SAN DIEGO AMERICAN INDIAN HEALTH CENTER (NPI# 1912439050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912439050 |
| 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 | 6192340206 |
| Mailing Telephone | 6192342158 |
| Mailing Fax Number | 6192340206 |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |
| Authorized Official Name | FELICIA SALAZAR (MEDICAL ASSISTANT) |
| Authorized Official Telephone | 6192342158 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 95005572 | CA | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770620700 | San Diego American Indian Health Center | Clinic/Center | 2630 1st Ave, San Diego, CA 92103-6599 | 2007-01-31 |
| 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 |
| 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 |
| 1548418619 | Chelsea Richardson | Dentist | 2630 1st Ave, San Diego, CA 92103-6599 | 2008-09-03 |
| Find all providers in the same location | ||||
| 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 | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| 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 |
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| 1508975202 | Lawrence J. Schlitt M.d., A Professional Medical Corp. | Preferred Provider Organization | 12395 El Camino Real Ste 120, San Diego, CA 92130-3083 | 2006-08-29 |
| 1932709532 | Frey Dental Corporation | Preferred Provider Organization | 8989 Rio San Diego Dr Ste 170, San Diego, CA 92108-1604 | 2020-11-01 |
| 1902348527 | Rb Senior Residences | Preferred Provider Organization | 15260 Amalia St, San Diego, CA 92129-1228 | 2016-11-14 |
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| 1588119317 | Pathways Community Services, LLC | Preferred Provider Organization | 8880 Rio San Diego Dr, Suite 800 Office 47, San Diego, CA 92108-1634 | 2016-08-22 |
| 1912365651 | Stephanie Knatz Peck, Phd Psychological Services Inc | Preferred Provider Organization | 4370 La Jolla Village Dr Ste 400, San Diego, CA 92122-1251 | 2016-02-09 |
| 1659761849 | Love Psychology, Inc. | Preferred Provider Organization | 2204 Garnet Ave, Suite 102, San Diego, CA 92109-3771 | 2015-01-27 |
| 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.