MATTHEW THOMAS HENNIGAN (NPI# 1770981888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770981888 |
| Entity Type | Individual |
| Full Name | MATTHEW THOMAS HENNIGAN |
| Practice Address |
7590 Miramar Rd Ste C San Diego CA 92126-4232 |
| Practice Telephone | 8585494255 |
| Mailing Telephone | 8585494255 |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2020-10-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA09532 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7590 MIRAMAR RD STE C |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92126-4232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366451593 | Stephen Paul Leibham | Internal Medicine | 7590 Miramar Rd Ste C, San Diego, CA 92126-4232 | 2006-08-05 |
| 1548737703 | American Current Care of California, A Medical Corporation | Clinic/Center | 7590 Miramar Rd Ste C, San Diego, CA 92126-4232 | 2018-10-25 |
| 1366919524 | Occupational Health Centers of California, A Medical Corporation | Clinic/Center | 7590 Miramar Rd Ste C, San Diego, CA 92126-4232 | 2018-10-25 |
| 1467908392 | U.S. Healthworks Medical Group, PC | Preventive Medicine | 7590 Miramar Rd Ste C, San Diego, CA 92126-4232 | 2016-08-31 |
| 1194173963 | Ian Nagata | General Practice | 7590 Miramar Rd Ste C, San Diego, CA 92126-4232 | 2016-06-02 |
| 1154613677 | Jordan Edwards | Hospitalist | 7590 Miramar Rd Ste C, San Diego, CA 92126-4232 | 2011-05-03 |
| 1962670877 | Varsha Deepak Israni | Physical Therapist | 7590 Miramar Rd Ste C, San Diego, CA 92126-4232 | 2008-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730741299 | Eye Connection Optometry, Inc | Optometrist | 9516 Miramar Road, San Diego, CA 92126 | 2019-07-05 |
| 1811450935 | Anne Phabmixay | Student in an Organized Health Care Education/Training Program | Douglas Young Wellness Center, 10717 Camino Ruiz Suite 207, San Diego, CA 92126 | 2019-04-08 |
| 1679035588 | Emily Nguyen | Registered Nurse | 8210 Elston Place, San Diego, CA 92126 | 2019-04-01 |
| 1558832139 | Dana Douglas-hiley | Speech-Language Pathologist | 9606 Tierra Grande St., Suite 107, San Diego, CA 92126 | 2018-12-08 |
| 1275022873 | Breeann Nicole Poulson | Speech-Language Pathologist | 9466 Black Mountain Rd Suite 100, San Diego, CA 92126 | 2018-05-09 |
| 1659878882 | My Phuong Thi Phan | Registered Nurse | 10938 Hyades Way, San Diego, CA 92126 | 2018-04-13 |
| 1083132153 | Ruth Tamar Morales | Occupational Therapist | Children's Ot Services, Inc, 9606 Tierra Grande St., #104, San Diego, CA 92126 | 2017-09-08 |
| 1487184339 | Chelsea Irene Johnson | Marriage & Family Therapist | 8670 New Salem St. Unit 106, San Diego, CA 92126 | 2017-06-14 |
| 1336508506 | Brenda L. Bebal | Nurse Practitioner | 10737 Camino Ruiz; Ste 235, Operation Samahan Health Clinic, San Diego, CA 92126 | 2016-02-17 |
| 1700245099 | Naval Medical Center San Diego | Pharmacy | Mcas Miramar Exchange Pharmacy, Bldg 2660, San Diego, CA 92126 | 2016-02-16 |
| Find all providers in zip 92126 | ||||
| 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 |
|---|---|---|---|---|
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| 1639776503 | Nathan Tuan Dinh | Physician Assistant | 8296 Via Escalada, San Diego, CA 92129-2223 | 2020-10-05 |
| 1750988671 | Denise Aquino | Physician Assistant | 7322 Mesa College Dr Apt 7, San Diego, CA 92111-4943 | 2020-10-04 |
| 1962009183 | Courtney Krysl | Physician Assistant | 14434 Corte Lampara, San Diego, CA 92129-3818 | 2020-10-01 |
| 1497369284 | Brian Carroll | Physician Assistant | 7242 Melotte St, San Diego, CA 92119-1613 | 2020-08-31 |
| 1871104067 | Satoshi Ikeda | Physician Assistant | 16198 Paseo Del Sur, San Diego, CA 92127-6155 | 2020-08-12 |
| 1760009989 | Lili Tran | Physician Assistant | 8865 Calle Tragar, San Diego, CA 92129-2156 | 2020-07-03 |
| 1245857259 | Kendra Roberta Witt | Physician Assistant | 11396 Poblado Rd, San Diego, CA 92127-1351 | 2020-06-25 |
| 1336766344 | Brandon Scott Johnson | Physician Assistant | 1540 Oliver Ave Apt C, San Diego, CA 92109-5595 | 2020-06-25 |
| 1104441021 | Kira Ann Tellache | Physician Assistant | 4520 Executive Dr Ste 325, San Diego, CA 92121-3087 | 2020-06-16 |
| Find all providers in SAN DIEGO | ||||
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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.