DR. MICHAEL PETER KOUMJIAN (NPI# 1366403321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366403321 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL PETER KOUMJIAN |
| Credential | MD |
| Practice Address |
5525 Grossmont Center Dr Ste 609 La Mesa CA 91942 |
| Mailing Address |
5525 Grossmont Center Dr Ste 609 La Mesa CA 91942-3009 |
| Practice Telephone | 6194665700 |
| Practice Fax Number | 6194608975 |
| Mailing Telephone | 6194665700 |
| Mailing Fax Number | 6194608975 |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2018-02-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | G37886 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0066270 | 05 |
| Street Address |
5525 GROSSMONT CENTER DR STE 609 |
| City | LA MESA |
| State | CA |
| Zip Code | 91942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164421012 | Lee Hyland Remington-boone | Family Medicine | 5525 Grossmont Center Dr, Suite 200, La Mesa, CA 91942-3009 | 2005-07-21 |
| 1679023303 | James Sullivan | Pharmacist | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-10-05 |
| 1033565940 | James Williams | Pharmacist | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-05-10 |
| 1255792438 | Lisa Schnurr | Family Medicine | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-03-15 |
| 1417316696 | Hollis Taggart Stahl | Physician Assistant | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-02-17 |
| 1598124133 | Hong Tran | Pharmacist | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-02-10 |
| 1578928321 | Thanhtruc Hoang Phan | Nurse Practitioner | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2015-12-22 |
| 1730593559 | Susette Var | Family Medicine | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2014-06-19 |
| 1154746535 | Victoria Sharma Md Inc | Specialist | 5525 Grossmont Center Dr, 602, La Mesa, CA 91942-3009 | 2014-02-21 |
| 1487093126 | Maila Alindog Marinas | Registered Nurse | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2013-06-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
| 1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
| 1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
| 1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
| 1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
| 1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
| 1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
| 1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
| 1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
| 1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370728 | North County Cvt Surgery Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3156 Vista Way Ste 100, Oceanside, CA 92056-3694 | 2020-09-14 |
| 1417560756 | Valiana Vascular Institute Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2501 E Chapman Ave Ste 220, Fullerton, CA 92831-3108 | 2020-08-26 |
| 1891252474 | Miguel Puig Md A Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1430 Esplanade Ste 10, Chico, CA 95926-3366 | 2019-03-01 |
| 1598247991 | Pavel V Petrik Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1331 W Avenue J Ste 203, Lancaster, CA 93534-2954 | 2018-08-31 |
| 1942797378 | Sharon A Bogerty Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 105 N Bascom Ave Ste 101b, San Jose, CA 95128-1811 | 2018-04-20 |
| 1992231112 | Samer Kanaan Md A Professional Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 27451 Los Altos, Suite 290, Mission Viejo, CA 92691 | 2017-05-08 |
| 1073065512 | Central California Chest Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 729 N Medical Center Dr W Ste 223, Clovis, CA 93611-6885 | 2016-11-01 |
| 1407214612 | George Arnold Mulder | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 Laurel St, Pasadena, CA 91103-2329 | 2016-02-02 |
| 1760849905 | Steven R Gundry Md Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 555 E Tachevah Dr Ste 3w103, Palm Springs, CA 92262-5747 | 2016-01-19 |
| 1386018687 | Riyad Youssef Tarazi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9120 Judicial Dr, Apt 7522, San Diego, CA 92122-6700 | 2015-11-24 |
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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.