SAN JOAQUIN PRIME CARE MEDICAL GROUP INC (NPI# 1265580500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265580500 |
| Entity Type | Organization |
| Organization Name | SAN JOAQUIN PRIME CARE MEDICAL GROUP INC |
| Practice Address |
330 E Pine St Exeter CA 93221-1838 |
| Practice Telephone | 5595922134 |
| Practice Fax Number | 5595925017 |
| Mailing Telephone | 5595922134 |
| Mailing Fax Number | 5595925017 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2015-04-24 |
| Authorized Official Name | RITA NYE (BILLING SUPERVISOR) |
| Authorized Official Telephone | 5597831181 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A43893 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0084780 | 05 | |
| CA | RHM53822F | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982891735 | San Joaquin Prime Care Medical Group Inc | Family Medicine | 30924 E Kings Canyon Rd, Squaw Valley, CA 93675-9601 | 2007-09-26 |
| 1487848131 | San Joaquin Prime Care Medical Group Inc | Family Medicine | 682 E Visalia Rd, Farmersville, CA 93223-1641 | 2007-09-05 |
| Street Address |
330 E PINE ST |
| City | EXETER |
| State | CA |
| Zip Code | 93221-1838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750369401 | Maria Ximena Simonuvic | Pediatrics | 330 E Pine St, Exeter, CA 93221-1838 | 2006-01-04 |
| 1699337949 | Family Healthcare Network | Clinic/Center | 330 E Pine St, Exeter, CA 93221-1838 | 2019-07-07 |
| 1518483775 | Shane Maroon | Massage Therapist | 330 E Pine St, Exeter, CA 93221-1838 | 2017-08-19 |
| 1962806521 | Leslee Heuer | Nurse Practitioner | 330 E Pine St, Exeter, CA 93221-1838 | 2014-10-10 |
| 1053431882 | Cynthia D Shipp-rowell | Nurse Practitioner | 330 E Pine St, Exeter, CA 93221-1838 | 2007-03-29 |
| 1538215934 | Lanora J Cook | Nurse Practitioner | 330 E Pine St, Exeter, CA 93221-1838 | 2007-01-26 |
| 1215083621 | Joanne Beattie | Nurse Practitioner | 330 E Pine St, Exeter, CA 93221-1838 | 2007-01-26 |
| 1154344927 | Stefan I Pentschev | Family Medicine | 330 E Pine St, Exeter, CA 93221-1838 | 2006-07-25 |
| 1891748752 | Sheila Scheinesson | Physician Assistant | 330 E Pine St, Exeter, CA 93221-1838 | 2006-05-19 |
| 1972561272 | Torey Sue Ivanic | Physician Assistant | 330 E Pine St, Exeter, CA 93221-1838 | 2006-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255766069 | Annita Ruth Regehr | Counselor | 125 S. 'f' St., Exeter, CA 93221 | 2013-09-11 |
| 1760609168 | Martina Gutierrez | Student in an Organized Health Care Education/Training Program | 514-516 N. Kaweah, Exeter, CA 93221 | 2007-04-19 |
| 1063638823 | Darren L Rich | Dentist | 140 S B St, Exeter, CA 93221 | 2007-04-18 |
| 1033127014 | Exeter District Ambulance | Ambulance | 302 East Palm Street, Exeter, CA 93221 | 2006-08-04 |
| 1942221171 | R Douglas Owen Do Inc | Family Medicine | 244 N Kaweah Ave, Exeter, CA 93221 | 2006-07-22 |
| 1417909615 | Ann E. Hickey | Internal Medicine | 560 South Elberta Road, Exeter, CA 93221 | 2006-05-16 |
| 1629029194 | Talaksoon Khademi | Obstetrics & Gynecology | 1014 San Juan Ave., Exeter, CA 93221 | 2006-05-12 |
| 1518402858 | Teresa De Jesus Cruz | Counselor | 516 N Kaweah Ave, Exeter, CA 93221 | 2016-12-22 |
| 1871726133 | Vance Physical Therapy and Wellness Inc | Clinic/Center | 511 W Visalia Rd, Exeter, CA 93221 | 2009-09-02 |
| 1912039959 | Ramiro Mena Raya Jr. | Counselor | 516 N Kaweah Ave, Exeter, CA 93221 | 2007-03-12 |
| Find all providers in zip 93221 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336402452 | Robert Kelly | Family Medicine | 21 Hampton Rd Bldg 32nd, Exeter, NH 03833-4831 | 2012-06-22 |
| 1356422778 | Marc Douglas Sopher | Family Medicine | 27 Hampton Rd, Exeter, NH 03833-4842 | 2006-10-19 |
| 1700972577 | Frank B. Dibble | Family Medicine | 136 Kingston Rd, Exeter, NH 03833-4357 | 2006-10-05 |
| 1659488757 | Gueorgui D Dimov | Family Medicine | 6 Hampton Rd, Bldg 3, Exeter, NH 03833-4854 | 2006-08-24 |
| 1942221171 | R Douglas Owen Do Inc | Family Medicine | 244 N Kaweah Ave, Exeter, CA 93221 | 2006-07-22 |
| 1912944265 | Robert S Munger | Family Medicine | 9 Buzell Avenue, Exeter, NH 03833 | 2006-06-02 |
| 1467402305 | Andrew J Stuka | Family Medicine | 1701 Wyoming Ave, Exeter, PA 18643-1491 | 2006-05-11 |
| 1497714505 | Elizabeth Ann Buchanan | Family Medicine | 20 Hampton Rd, Exeter, NH 03833-4823 | 2006-03-20 |
| 1477530376 | Core Health Services Inc | Family Medicine | 21 Hampton Road, Exeter, NH 03833 | 2005-12-30 |
| 1639163520 | Vincent Tan | Family Medicine | 21 Hampton Rd, Bldg 3, Exeter, NH 03833-4831 | 2005-09-07 |
| Find all providers in EXETER | ||||
Please comment or provide details below to improve the information on SAN JOAQUIN PRIME CARE MEDICAL GROUP INC.
| 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.