THEODORE B. PASTRANA JR. (NPI# 1992747653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992747653 |
| Entity Type | Individual |
| Full Name | THEODORE B. PASTRANA JR. |
| Credential | M.D. |
| Practice Address |
100 E Valencia Mesa Dr Ste 100 Fullerton CA 92835-3813 |
| Mailing Address |
100 E Valencia Mesa Dr #100 Fullerton CA 92835-3813 |
| Practice Telephone | 7145254185 |
| Practice Fax Number | 7145257321 |
| Mailing Telephone | 7145254185 |
| Mailing Fax Number | 7142527321 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2014-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G75374 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | 00G753470 | 01 |
| CA | 00G753470 | 05 |
| Street Address |
100 E VALENCIA MESA DR STE 100 |
| City | FULLERTON |
| State | CA |
| Zip Code | 92835-3813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891795449 | Raed Ali | Orthopaedic Surgery | 100 E Valencia Mesa Dr, Suite 310, Fullerton, CA 92835-3813 | 2005-07-26 |
| 1083088678 | Monica Martyn | Dietitian, Registered | 100 E Valencia Mesa Dr, Suite 111, Fullerton, CA 92835-3813 | 2015-11-19 |
| 1972991149 | Megan Somerville Wroe | Dietitian, Registered | 100 E Valencia Mesa Dr, Suite 111, Fullerton, CA 92835-3813 | 2014-12-22 |
| 1457750762 | Linda Cox | Registered Nurse | 100 E Valencia Mesa Dr, Suite 111, Fullerton, CA 92835-3813 | 2014-08-22 |
| 1952700320 | Cynthia Crystal Carrasco-gonzalez | Registered Nurse | 100 E Valencia Mesa Dr, Suite 111, Fullerton, CA 92835-3813 | 2014-08-21 |
| 1548697311 | Theodore Pastrana Md., Apc | Preferred Provider Organization | 100 E Valencia Mesa Dr, Ste. 100, Fullerton, CA 92835-3813 | 2013-10-10 |
| 1831526953 | Kathryn V Woeckener | Dietitian, Registered | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3813 | 2013-10-03 |
| 1588001267 | Ricarda Benz Md, Inc | Obstetrics & Gynecology | 100 E Valencia Mesa Dr, Suite 215, Fullerton, CA 92835-3813 | 2013-06-04 |
| 1518302777 | Gordon Gunn M.d Inc A Medical Corporation | Specialist | 100 E Valencia Mesa Dr, # 215, Fullerton, CA 92835-3813 | 2013-05-01 |
| 1770831521 | Aileen Sabio Estrada | Physician Assistant | 100 E Valencia Mesa Dr, Suite 310, Fullerton, CA 92835-3813 | 2012-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538774302 | Natalie Baugh | Nutritionist | 333 W Bastanchury Rd 110, Fullerton, CA 92835 | 2020-09-09 |
| 1073127098 | Cecile Mae Sam | Physical Therapist | 2932 Clover Ct, Fullerton, CA 92835 | 2020-09-08 |
| 1861966087 | Kimson F Johnston | Marriage & Family Therapist | 1370 Brea Blvd Suite 210, Fullerton, CA 92835 | 2019-01-22 |
| 1134636327 | Michelle Harriman, Psychologist - A Professional Corporation | Psychologist | 1440 N Harbor Blvd Ste 808, Fullerton, CA 92835 | 2018-01-09 |
| 1659818631 | Jacqueline Rene Miller | Specialist/Technologist | 2610 Associated Rd, Apt A4, Fullerton, CA 92835 | 2017-01-27 |
| 1912361106 | John Nathaniel Alvarez | Psychiatry & Neurology | 401 E Imperial Highway, Fullerton, CA 92835 | 2016-04-13 |
| 1083075030 | Advance Recovery Solution, LLC | Substance Abuse Rehabilitation Facility | 3744 N Hermosa Pl, Fullerton, CA 92835 | 2016-03-17 |
| 1467817981 | Michele Ledesma | Physical Therapy Assistant | 2800 N. Harbor Blvd., Fullerton, CA 92835 | 2015-12-29 |
| 1467820571 | Jonghan Kang | Acupuncturist | 1321 N Harbor Blvd Ste 205, Fullerton, CA 92835 | 2015-09-04 |
| 1265840987 | Allison Leigh Kennedy | Physician Assistant | 100 Laguna Rd Ste 208, Fullerton, CA 92835 | 2014-07-25 |
| Find all providers in zip 92835 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336672393 | John Sanguedolce | Family Medicine | 2849 Tarragon Ct, Fullerton, CA 92835-4308 | 2017-04-06 |
| 1760804314 | Nivie Sanghera-jhawar | Family Medicine | 1992 Berkshire Dr, Fullerton, CA 92833-4818 | 2014-01-16 |
| 1467892745 | Mark M. Song, M.d., Inc. | Family Medicine | 1401 S Brookhurst Rd Ste 115, Fullerton, CA 92833-4492 | 2013-07-01 |
| 1679709786 | Joseph Stanley Lawton | Family Medicine | 601 W. Fern Dr., Fullerton, CA 92832-1132 | 2009-06-03 |
| 1639334972 | John Fraser | Family Medicine | 1701 Raintree Rd, Fullerton, CA 92835-4042 | 2008-07-25 |
| 1104955194 | Wonbae Choe | Family Medicine | 720 N Harbor Blvd, Fullerton, CA 92832-1505 | 2007-03-05 |
| 1841341781 | Helmut Machowsky | Family Medicine | 2667 Camino Del Sol, Fullerton, CA 92833-4808 | 2007-01-16 |
| 1942378666 | Richard Donald Boucher | Family Medicine | 800 N. State College Blvd., Fullerton, CA 92834-6830 | 2006-12-01 |
| 1871602839 | Cynthia Yanina Mejia | Family Medicine | 1950 Sunny Crest Dr Ste 2600, Fullerton, CA 92835-3644 | 2006-08-30 |
| 1790791010 | Bryan-huy Ngoc Phi | Family Medicine | 2251 N Harbor Blvd, Fullerton, CA 92835 | 2006-07-31 |
| Find all providers in FULLERTON | ||||
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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.