DR. JON GABRIEL ELLISON (NPI# 1760630669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760630669 |
| Entity Type | Individual |
| Full Name | DR. JON GABRIEL ELLISON |
| Credential | M.D. |
| Practice Address |
7777 Alvarado Rd Ste 108 La Mesa CA 91942-8245 |
| Practice Telephone | 6194602774 |
| Practice Fax Number | 6194602774 |
| Mailing Telephone | 6194602774 |
| Mailing Fax Number | 6194602774 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2012-03-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
125049476 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497841134 | Jon Charles Ellison | Dentist | 1939 Erringer Rd, Simi Valley, CA 93065-3524 | 2006-10-04 |
| 1316900954 | Jon G Ellison | Family Medicine | 407 E 22nd St, Huntingburg, IN 47542-8964 | 2006-04-06 |
| Street Address |
7777 ALVARADO RD STE 108 |
| City | LA MESA |
| State | CA |
| Zip Code | 91942-8245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
| 1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
| 1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
| 1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
| 1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
| 1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
| 1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
| 1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
| 1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
| 1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
| Find all providers in zip 91942 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659326460 | Weiling Chang | Radiology | 8881 Fletcher Parkway #102, La Mesa, CA 91942 | 2006-05-23 |
| 1982657441 | William A. Renert | Radiology | 7777 Alvarado Road, Suite 108, La Mesa, CA 91941-3645 | 2006-05-18 |
| 1528011020 | Alexander S Urioste | Radiology | 8881 Fletcher Parkway, #102, La Mesa, CA 91942 | 2006-05-18 |
| 1740232776 | X-ray Medical Group, Inc | Radiology | 7777 Alvarado Rd, Suite 108, La Mesa, CA 91941-3616 | 2006-05-17 |
| 1346684156 | Scott Carey Honowitz | Radiology | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2013-04-23 |
| 1538502331 | Alex Wang Sun | Radiology | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2013-04-10 |
| 1720303191 | Valentin A. Lance | Radiology | 5555 Grossmont Center Dr, Radiology Department, La Mesa, CA 91942-3019 | 2010-03-29 |
| 1952514978 | Jenna I Liu | Radiology | 8881 Fletcher Parkway, #102, La Mesa, CA 91942 | 2007-05-07 |
| 1285673699 | Tuan Xuan Ha | Radiology | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2006-06-05 |
| 1144276189 | Grossmont Imaging, LLC | Radiology | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2006-05-25 |
| Find all providers in LA MESA | ||||
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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.