health net of california san bernardino superior court members by ...
health net of california san bernardino superior court members by ...
health net of california san bernardino superior court members by ...
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HEALTH NET OF CALIFORNIA<br />
SAN BERNARDINO SUPERIOR COURT<br />
MEMBERS BY PPG/PCP<br />
PPG # PARTICIPATING PHYSICIAN GROUP<br />
PHYSICIAN LAST<br />
NAME<br />
PHYSICIAN FIRST<br />
NAME<br />
PHYS<br />
MI<br />
PHYS<br />
TITLE PHYSICIAN ADDRESS PHYSICIAN CITY<br />
PHYS<br />
STATE<br />
PHYS<br />
ZIP LICENSE NPI MEMBERS<br />
0V4 San Bernardino Medical Group Thompson Donna R M.D. 1700 N. Waterman Ave. San Bernardino CA 92404 G 00067144 1033189568 7<br />
609 PrimeCare Medical Group <strong>of</strong> Sun City, Inc. To Bryan H M.D. 24910 Las Brisas Rd. 120 Murrieta CA 92562 A 00084344 1407948474 1<br />
0T2 PrimeCare Medical Group <strong>of</strong> Temecula, Inc. To Bryan H M.D. 25395 Hancock Ave. 240 Murrieta CA 92562 A 00084344 1407948474 1<br />
590 PrimeCare Medical Group <strong>of</strong> Inland Valley, Inc. To Sean S M.D. 8283 Grove Ave. 201 Rancho Cucamonga CA 91730 A 00075204 1922163310 6<br />
2970 United Family Care Tooma Raja S M.D. 8110 Mango Ave. 102 Fontana CA 92335 A 00036223 1497714927 2<br />
2743 Heritage Victor Valley Medical Group Tran Tiffany T M.D. 12408 Hesperia Rd. 2 Victorville CA 92395 A 00116304 1831350131 1<br />
741 PrimeCare Medical Group <strong>of</strong> Chino Valley Tsai William T D.O. 4950 San Bernardino St. 218 Montclair CA 91763 A 00007115 1285620443 2<br />
589 Riverside Physician Network Tweed Rosemarie D.O. 14114 Business Center Dr. A Moreno Valley CA 92553 A 00005397 1659320497 3<br />
2743 Heritage Victor Valley Medical Group Unassigned Unassigned 2<br />
3165 High Desert Primary Care - Premier Velasquez Joel G M.D. 12677 Hesperia Rd. 130 Victorville CA 92395 A 00051953 1639175490 3<br />
2970 United Family Care Verde Herminia Q M.D. 8110 Mango Ave. Fontana CA 92335 A 00032826 1104885607 4<br />
2743 Heritage Victor Valley Medical Group Vizcarra Michael C M.D. 11919 Hesperia Rd. Hesperia CA 92345 G 00029952 1962457911 1<br />
2688 Choice Medical Group, Inc Vora Dipak G M.D. 705 E. Virginia Way I Barstow CA 92311 A 00045558 1013950658 3<br />
3029 Desert Valley Medical Group, Inc. Walia Rajeev M.D. 17450 Main St. A Hesperia CA 92345 A 00082688 1104924679 2<br />
3132 Redlands - Yucaipa Medical Group Wang Cheng M.D. 355 Terracina Blvd. Grand Terrace CA 92373 G 00063715 1205859089 1<br />
546 HealthCare Partners Medical Group / Magan - Covina Weisz Jonathon M M.D. 420 W. Rowland St. Covina CA 91723 G 00074937 1841259298 2<br />
0D9 Beaver Medical Group - Yucaipa Office West Heather D M.D. 33758 Yucaipa Blvd. Yucaipa CA 92399 A 00064937 1891805040 4<br />
0N4 Beaver Medical Group - Highland Office Whiteside Paul M M.D. 7223 Church St. C1 Highland CA 92346 A 00035353 1861432874 11<br />
3204 St. Joseph Hospital Affiliated Physicians Wong Allan M M.D. 1310 W. Stewart Dr. 506 Orange CA 92868 G 00074464 1831224450 1<br />
0T5 Beaver Medical Group - Cooley Ranch Office Yamada Robert K M.D. 1300 E. Cooley Dr. Colton CA 92324 G 00058149 1790724243 1<br />
3071 Healthcare Partners IPA - Pasadena Yi Tom Y D.O. 127 N. Madison Ave. 107 Pasadena CA 91101 A 00007811 1336198514 1<br />
590 PrimeCare Medical Group <strong>of</strong> Inland Valley, Inc. Zini Gilbert J M.D. 8283 Grove Ave. 106 Rancho Cucamonga CA 91730 A 00030191 1558375303 1<br />
Provider Service Operations<br />
January 2012 5 <strong>of</strong> 5
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