County of Orange HMO B Provider Listing - Primary Care
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1 County of Orange HMO B Provider Listing - Primary Care Num PCP TIN PCP Name PCP Specialty PCP Zip Yes No HSU GOETHE I INTERNAL MEDICINE SUNSHINE SAMUEL E FAMILY PRACTICE STEARNS LAUREN M FAMILY PRACTICE LE NGUYET B FAMILY PRACTICE CHAU MARY C FAMILY PRACTICE JIGJINNI MADHUKAR B INTERNAL MEDICINE FORD LISA M FAMILY PRACTICE GREATER NEWPORT PHYSICIANS GENERAL PRACTICE JONES ELAINE K INTERNAL MEDICINE SWIFT ROBERT D FAMILY PRACTICE ING ARLENE FAMILY PRACTICE TSAI JERRY F INTERNAL MEDICINE LUECHA ANGSUMARN FAMILY PRACTICE PINZON FIDEL F FAMILY PRACTICE NGO VINH T INTERNAL MEDICINE HOPP SUSAN A INTERNAL MEDICINE RICK JAMES H INTERNAL MEDICINE DRAINE QUIDA D INTERNAL MEDICINE TRAN NGO M GENERAL PRACTICE COHEN GERALD A INTERNAL MEDICINE AMIN MUKESH S INTERNAL MEDICINE GONZALEZ DAVID R FAMILY PRACTICE BANG MICHAEL C FAMILY PRACTICE DAO MICHAEL M INTERNAL MEDICINE BURNETT LEE A FAMILY PRACTICE LEONG JASMINE K INTERNAL MEDICINE NEWSOME ANN E FAMILY PRACTICE OLSON ROBERT P GENERAL PRACTICE PETERSON STEPHEN D GENERAL PRACTICE CHEU PHILIP INTERNAL MEDICINE BABEL KAREN L FAMILY PRACTICE Page 1 of 2
2 County of Orange HMO B Provider Listing - Primary Care Num PCP TIN PCP Name PCP Specialty PCP Zip Yes No JACOMO JOHN R FAMILY PRACTICE BATHALA RAMA D FAMILY PRACTICE PATEL DEEPAK N FAMILY PRACTICE VARALLO MARK F FAMILY PRACTICE KEISNER SUSAN A FAMILY PRACTICE KOMANAPALLI LALITA M INTERNAL MEDICINE PRINCE KELLEY A FAMILY PRACTICE RUBINO FRANK G GENERAL PRACTICE FESKE WILLIAM I GENERAL PRACTICE HAUPTMAN MARK D INTERNAL MEDICINE SHAPIRO LEONARD INTERNAL MEDICINE TAM TACKSON INTERNAL MEDICINE FARAG BASEM R INTERNAL MEDICINE NASH DANIEL A FAMILY PRACTICE LOMARDA EVELYN GENERAL PRACTICE LOMARDA EVELYN GENERAL PRACTICE COLBURN KEITH K INTERNAL MEDICINE COLBURN KEITH K INTERNAL MEDICINE Page 2 of 2
3 County of Orange HMO B Provider Listing - Hospital Facilities Num Facility TIN Facility Name Facility Zip Yes No 1 4 FOREIGN PROVIDER CALLOWAY LABORATORIES INC REAGAN STREET SURGERY CENTER LLC THE SURGICAL CENTER AT SADDLEBACK WEST ANAHEIM MEDICAL CENTER GARDEN GROVE HOSPITAL AND MEDICAL CENTER MISSION ENDOSCOPY CENTER INC DIGESTIVE DISEASE CENTER THE CENTER FOR ENDOSCOPY V A MEDICAL CENTER-LONG BEACH V A MEDICAL