.961713	-118.361731	78.2q	6014.01
1710370747	1710370747	1	1	MISSION CITY COMMUNITY	15Dec2020	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	NETWORK INC	8527 SEPULVEDA BOULEVARD	None	NORTH HILLS	CA	913435824	34.225117	-118.467683	78.2kk	1175.30
1730258765	1730258765	1	1	MOMMY & ME MEDICAL GROUP	01Jul2004	022	PHYSICIANS GROUP	FNP029836	None	UNKNOWN	0	In state provider	36	San Bernardino	None	1711 ORANGE ST	None	REDLANDS	CA	923742254	34.079279	-117.182387	151i	80.01
1730258765	1730258765	1	2	MOMMY & ME MEDICAL GROUP	11Jun2007	022	PHYSICIANS GROUP	FNP092836	None	UNKNOWN	0	In state provider	33	Riverside	None	4190 CHICAGO AVE	None	RIVERSIDE	CA	925075348	33.971862	-117.348520	135a	305.01
1730258765	1730258765	1	3	MOMMY & ME MEDICAL GROUP	13Feb2008	022	PHYSICIANS GROUP	FNP029836	None	UNKNOWN	0	In state provider	33	Riverside	None	1688 N PERRIS BLVD	STE H4	PERRIS	CA	925714746	33.802745	-117.226204	133.1	426.20
1730258765	1730258765	1	4	MOMMY & ME MEDICAL GROUP	19Jun2008	022	PHYSICIANS GROUP	FNP029836	None	UNKNOWN	0	In state provider	33	Riverside	None	498 W 4TH ST	None	PERRIS	CA	925702070	33.782338	-117.236939	133.1	428
1730258765	1730258765	1	6	MOMMY & ME MEDICAL GROUP	02Mar2010	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	36	San Bernardino	None	416 W FOOTHILL BLVD	None	RIALTO	CA	923764953	34.106816	-117.377276	151h	35.09
1760409791	1760409791	1	1	MISSION CITY COMMUNITY	15Dec2020	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	19	Los Angeles	NETWORK	15206 PARTHENIA ST	None	NORTH HILLS	CA	913435305	34.228175	-118.463455	78.2kk	1175.30
1760578413	1760578413	1	1	MOY, CARL K MD INC	01Jan1994	022	PHYSICIANS GROUP	G43977	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	19	Los Angeles	None	500 N GARFIELD AVE	STE 104	MONTEREY PARK	CA	917541242	34.056240	-118.124710	78.2nn	4822.01
1770516304	1770516304	1	1	MENDOCINO COMMUNITY HEALTH	25Nov2003	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	17	Lake	CLINIC INC	5335 LAKESHORE BLVD	None	LAKEPORT	CA	954536123	39.111527	-122.906666	70.1	3
1801184841	1801184841	1	1	MAYWOOD FAMILY MEDICAL	08Aug2011	026	PHYSICIANS	A00045155	08	Family Practice	0	In state provider	19	Los Angeles	CENTER RAGAA Z ISKAROUS	5920 ATLANTIC BLVD	None	MAYWOOD	CA	902703101	33.986415	-118.185686	78.2ddd	5334.03
1811958952	1811958952	1	1	MENDOCINO COMMUNITY HEALTH	25Nov2003	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	23	Mendocino	None	333 LAWS AVE	None	UKIAH	CA	954826540	39.126481	-123.209702	93.1	113
1821132671	1821132671	1	1	MARTIN, MALVERSE MD AMC	31Oct1989	026	PHYSICIANS	G00038477	None	UNKNOWN	0	In state provider	19	Los Angeles	None	22110 ROSCOE BLVD	STE 203	WEST HILLS	CA	913043874	34.219627	-118.608082	78.2cccc	1343.04
1851409924	1851409924	1	2	MELBA A BERBANO MD INC	12Mar2007	022	PHYSICIANS GROUP	A00053064	None	UNKNOWN	0	In state provider	39	San Joaquin	None	1801 E MARCH LN	STE C320	STOCKTON	CA	952106676	38.003429	-121.285555	169a	34.09
1861420069	1861420069	1	1	MALONEY, PATRICK L MD	01Jan1987	026	PHYSICIANS	C00039953	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	19	Los Angeles	MAXSON BLDG	933 S SUNSET AVE	STE 106	WEST COVINA	CA	917903410	34.064572	-117.942863	78.2www	4067.02
