Mickoyan Poole (NPI# 1316201734, PAC ID# 2062669435) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1316201734 |
| PAC ID by PECOS | 2062669435 |
| Professional Enrollment ID | I20120821000295 |
| Full Name | Mickoyan Poole |
| Organization Legal Name | SOUTHERN CALIFORNIA EMERGENCY MEDICINE |
| Address |
1181 S Mount Vernon Ave Colton CA 92324-4208 |
| Phone Number | 9096398800 |
| Gender | M |
| Graduation Year | 1999 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 8628128196 |
| Number of Group Practice Members | 35 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1181 S Mount Vernon Ave, Colton, CA 92324-4208 | 9096398800 | SOUTHERN CALIFORNIA EMERGENCY MEDICINE |
| 33494 Oak Glen Rd, Yucaipa, CA 92399-2057 | 9097978900 | SOUTHERN CALIFORNIA EMERGENCY MEDICINE |
| Organization Legal Name | SOUTHERN CALIFORNIA EMERGENCY MEDICINE |
| Physicians | 39 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shelley Hasselman | Nurse Practitioner | Southern California Emergency Medicine | 301 W Redlands Blvd, Redlands, CA 92373-4633 |
| Travis Cruz | Physician Assistant | Southern California Emergency Medicine | 33494 Oak Glen Rd, Yucaipa, CA 92399-2057 |
| Eric Song | Physician Assistant | Southern California Emergency Medicine | 1181 S Mount Vernon Ave, Colton, CA 92324-4208 |
| John Christian Fox | Emergency Medicine | Southern California Emergency Medicine | 1295 Hamner Ave, Suite C, Norco, CA 92860-3161 |
| Kevin Morris | Physician Assistant | Southern California Emergency Medicine | 33494 Oak Glen Rd, Yucaipa, CA 92399-2057 |
| Nicholas M Walther | Physician Assistant | Southern California Emergency Medicine | 33494 Oak Glen Rd, Yucaipa, CA 92399-2057 |
| Anthony M Pinner | Physician Assistant | Southern California Emergency Medicine | 33494 Oak Glen Rd, Yucaipa, CA 92399-2057 |
| Lesley Laird | Physician Assistant | Southern California Emergency Medicine | 33494 Oak Glen Rd, Yucaipa, CA 92399-2057 |
| Christie Smirl | Nurse Practitioner | Southern California Emergency Medicine | 33494 Oak Glen Rd, Yucaipa, CA 92399-2057 |
| Willie Rivera Landeros | Physician Assistant | Southern California Emergency Medicine | 301 W Redlands Blvd, Redlands, CA 92373-4633 |
| Street Address |
1181 S MOUNT VERNON AVE |
| City | COLTON |
| State | CA |
| Zip | 92324-4208 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric Song | Physician Assistant | Southern California Emergency Medicine | 1181 S Mount Vernon Ave, Colton, CA 92324-4208 |
| Brian J Bearie | Emergency Medicine | Southern California Emergency Medicine | 1181 S Mount Vernon Ave, Colton, CA 92324-4208 |
| Dustin D Ware | Physician Assistant | Southern California Emergency Medicine | 1181 S Mount Vernon Ave, Colton, CA 92324-4208 |
| Sharon Headrick | Physician Assistant | Southern California Emergency Medicine | 1181 S Mount Vernon Ave, Colton, CA 92324-4208 |
| Haley Bogdanovich | Physician Assistant | Southern California Emergency Medicine | 1181 S Mount Vernon Ave, Colton, CA 92324-4208 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Suzanne Cao | Obstetrics/gynecology | Valley Obstetrics and Gynecology Medical Group Inc | 400 N Pepper Ave 2nd Fl, Attn Dale Conrad, Colton, CA 92324-1801 |
| Milton K Mudge | Orthopedic Surgery | San Bernardino Medical Orthopedic Group Inc | 400 N Pepper Ave, Arrowhead, Colton, CA 92324-1801 |
| Richard W Reis | Certified Registered Nurse Anesthetist (crna) | Inland Empire Anesthesia Medical Group, Inc | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Farideh Ghasemi | Nurse Practitioner | Quantum Healthcare Medical Associates Inc | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Jonathan L Allen | Orthopedic Surgery | San Bernardino Medical Orthopedic Group Inc | 400 N Pepper Ave, Arrowhead, Colton, CA 92324-1801 |
| Febbis Balinos | Family Medicine | Arrowhead Family Medical Group Inc | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Haaris R Naji | Internal Medicine | Quantum Healthcare Medical Associates Inc | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Elias A Giraldo | Neurology | California University of Science and Medicine | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Tawfikul Alam | Family Medicine | Quantum Healthcare Medical Associates Inc | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Heather H Bohn | Family Medicine | County of San Bernardino | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Find all physicians in zip 92324 | |||
| City | COLTON |
| Zip Code | 92324 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | COLTON + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.