MR. RUSSEL GROVER LADWIG (NPI# 1235163858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235163858 |
| Entity Type | Individual |
| Full Name | MR. RUSSEL GROVER LADWIG |
| Credential | PAC |
| Practice Address |
39500 Liberty Street Tri City Health Center Fremont CA 94538 |
| Mailing Address |
644 E Pintail Circle Fresno CA 93720-1266 |
| Practice Telephone | 5107708133 |
| Practice Fax Number | 5107708140 |
| Mailing Telephone | 5994339282 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA17196 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
39500 LIBERTY STREET TRI CITY HEALTH CENTER |
| City | FREMONT |
| State | CA |
| Zip Code | 94538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285676759 | Susan L Doughty | Nurse Practitioner | 39500 Liberty Street, Tri City Health Center, Fremont, CA 94538 | 2006-06-11 |
| 1063636223 | Bay Area Community Health | Clinic/Center | 39500 Liberty Street, Fremont, CA 94538-2211 | 2007-04-12 |
| 1942424106 | Bay Area Community Health | Clinic/Center | 39500 Liberty Street, Fremont, CA 94538-2211 | 2007-04-12 |
| 1326115627 | Nikhat Nazneen | Pediatrics | 39500 Liberty Street, Fremont, CA 94538 | 2006-11-29 |
| 1942387188 | Bay Area Community Health | Clinic/Center | 39500 Liberty Street, Fremont, CA 94538-2211 | 2006-11-01 |
| 1861507071 | Joby J Neelankavil | Dietitian, Registered | 39500 Liberty Street, Fremont, CA 94538 | 2006-08-20 |
| 1417964347 | Eden Domingo | Registered Nurse | 39500 Liberty Street, Tri City Health Center, Fremont, CA 94538 | 2006-08-02 |
| 1093729840 | Joanne Andrego | Nurse Practitioner | 39500 Liberty Street, Tricity Health Center, Fremont, CA 94538 | 2006-07-28 |
| 1215961917 | Arshia Arjumand | Family Medicine | 39500 Liberty Street, Tri-city Health Center, Fremont, CA 94538 | 2006-07-10 |
| 1245269406 | Suksham Puri-kumar | Pediatrics | 39500 Liberty Street, Tri-city Health Center, Fremont, CA 94538 | 2006-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394460 | Bay Area Kidney Care Medical Group Inc. | Clinic/Center | 39370 Mozart Terrace Unit 106, Fremont, CA 94538 | 2020-04-13 |
| 1740847284 | Gloria Ann Federico | Behavior Technician | 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2019-05-21 |
| 1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
| 1902370067 | Nicole Sandoval | Counselor | 39155 Liberty St Suite E500, Fremont, CA 94538 | 2019-01-11 |
| 1497225015 | Megan Galban | Behavior Technician | 39210 State St. Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1780154302 | Karla Patricia Plascencia | Behavior Technician | 39210 State Street Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1215407846 | Sydney J Torrens | Behavior Technician | 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2018-11-27 |
| 1932676277 | Jarah Harvan | Psychologist | 1999 Mowry Ave Ste F, Fremont, CA 94538 | 2018-10-24 |
| 1205321965 | Chien Shien Yang Md Inc | Psychiatry & Neurology | 1860 Mowry Ave Ste 301a, Fremont, CA 94538 | 2018-06-26 |
| 1912416199 | Advanced Interventional Surgical Center | Clinic/Center | 3077 Stevenson Blvd, Fremont, CA 94538 | 2017-09-20 |
| Find all providers in zip 94538 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962054213 | Phuong Thi Du Nguyen | Physician Assistant | 34311 Oconnell Ct, Fremont, CA 94555-3027 | 2019-07-16 |
| 1083107304 | Zeba Mundu | Physician Assistant | 35864 Mission Blvd, Fremont, CA 94536-1544 | 2018-06-12 |
| 1518402353 | Patrizia Andreina Visconti | Physician Assistant | 2557 Mowry Ave Ste 25, Fremont, CA 94538-1614 | 2017-01-04 |
| 1144698721 | Cindy Luo | Physician Assistant | 2557 Mowry Ave # 3a, Fremont, CA 94538-1603 | 2015-09-12 |
| 1639239205 | Jeffrey Cooper | Physician Assistant | 39120 Argonaut Way # 275, Fremont, CA 94538-1304 | 2006-12-12 |
| 1467529842 | Yvonne Muro | Physician Assistant | 686 Mowry Ave., Fremont, CA 94536-4113 | 2006-11-29 |
| 1487728747 | Mary J Flamme | Physician Assistant | 1848 N Nye Ave, Fremont, NE 68025-1300 | 2006-11-20 |
| 1104933548 | Andrea Jane Neault | Physician Assistant | N430 Wood Duck Dr, Fremont, WI 54940 | 2006-08-23 |
| 1720030471 | Jason Landon Garrow | Physician Assistant | E7376 Hwy H, Fremont, WI 54940-3454 | 2006-05-17 |
| 1639127517 | Larry G Kisby | Physician Assistant | 710 Reynolds Road, Fremont, NE 68025-2300 | 2006-05-04 |
| Find all providers in FREMONT | ||||
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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.