MR. RYAN JOEL BANCI MINTALAR (NPI# 1861973513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861973513 |
| Entity Type | Individual |
| Full Name | MR. RYAN JOEL BANCI MINTALAR |
| Practice Address |
15301 Warren Shingle Rd Beale Afb CA 95903-1907 |
| Practice Telephone | 5306344750 |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2019-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
15301 WARREN SHINGLE RD |
| City | BEALE AFB |
| State | CA |
| Zip Code | 95903-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831182047 | Sadina Lynn Brecheisen-beach | Nurse Practitioner | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2005-08-24 |
| 1407472111 | Shalaleh Khoei | Dietitian, Registered | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2020-06-18 |
| 1902443476 | Thuy-trang Thu Lam | Pharmacist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-12-04 |
| 1558920819 | Madison Lee Kernick | Dentist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2019-06-11 |
| 1669039525 | Dustin Lansing Bennett | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-05-24 |
| 1760944607 | David Chou | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2019-04-01 |
| 1548721244 | Nicolas Lara | Internal Medicine | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-03-26 |
| 1265901920 | Brianna Lee Holmes | Pharmacist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2018-11-24 |
| 1336634823 | Erika Jennifer Reid | Social Worker | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2018-06-27 |
| 1396247441 | John Patrick Bossalini | General Practice | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2018-03-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962575969 | Linda Lee Currier | Physical Therapist | 9 Medical Group, 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-11-16 |
| 1700984853 | Kimberly D Kumer | Psychiatry & Neurology | 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-09-20 |
| 1780637124 | Lillie M Mells | Social Worker | 9mdos/sgoh, 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-05-18 |
| 1003109844 | Jerrica Marie Wild | Military Health Care Provider | 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2011-05-26 |
| 1962413773 | William F Nakashima | Internal Medicine | 414 G St, Suite 106, Marysville, CA 95903 | 2006-08-10 |
| 1417999228 | Frank Peter Baccelli | Dentist | 15337 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2006-06-13 |
| 1245389071 | Kelly Neil West | Family Medicine | 9th Medical Group, 15301 Warren Shingle Road, Beale Afb, CA 95903-1907 | 2007-01-10 |
| 1912456369 | Martha Lawder | Dietitian, Registered | 15301 Warren Shingle Road, Beale, CA 95903-1907 | 2016-09-27 |
| 1487799755 | Dianna M. Garbett | Counselor | 15301 Warren Shingle Road, 9 Mdos Sgohf, Beale Afb, CA 95903-1907 | 2007-02-21 |
| 1770027807 | Maura Scolese | Physical Therapist | 3386 Loma Dr, Beale Afb, CA 95903-2122 | 2016-12-08 |
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| 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 |
|---|---|---|---|---|
| 1669039525 | Dustin Lansing Bennett | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-05-24 |
| 1760944607 | David Chou | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2019-04-01 |
| 1760929319 | Kristofer Darrow | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2017-01-20 |
| 1699228965 | Emily Shanes | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2016-08-03 |
| 1922472711 | Jennifer Middlebrooks | Physician Assistant | 15301 Warren Shingle Rd, 9 Mdos/sgok, Beale Afb, CA 95903-1907 | 2015-11-17 |
| 1669897849 | Zachary Wajvoda | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2014-02-25 |
| 1922311893 | Jason Whitley Webb | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2010-07-21 |
| 1609856954 | Joel Edward Brady | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2006-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407679 | Samantha Sidney Spinner | Physician Assistant | 1385 Shattuck Ave Apt 201, Berkeley, CA 94709-1468 | 2020-11-08 |
| 1134720972 | Alessandra Porfido | Physician Assistant | 733 Filbert St Apt 1, San Francisco, CA 94133-2767 | 2020-11-06 |
| 1992306872 | Kelsey Oberg | Physician Assistant | 1817 Oldfield Ct, El Cajon, CA 92019-4233 | 2020-11-05 |
| 1609477504 | Julia Claire Stiefel | Physician Assistant | 369 Orange St Apt A, Oakland, CA 94610-2979 | 2020-11-05 |
| 1164023347 | Wendy P Lewis | Physician Assistant | 10447 Highdale St, Bellflower, CA 90706-4122 | 2020-11-04 |
| 1245830181 | Lauren Bennett | Physician Assistant | 3360 Horizon St, Corona, CA 92881-0728 | 2020-10-29 |
| 1538769062 | Revital Ahl | Physician Assistant | 18141 Medley Dr, Encino, CA 91316-4447 | 2020-10-26 |
| 1922607423 | Emily Halla | Physician Assistant | 7473 Gresham Ct, San Jose, CA 95139-1424 | 2020-10-26 |
| 1386243889 | Ilaitia Lecia Namatasere | Physician Assistant | 614 Sycamore Ln Apt 225, Davis, CA 95616-7901 | 2020-10-26 |
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
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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.