ANDRES SMITH M.D. A PROFESSIONAL MEDICAL CORPORATION (NPI# 1225664964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225664964 |
| Entity Type | Organization |
| Organization Name | ANDRES SMITH M.D. A PROFESSIONAL MEDICAL CORPORATION |
| Practice Address |
6244 El Cajon Blvd Ste 29 San Diego CA 92115-3918 |
| Mailing Address |
4579 Maple Ave Ste 1 La Mesa CA 91941-3154 |
| Practice Telephone | 8886286680 |
| Practice Fax Number | 8886286680 |
| Mailing Telephone | 6192536451 |
| Mailing Fax Number | 8886286680 |
| Enumeration Date | 2020-03-13 |
| Last Update Date | 2020-08-07 |
| Authorized Official Name | ANDRES SMITH (PRESIDENT) |
| Authorized Official Telephone | 6197377511 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4579 Maple Ave Ste 1, La Mesa, CA 919413154 | 6192536451 | 8886286680 |
| Street Address |
6244 EL CAJON BLVD STE 29 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92115-3918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508821 | Mylene Valdez | Nurse Practitioner | 6244 El Cajon Blvd Ste 29, San Diego, CA 92115-3918 | 2020-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790313922 | Mayra Ailed Bugarin | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center 5454, El Cajon Blvd, San Diego, CA 92115 | 2020-04-01 |
| 1093369878 | Chang Liu | Counselor | 3539 College Avenue, San Diego, CA 92115 | 2019-07-30 |
| 1689238560 | Donia Ahadian | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center, 5454 El Cajon Blvd, San Diego, CA 92115 | 2019-04-26 |
| 1780157859 | James Michael Sites | Military Health Care Provider | Uss Shoup Ddg 86, San Diego, CA 92115 | 2019-01-10 |
| 1780163006 | Marcos Luis Sandoval | Case Manager/Care Coordinator | 6224 El Cajon Blvd, Suite 17, San Diego, CA 92115 | 2018-08-08 |
| 1437651981 | Phyllis Lynette Pryor | Licensed Vocational Nurse | 4974 El Cajon Blvd Suite A, San Diego, CA 92115 | 2018-03-01 |
| 1982125605 | Ellen Medical Transport | Non-emergency Medical Transport (VAN) | 4587 Winona Ave #5, San Diego, CA 92115 | 2017-07-03 |
| 1992225296 | P'okot LLC | Non-emergency Medical Transport (VAN) | 5511 Adelaide Ave, 26, San Diego, CA 92115 | 2017-06-27 |
| 1578019840 | Alfred Zygmunt Nowak | Specialist/Technologist | 6663 Reservoir Ln, San Diego, CA 92115 | 2016-08-28 |
| 1639534183 | Kalkaal Financial Enterprise, LLC. | Non-emergency Medical Transport (VAN) | 5055 Collwood Blvd., Unit 108, San Diego, CA 92115 | 2015-12-29 |
| Find all providers in zip 92115 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560467 | Helen Regina Stearns | Nurse Practitioner | 8797 Encino Ave, San Diego, CA 92123-3952 | 2020-08-28 |
| 1346852480 | Jenna Juenger | Nurse Practitioner | 10665 Calle Mar De Mariposa Apt 3215, San Diego, CA 92130-8730 | 2020-08-19 |
| 1750908414 | Deborah Lynne Monaghan | Nurse Practitioner | 14471 Via Venezia Apt 601, San Diego, CA 92129-1657 | 2020-06-29 |
| 1780211300 | Amanda Renee Phillips | Nurse Practitioner | 3034 Horton Ave, San Diego, CA 92103-6008 | 2020-03-24 |
| 1538792304 | Allison D White | Nurse Practitioner | 726 W Pennsylvania Ave, San Diego, CA 92103-3804 | 2020-02-19 |
| 1356981351 | Jordan Rae Burke | Nurse Practitioner | 11943 El Camino Real Ste 100, San Diego, CA 92130-2597 | 2020-01-08 |
| 1598319436 | Madison Taylor Shreeve | Nurse Practitioner | 3435 Del Mar Heights Rd # D6a, San Diego, CA 92130-2225 | 2019-07-29 |
| 1659930485 | Lovella Medilo | Nurse Practitioner | 4033 3rd Ave Ste 430, San Diego, CA 92103-2117 | 2019-06-05 |
| 1306300272 | Stephanie O'brien Sramek | Nurse Practitioner | 4077 5th Ave # Ems, San Diego, CA 92103-2105 | 2019-01-25 |
| 1467930875 | Reliable Care Md On The Go | Nurse Practitioner | 4565 Ruffner St Ste 201, San Diego, CA 92111-2259 | 2018-07-30 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.