PQ OUTREACH COALITION (NPI# 1619279361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619279361 |
| Entity Type | Organization |
| Organization Name | PQ OUTREACH COALITION |
| Other Organization Name | IMPACT COMMUNITY CLINIC |
| Practice Address |
10060 Carmel Mountain Rd San Diego CA 92129-3228 |
| Practice Telephone | 8582061860 |
| Practice Fax Number | 8584848577 |
| Mailing Telephone | 8582061860 |
| Mailing Fax Number | 8584848577 |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |
| Authorized Official Name | DR. WILLIAM KENNETH HARMANING (CHAIR BOARD OF DIRECTORS) |
| Authorized Official Telephone | 8582061860 |
| Authorized Official Credential | ED.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Impact Community Clinic | Other Name - Individual/Organization |
| Street Address |
10060 CARMEL MOUNTAIN RD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92129-3228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053836718 | Emily Anne Haven | Physical Therapist | 9351 Vervain Street, San Diego, CA 92129 | 2017-08-03 |
| 1366802944 | Katie Nguyen | Pharmacist | 13014 Lemon Pine Ct, San Diego, CA 92129 | 2016-02-25 |
| 1588029912 | Larry Labossiere II | Registered Nurse | 8195 Torrey Gardens Place, San Diego, CA 92129 | 2015-12-30 |
| 1184034746 | Jim S Chang | Dentist | 12798 Rancho Penasquitos Blvd # 1, San Diego, CA 92129 | 2014-05-05 |
| 1841627593 | John Richard Codington | Dentist | 9728 Carmel Mountain Ro., Suite B, San Diego, CA 92129 | 2013-09-26 |
| 1407298284 | Michael Saade | Dentist | 9310 Carmel Mountain Rd Ste A, San Diego, CA 92129 | 2013-07-22 |
| 1801141338 | Satnick Chiropractic | Acupuncturist | 12880 Rancho Penasquitos Blvd, Steb, San Diego, CA 92129 | 2012-07-20 |
| 1558627463 | Louise Jeremia Gatchalian Angelo | Student in an Organized Health Care Education/Training Program | 9434 Twin Trails Dr, Unit 201, San Diego, CA 92129 | 2012-04-04 |
| 1093965477 | Joanne C Vargas-velasco | Dentist | 12580 Ragweed Street, San Diego, CA 92129 | 2008-09-23 |
| 1699960377 | Robert B Case | Social Worker | 12602 Spindletop Rd, San Diego, CA 92129 | 2007-09-06 |
| Find all providers in zip 92129 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477002079 | Icare-usa LLC | Point of Service | 11036 Caminito Alvarez, San Diego, CA 92126-5701 | 2016-09-25 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1720233463 | Jenice Staniford | Point of Service | 4626 59th St, San Diego, CA 92115-3830 | 2008-11-21 |
| 1245428531 | Andrew J. Zakarian, Dds, Inc. | Point of Service | 3501 4th Ave, San Diego, CA 92103-4912 | 2007-10-11 |
| 1093902934 | Pathways Community Services LLC | Point of Service | 7986 Dagget St, San Diego, CA 92111-2321 | 2007-09-25 |
| 1073933602 | Trg Business Consulting Dynamics, Inc. | Point of Service | 7840 Mission Center Ct, Suite 102, San Diego, CA 92108-1319 | 2014-04-22 |
| 1649609959 | Advantage On Call | Point of Service | 2515 Camino Del Rio S, 142, San Diego, CA 92108-3792 | 2013-11-06 |
| 1437338621 | Providence Community Services | Point of Service | 3635 Ruffin Rd Ste 100, San Diego, CA 92123-1853 | 2007-10-24 |
| 1821290511 | Tim Le Dds & Christopher Tong Dds | Point of Service | 9330 Mira Mesa Blvd Ste B, San Diego, CA 92126-4822 | 2007-06-04 |
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|---|---|---|---|---|
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| 1710525092 | Rex Ross Bennett Jr. | Point of Service | 22687 E Cliff Dr, Santa Cruz, CA 95062-5357 | 2019-12-17 |
| 1508401985 | Live Leveled Family Therapy, Inc | Point of Service | 809 Quarry Rd Apt B, San Francisco, CA 94129-1150 | 2019-11-09 |
| 1558906982 | Session Sync, Inc. | Point of Service | 44262 Marcelina Court, Temecula, CA 92592 | 2019-11-08 |
| 1629622063 | Rose Woo Psychologists Inc | Point of Service | 16 S Oakland Ave Ste 214, Pasadena, CA 91101-2042 | 2019-07-24 |
| 1770136426 | Hmk Medical Transportation | Point of Service | 267 Aldama Ave, Pomona, CA 91767-1749 | 2019-07-22 |
| 1427516681 | Klifford T Kapus Dds., Msd A Dental Corporation | Point of Service | 4200 East Ave Ste 100, Livermore, CA 94550-4945 | 2019-03-06 |
| 1821553850 | Reginald Washington | Point of Service | 2733 Lemon Grove Ave, Lemon Grove, CA 91945-2938 | 2019-02-04 |
| 1417432246 | Access Multilingual Services, Inc. | Point of Service | 11041 Santa Monica Blvd, #813, Los Angeles, CA 90025-3523 | 2018-09-27 |
| 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.