SAN DIEGO AMERICAN INDIAN HEALTH CENTER (NPI# 1770620700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770620700 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO AMERICAN INDIAN HEALTH CENTER |
| Practice Address |
2630 1st Ave San Diego CA 92103-6599 |
| Practice Telephone | 6192342158 |
| Practice Fax Number | 6192340505 |
| Mailing Telephone | 6192342158 |
| Mailing Fax Number | 6192340505 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |
| Authorized Official Name | PHILLIP POWERS (BOARD CHAIRMAN) |
| Authorized Official Telephone | 6192342158 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
CA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912439050 | San Diego American Indian Health Center | Preferred Provider Organization | 2630 1st Ave, San Diego, CA 92103-6599 | 2017-03-29 |
| 1003902917 | San Diego American Indian Health Center | Social Worker | 2630 1st Ave, San Diego, CA 92103-6599 | 2006-10-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SAN DIEGO AMERICAN INDIAN HEALTH CENTER INC | 2630 1st Ave Ste 300, San Diego, CA 92103-6599 |
| Street Address |
2630 1ST AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-6599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679572911 | Richard Tew | General Practice | 2630 1st Ave, San Diego, CA 92103-6599 | 2005-07-19 |
| 1215543426 | Katherine Anne Perry | Nurse Practitioner | 2630 1st Ave, San Diego, CA 92103-6599 | 2020-09-22 |
| 1396358024 | Stephanie Joyce Reed | Nurse Practitioner | 2630 1st Ave, San Diego, CA 92103-6599 | 2020-08-24 |
| 1912439050 | San Diego American Indian Health Center | Preferred Provider Organization | 2630 1st Ave, San Diego, CA 92103-6599 | 2017-03-29 |
| 1790151660 | Michelle Epstein | Dentist | 2630 1st Ave, San Diego, CA 92103-6599 | 2015-08-14 |
| 1235470519 | Jenna Y Lau | Dentist | 2630 1st Ave, San Diego, CA 92103-6599 | 2013-03-11 |
| 1740534239 | Porta Verum | Social Worker | 2630 1st Ave, Suite 205, San Diego, CA 92103-6599 | 2012-11-05 |
| 1710239223 | Young Sun Suh | Family Medicine | 2630 1st Ave, San Diego, CA 92103-6599 | 2012-10-08 |
| 1437400207 | Jodi Staszak | Marriage & Family Therapist | 2630 1st Ave, Suite 205, San Diego, CA 92103-6599 | 2012-09-20 |
| 1801024393 | Shaun Michael Austin | Family Medicine | 2630 1st Ave, San Diego, CA 92103-6599 | 2009-06-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326696329 | Uchechukwu Nkiru Dijeh | Clinic/Center | 5203 Caminito Cachorro, San Diego, CA 92105-5357 | 2019-09-03 |
| 1710236120 | Operation Samahan, Inc. | Clinic/Center | 9955 F2 Carmel Mountain Rd., San Diego, CA 92129-2815 | 2012-08-30 |
| 1932338241 | El Dorado Community Service Center | Clinic/Center | 1733 Euclid Ave, San Diego, CA 92105-5414 | 2009-07-08 |
| 1831383637 | Planned Parenthood Pacific Southwest | Clinic/Center | 4305 University Ave Ste 350, San Diego, CA 92105-8602 | 2007-09-05 |
| 1841225836 | Planned Parenthood Pacific Southwest | Clinic/Center | 1602 Thomas Ave, San Diego, CA 92109-4423 | 2006-07-11 |
| 1689609679 | Planned Parenthood of The Pacific Southwest | Clinic/Center | 2017 1st Ave Ste 301, San Diego, CA 92101-2033 | 2006-07-11 |
| 1245265230 | Planned Parenthood of The Pacific Southwest | Clinic/Center | 220 Euclid Ave Ste 30, San Diego, CA 92114-3617 | 2006-07-11 |
| 1124053111 | Planned Parenthood Pacific Southwest | Clinic/Center | 10717 Camino Ruiz Ste 258, San Diego, CA 92126-2364 | 2006-07-11 |
| 1306871397 | Planned Parenthood Pacific Southwest | Clinic/Center | 7526 Clairemont Mesa Blvd, San Diego, CA 92111-1504 | 2006-07-11 |
| 1215962204 | Planned Parenthood Pacific Southwest | Clinic/Center | 4501 Mission Bay Dr # 1c D, San Diego, CA 92109-4923 | 2006-07-11 |
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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.