Brian L Spivack (NPI# 1295750305, PAC ID# 5496785081) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
Nation Provider ID (NPI) | 1295750305 |
PAC ID by PECOS | 5496785081 |
Professional Enrollment ID | I20090513000321 |
Full Name | Brian L Spivack |
Organization Legal Name | WALLACE G GOSNEY MD AND GILBERT R TURNER MD PTRS |
Address |
8263 Grove Ave Suite 204 Rancho Cucamonga CA 91730-3107 |
Phone Number | 9099465320 |
Gender | M |
Medical School | MEDICAL COLLEGE OF PENNSYLVANIA |
Graduation Year | 1988 |
Primary Specialty | GENERAL SURGERY |
Secondary Specialties | SURGICAL ONCOLOGY |
Group Practice PAC ID | 8224067616 |
Number of Group Practice Members | 3 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
050099 | SAN ANTONIO REGIONAL HOSPITAL |
Address | Phone | Organization |
---|---|---|
1798 N Garey Ave, Pomona, CA 91767-2918 | 9099465320 | WALLACE G GOSNEY MD AND GILBERT R TURNER MD PTRS |
8263 Grove Ave, Suite 204, Rancho Cucamonga, CA 91730-3107 | 9099465320 | WALLACE G GOSNEY MD AND GILBERT R TURNER MD PTRS |
Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
---|---|---|---|
MIPS_EC_021_overall | Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin | 100% |
Organization Legal Name | WALLACE G GOSNEY MD AND GILBERT R TURNER MD PTRS |
Physicians | 2 |
Name | Specialty | Organization | Address |
---|---|---|---|
Donna E Dudziak | General Surgery | Wallace G Gosney Md and Gilbert R Turner Md Ptrs | 1798 N Garey Ave, Pomona, CA 91767-2918 |
Street Address |
8263 GROVE AVE SUITE 204 |
City | RANCHO CUCAMONGA |
State | CA |
Zip | 91730-3107 |
Name | Specialty | Organization | Address |
---|---|---|---|
Patricia P Salas | Nurse Practitioner | Aids Healthcare Foundation | 8263 Grove Ave, Suite 201, Rancho Cucamonga, CA 91730-3107 |
Name | Specialty | Organization | Address |
---|---|---|---|
Charles L Taylor | Diagnostic Radiology | 102722 Arrow Route, Suite 520, Rancho Cucamonga, CA 91730 | |
Mazen K Munir | Family Medicine | 10165 Foothill Blvd, Suite 8, Rancho Cucamonga, CA 91730-0341 | |
James M Tatum | Optometry | 10165 Foothill Blvd, Suite 6, Rancho Cucamonga, CA 91730-0341 | |
Kiran N Setty | Podiatry | 10220 Foothill Blvd, Suite 4302, Rancho Cucamonga, CA 91730-0349 | |
Justin D Jette | Physical Therapy | Team Physical Therapy, Inc. | 10590 Town Ctr Dr, Suite 100, Rancho Cucamonga, CA 91730-0361 |
Jeffrey T Bekendam | Physical Therapy | Team Physical Therapy, Inc. | 10590 Town Ctr Dr, Suite 100, Rancho Cucamonga, CA 91730-0361 |
Natalie M Winblad | Physical Therapy | Team Physical Therapy, Inc. | 10590 Town Ctr Dr, Suite 100, Rancho Cucamonga, CA 91730-0361 |
Benjamin D Duncan | Physical Therapy | Team Physical Therapy, Inc. | 10590 Town Ctr Dr, Suite 100, Rancho Cucamonga, CA 91730-0361 |
Nariba K Maycock Gibson | Physical Therapy | Team Physical Therapy, Inc. | 10590 Town Ctr Dr, Suite 100, Rancho Cucamonga, CA 91730-0361 |
Nicholas W Price | Physical Therapy | Team Physical Therapy, Inc. | 10590 Town Ctr Dr, Suite 100, Rancho Cucamonga, CA 91730-0361 |
Find all physicians in zip 91730 |
City | RANCHO CUCAMONGA |
Zip Code | 91730 |
Specialty | GENERAL SURGERY |
City + Specialty | RANCHO CUCAMONGA + GENERAL SURGERY |
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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.