RAY DERAKSHAN, D.M.D. (NPI# 1255579793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255579793 |
| Entity Type | Organization |
| Organization Name | RAY DERAKSHAN, D.M.D. |
| Practice Address |
11134 Rancho Carmel Dr Suite #103 San Diego CA 92128-4671 |
| Practice Telephone | 8584851010 |
| Practice Fax Number | 8584851116 |
| Mailing Telephone | 8584851010 |
| Mailing Fax Number | 8584851116 |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2009-01-21 |
| Authorized Official Name | DR. RAY DERAKSHAN (OWNER/DENTIST) |
| Authorized Official Telephone | 8584851010 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 46044 | CA | Managed Care Organizations |
| Street Address |
11134 RANCHO CARMEL DR SUITE #103 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-4671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306901301 | Pearle Visioncare, Inc | Eyewear Supplier (Equipment, not the service) | 11134 Rancho Carmel Dr, Courtyard Ste.#102, San Diego, CA 92128-4671 | 2006-12-27 |
| 1235381450 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 11134 Rancho Carmel Dr, Ste #102, San Diego, CA 92128-4671 | 2008-10-21 |
| 1770621591 | Ray Derakshan | Dentist | 11134 Rancho Carmel Dr, Suite 103, San Diego, CA 92128-4671 | 2007-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790172997 | Time Express LLC | Preferred Provider Organization | 6035 University Ave Ste 31, San Diego, CA 92115-6343 | 2015-04-25 |
| 1740684042 | A Caring Touch Home Care | Preferred Provider Organization | 3025 Beyer Blvd Ste E102, San Diego, CA 92154-3432 | 2014-10-15 |
| 1881901932 | Stephen Chinn Od A Professional Corperation Dba As Stephen Chinn Od | Preferred Provider Organization | 2811 University Ave, Suite C, San Diego, CA 92104-2904 | 2010-09-10 |
| 1508975202 | Lawrence J. Schlitt M.d., A Professional Medical Corp. | Preferred Provider Organization | 12395 El Camino Real Ste 120, San Diego, CA 92130-3083 | 2006-08-29 |
| 1932709532 | Frey Dental Corporation | Preferred Provider Organization | 8989 Rio San Diego Dr Ste 170, San Diego, CA 92108-1604 | 2020-11-01 |
| 1912439050 | San Diego American Indian Health Center | Preferred Provider Organization | 2630 1st Ave, San Diego, CA 92103-6599 | 2017-03-29 |
| 1902348527 | Rb Senior Residences | Preferred Provider Organization | 15260 Amalia St, San Diego, CA 92129-1228 | 2016-11-14 |
| 1194271189 | Cvs Health | Preferred Provider Organization | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2016-08-30 |
| 1588119317 | Pathways Community Services, LLC | Preferred Provider Organization | 8880 Rio San Diego Dr, Suite 800 Office 47, San Diego, CA 92108-1634 | 2016-08-22 |
| 1912365651 | Stephanie Knatz Peck, Phd Psychological Services Inc | Preferred Provider Organization | 4370 La Jolla Village Dr Ste 400, San Diego, CA 92122-1251 | 2016-02-09 |
| 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.