1861670093	1861670093	1	1	MENDOCINO COAST CLINICS INC	01Jan2013	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	23	Mendocino	None	855 SEQUOIA CIR	None	FORT BRAGG	CA	954375466	39.430413	-123.802315	89	105
1891830568	1891830568	1	1	MOSAIC FAMILY CARE	01Nov2001	022	PHYSICIANS GROUP	FNP029143	None	UNKNOWN	0	In state provider	19	Los Angeles	MEDICAL GROUP INC	4857 HUNTINGTON DR N	None	LOS ANGELES	CA	900321939	34.086261	-118.178400	78.2i	2014.01
1912091018	1912091018	1	1	MARIN COMM CLINIC	06Mar2008	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	21	Marin	None	6090 REDWOOD BLVD	None	NOVATO	CA	949494569	38.094905	-122.561977	83b	1041.02
1912146887	1912146887	1	1	MLS CLINICAL & MEDICAL	20Apr2009	026	PHYSICIANS	A80070	None	UNKNOWN	0	In state provider	19	Los Angeles	CORPORATION	8530 FLORENCE AVE	STE 101	DOWNEY	CA	902404015	33.949426	-118.120969	78.2eee	5506.02
1922020585	1922020585	1	1	MENDOCINO COMMUNITY HEALTH	25Nov2003	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	23	Mendocino	LITTLE LAKE CLINIC	45 HAZEL ST	None	WILLITS	CA	954904222	39.399795	-123.352139	91	107
1922179498	1922179498	1	1	MOUNTAIN VALLEYS HEALTH	01Oct2002	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	45	Shasta	FALL RIVER VLY HEALTH CT	43658 HWY 299E	None	FALL RIVER MILLS	CA	960280490	41.050027	-121.400829	190	127.02
1922303437	1922303437	1	1	MARIN COMMUNITY CLINIC	04Apr2011	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	21	Marin	SAN RAFAEL CAMPUS	3260 KERNER BLVD	SUITE A	SAN RAFAEL	CA	949014840	37.962024	-122.501986	83b	1122.02
1942416045	1942416045	1	1	MANUEL F MENDOZA MD INC	04Jan2011	026	PHYSICIANS	None	None	UNKNOWN	0	In state provider	19	Los Angeles	None	11735 FIRESTONE BLVD	None	NORWALK	CA	906502808	33.913536	-118.083173	78.2jjjj	5520.02
1952574717	1952574717	1	1	MISSION NEIGHBORHOOD	17Apr2002	058	HEALTH ACCESS PROGRAM	None	None	UNKNOWN	0	In state provider	38	San Francisco	HEALTH CENTER	4434 MISSION ST	None	SAN FRANCISCO	CA	941121927	37.726694	-122.433397	162c	255
1972503142	1972503142	1	1	MARSHALL MEDICAL CENTER	01Dec1977	200	DEVELOPMENTAL SCREENING AND TRAUMA	None	None	UNKNOWN	0	In state provider	09	El Dorado	None	1100 MARSHALL WAY	None	PLACERVILLE	CA	956676533	38.725642	-120.790980	23.3	312
1972563617	1972563617	1	1	MEDICAL GRP OF PARAMOUNT	25Jan1994	022	PHYSICIANS GROUP	FNP21394	None	UNKNOWN	0	In state provider	19	Los Angeles	CLINICA MEDICA HISPANA	14906 PARAMOUNT BLVD	None	PARAMOUNT	CA	907233409	33.898173	-118.160087	78.2ooo	5536.01
1972955730	1972955730	1	1	MONTCLAIR MEDICAL	24Oct2016	022	PHYSICIANS GROUP	None	None	UNKNOWN	0	In state provider	36	San Bernardino	PROFESSIONAL CORPORATION	9675 MONTE VISTA AVE	STE C	MONTCLAIR	CA	917632233	34.078119	-117.698253	151c	2.03
1992850150	1992850150	1	1	MBA, HELENA O MD INC	11Jan2007	026	PHYSICIANS	A00075962	08	Family Practice	0	In state provider	33	Riverside	None	6485 DAY ST	STE 203	RIVERSIDE	CA	925070931	33.931874	-117.278843	135b	425.05