SAN DIEGO REGIONAL HEAD & NECK CENTER (NPI# 1235407685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235407685 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO REGIONAL HEAD & NECK CENTER |
| Practice Address |
6645 Alvarado Rd Ste 4000 San Diego CA 92120-5208 |
| Practice Telephone | 6192297100 |
| Practice Fax Number | 6192294938 |
| Mailing Telephone | 6192297100 |
| Mailing Fax Number | 6192294938 |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |
| Authorized Official Name | DR. PERRY MANSFIELD (OWNER) |
| Authorized Official Telephone | 6192297100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0901X |
Otolaryngology Specialization: Otology & Neurotology |
FNP41747 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
6645 ALVARADO RD STE 4000 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92120-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699741645 | Patrick Anthony Delaney | Psychiatry & Neurology | 6645 Alvarado Rd, Suite 229, San Diego, CA 92120-5208 | 2006-02-28 |
| 1548734577 | Steven Edward Keller | Physical Therapist | 6645 Alvarado Rd, San Diego, CA 92120 | 2019-01-12 |
| 1609146661 | Regional Head & Neck Surgical Associates | Otolaryngology | 6645 Alvarado Rd, Ste 4000, San Diego, CA 92120-5208 | 2012-01-09 |
| 1093018764 | Andre Gallares | Physician Assistant | 6645 Alvarado Rd, Suite 4000, San Diego, CA 92120-5208 | 2010-12-17 |
| 1649570284 | Cheryl Emily Kyinn | Physician Assistant | 6645 Alvarado Rd, Suite 415, San Diego, CA 92120-5208 | 2010-10-29 |
| 1962716183 | Tracy Mejia Sebastian | Physician Assistant | 6645 Alvarado Rd, San Diego, CA 92120-5208 | 2010-07-29 |
| 1407181035 | Brigitte Korkuch | Physician Assistant | 6645 Alvarado Rd, Ste 415, San Diego, CA 92120-5208 | 2009-10-15 |
| 1245471853 | Bryna Elizabeth Florence | Physician Assistant | 6645 Alvarado Rd, Suite 415, San Diego, CA 92120-5208 | 2009-03-11 |
| 1780822213 | San Diego Neuro Trauma Associates, Inc. | Neurological Surgery | 6645 Alvarado Rd, Suite 4000, San Diego, CA 92120-5208 | 2009-01-21 |
| 1922264845 | Hussein Abdulhadi, Md | Pain Medicine | 6645 Alvarado Rd, Suite 253, San Diego, CA 92120-5208 | 2008-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
| 1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
| 1225593601 | Truself Training, Inc | Clinic/Center | 5125 Waring Road, San Diego, CA 92120 | 2019-02-09 |
| 1508381799 | Antin Sachs | In Home Supportive Care | 4420 Rainier Avenue, Suite 202, San Diego, CA 92120 | 2017-08-08 |
| 1588186415 | Matthew B Wilbat | Behavioral Analyst | 6851 Alvarado Rd., #17, San Diego, CA 92120 | 2017-07-12 |
| 1548782923 | Mori Khatibzadeh Dds Inc. | Clinic/Center | 6171 Mission Gorge Road, Suite #114, San Diego, CA 92120 | 2017-07-07 |
| 1306379359 | Ken Samith Oerding | Nurse Practitioner | 5422 Reservoir Drive, E7, San Diego Ca, CA 92120 | 2017-04-06 |
| 1396134409 | Debra Michele Stern-ellis | Social Worker | 4647 Zion Avenue Kaiser Permanente, 2nd Floor - Oncology, San Diego, CA 92120 | 2015-01-13 |
| 1821494717 | Shohreh Tourian | Dentist | 7451 Mission Gorge Road, San Diego, CA 92120 | 2014-11-05 |
| 1184049215 | Charles Yin | Counselor | 6153 Fairmount Ave Suite #260, San Diego, CA 92120 | 2014-02-26 |
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| Taxonomy Code | 207YX0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otology & Neurotology |
| An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740701549 | Joe Saliba | Otolaryngology | 200 W. Arbor Dr, Mc 8895, San Diego, CA 92103 | 2017-06-30 |
| 1780884999 | Philip David Littlefield | Otolaryngology | 10670 Wexford St, San Diego, CA 92131-3940 | 2007-07-25 |
| 1043377245 | Michael J. O'leary, M.d., Inc. | Otolaryngology | 3590 Camino Del Rio N, Ste 101, San Diego, CA 92108-1716 | 2007-01-03 |
| 1417986613 | Michael Joseph O'leary | Otolaryngology | 3590 Camino Del Rio N, Ste 101, San Diego, CA 92108-1716 | 2006-07-01 |
| 1083687594 | Ben James Balough | Otolaryngology | 34520 Bob Wilson Dr, Suite 200, San Diego, CA 92134-2098 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962845834 | Yuan Liu | Otolaryngology | 11234 Anderson St Rm 2586a, Loma Linda, CA 92354-2804 | 2013-04-10 |
| 1699017301 | Shohet Ear Associates Medical Group Inc | Otolaryngology | 770 Pacific Coast Hwy, Seal Beach, CA 90740-6379 | 2013-03-20 |
| 1801152665 | Center for Fall Prevention, A Medical Corporation | Otolaryngology | 3831 Hughes Ave Ste 608, Culver City, CA 90232-6851 | 2012-04-05 |
| 1700151909 | Stuart Gerard Gherini | Otolaryngology | 1056 38th St, Sacramento, CA 95816-5513 | 2012-03-20 |
| 1144420738 | Shohet Ear Associates Medical Group Inc | Otolaryngology | 446 Old Newport Beach Blvd, Shohet Ear Associates Medical Group Inc, Newport Beach, CA 92663-4246 | 2007-07-20 |
| 1952426017 | Hernan Goldsztein | Otolaryngology | 530 Lomas Santa Fe Dr Ste 1, Solana Beach, CA 92075-1350 | 2007-03-20 |
| 1932253960 | Hana T. Bui, Md, A Professional Corporation | Otolaryngology | 1321 N Harbor Blvd Ste 101, Fullerton, CA 92835-4129 | 2007-01-23 |
| 1508876699 | Derald E Brackmann | Otolaryngology | 2100 W 3rd St Ste 111, Los Angeles, CA 90057-1999 | 2006-08-09 |
| 1629075635 | John Steven Oghalai | Otolaryngology | 1450 San Pablo St Ste 5100, Los Angeles, CA 90033-4500 | 2005-07-05 |
| 1356344022 | Kevin X Mckennan | Otolaryngology | 1111 Exposition Blvd Bldg 700, Sacramento, CA 95815-4314 | 2005-05-24 |
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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.