DR. RICARDO DAVALOS (NPI# 1609804749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609804749 |
| Entity Type | Individual |
| Full Name | DR. RICARDO DAVALOS |
| Credential | M.D. |
| Practice Address |
150 Avenida Cabrillo Suite #a San Clemente CA 92627 |
| Practice Telephone | 9493696993 |
| Practice Fax Number | 9493696469 |
| Mailing Telephone | 9493696993 |
| Mailing Fax Number | 9493696469 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A65157 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LIC | A65157 | 01 |
| CA | 00A651570 | 05 |
| Street Address |
150 AVENIDA CABRILLO SUITE #A |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952349599 | Wheenk LLC | Physical Therapist | 150 Avenida Cabrillo, Suite B, San Clemente, CA 92672-5595 | 2006-06-04 |
| 1215176375 | Kristin M Massamiri | Physical Therapist | 150 Avenida Cabrillo, Suite B, San Clemente, CA 92672-5595 | 2009-02-13 |
| 1891722336 | Hotosa Ebrahimzadeh | Family Medicine | 150 Avenida Cabrillo, Suite #a, San Clemente, CA 92672 | 2006-06-28 |
| 1932140068 | Kristin Massamiri | Physical Therapist | 150 Avenida Cabrillo, Suite B, San Clemente, CA 92672-5595 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407174 | Ryan Allen Merrell | Technician | 313 E. 17th Pl #l Costa Mesa, Costa Mesa, CA 92627 | 2020-11-04 |
| 1245703412 | Allure Transportation | Non-emergency Medical Transport (VAN) | 1835 Newport Blvd Ste 109 #110, Costa Mesa, CA 92627 | 2019-01-09 |
| 1750857686 | Living Success Center | Marriage & Family Therapist | 445 E. 17th Street, Suites D & E, Costa Mesa, CA 92627 | 2018-10-18 |
| 1790298909 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-a University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1679086862 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-b University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1245759018 | Surgical Assistant Associates | Clinic/Center | 186 E. 16th Street, Suite C, Costa Mesa, CA 92627 | 2017-09-13 |
| 1366962334 | Guadalupe A. Mejia Dental Corp. | Dentist | 700 W 19th St., Suite C, Costa Mesa, CA 92627 | 2017-06-21 |
| 1386189033 | Jian Yi Ye | Acupuncturist | 2488 Newport Blvd Ste B1, Costa Mesa, CA 92627 | 2017-01-04 |
| 1144764606 | Michele Marie Patton | Dental Hygienist | 2220 Fairview Rd., Costa Mesa, CA 92627 | 2016-12-18 |
| 1881148500 | Valerie Nguyen | Pharmacist | 1835 Newport Blvd # C, Costa Mesa, CA 92627 | 2016-08-10 |
| Find all providers in zip 92627 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598104069 | Gruber Medical Corporation | Family Medicine | 1613 Vista Luna, San Clemente, CA 92673-3661 | 2013-06-18 |
| 1982945085 | Nancy Krehbiel Brownell | Family Medicine | 99 Via Sonrisa, San Clemente, CA 92673-5664 | 2013-03-14 |
| 1386790400 | Ocean Breeze Medical Group, Inc. | Family Medicine | 150 Avenida Cabrillo Ste A, San Clemente, CA 92672-5595 | 2007-01-25 |
| 1326198144 | Amit Batra | Family Medicine | 101 W Avenida Vista Hermosa Ste 120, San Clemente, CA 92672 | 2007-01-12 |
| 1609943646 | Fred Howell Nelson | Family Medicine | 707 Calle Amable, San Clemente, CA 92673-3046 | 2006-11-28 |
| 1487735726 | Sara Shokouhi | Family Medicine | 675 Camino De Los Mares Ste 280, San Clemente, CA 92673-2836 | 2006-10-17 |
| 1881706026 | John P Chard | Family Medicine | 665 Camino De Los Maes, #207, San Clemente, CA 92673 | 2006-08-31 |
| 1356353502 | Family and Holistic Health | Family Medicine | 1450 N El Camino Real Ste A, San Clemente, CA 92672-5909 | 2006-08-13 |
| 1033149968 | Brian Francis Haskins | Family Medicine | 151 Avenida Barcelona, San Clemente, CA 92672-4245 | 2006-07-04 |
| 1952338600 | Andrea A Roberson | Family Medicine | 105 Avenida De La Estrella Ste 1a, San Clemente, CA 92672-3985 | 2006-06-27 |
| Find all providers in SAN CLEMENTE | ||||
| City | SAN CLEMENTE |
| Zip Code | 92627 |
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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.