CENTER-LONG BEACH GLENWOOD SURGICAL CENTER ORANGE COAST MEMORIAL MEDICAL CENTER RIVERSIDE COMMUNITY HOSPITAL AGMG ENDOSCOPY CENTER RIVERSIDE MEDICAL CLINIC SURGERY CENTER DESERT ADVANCED IMAGING MEDICAL CENTER CORONA REGIONAL MEDICAL CENTER WESTERN MEDICAL CENTER - SANTA ANA CHAPMAN MEDICAL CENTER MAGNOLIA SURGERY CENTER QUEST DIAGNOSTICS LAGUNA HILLS SURGERY CENTER NORTH ANAHEIM SURGICENTER DESERT REGIONAL MEDICAL CENTER PLACENTIA LINDA HOSPITAL LOS ALAMITOS MEDICAL CENTER LABORATORY CORPORATION OF AMERICA SIERRA VIEW DISTRICT HOSPITAL KAWEAH DELTA MEDICAL CENTER ST JUDE MEDICAL CENTER Page 1 of 2
4 County of Orange HMO B Provider Listing - Hospital Facilities Num Facility TIN Facility Name Facility Zip Yes No HOAG MEMORIAL HOSPITAL PRESBYTERIAN ST JOSEPH HOSPITAL - ORANGE MISSION HOSPITAL REGIONAL MEDICAL CENTER TORRANCE MEMORIAL MEDICAL CENTER DOWNEY REGIONAL MEDICAL CENTER - HOSPITAL INC AHMC ANAHEIM REGIONAL MEDICAL CENTER LP TRI CITY MEDICAL CENTER UC IRVINE MEDICAL CENTER SADDLEBACK MEMORIAL MEDICAL CENTER FOUNTAIN VALLEY REGIONAL HOSPITAL AND MEDICAL CENTER MIMG ENDOSCOPY CENTER HENRY MAYO NEWHALL MEMORIAL HOSPITAL LOMA LINDA UNIVERSITY MEDICAL CENTER LOMA LINDA UNIVERSITY MEDICAL CENTER LONG BEACH MEMORIAL MEDICAL CENTER JERRY L PETTIS MEMORIAL VA MEDICAL CENTER JERRY L PETTIS MEMORIAL VA MEDICAL CENTER BEVERLY RADIOLOGY MEDICAL GROUP ADVANCED MEDICAL ANALYSIS LLC EISENHOWER MEDICAL CENTER Page 2 of 2
5 County of Orange HMO B Provider Listing - Specialists Num Specialist TIN Specialist Name Specialty Specialist ZIP KOTOMORI RICHARD T PSYCHIATRY VU ALAN D PSYCHIATRY MATHER DEBORAH G PSYCHOLOGY ABDISHOO SERGE PSYCHIATRY DIBELLA GEOFFREY A PSYCHIATRY REEVE ROBERT B OPHTHALMOLOGY COWAN BENJAMIN F DIAGNOSTIC RADIOLOGY MASSOUDIAN MOHAMAD T RADIOLOGY SIMON STEPHEN M DIAGNOSTIC RADIOLOGY KHORASHADI FARHAD RADIOLOGY MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF ORANGE COUNTY INC PRETORIUS EUGENE S DIAGNOSTIC RADIOLOGY KEAYS SANDY MARRIAGE FAMILY THER ANTHEM PRESCRIPTION MANAGEMENT DBA PRECISIONRX PHARMACY APRIA PHARMACY NETWORK MEDICAL VENDOR (DME) DUNBAR RICHARD D RADIOLOGY LE RICHARD D PULMONARY DISEASE PHUNG THANH G DIAGNOSTIC RADIOLOGY FOUNTAIN VALLEY ORTHOTICS & PROSTHETICS ORTHOTICS/PROSTHETIC KAVEGGIA LASZLO P DIAGNOSTIC RADIOLOGY CARE AMBULANCE SERVICE GROUND AMBULANCE URSINO JOHN J