MR. PLUMMER LEON WAX JR. (NPI# 1376741934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376741934 |
| Entity Type | Individual |
| Full Name | MR. PLUMMER LEON WAX JR. |
| Credential | PA-C |
| Practice Address |
5525 Grossmont Center Dr La Mesa CA 91942-3009 |
| Practice Telephone | 8584992600 |
| Mailing Telephone | 8584992600 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2015-08-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA15657 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5525 GROSSMONT CENTER DR |
| City | LA MESA |
| State | CA |
| Zip Code | 91942-3009 |
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164404034 | Xavier Idelfonso Valdez | Physician Assistant | 4561 Dickey Dr, La Mesa, CA 91941-5735 | 2005-11-16 |
| 1174921183 | Michael Ryan Lenihan Jr. | Physician Assistant | 4215 Spring St Ste 125, La Mesa, CA 91941-7983 | 2014-12-08 |
| 1417372350 | Laci Helmhout | Physician Assistant | 4215 Spring St, La Mesa, CA 91941-7965 | 2014-03-02 |
| 1750683975 | Christopher Abrom Morris | Physician Assistant | 4215 Spring St, Suite 125, La Mesa, CA 91941-7965 | 2010-11-19 |
| 1073713673 | Jasveen Dhillon | Physician Assistant | 4561 Dickey Dr, La Mesa, CA 91941-5735 | 2007-07-20 |
| 1518170562 | On Call Inc | Physician Assistant | 4215 Spring St, Suite 125, La Mesa, CA 91941-7965 | 2007-05-07 |
| 1154348829 | Kimberly A Kreifeldt | Physician Assistant | 4215 Spring St, Suite 125, La Mesa, CA 91941-7965 | 2006-07-17 |
| 1558387886 | Gary Lee Meyer | Physician Assistant | 4561 Dickey Dr, La Mesa, CA 91941-5735 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
| 1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
| 1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
| 1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
| 1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
| 1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
| 1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
| 1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
| 1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
| 1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
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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.