DR. CHARLES DELOSS PICKETT II (NPI# 1518398007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518398007 |
| Entity Type | Individual |
| Full Name | DR. CHARLES DELOSS PICKETT II |
| Credential | D.O. |
| Practice Address |
812 Corral Ct Bonita CA 91902-2313 |
| Practice Telephone | 6194799732 |
| Practice Fax Number | 6194795259 |
| Mailing Telephone | 6194799732 |
| Mailing Fax Number | 6194795259 |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
20A 4412 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | OSTEOPATHIC MEDICAL BOARD OF CALIFORNIA | 20A 4412 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043516610 | Charles Delvon Pickett | Military Health Care Provider | 7019 N Litchfield Ave, Luke Afb, 56/amds, Luke Afb, AZ 85309 | 2011-01-31 |
| Street Address |
812 CORRAL CT |
| City | BONITA |
| State | CA |
| Zip Code | 91902-2313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437693306 | A Caring Touch Home Care LLC | Home Health | 4045 Bonita Rd, 207, Bonita, CA 91902 | 2016-12-13 |
| 1578882494 | Sandhya Hegde Dds, Inc | Dentist | 4424 Bonita Road, Bonita, CA 91902 | 2010-05-18 |
| 1861684680 | Jennifer E Sims Dds Inc | Dentist | 5080 Bonita Road, Suite N, Bonita, CA 91902 | 2007-08-15 |
| 1669528543 | Dora A. Sanchez | Marriage & Family Therapist | 4045 Bonita Rd Ste 108, Bonita, CA 91902 | 2007-01-25 |
| 1528126190 | Bonita Cardiovascular Med Grp Inc | Surgery | 3916 Palm Drive, Bonita, CA 91902 | 2006-12-05 |
| 1265447668 | Lilinda Cruz Enano | Dentist | 4144 Bonita Rd, Bonita, CA 91902 | 2006-07-31 |
| 1548505803 | Marisa Cristina Ludden | Dentist | 5050 Bonita Rd, Bonita, CA 91902 | 2012-11-27 |
| 1629255021 | Julie K Laffen | Acupuncturist | 4514 Bonita Rd, Bonita, CA 91902 | 2008-01-28 |
| 1366563967 | Kristi Lee | Pharmacist | 4348 Bonita Road, Bonita, CA 91902 | 2007-04-02 |
| 1306191622 | Karen V. Houston | Dental Hygienist | 3340 Bonita Mesa Rd, Bonita, CA 91902-1021 | 2012-07-24 |
| Find all providers in zip 91902 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446091 | Candace Maglinao | Family Medicine | 21010 Anza Ave Apt 12, Torrance, CA 90503-4254 | 2020-10-30 |
| 1942826797 | In-home Medical Mobile Services, Inc. | Family Medicine | 3400 E 8th St Ste 202, National City, CA 91950-3169 | 2020-06-17 |
| 1386269306 | Universal Mobile Doctors Inc | Family Medicine | 15333 Sherman Way Ste P, Van Nuys, CA 91406-4204 | 2020-06-16 |
| 1619597671 | Harry Eisenbach | Family Medicine | 9312 Smoketree Ln, Villa Park, CA 92861-1011 | 2020-04-20 |
| 1669092854 | Wellbeing Clinic Inc | Family Medicine | 1621 S New Hampshire Ave, Los Angeles, CA 90006-4513 | 2020-04-17 |
| 1619513611 | Krista Mckinney | Family Medicine | 344o E. La Palma Avenue, Anaheim, CA 92806 | 2019-11-25 |
| 1457995565 | Ucsf Medical Group Business Services | Family Medicine | 1100 Park Pl Ste 100, San Mateo, CA 94403-7119 | 2019-10-31 |
| 1780237313 | Charles Kim Md Inc | Family Medicine | 3055 W Orange Ave Ste 204, Anaheim, CA 92804-3154 | 2019-07-23 |
| 1083277206 | Baum 5 Star Healthcare | Family Medicine | 560 W Grangeville Blvd Ste A, Hanford, CA 93230-2858 | 2019-04-15 |
| 1477025278 | Connexus Family Clinic Inc | Family Medicine | 1930 E. Anaheim Street, N/a, Long Beach, CA 90813-3908 | 2018-12-19 |
| Find all providers with the same taxonomy | ||||
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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.