PSYCHIATRY ZACHARIAH SUSAN PSYCHIATRY PHAM HANH V DIAGNOSTIC RADIOLOGY ALT STEVEN J EMERGENCY MEDICINE YAMADA KAREN S NURSE PRACTITIONER BARGER CYNTHIA Q NURSE PRACTITIONER KELLEY LYNETTA J NURSE PRACTITIONER ODONNELL MICHAEL P RADIOLOGY WILLIAMS RUSSELL A GEN VASCULAR SURGERY VENKATESH HOSKOTE B EMERGENCY MEDICINE PUGH PEGGY A DIAGNOSTIC RADIOLOGY GUZALO ERICA A DIAGNOSTIC RADIOLOGY URSINO JOHN J PSYCHIATRY MAI DAVID T DIAGNOSTIC RADIOLOGY PORTER DEAN M EMERGENCY MEDICINE KHAJAVI SOHEILA S PSYCHIATRY WILLIES SPECIALTY SHOP MEDICAL VENDOR (DME) Yes No Page 1 of 3
6 County of Orange HMO B Provider Listing - Specialists Num Specialist TIN Specialist Name Specialty Specialist ZIP MOORE JEANNE L PSYCHOLOGY ZACHARIAH SUSAN PSYCHIATRY MASSA CHRISTOPHER S CARDIOVASCU DISEASE PEREZ CLAUDIA S MARRIAGE FAMILY THER ANATOMICAL PATHOLOGY CONSORTIUM LLC PATHOLOGY STROMBERG GARY A RADIOLOGY THOMAS JULIE A PSYCHIATRY LI VICTOR ANESTH PAIN MANAGMNT PERSI ROXIE R PSYCHOLOGY PHILLIPS NABIL A HEMATOLOGY TURNER ALAN T RADIOLOGY LEVEN STEVEN B PULMONARY DISEASE MAYER FREDERICK A PODIATRIST JANIK ALICE K MARRIAGE FAMILY THER JANIK ANDREW S PSYCHIATRY SCHAEFER AMBULANCE SERVICE GROUND AMBULANCE TIEGS VERNA G DIAGNOSTIC RADIOLOGY MOORE DARLENE M MARRIAGE FAMILY THER SADDLEBACK MEDICAL CENTER INSTITUTIONAL MITCHELL RICHARD A RADIOLOGY TRAN THUAN T RADIOLOGY HANGER PROSTHETICS AND ORTHOTICS WEST INC ORTHOTICS/PROSTHETIC MILLER JEFFREY S DIAGNOSTIC RADIOLOGY SHARZER MARK A RADIOLOGY KNOHL HOWARD R NUCLEAR MEDICINE DOCTORS AMBULANCE SERVICE GROUND AMBULANCE RYU CHUN K PSYCHIATRY WESTERN DRUG MEDICAL SUPPLY MEDICAL VENDOR (DME) RO HONG I DIAGNOSTIC RADIOLOGY CHASE RESA L PATHOLOGY OWENS JOHN E PHYSICAL MED & REHAB SMITH JODI O OPHTHALMOLOGY TRAN CAROL L PODIATRIST FARGO RAMIZ A EMERGENCY MEDICINE CHON KENNETH S RADIOLOGY SPECHT NORMAN L CRITICAL CARE MED SPIELLER SUSAN G DIAGNOSTIC RADIOLOGY Yes No Page 2 of 3
7 County of Orange HMO B Provider Listing - Specialists Num Specialist TIN Specialist Name Specialty Specialist ZIP OCULAR PROSTHETICS INC ORTHOTICS/PROSTHETIC HANFT ALAN C PSYCHIATRY PREDA ADRIAN PSYCHIATRY MYERS ROBERT F PSYCHOLOGY FERNANDEZ GAIL E PSYCHIATRY DUBIN MARK D RADIOLOGY MOLINA CARLOS RADIOLOGY CITY OF HUNTINGTON BEACH GROUND AMBULANCE Yes No Page 3 of 3
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