MARK DREW PELLEGRINO (NPI# 1124176912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124176912 |
| Entity Type | Individual |
| Full Name | MARK DREW PELLEGRINO |
| Credential | MD |
| Practice Address |
441 N Lakeview Ave Anaheim CA 92807-3028 |
| Practice Telephone | 8889882800 |
| Mailing Telephone | 8889882800 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2008-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
G69878 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538170691 | Mark J. Pellegrino | Physical Medicine & Rehabilitation | 6651 Frank Ave Nw, North Canton, OH 44720 | 2006-08-11 |
| Street Address |
441 N LAKEVIEW AVE |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92807-3028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013911551 | Jennifer Linzmeyer | Pediatrics | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2005-06-13 |
| 1255609418 | Sheila Elizabeth Ford | Pediatrics | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2011-12-02 |
| 1982909222 | Sarah Elisabeth Gomez | Nurse Practitioner | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2011-01-18 |
| 1265664635 | Beatrix M Schieffer | Psychologist | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2009-08-18 |
| 1598992307 | Minhee Song | Physical Therapist | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2009-06-18 |
| 1992949333 | Carol King | Nurse Practitioner | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2009-04-29 |
| 1144463951 | Maria Eugenia Campi | Speech-Language Pathologist | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2009-04-08 |
| 1356587547 | Jose Pena | Physical Therapy Assistant | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2008-12-18 |
| 1467607929 | Grant Masaru Yasui | Anesthesiology | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2008-11-25 |
| 1255583696 | Claudio Cassinelli | Social Worker | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2008-10-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801400759 | Katie Greasby | Marriage & Family Therapist | 509 S. Villa Real Dr. #117, Anaheim Hills, CA 92807 | 2020-09-08 |
| 1386201481 | Joseph Hasrouni | Counselor | Cvs 9753, 5735 E. La Palma Ave, Anaheim, CA 92807 | 2019-05-23 |
| 1144739277 | Luis Antonio Perez | Social Worker | 2112 E 4th St. #107, Santa Ana, CA 92807 | 2017-09-20 |
| 1548781883 | F.foroutan Dds Inc. | Dentist | 5031 E. Orangethorpe Ave., Suite # B-2, Anaheim Hills, CA 92807 | 2017-06-27 |
| 1487101515 | Eloy Ramirez | Counselor | 233 S. Quintana Drive, Anaheim, CA 92807 | 2016-09-07 |
| 1255786448 | K's Loving Care | Custodial Care Facility | 1211 N Amelia St, Anaheim, CA 92807 | 2016-04-26 |
| 1265806673 | Jessica Vickers | Marriage & Family Therapist | 5500 E Santa Ana Canyon Rd Ste 216, Anaheim, CA 92807 | 2015-11-23 |
| 1033596796 | Donovan Garcia Teves | Specialist | 1261 Lakeview Ave., Suite 'a', Anaheim Hills, CA 92807 | 2015-05-01 |
| 1235544354 | Nicole Reaves | Occupational Therapist | 5630 E Santa Ana Canyon Rd Ste 105, Anaheim, CA 92807 | 2014-06-26 |
| 1093143471 | Behrang E Toubak | Counselor | 6381 E Via Arboles, Anaheim, CA 92807 | 2013-10-23 |
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| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| 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 Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427345503 | Neetu Bhola | Family Medicine | 411 N. Lakeview Avenue, Anaheim, CA 92807 | 2011-07-08 |
| 1093800617 | Anaheim Cardiology Medical Group, Inc | Family Medicine | 1735 W. Romneya Dr., Anaheim, CA 92801 | 2006-10-03 |
| 1639431836 | Reza Talebi Dolouei | Family Medicine | 1735 W Romneya Dr, Anaheim, CA 92801-1804 | 2012-06-13 |
| 1609943505 | Douglas B. Nelson | Family Medicine | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2006-11-29 |
| 1346317286 | Monica Mehren | Family Medicine | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2006-11-29 |
| 1659448595 | Charles A. Kellerman | Family Medicine | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2006-11-29 |
| 1023189909 | Donald I. King | Family Medicine | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2006-11-13 |
| 1407927460 | William R. Ford | Family Medicine | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2006-11-13 |
| 1518937754 | Rakesh K Bhola | Family Medicine | 1801 W Romneya Dr, #504, Anaheim, CA 92801 | 2006-01-23 |
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|---|---|---|---|---|
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| 1225657331 | Samantha Lillian Escalera | Family Medicine | 9608 Planter St, Pico Rivera, CA 90660-4743 | 2020-04-09 |
| 1164058897 | Amani A Osman | Family Medicine | 9753 Holder St, Cypress, CA 90630-4004 | 2020-03-13 |
| 1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
| 1013549914 | Vertini Medical Group Inc | Family Medicine | 1001 W Carson St Ste S, Torrance, CA 90502-2051 | 2020-02-07 |
| 1295297463 | Cedars Family Medicine Inc | Family Medicine | 18021 Sky Park Cir Ste G, Irvine, CA 92614-6569 | 2019-04-04 |
| 1811455967 | Hope Geriatric Medical Center Inc | Family Medicine | 9 Coursan, Laguna Niguel, CA 92677-8902 | 2019-03-07 |
| 1245702174 | Jonah Medical Group Inc | Family Medicine | 20627 Golden Springs Dr Ste D, Walnut, CA 91789-4814 | 2018-12-17 |
| 1104392885 | Wilshire Connected Care | Family Medicine | 277 South St Ste S, San Luis Obispo, CA 93401-5039 | 2018-10-19 |
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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.