TUSTIN PLACE MEDICAL GROUP (NPI# 1972812139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972812139 |
| Entity Type | Organization |
| Organization Name | TUSTIN PLACE MEDICAL GROUP |
| Practice Address |
13095 Jamboree Rd Tustin CA 92782-9150 |
| Mailing Address |
2980 N Beverly Glen Cir Suite 301 Los Angeles CA 90077-1726 |
| Practice Telephone | 7148388254 |
| Mailing Telephone | 3104749809 |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2011-03-01 |
| Authorized Official Name | JAYENDRA AMIN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7148388254 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | TUSTIN PLACE MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Street Address |
13095 JAMBOREE RD |
| City | TUSTIN |
| State | CA |
| Zip Code | 92782-9150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760594790 | Anthony F Naples | Family Medicine | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2006-08-31 |
| 1134652241 | Ardeshir Ebn Alnassir | Physician Assistant | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2017-04-05 |
| 1104222124 | Stacey Shoop | Physician Assistant | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2014-11-19 |
| 1801070933 | Jennifer Nishkian Moore | Physician Assistant | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2007-12-26 |
| 1508083239 | Cristina Sanchez | Physician Assistant | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2007-04-20 |
| 1710020805 | Jay Amin Md Inc | Internal Medicine | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2007-02-15 |
| 1225171333 | Anthony F Naples Phd Md Inc | Family Medicine | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2007-02-15 |
| 1548330772 | Yousef Shemseddin Beshqoy | Chiropractor | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548890528 | Christina Maria Clayton | Registered Nurse | 3100 Park Ave Apt 7-201, Tustin, CA 92782 | 2020-01-18 |
| 1447769963 | National Vision, Inc. | Technician/Technologist | 15020 Kensington Park Drive, J300, Tustin, CA 92782 | 2017-09-27 |
| 1487175410 | Vanson Dental Corporation | Dentist | 15160 Kensington Park Drive, Ste 610, Tustin, CA 92782 | 2017-06-29 |
| 1982133526 | Hee Eun Lee | Occupational Therapist | 2741 Dunstan Drive, Tustin, CA 92782 | 2017-06-07 |
| 1881129229 | Lydia Anna Bray | Pharmacist | 2102 Seminole, Tustin, CA 92782 | 2017-04-24 |
| 1427591577 | Charlie Huang | Internal Medicine | 15000 Kensington Park Dr Ste 250, Tustin, CA 92782 | 2016-11-21 |
| 1144672270 | Leiza Yamila Walia | Dentist | 15160 Kensington Park Dr Ste 610, Tustin, CA 92782 | 2016-07-13 |
| 1467831131 | Steven Yi Sun | Pediatrics | 15000 Kensington Park Dr, Tustin, CA 92782 | 2015-05-27 |
| 1639506405 | Medivan | Non-emergency Medical Transport (VAN) | 13800 Parkcenter Lane, Tustin, CA 92782 | 2013-10-10 |
| 1124266085 | Stacie Lynn Aragon | Counselor | 1 Hope Dr., Tustin, CA 92782 | 2009-01-30 |
| Find all providers in zip 92782 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639444292 | Miguel Dominguez Md, A Professional Corporation | Non-Pharmacy Dispensing Site | 18102 Irvine Blvd, Ste 208, Tustin, CA 92780-3402 | 2012-03-15 |
| 1083903496 | Comprehensive Health Care Specialists Medical Group, Inc | Non-Pharmacy Dispensing Site | 13522 Newport Ave, Suite 102, Tustin, CA 92780-3707 | 2011-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982225496 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 5757 Pacific Ave Ste 228, Stockton, CA 95207-5159 | 2020-05-06 |
| 1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| Find all providers with the same taxonomy | ||||
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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.