MICHELLE KILUK (NPI# 1124058870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124058870 |
| Entity Type | Individual |
| Full Name | MICHELLE KILUK |
| Credential | PA |
| Practice Address |
5555 Grossmont Center Dr La Mesa CA 91942-3019 |
| Mailing Address |
5555 Grossmont Center Dr Cancer Center Oncology Medical Group La Mesa CA 91942-3019 |
| Practice Telephone | 6196443030 |
| Practice Fax Number | 6196443083 |
| Mailing Telephone | 6196443030 |
| Mailing Fax Number | 6196443083 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2010-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
PA13895 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
5555 GROSSMONT CENTER DR |
| City | LA MESA |
| State | CA |
| Zip Code | 91942-3019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770589293 | Raed A Al-naser | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2005-06-21 |
| 1568062552 | Justin Cantley | Nurse Practitioner | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2020-10-28 |
| 1942828314 | Honey Mae Cosare Surmillon | Licensed Vocational Nurse | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2020-07-11 |
| 1922632801 | Susan Daniels | Occupational Therapist | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2020-02-28 |
| 1457917791 | Elpitha K Tsiskakis | Physician Assistant | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2019-05-13 |
| 1336601053 | Diane Wade Bloomberg | Dietitian, Registered | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2019-04-02 |
| 1265992846 | Vincent Crump | Registered Nurse | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2019-03-21 |
| 1295210029 | United Urology Consultants, P.C. | Urology | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2018-09-27 |
| 1639660368 | Aileen Cathy Chu | Pharmacist | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2018-05-29 |
| 1447767678 | Leslie Ling | Registered Nurse | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2018-01-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
| 1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
| 1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
| 1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
| 1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
| 1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
| 1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
| 1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
| 1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
| 1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699737676 | Melissa S Copeland | Internal Medicine | 4215 Spring St Ste 125, La Mesa, CA 91941-7983 | 2006-04-05 |
| 1154618593 | Igor Medic | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2011-07-06 |
| 1629286505 | Reema R. Batra | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2007-05-21 |
| 1134280605 | David J Bodkin | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2006-12-12 |
| 1164583639 | Kai Zu | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2006-12-12 |
| 1588674741 | Michael Anthony Crucitt | Internal Medicine | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2006-08-09 |
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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.