Jose A Carrillo (NPI# 1902006661, PAC ID# 8921145384) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROLOGY.
| Nation Provider ID (NPI) | 1902006661 |
| PAC ID by PECOS | 8921145384 |
| Professional Enrollment ID | I20091017000039 |
| Full Name | Jose A Carrillo |
| Organization Legal Name | PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION |
| Address |
2121 Santa Monica Blvd Santa Monica CA 90404-2303 |
| Phone Number | 3108295511 |
| Gender | M |
| Medical School | DARTMOUTH MEDICAL SCHOOL |
| Graduation Year | 2005 |
| Primary Specialty | NEUROLOGY |
| Group Practice PAC ID | 0840548624 |
| Number of Group Practice Members | 198 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050224 | HOAG MEMORIAL HOSPITAL PRESBYTERIAN |
| 050290 | PROVIDENCE SAINT JOHN'S HEALTH CENTER |
| 050353 | PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE |
| 050168 | ST JUDE MEDICAL CENTER |
| 050348 | UNIVERSITY OF CALIFORNIA IRVINE MED CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 3108295511 | PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION |
| Organization Legal Name | PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION |
| Physicians | 200 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa Chialin Liu | Internal Medicine | Providence Saint Johns Medical Foundation | 12121 Santa Monica Blvd, Los Angeles, CA 90025-2515 |
| Asad Julian Bedran | Family Medicine | Providence Saint Johns Medical Foundation | 8570 W Sunset Blvd, West Hollywood, CA 90069-2359 |
| Matthew K Nienaber | Internal Medicine | Providence Saint Johns Medical Foundation | 1821 Wilshire Blvd, Suite 100, Santa Monica, CA 90403-5627 |
| Jennifer P Carleton-nathan | Family Medicine | Providence Saint Johns Medical Foundation | 700 S Flower St, Suite 2340, Los Angeles, CA 90017-4123 |
| Meghan Moore | Physician Assistant | Providence Saint Johns Medical Foundation | 525 Broadway, Suite 1101, Santa Monica, CA 90401-2971 |
| Michelle Grotz-rhone | Internal Medicine | Providence Saint Johns Medical Foundation | 9725 Wilshire Blvd, Beverly Hills, CA 90212-2002 |
| Mina Kang | Internal Medicine | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Carol Nishikubo | Hematology/oncology | Providence Saint Johns Medical Foundation | 12555 W Jefferson Blvd, Los Angeles, CA 90066-7032 |
| Howard Ronald Krauss | Ophthalmology | Providence Saint Johns Medical Foundation | 2125 Arizona Ave, Santa Monica, CA 90404-1337 |
| Richard L Ross | Family Medicine | Providence Saint Johns Medical Foundation | 901 Wilshire Blvd, Fl 3, Santa Monica, CA 90401-1854 |
| Street Address |
2121 SANTA MONICA BLVD |
| City | SANTA MONICA |
| State | CA |
| Zip | 90404-2303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mina Kang | Internal Medicine | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Sean Dooley | Internal Medicine | Inpatient Specialists of California PC | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Yuki Takasumi | Pathology | Pathology Medical Group of Saint John's | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Marissa L Zobrist | Emergency Medicine | Saint Johns Emergency Medicine Specialists Inc A Medical Group | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Judy D Truong | Physician Assistant | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Janie Gia-lin Weng Grumley | General Surgery | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Peter A Elliott | Urology | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Frederick R Singer | Internal Medicine | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | |
| Lucia Nicole Dobrawa | Physician Assistant | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Yalda B Naeini | Pathology | Pathology Medical Group of Saint John's | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vivanti N Jain | Plastic and Reconstructive Surgery | 2021 Santa Monica Blvd, Santa Monica, CA 90404-0001 | |
| Margaret Ann Regan Rainey | Nurse Practitioner | Regents of The University of California | 1225 15th St, Suite 2100, Santa Monica, CA 90404-1101 |
| Ralph A Massey | Dermatology | 1260 15th St, Suite 1401, Santa Monica, CA 90404-1106 | |
| Peter Galier | Internal Medicine | Premier Health Partners of Santa Monica | 1260 15th St, Suite 1415, Santa Monica, CA 90404-1135 |
| John Patrick Whelan | Rheumatology | The Regents of The University of California | 1260 15th St, Suite 1502, Santa Monica, CA 90404-1135 |
| Melissa D Alexander | Qualified Audiologist | 1260 15th St, P2, Santa Monica, CA 90404-1135 | |
| Malena Shu-chuan Law | General Practice | Premier Health Partners of Santa Monica | 1260 15th St, Suite 1415, Santa Monica, CA 90404-1135 |
| Mohammed Fahad Ali | Internal Medicine | The Regents of The University of California | 1260 15th St, Suite 1502, Santa Monica, CA 90404-1135 |
| Manoochehr Yashari | Obstetrics/gynecology | 1260 15th St, Suite 616, Santa Monica, CA 90404-1141 | |
| Quynhtrang Le Sebastian | Dermatology | 1260 15th St, Suite 709, Santa Monica, CA 90404-1142 | |
| Find all physicians in zip 90404 | |||
| City | SANTA MONICA |
| Zip Code | 90404 |
| Specialty | NEUROLOGY |
| City + Specialty | SANTA MONICA + NEUROLOGY |
Please comment or provide details below to improve the information on Jose A Carrillo.
| 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.