ST MARY SPECIALTY CLINIC (NPI# 1588972806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588972806 |
| Entity Type | Organization |
| Organization Name | ST MARY SPECIALTY CLINIC |
| Practice Address |
19333 Bear Valley Rd Ste 106 Apple Valley CA 92308-5149 |
| Mailing Address |
Dept La 21190 Pasadena CA 91185-1190 |
| Practice Telephone | 7602405505 |
| Practice Fax Number | 7602405525 |
| Mailing Telephone | 7144494800 |
| Mailing Fax Number | 7144494956 |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2013-05-31 |
| Authorized Official Name | DR. MOSES T MUKAI JR. (PRESIDENT) |
| Authorized Official Telephone | 7144494800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
19333 BEAR VALLEY RD STE 106 |
| City | APPLE VALLEY |
| State | CA |
| Zip Code | 92308-5149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144831850 | Lisa K Frandsen | Behavioral Analyst | 19794 Poppy Rd, Apple Valley, CA 92308 | 2020-08-14 |
| 1518484195 | Jennifer Redwine | Behavioral Analyst | 1905 Business Center Drive South, Unit 100, San Bernardino, CA 92308 | 2017-08-24 |
| 1508397100 | West Care Transportation | Non-emergency Medical Transport (VAN) | 15480 Straight Arrow Rd #b, Apple Valley, CA 92308 | 2017-03-24 |
| 1811346497 | E Kim Dental Corp | Dentist | 21580 Bear Valley Rd., Ste B2-2, Apple Valley, CA 92308 | 2016-06-06 |
| 1134575376 | Seth Owuor | Pharmacist | 14426 Palmdale Road, Victorville, CA 92308 | 2016-05-06 |
| 1043608763 | Kamal Ebadpour | Adult Companion | 13224 Iroquois Road, Apple Valley, CA 92308 | 2015-01-05 |
| 1487099669 | Hateem Siddiqui | Internal Medicine | 19059 Bear Valley Rd # 3, Apple Valley, CA 92308 | 2013-05-01 |
| 1225305618 | Edward N. Sianipar | Nurse Practitioner | 19059 Bear Valley Rd., #1, Apple Valley, CA 92308 | 2011-11-29 |
| 1043508559 | Southern California Primary Medical Inc | Clinic/Center | 19341 Bear Valley Rd Ste 101, Apple Valley, CA 92308 | 2011-07-18 |
| 1396070959 | Asghar Ali Rajani | Registered Nurse | 19059 Bear Valley Road, Apple Valley, CA 92308 | 2009-10-14 |
| Find all providers in zip 92308 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659982130 | Anaya Women's Ob/gyn Group | Obstetrics & Gynecology | 18056 Wika Rd Ste B, Apple Valley, CA 92307-2194 | 2020-08-10 |
| 1659428001 | Viruch Vachirakorntong | Obstetrics & Gynecology | 15998 Quantico Rd Ste A, Apple Valley, CA 92307-1302 | 2007-01-05 |
| 1417045113 | Vijay Arora | Obstetrics & Gynecology | 16167 Siskiyou Rd, Apple Valley, CA 92307-1314 | 2006-10-10 |
| 1164517132 | Genesis Obgyn Medical Group Inc. | Obstetrics & Gynecology | 16000 Apple Valley Road, Suite C3, Apple Valley, CA 92307 | 2006-10-04 |
| 1235243429 | Mohammad Reza Ahmadinia | Obstetrics & Gynecology | 18112 Outer Highway 18, Suite 101, Apple Valley, CA 92307-2211 | 2006-08-18 |
| 1992754899 | Viruch Vachirakorntong Md Inc | Obstetrics & Gynecology | 15998 Quantico Rd, Suite A, Apple Valley, CA 92307-1302 | 2006-05-08 |
| 1528043429 | Carlos D Montes | Obstetrics & Gynecology | 18564 Highway V18, Suite 303, Apple Valley, CA 92307-2338 | 2005-12-13 |
| 1649533274 | Sarah Nichole Noppen | Obstetrics & Gynecology | 19341 Bear Valley Rd Ste 105, Apple Valley, CA 92308-5152 | 2012-06-19 |
| 1548554611 | Victor C Moneke Md Inc | Obstetrics & Gynecology | 15995 Tuscola Rd Ste 208, Apple Valley, CA 92307-2159 | 2011-06-06 |
| 1366752701 | Amal K Guha Md Inc | Obstetrics & Gynecology | 16124 Kasota Rd, Suite A, Apple Valley, CA 92307-2232 | 2010-10-19 |
| Find all providers in APPLE VALLEY | ||||
| City | APPLE VALLEY |
| Zip Code | 92308 |
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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.