Andres Jimenez (NPI# 1871609404, PAC ID# 0446395842) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1871609404 |
| PAC ID by PECOS | 0446395842 |
| Professional Enrollment ID | I20100310000601 |
| Full Name | Andres Jimenez |
| Organization Legal Name | PROVIDENCE MEDICAL INSTITUTE |
| Address |
1499 W 1st St San Pedro CA 90732-3255 |
| Phone Number | 3108319482 |
| Gender | M |
| Medical School | UNIVERSITY OF SOUTHERN CALIFORNIA SCHOOL OF MEDICINE |
| Graduation Year | 1984 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 5991609737 |
| Number of Group Practice Members | 250 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050078 | PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO |
| 050351 | TORRANCE MEMORIAL MEDICAL CENTER |
| 050353 | PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE |
| Address | Phone | Organization |
|---|---|---|
| 1499 W 1st St, San Pedro, CA 90732-3255 | 3108319482 | PROVIDENCE MEDICAL INSTITUTE |
| Organization Legal Name | PROVIDENCE MEDICAL INSTITUTE |
| Physicians | 252 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa A Garner | Nurse Practitioner | Providence Medical Institute | 24035 Newhall Ranch Rd, Santa Clarita, CA 91355-5702 |
| Jennifer S Lee | Nurse Practitioner | Providence Medical Institute | 12618 Hawthorne Blvd, Hawthorne, CA 90250-3907 |
| Danielle N Anderson | Obstetrics/gynecology | Providence Medical Institute | 2601 W Alameda Avenue, Suite 212, Burbank, CA 91505-4800 |
| Julie A Gould | Obstetrics/gynecology | Providence Medical Institute | 405 N Maclay Ave, Suite 104, San Fernando, CA 91340-2455 |
| Reza Askari | Obstetrics/gynecology | Providence Medical Institute | 621 S Butte St, San Pedro, CA 90732-3510 |
| Brenda Shen | Family Medicine | Providence Medical Institute | 2382 Crenshaw Blvd, Suite 5, Torrance, CA 90501-3333 |
| Raj U Dugel | Ophthalmology | Providence Medical Institute | 4825 Torrance Blvd, Suite 100, Torrance, CA 90503-4167 |
| Jeffrey Work | Interventional Cardiology | Providence Medical Institute | 21501 Avalon Blvd, Suite 100, Carson, CA 90745-2210 |
| Peter J Georgio Ii | Family Medicine | Providence Medical Institute | 1010 N Sepulveda Blvd, Manhattan Beach, CA 90266-5929 |
| Michael M Marvi | Neurology | Providence Medical Institute | 1870 Veteran Ave, Apt 102, Los Angeles, CA 90025-4569 |
| Street Address |
1499 W 1ST ST |
| City | SAN PEDRO |
| State | CA |
| Zip | 90732-3255 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lawrence B Greenberg | Family Medicine | Providence Medical Institute | 1499 W 1st St, San Pedro, CA 90732-3255 |
| Keri Sharona Hyatt Wardwell | Family Medicine | Providence Medical Institute | 1499 W 1st St, San Pedro, CA 90732-3255 |
| Crescenzo Pisano | Internal Medicine | Providence Medical Institute | 1499 W 1st St, San Pedro, CA 90732-3255 |
| Patricio Clavecillas | Family Medicine | Providence Medical Institute | 1499 W 1st St, San Pedro, CA 90732-3255 |
| Olga M Calof | Endocrinology | Providence Medical Institute | 1499 W 1st St, San Pedro, CA 90732-3255 |
| Terry T Ishihara | Family Medicine | Providence Medical Institute | 1499 W 1st St, San Pedro, CA 90732-3255 |
| Aeree Yoon | Internal Medicine | Providence Medical Institute | 1499 W 1st St, San Pedro, CA 90732-3255 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Enrique Santana | Chiropractic | 28122 S Western Ave, San Pedro, CA 90732-1248 | |
| Lawrence Marshall | Optometry | 28142 S Western Ave, San Pedro, CA 90732-1248 | |
| Stephen D Taus | Internal Medicine | 1366 W 7th St, San Pedro, CA 90732-3500 | |
| Neel Shah | Emergency Medicine | Stephen R Shea Md Inc | 1300 W 7th St, San Pedro, CA 90732-3505 |
| Israel J Hernandez-arce | Internal Medicine | Providence Medical Institute | 1300 W 7th St, San Pedro, CA 90732-3505 |
| Steven Kwon | Internal Medicine | Providence Medical Institute | 1300 W 7th St, San Pedro, CA 90732-3505 |
| Gayne Marie Brenneman-slay | Anesthesiology | New Line Anesthesia Services Inc | 1300 W 7th St, Providence Little Company of Mary Medica, San Pedro, CA 90732-3505 |
| Mehdi Hemmat | Obstetrics/gynecology | Providence Medical Institute | 1300 W 7th St, San Pedro, CA 90732-3505 |
| Alex D Doo | Emergency Medicine | Stephen R Shea Md Inc | 1300 W 7th St, San Pedro, CA 90732-3505 |
| Aja Castillo | Nurse Practitioner | Stephen R Shea Md Inc | 1300 W 7th St, San Pedro, CA 90732-3505 |
| Find all physicians in zip 90732 | |||
| City | SAN PEDRO |
| Zip Code | 90732 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SAN PEDRO + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.