RICKY A OLDENBURG (NPI# 1598849374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598849374 |
| Entity Type | Individual |
| Full Name | RICKY A OLDENBURG |
| Credential | PA-C |
| Practice Address |
36243 Inland Valley Drive Suite 180 Wildomar CA 92595 |
| Mailing Address |
27168 Newport Rd Suite 1 Menifee CA 92584-7383 |
| Practice Telephone | 9516000110 |
| Practice Fax Number | 9516004645 |
| Mailing Telephone | 9512463033 |
| Mailing Fax Number | 9512467373 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA16971 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
36243 INLAND VALLEY DRIVE SUITE 180 |
| City | WILDOMAR |
| State | CA |
| Zip Code | 92595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023054269 | Purnima K Patel | Internal Medicine | 36243 Inland Valley Drive, Suite 160, Wildomar, CA 92595-9548 | 2006-06-22 |
| 1710100359 | Bear Creek Pharmacy Ltc | Pharmacist | 36243 Inland Valley Drive, Suite 150, Wildomar, CA 92595 | 2007-04-11 |
| 1689758468 | Ernest V Juarez | Physician Assistant | 36243 Inland Valley Drive, Suite 180, Wildomar, CA 92595 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184190845 | Amber Nicole Salgado | Licensed Vocational Nurse | 33685 Harvest Way East, Wildomar, CA 92595 | 2018-10-22 |
| 1417448168 | Inland Valley Trauma and Acute Care Surgery Apc Inc | Surgery | 36320 Inland Valley Dr Ste 101a, Wildomar, CA 92595 | 2018-05-29 |
| 1033636311 | Omar H Nael | Behavioral Analyst | 35925 Susan Dr, Wildomar, CA 92595 | 2017-08-27 |
| 1023535820 | Dennis Bonavilla | Specialist/Technologist, Other | 34859 Frederick Street, Suite 112, Wildomar, CA 92595 | 2017-08-23 |
| 1578965901 | Purnima K Patel M.d Inc | Internal Medicine | 32423 Inland Valley Dr. Ste 160, Wildomar, CA 92595 | 2014-09-17 |
| 1740523133 | Jerry Zhong Yu | Internal Medicine | 36320 Inland Valley Dr Ste 308, Wildomar, CA 92595 | 2013-04-03 |
| 1871859553 | Norman Orr | Internal Medicine | 36485 Valley Medical Center, Wildomar, CA 92595 | 2012-04-06 |
| 1902190226 | Brian Patrick Tiu | Surgery | 36320 Inland Valley Dr Ste 101, Wildomar, CA 92595 | 2011-06-03 |
| 1508013897 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 24335 Prielipp Rd Bldg A, Ste 116, Wildomar, CA 92595 | 2008-08-19 |
| 1760604383 | Nasko Lubenov Atanassov | Physical Therapist | 36485 Inland Valey Drive, Wildomar, CA 92595 | 2007-05-03 |
| Find all providers in zip 92595 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225486251 | Kenneth Granados | Physician Assistant | 24786 Kentman Ct, Wildomar, CA 92595-7761 | 2016-05-31 |
| 1932644143 | Lynda Truong | Physician Assistant | 36485 Inland Valley Dr, Wildomar, CA 92595-9681 | 2016-12-23 |
| 1306204318 | Eds-i Practices of California, A Medical Corporation | Physician Assistant | 36485 Inland Valley Dr, Wildomar, CA 92595-9681 | 2016-02-04 |
| 1053779140 | California Em-i Medical Services, A Medical Corporation | Physician Assistant | 36485 Inland Valley Dr, Wildomar, CA 92595-9681 | 2016-02-03 |
| 1447544630 | Glennise Daneen Pratt | Physician Assistant | 36320 Inland Valley Drive, 307, Wildomar, CA 92595-9083 | 2011-06-05 |
| 1073842183 | Charity Morris | Physician Assistant | 23905 Clinton Keith Rd, #114, Wildomar, CA 92595-7897 | 2009-12-18 |
| 1649328568 | Blanca E Casas | Physician Assistant | 36450 Inland Valley Dr, Wildomar, CA 92595-9583 | 2007-01-08 |
| 1689758468 | Ernest V Juarez | Physician Assistant | 36243 Inland Valley Drive, Suite 180, Wildomar, CA 92595 | 2006-10-25 |
| 1083729891 | Lisa M Bornmann | Physician Assistant | 36485 Inland Valley Dr, Wildomar, CA 92595-9681 | 2006-08-20 |
| 1265547087 | Joseph S Demattia | Physician Assistant | 36485 Inland Valley Dr, Wildomar, CA 92595-9681 | 2006-08-20 |
| Find all providers in WILDOMAR | ||||
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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.