MR. MICHAEL THOMAS LANCE (NPI# 1740310531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740310531 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL THOMAS LANCE |
| Credential | P.A.-C |
| Practice Address |
8891 Central Ave Montclair CA 91763-1618 |
| Mailing Address |
4374 9th St Riverside CA 92501-3106 |
| Practice Telephone | 9096254848 |
| Mailing Telephone | 9518092094 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA18755 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063032001 | Michael Dale Lance II | Nurse Anesthetist, Certified Registered | 530 S Jackson St, Louisville, KY 40202-1675 | 2020-04-20 |
| 1073655304 | Michael D Lance | Psychiatry & Neurology | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2007-02-13 |
| Street Address |
8891 CENTRAL AVE |
| City | MONTCLAIR |
| State | CA |
| Zip Code | 91763-1618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962428060 | Central Avenue Urgent Care Center | Clinic/Center | 8891 Central Ave, Montclair, CA 91763-1618 | 2006-07-14 |
| 1043775919 | Central Urgent Medical Care | Clinic/Center | 8891 Central Ave, Montclair, CA 91763-1618 | 2019-02-05 |
| 1336611813 | Beau Christian | Registered Nurse | 8891 Central Ave, Montclair, CA 91763-1618 | 2018-12-21 |
| 1720514466 | Kyungsoo Korinn Go | Physician Assistant | 8891 Central Ave, Montclair, CA 91763-1618 | 2017-05-01 |
| 1992259071 | Daniel Mccullough | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2016-08-07 |
| 1265898126 | Noor Dakkak | Physician Assistant | 8891 Central Ave, Montclair, CA 91763-1618 | 2016-01-07 |
| 1467821363 | Danielle Barrett | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2015-09-21 |
| 1396137329 | Gale Estelle Laidlaw | Nurse Practitioner | 8891 Central Ave, Montclair, CA 91763-1618 | 2015-02-27 |
| 1093115941 | Michelle Anne Matyseck | Physician Assistant | 8891 Central Ave, Montclair, CA 91763-1618 | 2014-08-28 |
| 1992120042 | Joann Enderica | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2014-02-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335760 | Cho Jeon Yun Dental Partnership | Dentist | 9655 Monte Vista Ave #406, Montclair, CA 91763 | 2020-08-07 |
| 1215498811 | Above Urgent Care Center | Emergency Medicine | 8891 N. Central Ave Ste A, Montclair, CA 91763 | 2019-03-27 |
| 1467936906 | Bronislava Kroulik | Behavior Technician | 4950 San Bernardino St Ste 101, Montclair, CA 91763 | 2018-09-20 |
| 1063936110 | Monique Karina Enriquez | Licensed Vocational Nurse | 5580 Moreno St #82, Montclair, CA 91763 | 2017-07-31 |
| 1972961159 | Lacy Pinsky | Specialist/Technologist | 5035 Flora St., Montclair, CA 91763 | 2016-02-03 |
| 1912333790 | Cinta Hospice Care Inc | Hospice Care, Community Based | 5050 Palo Verde Street, Suite 101, Montclair, CA 91763 | 2013-09-24 |
| 1720334626 | Priority One Hospice, Inc. | Hospice Care, Community Based | 4959 Palo Verde St Ste 107c, Montclair, CA 91763 | 2012-07-28 |
| 1689982498 | Paulina Trujillo Perez | Counselor | 9916 Central Ave., Montclair, CA 91763 | 2010-09-15 |
| 1982846499 | Esther Phillips Agepogu | Physician Assistant | 9301 Central Ave., Montclair, CA 91763 | 2009-03-30 |
| 1568633139 | Mahin Nosrati-jahromi | Dentist | 9509 Central Ave #d, Montclair, CA 91763 | 2008-03-21 |
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| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437440625 | Charinda Charoen | Physician Assistant | 9301 Central Ave Ste 201, Montclair, CA 91763-2446 | 2011-04-22 |
| 1982846499 | Esther Phillips Agepogu | Physician Assistant | 9301 Central Ave., Montclair, CA 91763 | 2009-03-30 |
| 1992120042 | Joann Enderica | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2014-02-26 |
| 1548557309 | Esther Loya | Physician Assistant | 8891 Central Ave, Montclair, CA 91763-1618 | 2011-06-30 |
| 1801187083 | Laurie M. Woll D.o. | Physician Assistant | 9301 Central Ave Ste 201, Montclair, CA 91763-2446 | 2011-04-22 |
| 1033431960 | Valentina Kolker | Physician Assistant | 1 Bay Ave, Harries Pavilion, Suite 1, Montclair, NJ 07042-4837 | 2010-02-19 |
| 1043371636 | Martin Madrigal | Physician Assistant | 5404 Moreno St, Suite N, Montclair, CA 91763-1667 | 2006-12-13 |
| 1750491908 | Jonathan Martinez | Physician Assistant | 4959 Palo Verde St, Ste 101a, Montclair, CA 91763-2340 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
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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.