OAKDALE MEDICAL GROUP INC (NPI# 1598862054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598862054 |
| Entity Type | Organization |
| Organization Name | OAKDALE MEDICAL GROUP INC |
| Practice Address |
350 S Oak Ave Oakdale CA 95361-3519 |
| Mailing Address |
Po Box 661510 Arcadia CA 91066-1510 |
| Practice Telephone | 2098484144 |
| Mailing Telephone | 6264470296 |
| Mailing Fax Number | 6264476057 |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2016-03-29 |
| Authorized Official Name | STEVEN P. MARON (PRESIDENT) |
| Authorized Official Telephone | 6264470296 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | G64122 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1598862054 | 05 |
| Street Address |
350 S OAK AVE |
| City | OAKDALE |
| State | CA |
| Zip Code | 95361-3519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184612483 | Brian Karl O'bannon | Physician Assistant | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2005-10-11 |
| 1346620887 | Eric Jon Healy | Pharmacist | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2015-05-30 |
| 1730567108 | Mabrook L. Shehata Md Medical Corporation | Specialist | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2015-05-18 |
| 1669883278 | Geanny Ryan | Nurse Practitioner | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2014-05-16 |
| 1417102716 | Oak Valley Hospital District | Ambulance | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2008-12-01 |
| 1942475900 | Yosemite Pathology Medical Group,inc | Clinical Medical Laboratory | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2008-04-29 |
| 1346381415 | Oak Valley Hospital District | Ambulance | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2007-02-09 |
| 1003954694 | Max Mehrdad Maude | Physician Assistant | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2007-02-03 |
| 1649317793 | Hong Kee Kim | Anesthesiology | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2007-01-30 |
| 1750300372 | Bruce Baysin Chou | Anesthesiology | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2006-07-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427453190 | Janet Kennedy Barretta | Marriage & Family Therapist | 210 South Sierra Suite 209 Serenity Heart Counseling Se, Oakdale, CA 95361 | 2014-10-23 |
| 1629483946 | Gina Maria Womack | Physical Therapy Assistant | 1570 E. F Street # N, Oakdale, CA 95361 | 2014-06-25 |
| 1457636946 | Eugene Awuah | Pharmacist | 2048 Royal Ascot Way, Oakdale, CA 95361 | 2011-10-15 |
| 1679852669 | Shiow-yan Chen | Pharmacist | 1449 East F Street Suite 102, Oakdale, CA 95361 | 2011-08-09 |
| 1659592475 | David Michael Meyers | Chiropractor | 715 West F Street, Oakdale, CA 95361 | 2007-05-01 |
| 1043372691 | Joanne Mccartney | Nurse Practitioner | 700 Laurel Avenue, Oakdale, CA 95361 | 2006-12-13 |
| 1457445587 | Suzanne Streater | Marriage & Family Therapist | 145 North Second Avenue, Suite 8, Oakdale, CA 95361 | 2006-10-03 |
| 1689786972 | Christina Louise Tourtlotte | Dentist | 1473 East G St, Ste C, Oakdale, CA 95361 | 2006-08-31 |
| 1750395042 | Janet R Busic | Psychologist | 7248 Gold Run Dr, Oakdale, CA 95361 | 2006-07-29 |
| 1609807346 | Consuelos S. Dizon | Anesthesiology | Oak Valley Hospital, 350 South Oak Ave., Oakdale, CA 95361 | 2006-07-05 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780609982 | Rajendra Upendrabhai Patel | Emergency Medicine | 350 South Oak Ave, Oakdale, CA 95361-3519 | 2006-07-12 |
| 1750785119 | Oakdale Ess LLC | Emergency Medicine | 130 Hospital Dr, Oakdale, LA 71463-3035 | 2014-10-14 |
| 1336430651 | Nes Central Louisiana, Inc. | Emergency Medicine | 130 Hospital Dr, Oakdale, LA 71463-3035 | 2011-04-20 |
| 1538272281 | Michael A. Dayan | Emergency Medicine | 350 South Oak Avenue, Oakdale, CA 95361-3519 | 2006-08-16 |
| 1588691489 | Arun Jain | Emergency Medicine | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2006-06-27 |
| 1356389027 | Patrick Samir Chaftari | Emergency Medicine | 130 Hospital Dr, Oakdale, LA 71463-3035 | 2006-06-03 |
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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.