MRS. ISIS BURAKOM RUTLEDGE (NPI# 1235372020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235372020 |
| Entity Type | Individual |
| Full Name | MRS. ISIS BURAKOM RUTLEDGE |
| Credential | LMT |
| Practice Address |
4520 Executive Dr Ste 225 San Diego CA 92121-3018 |
| Mailing Address |
1220 Rosecrans St #120 San Diego CA 92106-2674 |
| Practice Telephone | 6193234089 |
| Mailing Telephone | 6193234089 |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2016-10-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | 68684 | CA | Other Service Providers |
| N | 171W00000X | Contractor | 4969 | CO | Other Service Providers |
| Street Address |
4520 EXECUTIVE DR STE 225 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-3018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700847662 | Seaton Q Do | Physical Therapist | 4520 Executive Dr, Suite 101, San Diego, CA 92121-3018 | 2006-03-30 |
| 1174977870 | Suzanne Smith | Dietitian, Registered | 4520 Executive Dr, Suite Plaza 1, San Diego, CA 92121-3018 | 2016-04-19 |
| 1083072755 | Adam Moore | Physical Therapist | 4520 Executive Dr, Suite 101, San Diego, CA 92121-3018 | 2016-02-09 |
| 1427420405 | Darrel Dyas | Specialist/Technologist | 4520 Executive Dr, Ste. Plz. 1, San Diego, CA 92121-3018 | 2015-10-29 |
| 1871972083 | Gregory M. Berkoff D.c., Inc. | Chiropractor | 4520 Executive Dr, Suite 105, San Diego, CA 92121-3018 | 2015-05-20 |
| 1568887149 | Manoj Motwani | Ophthalmology | 4520 Executive Dr, Suite 230, San Diego, CA 92121-3018 | 2014-02-19 |
| 1093143430 | Roybal Md Chemical Dependence Treatment Inc | Counselor | 4520 Executive Dr, Suite 225, San Diego, CA 92121-3018 | 2013-10-22 |
| 1316244619 | Daniel Michaels M.d., Inc | Family Medicine | 4520 Executive Dr, Suite 105, San Diego, CA 92121-3018 | 2011-02-22 |
| 1700030053 | Motwani Lasik Institute | Ophthalmology | 4520 Executive Dr, Suite #230, San Diego, CA 92121-3018 | 2008-11-13 |
| 1073656997 | Ernest Wong | Dentist | 4520 Executive Dr, Suite 200, San Diego, CA 92121-3018 | 2007-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689215204 | Jacinto Verges IIi | Contractor | 2117 Bluebird St, San Diego, CA 92114-1502 | 2019-10-04 |
| 1992231633 | Michael Williams | Contractor | 8590 Production Ave, Suite B, San Diego, CA 92121-2281 | 2017-05-01 |
| 1083168983 | Mohamed Omar Yusuf | Contractor | 4252 Van Dyke Ave Apt 4, San Diego, CA 92105-1255 | 2016-08-09 |
| 1194184648 | David Troupin | Contractor | 2949 Garnet Ave, San Diego, CA 92109-3826 | 2016-02-12 |
| 1881062917 | Derlin Hsu | Contractor | 4663 Kansas St, Unit 10, San Diego, CA 92116-3223 | 2015-09-06 |
| 1316339211 | Del Sur Speech Therapy | Contractor | 8395 Katherine Claire Ln, San Diego, CA 92127-4107 | 2015-03-02 |
| 1487052007 | Tara Marie Graviss | Contractor | 4661 35th St, San Diego, CA 92116-3537 | 2014-12-13 |
| 1437568094 | Celeste Conover | Contractor | 7455 Sean Taylor Ln, San Diego, CA 92126-6091 | 2014-08-07 |
| 1942627765 | Matthew Topper | Contractor | 2254 San Diego Ave, Suite 200, San Diego, CA 92110-2944 | 2014-03-19 |
| 1376967638 | Miramar Billing Solutions, Inc. | Contractor | 4203 Genesee Ave, #103, San Diego, CA 92117-4950 | 2014-02-06 |
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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.