THC - ORANGE COUNTY, LLC (NPI# 1093947251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093947251 |
| Entity Type | Organization |
| Organization Name | THC - ORANGE COUNTY, LLC |
| Practice Address |
1940 El Cajon Blvd San Diego CA 92104 |
| Mailing Address |
1940 El Cajon Blvd San Diego CA 92104-1005 |
| Practice Telephone | 6195434500 |
| Practice Fax Number | 6192942979 |
| Mailing Telephone | 6195434500 |
| Mailing Fax Number | 6192942979 |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | MR. MOSTAFA ADAM DARVISH (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7148934541 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZT30220I | 05 | |
| CA | BLUE CROSS | 052035 | 01 |
| CA | HEALTH NET | ZZT40220I | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043395742 | Thc - Orange County, LLC | Long Term Care Hospital | 550 N Monterey Ave, Ontario, CA 91764 | 2006-10-25 |
| 1902038169 | Thc - Orange County, LLC | General Practice | 875 N Brea Blvd, Brea, CA 92821 | 2009-08-20 |
| 1578795738 | Thc - Orange County, LLC | General Practice | 550 N Monterey Ave, Ontario, CA 91764 | 2009-08-20 |
| 1679705826 | Thc - Orange County, LLC | General Practice | 200 Hospital Cir, Westminster, CA 92683 | 2009-08-20 |
| 1629240577 | Thc - Orange County, LLC | Skilled Nursing Facility | 875 N Brea Blvd, Brea, CA 92821 | 2008-04-01 |
| 1821204058 | Thc - Orange County, LLC | General Practice | 5525 W Slauson Ave, Los Angeles, CA 90056 | 2007-05-15 |
| 1780768416 | Thc - Orange County, LLC | Long Term Care Hospital | 875 N Brea Blvd, Brea, CA 92821 | 2006-10-25 |
| 1447335146 | Thc - Orange County, LLC | Long Term Care Hospital | 5525 W Slauson Ave, Los Angeles, CA 90056 | 2006-10-25 |
| 1528143179 | Thc - Orange County, LLC | Long Term Care Hospital | 200 Hospital Cir, Westminster, CA 92683 | 2006-10-25 |
| 1992880512 | Thc - Orange County, LLC | Long Term Care Hospital | 1940 El Cajon Blvd, San Diego, CA 92104 | 2006-10-25 |
| Street Address |
1940 EL CAJON BLVD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124079793 | Samuel J. Clark, M.d., Inc. | Internal Medicine | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2006-05-16 |
| 1073143848 | Sandra M. Hayes, Medical Services, Inc. | Preventive Medicine | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2020-01-21 |
| 1013557636 | Js Cardiology | Internal Medicine | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2020-01-11 |
| 1699317644 | Avicenna Critical Care, PC | Internal Medicine | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2019-10-10 |
| 1912471756 | Shelby Turner | Occupational Therapist | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2019-01-15 |
| 1396256558 | Catherine Maywood, M.d., A Professional Corporation | Internal Medicine | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2017-10-16 |
| 1699209577 | Diana Nawrocki | Physical Therapist | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2017-04-17 |
| 1083070189 | California Emergency Physicians Medical Group, A Professional Corp | Internal Medicine | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2016-01-06 |
| 1942600416 | Catherine Aquino | Registered Nurse | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2014-09-02 |
| 1528336211 | Dr. Gerardo B. Martin, Inc. | Family Medicine | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2011-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750933610 | Hinderberger Dental Corporation | Dentist | 2050 El Cajon Boulevard, San Diego, CA 92104 | 2019-07-11 |
| 1912487265 | Graham Ashton Harris | Dentist | 2310 Craven Street, Bldg 3230, Fpo, AA 92104 | 2018-08-16 |
| 1700393485 | Christian Jacot | Occupational Therapy Assistant | 3128 Nile Street, San Diego, CA 92104 | 2018-01-04 |
| 1316452931 | Enrico Resurreccion Santos | Dental Hygienist | 2310 Craven St. Bldg. 3230, San Diego, CA 92104 | 2017-12-05 |
| 1164940789 | Robert Brian Damone | Acupuncturist | 3370 29th Street, San Diego, CA 92104 | 2017-09-04 |
| 1780100636 | Nicole Palacios | Counselor | 4170 Texas Street, Apt 1, San Diego, CA 92104 | 2017-08-22 |
| 1063938587 | Indie C Oliver Landrum | Case Manager/Care Coordinator | 2220 Broadway, San Diego, CA 92104 | 2017-08-16 |
| 1669829008 | Krystah Lynn Smith | Doula | 3370 Cherokee Ave, Unit 43, San Diego, CA 92104 | 2016-05-16 |
| 1063871853 | Holly Nicole Hinderberger | Dentist | 2050 El Cajon Blvd, San Diego, CA 92104 | 2016-02-22 |
| 1316336258 | Jorge E Talavera | Military Health Care Provider | 3875 Florida St Apt 2, San Diego, CA 92104 | 2015-01-15 |
| Find all providers in zip 92104 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1629626981 | Rejuvenate Medical Group Inc | General Practice | 5030 Camino De La Siesta Ste 404, San Diego, CA 92108-3120 | 2019-08-29 |
| 1114484573 | Revive Medical of San Diego | General Practice | 7220 Trade St Ste 209, San Diego, CA 92121-2326 | 2019-02-21 |
| 1144790643 | Elaine Esguerra | General Practice | 751 Kentmere Ter, San Diego, CA 92154-8415 | 2018-11-28 |
| 1609350909 | Cristina Lavenant Gordon | General Practice | 10912 Derrydown Way, San Diego, CA 92130-2897 | 2018-09-21 |
| 1144723289 | Andrew T Bagby | General Practice | 601 Mc Cain Blvd, San Diego, CA 92135 | 2018-03-15 |
| 1568828671 | Ceferina Pulgar Ruiz | General Practice | 6809 Freed Manor Lane, San Diego, CA 92114 | 2016-01-05 |
| 1578941597 | Zenus Joe Wilson | General Practice | 2446 Trident Way Bldg 637, San Diego, CA 92155-5494 | 2015-05-11 |
| 1457761090 | David Lilienfeld | General Practice | 13412 Pantera Rd, San Diego, CA 92130-1022 | 2014-05-05 |
| 1972920882 | Genevieve Dowling | General Practice | 5575 Ruffin Rd # 100us, San Diego, CA 92123-1380 | 2014-03-28 |
| Find all providers in SAN DIEGO | ||||
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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.