Ethel U Antonio (NPI# 1386778967, PAC ID# 5294074860) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1386778967 |
| PAC ID by PECOS | 5294074860 |
| Professional Enrollment ID | I20190226000465 |
| Full Name | Ethel U Antonio |
| Organization Legal Name | LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GROUP INC. |
| Address |
1500 W W Covina Pkwy West Covina CA 91790-2708 |
| Phone Number | 6264309991 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7618005166 |
| Number of Group Practice Members | 86 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1500 W W Covina Pkwy, West Covina, CA 91790-2708 | 6264309991 | LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GROUP INC. |
| Organization Legal Name | LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GROUP INC. |
| Physicians | 109 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Liza Mae E Ocampo | Nurse Practitioner | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Lia H Yoon | Nurse Practitioner | Lakeside Medical Organization, A Medical Group Inc. | 12660 Riverside, Suite 320, North Hollywood, CA 91607-3429 |
| Panny Pang | Physical Therapy | Lakeside Medical Organization, A Medical Group Inc. | 101 S 1st St, Suite 1800, Burbank, CA 91502-1959 |
| Denise L Hom | Family Medicine | Lakeside Medical Organization, A Medical Group Inc. | 7325 Medical Ctr Dr, Suite 300, West Hills, CA 91307-4117 |
| Debra L Hilburn | Nurse Practitioner | Lakeside Medical Organization, A Medical Group Inc. | 8510 Balboa Blvd, Suite 150, Northridge, CA 91325-5810 |
| Verna S Liss | Family Medicine | Lakeside Medical Organization, A Medical Group Inc. | 612 E Janss Rd, Thousand Oaks, CA 91360-5113 |
| Carmen S Slavov | Internal Medicine | Lakeside Medical Organization, A Medical Group Inc. | 14901 Rinaldi St, Suite 200 201, Mission Hills, CA 91345-1204 |
| Diana Dermendjian | Family Medicine | Lakeside Medical Organization, A Medical Group Inc. | 191 S Buena Vista St, Suite 200 and 240, Burbank, CA 91505-4542 |
| Frederick O Galloway | Physician Assistant | Lakeside Medical Organization, A Medical Group Inc. | 191 S Buena Vista St, Suite 150, Burbank, CA 91505-4522 |
| Jose Mari M Esparrago | Internal Medicine | Lakeside Medical Organization, A Medical Group Inc. | 14901 Rinaldi St, Suite 200 201, Mission Hills, CA 91345-1204 |
| Street Address |
1500 W W COVINA PKWY |
| City | WEST COVINA |
| State | CA |
| Zip | 91790-2708 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Liza Mae E Ocampo | Nurse Practitioner | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Tim T Le | Family Medicine | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Jenifer E Chungafung | Family Medicine | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Kevin S Bromage | Family Medicine | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Nirav K Shah | Emergency Medicine | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Van H. Duong | Family Medicine | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Huy Tu Nguyen | Family Medicine | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Ruth M. Karunananthan | Internal Medicine | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2708 |
| Peter P Camarata | Physician Assistant | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2703 |
| Enrico A Melson | Family Practice | Lakeside Medical Organization, A Medical Group Inc. | 1500 W W Covina Pkwy, West Covina, CA 91790-2703 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Federico Hinojosa | Physician Assistant | 1901 W Badillo St, West Covina, CA 91790-1133 | |
| Hemalatha Parekh | General Practice | Indus Healthcare, Inc. | 333 N Sunset Ave, West Covina, CA 91790-1651 |
| Susan Lissette Vasquez | Physician Assistant | Indus Healthcare, Inc. | 333 N Sunset Ave, West Covina, CA 91790-1651 |
| Cesar A Jimenez | Internal Medicine | Mayflower Medical Group Inc | 140 N Orange Ave, Suite 100, West Covina, CA 91790-2016 |
| Suneetha S. Ali | Obstetrics/gynecology | Mayflower Medical Group Inc | 140 N Orange Ave, Suite 100, West Covina, CA 91790-2016 |
| Lina C. Dela Cruz | Internal Medicine | Mayflower Medical Group Inc | 140 N Orange Ave, Suite 100, West Covina, CA 91790-2016 |
| Zinovi Rozenblat | Psychiatry | Pacific Clinics | 1517 W Garvey Ave N, West Covina, CA 91790-2138 |
| Leila E Jimenez | Nurse Practitioner | Pacific Clinics | 1517 W Garvey Ave N, West Covina, CA 91790-2138 |
| Anjana Wilkerson | Physical Therapy | Southern California Sports Rehabilitation Inc. | 1321 W Garvey N Ave, West Covina, CA 91790-2242 |
| Akbar Omar | General Practice | 222 N Sunset Ave, Suite C, West Covina, CA 91790-2278 | |
| Find all physicians in zip 91790 | |||
| City | WEST COVINA |
| Zip Code | 91790 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WEST COVINA + NURSE PRACTITIONER |
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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.