LOS MEDANOS MEDICAL GROUP, INC. (NPI# 1992867576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992867576 |
| Entity Type | Organization |
| Organization Name | LOS MEDANOS MEDICAL GROUP, INC. |
| Practice Address |
3006 Railroad Ave Pittsburg CA 94565-5202 |
| Practice Telephone | 9254322977 |
| Practice Fax Number | 9254326418 |
| Mailing Telephone | 9254322977 |
| Mailing Fax Number | 9254326418 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL RUSSELL (PRESIDENT) |
| Authorized Official Telephone | 9254322977 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | G30873 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZZ71706Z | 05 |
| Street Address |
3006 RAILROAD AVE |
| City | PITTSBURG |
| State | CA |
| Zip Code | 94565-5202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497174338 | Bay Area Doctors Inc | Psychiatry & Neurology | 3006 Railroad Ave, Ste 100, Pittsburg, CA 94687-5202 | 2014-04-08 |
| 1154759777 | Rick Flynn | Social Worker | 3006 Railroad Ave, Pittsburg, CA 94565-5202 | 2013-10-16 |
| 1942636527 | Lorie Ann Bellgard | Nurse Practitioner | 3006 Railroad Ave, Pittsburg, CA 94565-5202 | 2013-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164068011 | Gina Marie Whittenburg | Counselor | 161 Sequoia Drive, Pittsburg, CA 94565 | 2019-11-25 |
| 1386287902 | Diamond Redus | Behavior Technician | 2328 Loveridge Rd Apt 209, Pittsburg, CA 94565 | 2019-10-27 |
| 1851952469 | Renee Slocum | Behavior Technician | 7567 Amador, Dublin, CA 94565 | 2019-06-25 |
| 1881258606 | Mabel Paz Zavala | Student in an Organized Health Care Education/Training Program | 3750 Roundhill Dr, Pittsburg, CA 94565 | 2019-04-26 |
| 1457810939 | Richard L Anilao | Nurse's Aide | 142 San Tomas Dr, Pittsburg, CA 94565 | 2019-03-14 |
| 1568931079 | Nashira Hudson | Behavioral Analyst | 3401 Delta Fair Blvd., Antioch, CA 94565 | 2018-11-14 |
| 1497230726 | Rosa Maria Gonzalez | Behavioral Analyst | 198 Alberts Ave, Bay Point, CA 94565 | 2018-10-02 |
| 1831670090 | Rael Bernstein Dds Apc | Dentist | 1600 N Park Blvd, Pittsburg, CA 94565 | 2018-08-27 |
| 1285120592 | Vanessa Fregoso | Behavioral Analyst | 2275 Southwood Dr., Pittsburg, CA 94565 | 2018-07-10 |
| 1457847014 | Monica Monarque | Behavioral Analyst | 2113 Cerrito Ct, Pittsburg, CA 94565 | 2018-07-06 |
| Find all providers in zip 94565 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710273388 | Psu Student Health Center | Internal Medicine | 1801 S Broadway St, Pittsburg, KS 66762 | 2011-06-22 |
| 1114228715 | Sung Ha Ryoo M D Inc | Internal Medicine | 2250 Gladstone Dr Ste 1, Pittsburg, CA 94565-5124 | 2010-11-12 |
| 1093855421 | Donald M Holsinger | Internal Medicine | 1801 S Joplin, Student Health Services, Pittsburg, KS 66762 | 2007-02-07 |
| 1124118005 | Kathleen M. Sandness | Internal Medicine | 1701 South Broadway, Pittsburg, KS 66762 | 2006-10-13 |
| 1457446791 | John D Taylor | Internal Medicine | 1018 Ohio St, Pittsburg, KS 66762-6437 | 2006-10-03 |
| 1184736498 | Mark D Carlson | Internal Medicine | 2401 S Tucker Ave Ste 1, Pittsburg, KS 66762-6619 | 2006-08-31 |
| 1851307219 | Pacita R Aducayen | Internal Medicine | 2250 Gladstone Dr Ste 2, Pittsburg, CA 94565-5124 | 2006-07-31 |
| 1295768257 | Norman W Krouskop Jr. | Internal Medicine | 4710 State Highway 11 W, Pittsburg, TX 75686-8042 | 2006-07-09 |
| 1275512774 | Gregory Scott Zarcone | Internal Medicine | 2701 Us Highway 271 N, Pittsburg, TX 75686-4289 | 2006-01-12 |
| 1215939780 | William Robert Christensen | Internal Medicine | 2701 Hwy 271 North, Pittsburg, TX 75686-1032 | 2005-08-13 |
| Find all providers in PITTSBURG | ||||
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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.