DR. AVI J HETTENA (NPI# 1013029487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013029487 |
| Entity Type | Individual |
| Full Name | DR. AVI J HETTENA |
| Other Name | N/A N/A N/A |
| Credential | M.D. |
| Practice Address |
6037 La Granada, Suite C Rancho Santa Fe CA 92067 |
| Mailing Address |
Po Box 7281 Rancho Santa Fe CA 92067-7281 |
| Practice Telephone | 8587562116 |
| Practice Fax Number | 8584005113 |
| Mailing Telephone | 5186378637 |
| Mailing Fax Number | 4153584754 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-01-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | G45263 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
G45263 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G452630 | 05 | |
| CA | MEDICARE RAILROAD | 110017611 | 01 |
| Street Address |
6037 LA GRANADA, SUITE C |
| City | RANCHO SANTA FE |
| State | CA |
| Zip Code | 92067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467979377 | Taylor Duncan | Chiropractor | 18025 Calle Ambiente Suite 204, Rancho Santa Fe, CA 92067 | 2017-08-23 |
| 1831628692 | Del Sur Pharmacy | Pharmacy | 16089 San Dieguito Rd, H102, Rancho Santa Fe, CA 92067 | 2017-06-06 |
| 1295286714 | Tharaknath Rao | Internal Medicine | 14767 Calle Carla, Rancho Santa Fe, CA 92067 | 2016-10-19 |
| 1861885295 | Kenneth Widder | Pathology | 16231 El Camino Real, Rancho Santa Fe, CA 92067 | 2015-03-10 |
| 1164869962 | Gary Lee Nobbel | Plastic Surgery | 5002 Linea Del Cielo, Rancho Santa Fe, CA 92067 | 2013-06-03 |
| 1104187137 | Leslie Buncher | Obstetrics & Gynecology | 6225 San Elijo, Rancho Santa Fe, CA 92067 | 2012-06-06 |
| 1316213440 | Ahmad Mehran | Obstetrics & Gynecology | 16818 Circa Del Norte, Rancho Santa Fe, CA 92067 | 2012-03-22 |
| 1598030025 | Fernald William Wentzell | Specialist | 5407 Linea Del Cielo, Rancho Santa Fe, CA 92067 | 2012-03-16 |
| 1013211754 | Deborah Leah Goodman | Preventive Medicine | 5725 Loma Verde Drive, Rancho Santa Fe, CA 92067 | 2011-01-10 |
| 1972736445 | Herbert Nathaniel Weissman | Psychologist | 6896 Farms View Court, Rancho Santa Fe, CA 92067 | 2009-08-31 |
| Find all providers in zip 92067 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1710585328 | Empire Medical Specialist | Internal Medicine | 28625 Quaint St, Agoura Hills, CA 91301-1735 | 2020-10-15 |
| 1538774989 | Modern Telehealth | Internal Medicine | 1509 Espinosa Cir, Palos Verdes Estates, CA 90274-1917 | 2020-09-12 |
| 1073137733 | Jafar Alsaid | Internal Medicine | 2009 Baywood Ln, Davis, CA 95618-0500 | 2020-05-29 |
| 1164041422 | Advanced Care Multispecialty Medical Group Apc | Internal Medicine | 13990 Bear Fence Court, Moorpark, CA 93021-5022 | 2020-04-15 |
| 1629600416 | Valley Kidney Medical Group Inc | Internal Medicine | 1646 E Herndon Ave Ste 106, Fresno, CA 93720-3380 | 2020-02-10 |
| 1437789278 | Spectrum Dialysis | Internal Medicine | 18040 Sherman Way Ste 220, Reseda, CA 91335-4631 | 2020-01-21 |
| 1932745007 | K Care Ipa | Internal Medicine | 18000 Studebaker Rd Ste 100, Cerritos, CA 90703-7929 | 2019-11-22 |
| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1669930723 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 160, Chico, CA 95928-8351 | 2019-03-07 |
| 1295293363 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 220, Chico, CA 95928-8351 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
| City | RANCHO SANTA FE |
| Zip Code | 92067 |
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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.